Presenting Features of Rectovaginal Endometriosis & Its Treatment Options

What is Rectovaginal Endometriosis?

Rectovaginal Endometriosis is a pathological condition that occurs when the endometrial tissues that line the uterus grows outside of it and attaches to the rectum or the vagina. The common areas where Rectovaginal Endometriosis has its effects include the vagina, rectum, uterosacral ligaments, and rectovaginal septum. At times, this condition also interferes with the normal functioning of the bowels. The endometrial tissues that grow outside of the uterus are termed as adhesions. As a result of these adhesions, large growths form that can be quite painful and can affect the functioning of the nearby organs.[1]

Rectovaginal Endometriosis can also cause internal injuries which can cause bleeding and other complications. Endometriosis is subdivided into four categories depending on the severity. Rectovaginal Endometriosis comes under the fourth category meaning that it is the most severe form of endometriosis. Studies suggest that more than 30% of females with endometriosis have Rectovaginal Endometriosis. Treatment wise, there is no cure for this condition but both conservative and surgical treatments are available for treating the symptoms of Rectovaginal Endometriosis.[1]

What is Rectovaginal Endometriosis?

Frequently, Rectovaginal Endometriosis has been known to be associated with other forms of pelvic endometriosis, specifically ovarian endometriosis.[1] The article below highlights some of the presenting features of Rectovaginal Endometriosis and ways to manage the condition.

What Are The Presenting Features of Rectovaginal Endometriosis?

The primary presenting features of Rectovaginal Endometriosis include excessively heavy menstrual periods. The female will also experience bleeding in between periods as well. Severe cramping is also one of the primary symptoms of Rectovaginal Endometriosis. Sexual intercourse is extremely painful in females with this condition. The female will also have severe pain around the bladder area along with incontinence.[2]

The fertility of a female also gets affected as a result of Rectovaginal Endometriosis. Additionally, the female will also have to strain when passing bowel movements which will be very painful. At times, there may be bleeding from the rectum. In some cases, constipation along with diarrhea is also seen in females with Rectovaginal Endometriosis along with severe pain in the stomach.[2]

Some females with Rectovaginal Endometriosis also complain of swelling around the rectum, vagina, or the perineal area. It should be noted here that not everyone with Rectovaginal Endometriosis will have severe symptoms. There are cases where females have mild Rectovaginal Endometriosis but will still have intense symptoms and other females with severe Rectovaginal Endometriosis will have minimal symptoms. Thus, the severity of the condition cannot be gauged just by the severity of the symptoms alone.[2]

What Are The Treatment Options For Rectovaginal Endometriosis?

Unfortunately, as of now, there is no cure for Rectovaginal Endometriosis but treatments are available that can help deal with the symptoms of this condition. The treatments are both conservative as well as surgical in nature. Some physicians prescribe hormonal birth control pills. These contain progesterone which is quite effective in preventing buildup of endometrial tissues.[2]

It has been seen that about 40% of females with Rectovaginal Endometriosis tend to get improvement with hormonal birth control pills. However, these medications can cause certain side effects like headaches and bloating. It may also lead to weight gain. It should also be noted that females who are desirous of conceiving should avoid these hormone birth control pills. If these medications are ineffective in controlling the symptoms of Rectovaginal Endometriosis, then surgery is the route taken by physicians to manage the symptoms.[2]

A laparoscopic surgery can be performed to remove the adhesions. This procedure is minimally invasive and involves use of a laparoscope with a camera attached to it to look around the area of the adhesions and remove them when identified. This procedure also gives a clear idea to the physician about the severity of the condition. Additional treatments will be required of Rectovaginal Endometriosis which may result in certain internal complications like infection or intestinal blockage.[2]

In cases where a female does not wish to get pregnant, then hysterectomy along with oophorectomy can be performed to remove the entire uterus and ovaries and the adhesions along with it. This will clear most of the symptoms away. However, there have been cases where females have continued to have symptoms despite complete removal of the uterus and ovaries. Thus this surgical procedure cannot be taken as a cure for Rectovaginal Endometriosis. Removal of adhesions becomes absolutely necessary in people with severe Rectovaginal Endometriosis.[2]

In conclusion, Rectovaginal Endometriosis is a chronic condition in which the endometrial tissues that line the uterus start growing in the rectovaginal area outside of the uterus. The vagina and rectum are mostly involved in this condition. Rectovaginal Endometriosis can affect the fertility of a female and thus diagnosis and treatment is necessary.[1,2]

As of now, there is no cure for this condition but treatments in the form of birth control hormonal pills and surgery tends to improve the symptoms significantly and even increase the chances of the female getting pregnant. In some cases, even after surgery, there may not be complete improvement of the symptoms and therefore surgery may also be followed with medications to prevent new adhesions from growing or slow down the process of growth. If a female suspects that she might have Rectovaginal Endometriosis then it is best to consult with a gynecologist for a thorough evaluation and treatment of the condition.[2]