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Is rectovaginal endometriosis a progressive disease?
Luigi Fedele1, Stefano Bianchi, Giovanni Zanconato
1Clinica Ostetrico-Ginecologica dell'Università di Milano, Ospedale San Paolo, Milan, Italy. luigi.fedele@unimi.it
American Journal of Obstetrics and Gynecology
|November 18, 2004
Summary
Asymptomatic rectovaginal endometriosis rarely progresses or causes pain. This study followed 88 patients for up to 9 years, finding minimal disease advancement or symptom development.
Area of Science:
- Gynecology
- Reproductive Medicine
- Surgical Pathology
Background:
- Rectovaginal endometriosis is a debilitating condition.
- Asymptomatic cases require observation to understand natural history.
Purpose of the Study:
- To observe the natural history of untreated asymptomatic rectovaginal endometriosis.
- To assess disease progression and symptom development in these patients.
Main Methods:
- Prospective, observational study of 88 patients.
- Follow-up duration of 1 to 9 years.
- Regular evaluation of pain, clinical, and transrectal ultrasonographic findings.
Main Results:
- Only 2 patients developed symptoms requiring surgery due to increased lesion size.
- 4 patients showed lesion growth without new symptoms.
- Estimated 6-year cumulative incidence of disease progression or new pain was 9.7%.
Conclusions:
- Progression and new symptoms are rare in asymptomatic rectovaginal endometriosis.
- Observation is a viable management strategy for select patients.