Postcoital bleeding in a case of recto-vaginal endometriosis

Rectovaginal Endometriosis (RVE) is a severe form of endometriosis classified by Kirtner as stage 4 [1,2]. It is less frequent than peritoneal or ovarian endometriosis affecting 3.8% to 37% of patients with endometriosis [3,4]. RVE infiltrates the rectum, vagina, and rectovaginal septum, up to obliteration of the pouch of Douglas [4]. Endometriotic nodules exceeding 30 mm in diameter have 17.9% risk of ureteral involvement [5], while 5.3% to 12% of patients have bowel endometriosis, most commonly found in the recto-sigmoid involving 74% of those patients [3,4].