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Surgical treatment of symptomatic rectosigmoid endometriosis
K T Tran1, H C Kuijpers, W N Willemsen
1Department of Surgery, University Hospital Nijmegen, The Netherlands.
Objective:
To assess the results of surgical treatment of symptomatic intestinal endometriosis.
Design:
Retrospective study.
Setting:
University hospital, The Netherlands.
Subjects:
14 patients in whom medical treatment had failed.
Interventions:
Hysterectomy (n = 5), salpingo-oophorectomy (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, morbidity, and relief of symptoms.
Results:
9 patients became symptom free (64%), 5 of whom developed postmenopausal symptoms later on. 2 had unrelated vague abdominal symptoms and 3 more could not be assessed because they underwent in vitro fertilisation and developed stimulation-related abdominal symptoms. All were content with the operative results.
Conclusions:
Operations for rectosigmoid endometriosis are technically difficult with a long operating time and considerable blood loss, but they are successful in relieving symptoms when conservative treatment has failed.