Cited by 175Endometriosis Research and TreatmentGynecological conditions and treatmentsEndometrial and Cervical Cancer Treatments

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Surgery: Rectovaginal septum, endometriosis or adenomyosis: laparoscopic management in a series of 231 patients

Donnez, J., Nisolle, M., Casanas-Roux, F., Bassil, S., Anaf, V.·1995·Human Reproduction

DOI 10.1093/oxfordjournals.humrep.a136001

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Abstract

A series of 231 cases of deep-infiltrating endometriosis of the rectovaginal septum is presented. Laparoscopic procedures with excision of deep fibrotic endometriotic nodules were performed in all cases. In three cases, the bowel lumen was entered. No other peri-operative complications were observed. Three cases of urinary retention were reported. The nodule resection resulted in considerable pain relief. Histologically, the rectovaginal nodule was similar to an adenomyoma. Indeed it was a circumscribed nodular aggregate of smooth muscle and endometrial glands. This form of disease must be considered as a specific disease which originates from the Mullerian rests present in the rectovaginal septum and we suggest that it be called 'rectovaginal adenomyosis'.

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Background
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BackgroundInfluential
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Background
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“, endometriomas), and deeply infiltrating endometriosis (DIE) [5].”
Background
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“[55] If disease is infiltrating the rectovaginal septum, the recurrence rate may be higher.[56] The relationship between adhesions and pain is”
Background
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Self-citation
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Self-citation
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“…their experience in laparoscopic surgical treatment for deep endometriosis located on the rectovaginal septum (Nezhat et al, 1992; Canis et al, 1993; Donnez et al, 1995), the Pouch of Douglas (Martin, 1988; Reich et al, 1991; Redwine, 1992) or the uterovesical fold (Nezhat and Nezhat, 1993;…”
Background
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“The surgical procedure that we use in rectal nodule excision is similar to that performed by other surgical teams and as first described by Donnez et al. (1995). Both pararectal spaces are opened below the lateral limits of the rectal nodule and the rectovaginal space is reached under the inferior limit of the nodule.”
Method
Laparoscopic identification of pelvic nerves in patients with deep infiltrating endometriosis
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Background
Rectal Endoscopic Ultrasound with a Radial Probe in the Assessment of Rectovaginal Endometriosis
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Self-citation
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“The surgical procedure that we use in rectal shaving is similar to that performed by other surgical teams and as first described by Donnez et al.(37) Both pararectal spaces are opened below the lateral limits of the rectal nodule, and the nodule is then dissected away from the rectal wall, using the PlasmaJet (Plasma…”
Method
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“377 378 Donnez et al have published extensively on clinical outcomes following largely the 379 shaving technique and have reported both low complications and recurrence 380 rates(7, 23).”
Background
Stereometric evaluation of peritoneal endometriosis and endometriotic nodules of the rectovaginal septum
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Self-citation
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“The first step is performed laparoscopically, and involves rectal shaving similar to that described by Donnez et al. (1995).”
BackgroundMethod
Is Endometriosis Really Associated with Pain?
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Self-citation
Targeting Mast Cells in Endometriosis with Janus Kinase 3 Inhibitor, JANEX‐1
D’Cruz, O. J., & Uckun, F. M. (2007) · American Journal of Reproductive Immunology · doi:10.1111/j.1600-0897.2007.00502.x · Cited by 35
Pathophysiological approach to bowel dysfunction after segmental colorectal resection for deep endometriosis infiltrating the rectum: a preliminary study
Armengol‐Debeir, L., Savoye, G., Leroi, A., Gourcerol, G., Savoye, G., Tuech, J., Vassilieff, M., & Roman, H. (2011) · Human Reproduction · doi:10.1093/humrep/der190 · Cited by 37
“The latter approach may be performed without opening the rectum (shaving) or by removing the nodule along with the surrounding rectal wall (full thickness or disc excision) (Nezhat et al., 1993; Koninckx et al., 1994; Donnez et al., 1995, 1997; Roman et al., 2011).”
Background
10 Advanced laparoscopic surgery for the removal of rectovaginal septum endometriotic or adenomyotic nodules
Donnez, J., & Nisolle, M. (1995) · Baillière s Clinical Obstetrics and Gynaecology · doi:10.1016/s0950-3552(05)80398-0 · Cited by 36
Self-citation
Rectal shaving using PlasmaJet in deep endometriosis of the rectum
Roman, H. (2013) · Fertility and Sterility · doi:10.1016/j.fertnstert.2013.07.1973 · Cited by 35
Impact of osteopathic manipulative therapy on quality of life of patients with deep infiltrating endometriosis with colorectal involvement: results of a pilot study
Daraï, C., Deboute, O., Zacharopoulou, C., Laas, E., Canlorbe, G., Belghiti, J., Zilberman, S., Ballester, M., & Daraï, É. (2015) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2015.03.001 · Cited by 34
“patients to severe postoperative complications such as rectovaginal fistulae and neurogenic bladder [1,6–10].”
Focusing on surgery results in infertile patients with deep endometriosis
Angioni, S. L., Cela, V., Sedda, F., Loi, E. S., Cofelice, V., Pontis, A., & Melis, G. B. (2015) · Gynecological Endocrinology · doi:10.3109/09513590.2015.1062868 · Cited by 32
Analysis of cytokines in the peritoneal fluid of endometriosis patients as a function of the menstrual cycle stage using the Bio-Plex® platform
Bersinger, N. A., Déchaud, H., McKinnon, B. D., & Mueller, M. D. (2012) · Archives of Physiology and Biochemistry · doi:10.3109/13813455.2012.687003 · Cited by 31
“…although now considered as a collection of related conditions characterized by disparate morphological, histological and biochemical properties (Donnez et al., 1995; Nisolle and Donnez, 1997), is increasingly being recognized as being an inflammatory disease in an altered pelvic environment…”
Background
Conservative Management of Rectovaginal Deep Endometriosis: Shaving Should Be Considered as the Primary Surgical Approach in a High Majority of Cases
Donnez, O. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10215183 · Cited by 29
“Avoiding vaginal fornix excision is recommended by a number of authors, as it might be associated with increased complication rates [50,51,74].”
Background
Long-term evaluation of quality of life and gastrointestinal well-being after segmental colo-rectal resection for deep infiltrating endometriosis (ENDO-RESECT QoL)
Turco, L., Scaldaferri, F., Chiantera, V., Cianci, S., Ercoli, A., Fagotti, A., Fanfani, F., Ferrandina, G., Nicolotti, N., Tamburrano, A., et al. (2019) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-019-05382-8 · Cited by 27
Rectovaginal endometriosis – a frequently missed diagnosis
Griffiths, A., Koutsouridou, R. N., & Penketh, R. (2007) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443610701497660 · Cited by 30
“Surgical excision is a highly effective method of treatment (Donnez et al. 1995; Nezhat et al. 1992).”
Method
Voiding Dysfunction after Colorectal Surgery for Endometriosis: A Systematic Review and Meta-analysis
Vésale, E., Roman, H., Moawad, G., Benoit, L., Touboul, C., Daraï, É., & Bendifallah, S. (2020) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2020.07.019 · Cited by 31
Laparoscopic laser resection of rectovaginal pouch and rectovaginal septum endometriosis: the impact on pelvic pain and quality of life
KRISTENSEN, J., & Jørgen Kjer, J. (2007) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1080/00016340701645006 · Cited by 27
Deep endometriosis: The place of laparoscopic shaving
Donnez, O., & Donnez, J. (2021) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2020.05.006 · Cited by 28
Self-citation
Laparoscopic treatment of symptomatic endometriosis
Pouly, J.-L., Drolet, J., Canis, M. J., Boughazine, S., Mage, G., Bruhat, M. A., & Wattiez, A. (1996) · Human Reproduction · doi:10.1093/humrep/11.suppl_3.67 · Cited by 27
Diagnosis and treatment of rectovaginal endometriosis: an overview
KRUSE, C., SEYER‐HANSEN, M., & FORMAN, A. (2012) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1111/j.1600-0412.2012.01367.x · Cited by 26
Sexual Function and Quality of Life in Patients Affected by Deep Infiltrating Endometriosis: Current Evidence and Future Perspectives
Vitale, S. G., Rosa, V. L. L., Vitagliano, A., Noventa, M., Laganà, F. M., Ardizzone, A., Rapisarda, A. M. C., Terzić, M., Terzic, S., & Laganà, A. S. (2017) · Journal of Endometriosis and Pelvic Pain Disorders · doi:10.5301/jeppd.5000303 · Cited by 25
Multidisciplinary laparoscopic treatment for bowel endometriosis
Wolthuis, A. M., & Tomassetti, C. (2013) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2013.11.008 · Cited by 25
Choosing the right technique for deep endometriosis
Nisolle, M., Brichant, G., & Tebache, L. (2019) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2019.01.010 · Cited by 24
Self-citation
Uterine rupture following laparoscopic resection of rectovaginal endometriosis: a new risk factor?
Putte, I. V. D., Campo, R., Gordts, S., & Brosens, I. A. (1999) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1999.tb08334.x · Cited by 23
Hysterolaparoscopy: A Gold Standard for Diagnosing and Treating Infertility and Benign Uterine Pathology
Varlas, V. N., Rhazi, Y., Cloțea, E., Roxana Georgiana, B. O. R. S., Mirică, R., & Bacalbaşa, N. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10163749 · Cited by 23
Troubles fonctionnels urinaires liés à l’endométriose profonde et à son traitement : revue de la littérature
Campin, L., Borghese, B., Marcellin, L., Santulli, P., Bourret, A., & Chapron, C. (2014) · Journal de gynécologie, obstétrique et biologie de la reproduction. Supplément/Journal de gynécologie obstétrique et biologie de la reproduction · doi:10.1016/j.jgyn.2014.03.003 · Cited by 22
Endometriose de septo retovaginal: doença de diagnóstico e tratamento específicos
Abrão, M. S., Neme, R. M., & Averbach, M. (2003) · Arquivos de Gastroenterologia · doi:10.1590/s0004-28032003000300011 · Cited by 20
Surgery-related complications and long-term functional morbidity after segmental colo-rectal resection for deep infiltrating endometriosis (ENDO-RESECT morb)
Turco, L., Tortorella, L., Tuscano, A., Palumbo, M., Fagotti, A., Uccella, S., Fanfani, F., Ferrandina, G., Nicolotti, N., Vargiu, V., et al. (2020) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-020-05694-0 · Cited by 17
Endoscopic treatment of deep infiltrating endometriosis (DIE) involving the bladder and rectosigmoid colon
Langebrekke, A., Istre, O., Busund, B., Johannessen, H., & Qvigstad, E. (2006) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1080/00016340500449907 · Cited by 20
“Our experience was in line with other publications that emphasize the importance of preoperative evaluation (2,4).”
Result
Rectal Shaving Using Plasma Energy in Deep Infiltrating Endometriosis of the Rectum: Four Years of Experience
Marty, N., Touleimat, S., Moatassim, S., Millochau, J.-C., Vallée, A., Loi, E. S., Desnyder, E., & Roman, H. (2017) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2017.06.019 · Cited by 20

Authors: Donnez, J., Nisolle, M., Casanas-Roux, F., Bassil, S., & Anaf, V.
Affiliations: Cliniques Universitaires Saint-Luc (BE)
ORCID: Nisolle, M.
Venue: Human Reproduction
Publisher: Oxford University Press (OUP)
Published: 1995-03
Volume: 10
Issue: 3
Pages: 630-635
ISSN: 0268-1161 (ISSN-L)
1460-2350
DOI: 10.1093/oxfordjournals.humrep.a136001
OpenAlex: W2120545985
Cited by: 175
References: 0
Citations by year: 2026: 2 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 4 · 2020: 8 · 2019: 2 · 2018: 6 · 2017: 5 · 2016: 6 · 2015: 6 · 2014: 3 · 2013: 12 · 2012: 5
FWCI: 7.97
Type: journal article
Language: en
Open access: closed
Locations: Human Reproduction (publishedVersion)
PubMed (publishedVersion)
Digital Access to Libraries (submittedVersion)
Open Repository and Bibliography (University of Liège) (submittedVersion)
Topics: Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
Keywords: rectovaginal septum, deep infiltrating endometriosis, laparoscopic resection, endometriotic nodules, Müllerian remnants, urinary retention, analgesia, adenomyoma
MeSH terms: Endometriosis, Female, Humans, Image Processing, Computer-Assisted, Infertility, Female, Laparoscopy, Radiography, Rectal Diseases, Vaginal Diseases, Pelvic Pain

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Surgery: Rectovaginal septum, endometriosis or adenomyosis: laparoscopic management in a series of 231 patients

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