Intrapartum rupture of the rectovaginal septum with transanal fetal hand delivery and intact anal sphyncter

Rectovaginal lacerations in the mare occur during parturition when the foal’s limb(s) or head are forced caudal and dorsal. The injury is seen predominantly in primiparous mares and is usually due to violent expulsive efforts by the mare (Colbern et al., 1985; Turner and McIlwraith, 1989). The injury is also seen following forced extraction of a large fetus or extraction before full dilation of the birth canal. Third-degree perineal lacerations occur when there is tearing through the rectovaginal septum, the musculature of the rectum and vagina, and the perineal body.

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Expression of aromatase (P450 aromatase/CYP19) in peritoneal and ovarian endometriotic tissues and deep endometriotic (adenomyotic) nodules of the rectovaginal septum

Fertility and Sterility ◽

10.1016/j.fertnstert.2005.10.041 ◽

2006 ◽

Vol 85 (5) ◽

pp. 1516-1518 ◽

Cited By ~ 23

Author(s):

Jean-François Heilier ◽

Olivier Donnez ◽

Valérie Van Kerckhove ◽

Dominique Lison ◽

Jacques Donnez

Keyword(s):

Rectovaginal Septum ◽

P450 Aromatase

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Proctogyneacology – who should treat? A proposed treatment algorithm

Nowa Medycyna ◽

10.25121/nm.2020.27.4.143 ◽

2020 ◽

Vol 27 (4) ◽

Author(s):

Małgorzata Kołodziejczak ◽

Przemysław Ciesielski ◽

Maja Gorajska-Sieńko

Keyword(s):

Anal Sphincter ◽

Reproductive Tract ◽

Inflammatory Diseases ◽

Uterine Prolapse ◽

Treatment Algorithm ◽

Female Reproductive Tract ◽

Rectovaginal Septum ◽

Therapeutic Success ◽

Radiation Induced ◽

Rectovaginal Fistulas

Proctogyneacology deals with conditions involving the anal canal, anal sphincter muscles, rectum, rectovaginal septum, and the female reproductive tract. They may be due to sagging of the pelvic floor and the rectovaginal septum (rectal, vaginal or uterine prolapse, enterocele and rectocele), perinatal injury, including sphincter damage, rectovaginal fistulas, endometriosis with anal sphincter and rectovaginal septum involvement, proctological inflammatory diseases in pregnancy, as well as radiation-induced rectal damage after gynaecological cancer treatment. There are no set guidelines defining which specialist should operate on these patients. We attempted to systematise this issue in the form of an algorithm. An interdisciplinary dialogue allowing for our professional development and, most of all, therapeutic success and reduced risk of postoperative complications, seems to be crucial.

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Surgical treatment of patients with deep infiltrating endometriosis of the rectovaginal septum

Voprosy ginekologii akušerstva i perinatologii ◽

10.20953/1726-1678-2021-4-5-11 ◽

2021 ◽

Vol 20 (4) ◽

pp. 5-11

Author(s):

E.A. Galliamov ◽

◽

L.N. Aminova ◽

V.A. Alimov ◽

A.G. Kozub ◽

...

Keyword(s):

Surgical Treatment ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Comparison Group ◽

Chronic Pelvic Pain Syndrome ◽

Main Group ◽

Pelvic Pain Syndrome ◽

Deep Infiltrating Endometriosis ◽

Rectovaginal Septum ◽

Infiltrating Endometriosis

Objective. To optimize the tactics of surgical treatment of deep infiltrating endometriosis of the rectovaginal septum, including with bowel involvement. Patients and methods. The study included 122 patients diagnosed with deep infiltrating endometriosis of the rectovaginal septum, who underwent surgical interventions of different volumes using laparoscopy. The patients were divided into a main group and a comparison group. The main group consisted of 92 patients with deep infiltrating endometriosis of the rectovaginal septum who underwent surgical treatment using the original technique of systematic approach; the comparison group consisted of 30 patients who were operated using the generally accepted technique. Results. There was a statistically significant decrease in the operation duration, intraoperative blood loss, as well as more effective relief of dysmenorrhea and chronic pelvic pain syndrome, less complications and relapses in the main group compared to the comparison group. In addition, it was found that the combination of three symptoms such as dysmenorrhea, dyspareunia and chronic pelvic pain increase the likelihood of deep infiltrating endometriosis up to 93%. Conclusion. Based on the results obtained, the proposed method of surgical treatment of deep infiltrating endometriosis is more efficient and safer in comparison with the generally accepted technique, which can be considered as a valid reason for its wide introduction into clinical practice. Key words: deep infiltrating endometriosis, bowel endometriosis, surgical treatment of endometriosis, treatment algorithm

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Rectovaginal extragastrointestinal stromal tumour (EGIST): an additional entity to be considered in the differential diagnosis of tumours of the rectovaginal septum

BMJ Case Reports ◽

10.1136/bcr-2020-237669 ◽

2021 ◽

Vol 14 (3) ◽

pp. e237669

Author(s):

Susan Addley ◽

Moiad Alazzam ◽

Catherine Johnson ◽

Hooman Soleymani majd

Keyword(s):

Differential Diagnosis ◽

Case Report ◽

High Risk ◽

Kinase Inhibitor ◽

Correct Diagnosis ◽

Rectovaginal Septum ◽

Gastrointestinal Stromal Tumours ◽

Diagnostic Challenge ◽

High Quality ◽

Primary Surgery

Gastrointestinal stromal tumours (GISTs) are rare - and rectovaginal extragastrointestinal stromal tumours (RV-EGISTs) even rarer. We share a case of RV-EGIST, complemented by high-quality radiological and surgical images. A review of current literature pertaining to RV-EGIST is also included. Our case report highlights the diagnostic challenge presented by extragastrointestinal stromal tumours. Differentiated from overlapping pathologies only by targeted application of immunohistopathology and cytogenetics, the inclusion of RV-EGIST in the differential diagnosis of a rectovaginal tumour is essential to making this correct diagnosis. Primary surgery is the treatment of choice for RV-EGIST if complete cytoreduction can be achieved, combined with adjuvant tyrosine kinase inhibitor (TKI) therapy for those with high-risk features to further reduce rates of future recurrence.

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Expression of p63 Differs in Peritoneal Endometriosis, Endometriomas, Adenomyosis, Rectovaginal Septum Endometriosis, and Abdominal Wall Endometriosis

Archives of Pathology & Laboratory Medicine ◽

10.5858/2007-131-1099-eopdip ◽

2007 ◽

Vol 131 (7) ◽

pp. 1099-1102

Author(s):

Omero B. Poli Neto ◽

Hebert M. Ferreira; ◽

Leandra N. Z. Ramalho ◽

Júlio C. Rosa e Silva ◽

Francisco J. Candido dos Reis ◽

...

Keyword(s):

Abdominal Wall ◽

Task Force ◽

Tertiary Care ◽

Female Genital Tract ◽

University Hospital ◽

Rectovaginal Septum ◽

Tissue Samples ◽

Abdominal Wall Endometriosis ◽

Peritoneal Endometriosis ◽

Accompanying Symptoms

Abstract Context.—Although there is evidence that endometriosis results from basal endometrium dislocation, the underlying biology is not fully understood. One protein that plays an important role in regulating epithelial proliferation and differentiation is the 63-kDa membrane protein (p63), which is also a marker of basal and reserve cells in the female genital tract. Objective.—To determine whether p63 is expressed differently in peritoneal endometriosis, endometriomas, and adenomyosis, as well as in deep endometriotic nodules of the rectovaginal septum and abdominal wall. Design.—This study includes a prospective series of consecutive patients (Canadian Task Force classification II-2) from a tertiary care university hospital. Specimens collected from 83 patients (15 peritoneal endometriosis specimens, 22 endometrioma specimens, 36 adenomyosis specimens, and 10 rectovaginal septum/abdominal wall specimens) were evaluated. Diagnostic and operative laparoscopies or laparotomies were performed, and tissue samples were obtained. Immunohistochemistry was used to evaluate p63 expression. Results.—Positivity for p63 was detected in 93.3% of the peritoneal endometriosis specimens, 81.8% of the endometrioma specimens, 36.1% of the adenomyosis specimens, and none of the rectovaginal/abdominal wall endometriosis specimens (P < .001). Distribution of p63 immunostaining in the positive specimens was homogeneous. Conclusions.—Endometriotic lesions express p63 differently, and some retain the basal/reserve cell immunophenotype. Nevertheless, it remains unclear whether the lack of p63 expression in some lesions is related to the extent of the disease, to its clinical behavior, or to exacerbation of the accompanying symptoms.

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