Is rectovaginal endometriosis a progressive disease?

Am J Obstet Gynecol. 2004 Nov;191(5):1539-42. doi: 10.1016/j.ajog.2004.06.104.


Objective: The purpose of this study was to observe the natural history of untreated asymptomatic rectovaginal endometriosis.

Study design: This was a prospective, observational study. Eighty-eight patients with untreated asymptomatic rectovaginal endometriosis were followed for 1 to 9 years. Pain symptoms and clinical and transrectal ultrasonographic findings were evaluated before and every 6 months after diagnosis.

Results: Two patients had specific symptoms that were attributable to rectovaginal endometriosis that was associated with an increase in lesion size and underwent surgery. In 4 other patients, the size of the endometriotic lesions increased, but the patients remained symptom free. The estimated cumulative proportion of patients with progression of disease and/or appearance of pain symptoms that were attributable to rectovaginal endometriosis after 6 years of follow up was 9.7%. For the remaining patients, the follow-up period was uneventful, with no detectable clinical nor echographic changes of the lesions and with no appearance of new symptoms.

Conclusion: Progression of the disease and appearance of specific symptoms rarely occurred in patients with asymptomatic rectovaginal endometriosis.

MeSH terms

  • Adult
  • Disease Progression
  • Endometriosis / diagnostic imaging*
  • Endometriosis / pathology
  • Female
  • Humans
  • Longitudinal Studies
  • Pelvic Pain
  • Prospective Studies
  • Rectal Diseases / diagnostic imaging*
  • Rectal Diseases / pathology
  • Severity of Illness Index
  • Ultrasonography
  • Vaginal Diseases / diagnostic imaging*
  • Vaginal Diseases / pathology