RECTOVAGINAL SEPTUM ADENOMYOTIC NODULES - A SERIES OF 500 CASES

Objective Laparoscopic procedure with excision of deep fibrotic endome triotic nodules of the rectovaginal septum and histological study of t he lesions. Setting An academic teaching hospital. Participants A seri es of 500 women undergoing laparoscopy for pelvic pain or infertility. Results Laparoscopic (n = 497) and laparotomic (n = 3) excision of en dometriotic nodules resulted in considerable pain relief. Histological ly the rectovaginal nodule was similar to an adenomyoma as it was a ci rcumscribed nodular aggregate of smooth muscle and endometrial glands and stroma. The variations in oestrogen receptor and progesterone rece ptor content suggested a regulatory mechanism different from that of e utopic endometrium. Conclusion This form of disease should be consider ed as an entity distinct from peritoneal and ovarian endometriosis, an d originating from the Mullerian rests present in the rectovaginal sep tum.