Operative therapy of deep endometriosis in the septum rectovaginale [Die opevative therapie der tiefen endometriose im septum rectovageinale]

The deep infiltrating endometriosis of the rectovaginal septum is a specific entity. Severe pelvic endometriosis frequently involves the lower recto-sigmoid colon, rectum, ureter, uterus or vagina. Symptoms associated with endometriosis depend on the location, extension and activity of the endometriotic nodule. The choice of the surgical access depends on the experience of the surgeon and on the location of the lesion. The goal of surgery is to remove all endometriotic lesions entirely. If fertility has to be conserved, reconstructive operative techniques become important and compromises may be necessary concerning the extend of surgery. Radical surgery of deep endometriosis results in a significant improvement of symptoms while the complication rate is relatively low. Surgical treatment of deep symptomatic endometriosis infiltrating the septum rectovaginale is superior to medical treatment and represents the treatment of choice.