RECTOVAGINAL SEPTUM, ENDOMETRIOSIS OR ADENOMYOSIS - LAPAROSCOPIC MANAGEMENT IN A SERIES OF 231 PATIENTS

A series of 231 cases of deep-infiltrating endometriosis of the rectov aginal septum is presented. Laparoscopic procedures with excision of d eep fibrotic endometriotic nodules were performed in all cases. In thr ee cases, the bowel lumen was entered, No other peri-operative complic ations were observed, Three cases of urinary retention were reported, The nodule resection resulted in considerable pain relief. Histologica lly, the rectovaginal nodule was similar to an adenomyoma. Indeed it w as a circumscribed nodular aggregate of smooth muscle and endometrial glands, This form of disease must be considered as a specific disease which originates from the Mullerian rests present in the rectovaginal septum and we suggest that it be called 'rectovaginal adenomyosis'.