[Treatment of rectovaginal endometriosis]

Abstract

FREQUENT: The most frequent deep localization, endometriosis of the rectovaginal septum may penetrate into the vagina or rectum.

Medical treatment: Hormone therapy suppresses menstruation if a short-term regimen is given, but the cost of long-term therapy with LHRH analogues and estrogen substitution may be high.

Surgery: Definitive treatment is difficult to achieve, but surgery may be required. The risks of surgery for this benign disease must be weighed against the expected benefit, particularly in drug-resistant cases where pain is severe or rectal symptoms predominant.

Asymptomatic disease: No specific treatment is required in asymptomatic patients or when unpainful disease is discovered at infertility explorations.