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Medline ® Abstract for Reference 24

of 'Endometriosis: Treatment of rectovaginal and bowel disease'

Is rectovaginal endometriosis a progressive disease?
Fedele L, Bianchi S, Zanconato G, Raffaelli R, Berlanda N
Am J Obstet Gynecol. 2004;191(5):1539.
OBJECTIVE: The purpose of this study was to observe the natural history of untreated asymptomatic rectovaginal endometriosis.
STUDY DESIGN: 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.
CONCLUSION: Progression of the disease and appearance of specific symptoms rarely occurred in patients with asymptomatic rectovaginal endometriosis.
Clinica Ostetrico-Ginecologica dell'Universitàdi Milano, Ospedale San Paolo, Milan, Italy. luigi.fedele@unimi.it