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Rectovaginal septum adenomyotic nodules: a series of 500 cases
J Donnez1, M Nisolle, S Gillerot
1Cliniques Universitaires St-Luc, University of Louvain, Brussels, Belgium.
Objective:
Laparoscopic procedure with excision of deep fibrotic endometriotic nodules of the rectovaginal septum and histological study of the lesions.
Setting:
An academic teaching hospital.
Participants:
A series of 500 women undergoing laparoscopy for pelvic pain or infertility.
Results:
Laparoscopic (n = 497) and laparotomic (n = 3) excision of endometriotic nodules resulted in considerable pain relief. Histologically the rectovaginal nodule was similar to an adenomyoma as it was a circumscribed nodular aggregate of smooth muscle and endometrial glands and stroma. The variations in oestrogen receptor and progesterone receptor content suggested a regulatory mechanism different from that of eutopic endometrium.
Conclusion:
This form of disease should be considered as an entity distinct from peritoneal and ovarian endometriosis, and originating from the Müllerian rests present in the rectovaginal septum.