Urological and colorectal complications following surgery for rectovaginal endometriosis.
Slack A., Child T., Lindsey I., Kennedy S., Cunningham C., Mortensen N., Koninckx P., McVeigh E.
OBJECTIVES: To report the short- and medium-term complications of laparoscopic laser excisional surgery for rectovaginal endometriosis. DESIGN: Retrospective cohort study. SETTING: University teaching hospital, UK. POPULATION: A total of 128 women with histologically confirmed rectovaginal endometriosis who underwent laparoscopic laser surgery between May 1999 and September 2006. METHODS: Women were identified from operative database, and a case note review was performed. Data for surgical outcome and surgical complications were collected. MAIN OUTCOME MEASURES: Rates of urinary tract and colorectal complications. RESULTS: A total of 128 women underwent surgery. Of these, 32 required intraoperative closure of a rectal wall defect, including 3 segmental rectosigmoid resections. There were three rectovaginal fistulae and one ureterovaginal fistula. Ureteric damage occurred in two women, and five women suffered postoperative urinary retention. The risk of intraoperative bowel intervention was increased in women who complained of cyclical rectal bleeding. CONCLUSION: Laparoscopic laser excision of rectovaginal endometriosis is a safe procedure with similar, if not lower, complication rates to other published surgical series.