Quality of life following radical excision of rectovaginal endometriosis associated with complete obliteration of the posterior cul de sac

Objectives To review the available literature and studies, both published a nd unpublished on the effect of radical surgery for obliterative endometrio tic cul de sac disease on the quality of life. Design Review of literature and audit studies of rectovaginal disease. Setting Two specialist endometriosis practices, one in the United States an d the other in a UK district general hospital. Subjects Patients presenting with rectovaginal endometriosis. Interventions Radical laparoscopic excision. Main outcome measures Reduction of pain as measured on ranked ordinal, scal es and quality of life measures. Results Radical laparoscopic surgery for the excision of rectovaginal endom etriosis is associated with a significant diminution in symptoms and an imp rovement in quality of life. This is particularly so for patients who rated their symptoms as severe prior to surgery. Conclusion Initial studies show promising results for radical surgery. Ther e is however, a need for randomized controlled trials and proper audit to a ssess the efficacy and morbidity of this surgery.