Rectovaginal Septum Endometriosis

Endometriosis is a condition where tissue similar to the endometrial stroma or glands is found in locations outside the uterus. The disease generally affects women during their reproductive years (more commonly in their 40s or 50s) and involves 7-10% of the female population (1) . Among women who undergo a diagnostic laparoscopy for infertility the prevalence of endometriosis is 20-50% (2-3) . When chronic pelvic pain is associated, the prevalence can increase up to 80% (4) . The ectopic endometrium can be found inside the uterine wall (adenomyosis), or outside, either within the pelvic organs (internal pelvic endometriosis or deep pelvic endometriosis) or in organs and tissues outside the pelvic space (extrapelvic endometriosis). It is often divided into peritoneal, ovarian and deep pelvic endometriosis (5) . It is most frequently localized to the ovaries, utero-sacral ligaments and peritoneum, then in the recto-vaginal septum, uterine tubes, rectosigmoid colon and bladder. Less frequent or rare localizations include the appendix, cervix, vagina, umbilicus, inguinal region, ureter, pleura, lung, limbs, and brain. In deep pelvic endometriosis (DPE) the lesions are found more than 5 mm below the pelvic peritoneal surface. The estimated incidence of bowel endometriosis in DPE varies between 3% and 37% and in 90% of cases the involved tract is the rectum or the rectosigmoid colon (6-