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Cited by 216Endometriosis Research and TreatmentGynecological conditions and treatmentsEctopic Pregnancy Diagnosis and Management

Long-term follow-up after conservative surgery for rectovaginal endometriosis

Fedele, Luigi, Bianchi, Stefano, Zanconato, Giovanni, Bettoni, Gaia, Gotsch, Francesca·2004·American Journal of Obstetrics and Gynecology
DOI 10.1016/j.ajog.2003.10.698
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Abstract

Objective The purpose of this study was to evaluate long-term results in patients who received conservative surgical treatment for rectovaginal endometriosis. Study design We analyzed the follow-up data for 83 women who underwent surgery for rectovaginal endometriosis. The inclusion criteria were age 20 to 42 years, moderate-to-severe pain symptoms, conservative treatment with retention of the uterus, and at least 1 ovary; the follow-up period was > or =12 months. Kaplan-Meier analysis and Cox regression were used to calculate recurrence rates. Results The cumulative rates of pain recurrence, clinical or sonographic recurrence, and new treatment were 28%, 34%, and 27%, respectively. The younger patients had the higher risk of recurrence. Pregnancy had protective effects against the recurrence of symptoms and a need for a new treatment. Patients who underwent bowel resection had fewer recurrences. Conclusion Segmental resection and anastomosis of the bowel, when necessary, improves the outcome without affecting chances of conception. Higher recurrence rates in younger patients seems to justify a more radical treatment in this group of women.

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  • Women with rectovaginal disease experience lesion recurrence, and 25% undergo repeat conservative or definitive surgery for pain relapse.

    “Furthermore, in case series, women with rectovaginal disease also experience lesion recurrence (Fedele et al., 2004;Brouwer and Woods, 2007;Kristensen and Kjer, 2007) and 25% undergo repetitive conservative or definitive surgery to treat pain relapse (Reich et al., 1991;Nezhat et al., 1992;Mohr et al., 2005;Mereu et al., 2007).”

    From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Fedele et al., 2004

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Authors
Fedele, L., Bianchi, S., Zanconato, G., Bettoni, G., & Gotsch, F.
Affiliations
University of Verona (IT)
Corresponding author
Fedele, Luigi
ORCID
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2004-04
Volume
190
Issue
4
Pages
1020-1024
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/j.ajog.2003.10.698
OpenAlex
W2072958973
Cited by
216
References
10
Citations by year
2026: 5 · 2025: 3 · 2024: 3 · 2023: 1 · 2021: 7 · 2020: 12 · 2019: 8 · 2018: 6 · 2017: 9 · 2016: 9 · 2015: 12 · 2014: 16 · 2013: 8 · 2012: 10
FWCI
11.94
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • American Journal of Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
Keywords
rectovaginal endometriosis, conservative surgery, long-term follow-up, recurrence, segmental bowel resection, intestinal anastomosis, pain recurrence, pregnancy, uterine preservation
MeSH terms
Adult, Age Factors, Endometriosis, Female, Follow-Up Studies, Humans, Italy, Rectal Diseases, Recurrence, Reoperation, Severity of Illness Index, Gynecologic Surgical Procedures, Vaginal Diseases, Proportional Hazards Models, Outcome Assessment, Health Care, Survivors, Disease-Free Survival

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