SURGICAL-TREATMENT OF SYMPTOMATIC RECTOSIGMOID ENDOMETRIOSIS

Objective: To assess the results of surgical treatment of symptomatic intestinal endometriosis. Design: Retrospective study. Setting: Univer sity hospital, The Netherlands. Subjects: 14 patients in whom medical treatment had failed. Interventions: Hysterectomy (n = 5), salpingo-oo phorectomy (n = 8, bilateral in 5), posterior vaginal wall excision (n = 14), and partial resection (n = 6) or anterior wedge excision (n = 8) of the rectum. Main outcome measures: Blood loss, operating time, m orbidity, and relief of symptoms. Results: 9 patients became symptom f ree (64%), 5 of whom developed postmenopausal symptoms later on. 2 had unrelated vague abdominal symptoms and 3 more could not be assessed b ecause they underwent in vitro fertilisation and developed stimulation -related abdominal symptoms. All were content with the operative resul ts. Conclusions: Operations for rectosigmoid endometriosis are technic ally difficult with a long operating time and considerable blood loss, but they are successful in relieving symptoms when conservative treat ment has failed.