title: Diagnosis and treatment of rectovaginal endometriosis: an overview.
abstract: Rectovaginal endometriosis can be a cause of severe pain, dyspareunia and intestinal problems. A thorough examination is needed and should include diagnostic imaging, such as transvaginal or transrectal ultrasound or magnetic resonance imaging. Medical therapies, such as oral contraceptives, progestins and levonorgestrel-releasing intrauterine devices, all seem to reduce pain and should always be considered. Surgical treatment is challenging and implies a risk of severe complications. It is preferable to treat endometriotic lesions with superficial infiltration into the rectal wall by local laparoscopic excision, while segmental rectal resection is needed in the case of severe intestinal infiltration. This review describes available diagnostic tools, the possibilities for medical treatment and the alternative surgical approaches.
authors.affiliation: Department of Obstetrics and Gynecology, Aarhus University Hospital Skejby, Brendstrupgaardsvej, Aarhus, Denmark. ckruse@dadlnet.dk
authors.forename: Christina
authors.initials: C
authors.lastname: Kruse
authors.forename: Mikkel
authors.initials: M
authors.lastname: Seyer-Hansen
authors.forename: Axel
authors.initials: A
authors.lastname: Forman
mesh_terms: D000282:Administration, Intravaginal; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001466:Barium Sulfate; D003106:Colon / Q000473:pathology; D003248:Constipation / Q000209:etiology / Q000628:therapy; D003271:Contraceptive Agents, Female / Q000627:therapeutic use; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use; D003287:Contrast Media; D003613:Danazol / Q000627:therapeutic use; D003952:Diagnostic Imaging; D004412:Dysmenorrhea / Q000209:etiology / Q000628:therapy; D004414:Dyspareunia / Q000209:etiology / Q000628:therapy; D004715:Endometriosis / Q000175:diagnosis* / Q000628:therapy*; D016145:Endoscopy, Digestive System; D004733:Enema; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007434:Intrauterine Devices; D010535:Laparoscopy; D016912:Levonorgestrel / Q000627:therapeutic use; D017699:Pelvic Pain / Q000209:etiology / Q000628:therapy; D011183:Postoperative Complications; D045167:Progesterone Congeners / Q000627:therapeutic use; D012002:Rectal Diseases / Q000175:diagnosis* / Q000628:therapy*; D012007:Rectum / Q000473:pathology / Q000601:surgery; D014621:Vagina / Q000473:pathology / Q000601:surgery; D014623:Vaginal Diseases / Q000175:diagnosis* / Q000628:therapy*
chemical_list: D047072:Aromatase Inhibitors; D003271:Contraceptive Agents, Female; D003278:Contraceptives, Oral, Hormonal; D003287:Contrast Media; D004965:Estrogen Antagonists; D045167:Progesterone Congeners; D001466:Barium Sulfate; D007987:Gonadotropin-Releasing Hormone; D016912:Levonorgestrel; D003613:Danazol