title: Is rectovaginal endometriosis a progressive disease?
abstract: OBJECTIVE
  The purpose of this study was to observe the natural history of untreated asymptomatic rectovaginal endometriosis.
  
  
  METHODS
  This was a prospective, observational study. Eighty-eight patients with untreated asymptomatic rectovaginal endometriosis were followed for 1 to 9 years. Pain symptoms and clinical and transrectal ultrasonographic findings were evaluated before and every 6 months after diagnosis.
  
  
  RESULTS
  Two patients had specific symptoms that were attributable to rectovaginal endometriosis that was associated with an increase in lesion size and underwent surgery. In 4 other patients, the size of the endometriotic lesions increased, but the patients remained symptom free. The estimated cumulative proportion of patients with progression of disease and/or appearance of pain symptoms that were attributable to rectovaginal endometriosis after 6 years of follow up was 9.7%. For the remaining patients, the follow-up period was uneventful, with no detectable clinical nor echographic changes of the lesions and with no appearance of new symptoms.
  
  
  CONCLUSIONS
  Progression of the disease and appearance of specific symptoms rarely occurred in patients with asymptomatic rectovaginal endometriosis.
authors.affiliation: Clinica Ostetrico-Ginecologica dell'Università di Milano, Ospedale San Paolo, Milan, Italy. luigi.fedele@unimi.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Fedele
authors.forename: Stefano
authors.initials: S
authors.lastname: Bianchi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Zanconato
authors.forename: Ricciarda
authors.initials: R
authors.lastname: Raffaelli
authors.forename: Nicola
authors.initials: N
authors.lastname: Berlanda
mesh_terms: D000328:Adult; D018450:Disease Progression; D004715:Endometriosis / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D017699:Pelvic Pain; D011446:Prospective Studies; D012002:Rectal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D012720:Severity of Illness Index; D014463:Ultrasonography; D014623:Vaginal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology