The Facts of Rectovaginal Endometriosis
Endometriosis is a condition in which the tissues that normally place your uterus – called endometrial tissue – grow and accumulate in other parts of your abdomen and vagina.
During your menstrual cycle, these tissues can respond to hormones as they do in your uterus. However, because it is outside the uterus when it is not its own, it can affect other organs, cause inflammation, and cause scarring.
There are degrees of severity of endometriosis:
- Endometriosis builds up. Small areas are involved, and the muscles do not grow very deep in your pelvic organs.
- Deep endometriosis. This is the worst-case scenario. Rectovaginal endometriosis falls below this level.
Rectovaginal endometriosis is one of the most difficult and painful forms of a reliable source of infection. Endometrial tissue can exceed two inches or more in-depth. It can penetrate deep into the vagina, rectum, and tissues between the vagina and the rectum called the rectovaginal septum.
Rectovaginal endometriosis is less common than endometriosis in the ovaries or lining of the abdomen. According to a review by the International Journal of Women’s Health, rectovaginal endometriosis affects up to 37 percent Reliable Source for women with endometriosis.
What are the symptoms?
Some symptoms of rectovaginal endometriosis are similar to other types of endometriosis.
Symptoms of other types of endometriosis include:
- pelvic pain and cramps
- painful times
- painful sex
- pain during bowel movement
Signs that are different in this case include:
- discomfort during bowel movement
- constipation or diarrhea
- Pain in the rectum that may sound like “sitting on thorns”
These symptoms are usually worse during your menstrual cycle.
What causes rectovaginal endometriosis?
- Cell conversion. Cells affected by endometriosis respond differently to hormones and other chemical signals.
- Inflammation. Certain factors that play a role in inflammation are found in high levels of tissue affected by endometriosis.
- Surgery. Surgical delivery, hysterectomy, or other pelvic surgery can be dangerous for further episodes of endometriosis. The 2016 Reproductive Science study suggests that these surgeries can cause the body to stimulate the growth of already active tissue.
- Genetics. Endometriosis can work in families. If you have a mother or sister who has the disease, there are double to ten risks of a reliable source of growth, rather than someone with no family history of the disease.
How is this achieved?
Rectovaginal endometriosis can be difficult to diagnose. There are no clear guidelines A reliable source on how to diagnose this type of disease.
Your doctor will first ask questions about your symptoms, including:
When did you start menstruating? Was it painful?
Do you have symptoms such as pelvic pain, or pain during sex or bowel movements?
What symptoms do you have in your time?
How many symptoms do you have? Have they changed? If so, how did they change?
Have you ever undergone genital surgery, such as surgical delivery?
After that, your doctor will examine your vagina and rectum with a closed finger to check for any pain, lumps or abnormal tissue.
Your doctor may also use one or more of the following tests to examine endometrial tissue outside the uterus:
- Ultrasound. This test uses high-frequency sound waves to create images inside your body. A transducer can be inserted into your vagina (transvaginal ultrasound) or rectum.
- MRI. This test uses powerful magnets and radio waves to create images of the inside of your abdomen. It can show endometriosis sites in your organs and the lining of the stomach.
- CT colonography (visual colonoscopy). This test uses a low-dose X-ray to take pictures of the inner lining of your colon and part.
- Laparoscopy. This surgery is often the best way to ensure a reliable source. While you are asleep and in pain under general anesthesia, your surgeon cuts a small incision in your abdomen. They will insert a thin tube with a camera on one side, called a laparoscope, into your abdomen to look at the endometrium tissue. A tissue sample is usually removed for testing.
After your doctor has identified endometrial tissue, they will check its weight. Endometriosis is divided into categories based on the number of endometrial tissue you have outside your uterus and how deep it is:
- Section 1. Minor. There are some distinct areas of endometrial tissue.
- Section 2. Mild. Tissues especially on the face of organs without a scar
- Section 3. Middle. Many organs are involved, there are certain areas of the scar.
- Section 4. It is difficult. There are many organs involved in the wider areas of endometrial tissue and scar.
However, the stage of endometriosis has nothing to do with symptoms. There may be significant symptoms even with low levels of disease. Rectovaginal endometriosis is usually a stage 4Trust Source.
What therapies are available?
Because the condition persists and is incurable, the goal of treatment is to control your symptoms. Your doctor will help you choose a treatment depending on the severity of the condition and where it is diagnosed. This usually involves a combination of surgery and medication.
Surgery to remove as much tissue as possible offers great relief. Studies suggest that it can improve up to 70 percent Reliable Source of Pain-Related Symptoms. Endometriosis surgery can be performed laparoscopically or with a robot using small incisions using small instruments.
Surgical procedures may include:
- Shaving. Your surgeon will use a sharp instrument to remove areas of endometriosis. This procedure can leave certain endometrial tissue behind.
- Recovery. Your surgeon will remove a portion of the intestines where the endometriosis has grown, and then reconnect the abdomen.
- Get a cut. In small sections of endometriosis, your surgeon may cut a disc of the affected intestinal tissue and close the opening.
Currently, there are two main types of drugs used to treat rectovaginal and other types of endometriosis: hormones and pain relief.
Hormone therapy can help reduce endometrial tissue growth and reduce its function outside the uterus.
Types of hormonal drugs include:
- birth control, including pills, pads or ring
- gonadotropin-releasing hormone (GnRH) agonists
- danazol, which can be widely used today
- progestin injections (Depo-Provera)
Your doctor may also recommend anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) or naproxen (Aleve), to help control pain.
Are problems possible?
Surgery to treat rectovaginal endometriosis can cause problems such as:
- bleeding inside the abdomen
- a fistula, or abnormal contact, between the vagina and the rectum or other organs
- chronic constipation
- leaks around the reconnected intestines
- trouble passing excrement
- managing incomplete symptoms that require further surgery
Women with this type of endometriosis can have a greater risk of pregnancy. Pregnancy rates in women with rectovaginal endometriosis are lower than in women with lower extremities. In vitro surgery and pregnancy can increase your pregnancy risk.
What can you expect?
Your opinion depends on how serious your endometriosis is and how it is treated. Surgery can relieve pain and improve fertility.
Because endometriosis is a painful condition, it can have a profound effect on your daily life. For support in your area, visit the Endometriosis Foundation of America or the Endometriosis Association.