The diagnosis and management of infiltrating nodular recto-vaginal endometriosis.

This paper reviews the history of infiltrating recto-vaginal endometriosis, its clinical and histological diagnosis, together with discussion of treatment options available. Important new work demonstrates significant serious symptomatology which patients suffer, and the relief that can be obtained by radical surgical excision. However this treatment is only available in certain specialist centres. The appropriate methods of management are yet to be subject to a proper randomized control trial, and results of treatment can only be assessed by meticulous recording of patient signs and symptomatology pre- and post-operation associated with histological confirmation of the disease.