Medical treatment for rectovaginal
endometriosis: what is the evidence?
Finally, rectal and rectovaginal
exams are performed to evaluate posterior POP and the perineal body.
fistula was not due to injury to the rectum by scissors or scalpel, but due to suturing the rectum to vault by taking a deep bite during suturing the vault.
Key components of surveillance evaluation Endometrial cancer Ovarian cancer History and Symptom assessment, Symptom assessment, physical exam pelvic exam with pelvic exam with speculum and speculum and rectovaginal
exam Vaginal Not recommended Not recommended cytology Imaging Not routinely Not routinely (CT/MRI/PET) recommended recommended (consider cases of fertility- preserving surgery) Tumor markers Not recommended.
The clinical appearance of two orifices in the introitus with an absent anal opening leads to the differential diagnosis of anorectal agenesis without fistula, a rectovaginal
fistula (high or low) or a rectovestibular fistula with either a urogenital sinus or MRKH syndrome.
8) HAM has already been applied in multiple sites of gastrointestinal tract, such as duodenum, colon, and in rectovaginal
fistula showing significant effects on epithelialization, neovascularization, proper wound healing, and better outcome.
Estrogen and progestogen receptor positive endometriotic lesions and disseminated cells in pelvic sentinel lymph nodes of patients with deep infiltrating rectovaginal
endometriosis: a pilot study.
Major mesh related complications include erosion into the vagina, bladder or rectum, mid-rectal stricture, rectovaginal
fistula and chronic pelvic pain due to pudendal nerve irritation or chronic inflammation around the mesh.
Other cases like rectovaginal
fistula were however excluded.
To reduce recurrence, the rectovaginal
cul-de-sac is obliterated, the peritoneum overlying the sacrospinous ligament on either side is incised, and the peritoneum and rectum are then retracted in order to allow identification of the tissue above the sacrospinous ligament, after which a vaginopexy is performed by fixation of the vaginal vault to the sacrospinous or uterosacral ligaments.
It may be a condition on its own or associated with agenesis of other parts like atresia recti, rectovaginal
fistula, rectocystic fistula, vagino-urethral agenesis, cleft scrota etc.
On rectal examination, the mass was palpable in the rectovaginal
space with the rectal mucosa free.