Adenomyoseknoten des rektovaginalen septums: eine eigenen entität

Objective: Laparoscopic procedure with excision of deep fibrotic endometriotic nodules of the rectovaginal septum and histological study of the lesions. Setting: An academic teaching hospital. Patients: A series of 500 patients underwent a laparoscopy for pelvic pain and/or infertility. Results: Laparoscopic (n = 497) and laparotomic (n = 3) excision of endometriotic nodules was performed on a series of 500 patients. The nodule resection resulted in considerable pain relief. Histologically, the rectovaginal nodale was similar to an adenomyoma as it was a circumscribed nodular aggregate of smooth muscle and endometrial glands and stroma. The variations in estrogen receptor (ER) and progesterone receptor (PR) content suggested a regulatory mechanism different from that of eutopic endometrium. Conclusion: This form of disease should be considered as a distinct entity, different from peritoneal and ovarian endometriosis, and originating from the Müllerian rests present in the rectovaginal septum.