What is Rectovaginal Endometriosis

Symptoms, Causes and Treatment

What is Rectovaginal Endometriosis
What is Rectovaginal Endometriosis

What is Rectovaginal Endometriosis : Endometriosis is a kind of disease or condition that occurs when the endometrial tissues – the tissues that line the interior of the uterus, grows outside the uterus and accumulates in rectum, vagina and other parts of pelvis and abdomen.

The tissues consist of blood cells, gland, and other connective tissues. The tissue grows typically to prepare the lining of the womb for the process of ovulation. Endometrial tissues shed during menstruation each month. During the cycle, tissues respond to the hormones just like it react in the uterus. If these tissues are outside the uterus, they cannot be expelled out from the body during the menstruation. The tissue can cause harmful effects to the organ and can trigger inflammation and scarring.

The areas where these tissues can grow are:

  • Fallopian tubes
  • Ovaries
  • Peritoneum
  • Lymph nodes

The lesions usually develop with time and cause severe pain. The pain and other symptoms can affect your life in various ways like hampering the ability to work, difficulty in maintaining a relationship, high cost of medical treatment, pain during sex and infertility, and thus one may need to opt for IVF treatment.

Endometriosis has different levels:

  • Superficial Endometriosis: During this level, the endometrial tissues grow in smaller areas but do not grow deep in pelvic organs.
  • Deep Infiltrating Endometriosis: This level of endometriosis is severe, and rectovaginal endometriosis falls at this level.

What is Rectovaginal Endometriosis?

One of the most painful and severe kinds of endometriosis disease is Rectovaginal Endometriosis. When the endometrial tissues penetrate deep into rectum, vagina, and other tissues between these parts, the condition is called Rectovaginal Endometriosis. It can grow into the areas including:

  • Rectum
  • Vagina
  • Rectovaginal septum
  • Rectouterine pouch
  • Uterosacral Ligaments

The tissues can also develop and interfere with the functioning of bowel, and areas close to the bowel. The tissues that attach to the outside of the uterus are known as adhesions and are similar to the endometrium, the womb lining.

The adhesions can grow deep, interfering with the functioning of other organs. In severe cases, this may cause internal injuries causing severe bleeding and infections.

Based on the severity of disease and the depth of tissues growth outside the uterus, one can classify the endometriosis into four stages. Rectovaginal Endometriosis is the fourth and the most severe stage.


Some of the symptoms of Rectovaginal Endometriosis are same as symptoms of endometriosis. These symptoms include:

  • Painful periods
  • Pelvic pains
  • Cramps
  • Painful sex
  • Pain and discomfort during bowel movement
  • Infertility
  • Incontinence
  • Pain in bladder

Other symptoms of Rectovaginal Endometriosis are:

  • Bleeding from Rectum
  • Diarrhea or constipation
  • Pain in rectum
  • Bleeding between periods
  • Swelling in vagina, rectum, stomach and/or perineum
  • Bloating with some retention of fluid

Most of these symptoms worsen during the menstrual periods. However, Rectovaginal Endometriosis patients will not necessarily experience all these symptoms. The severity of the symptoms shared above might not always indicate the severity of the disease.


The exact cause of the endometriosis is not known. However, a few theories are stating the reasons for the occurrence of this condition. Sometimes, the disease runs in families, suggesting genetics to play a role. Other factors that cause adhesions in the body or any endometriosis are:

  • Retrograde Menstruation: The most commonly known cause of endometriosis is a backward flow of menstrual blood. It is called retrograde menstruation. During periods, the blood and tissue may flow backward through the fallopian tubes and towards the pelvis. Hence, the endometrial tissues can get deposited outside the uterus and into other parts of the abdomen and pelvis.
  • Autoimmune conditions: Normally, the immune system detects and removes the adhesions formed outside of the uterus. Some researchers believe that the disorder of the immune system might be the cause of endometriosis.
  • Surgery or traumatic Injury: Some of the researches also suggest that any trauma caused to the uterus or other structures around it may cause a shift in these tissues and result in endometriosis. Having hysterectomy, cesarean delivery or pelvic surgery may increase the risk of the disease
  • Hormones: Problem in maintaining the balance between estrogen and other hormones or an excessive amount of estrogenin the body may also cause adhesions.


Diagnosis of rectovaginal endometriosis can be quite tricky. However, if the symptoms of endometriosis like pain, bloating and irregular bleeding, are observed, the doctor may ask a few questions related to periods, pelvic pain, pain during bowel movement or sex, and other medical questions related to surgery to the pelvic area or cesarean delivery.

The doctor might advise the patient to have one of the tests to diagnose the presence of the tissue outside of uterus:

  • Ultrasound
  • MRI
  • CT colonography
  • Laparoscopy

If the tests show any signs of endometriosis, the doctor will assess the severity of the problem. Thus one can classify the seriousness of the issue in four stages as Minimal, Mild, Moderate, and Severe.


Endometriosis is chronic and ongoing. The treatment is based on the severity and the location where the adhesions are formed. Usually, rectovaginal endometriosis treatment involves the combination of medication and surgery.

There are two kinds of medications involved to treat the endometriosis: pain reliever and hormones.

Hormonal therapy is used to slow down and prevent further accumulation of endometrial tissues. Hormonal birth control pills containing progesterone are used to reduce the growth and activity of these tissues.

When medication is not effective in treating the condition, surgery is suggested to remove the adhesions from the body. If the patient does not want to get pregnant, they may opt for a hysterectomy, removing uterus and ovaries. However, if the patient wants to get pregnant, hysterectomy is not the option in such cases.

Often, severe endometriosis requires surgical removal of adhesions from the body to prevent further complications.

The patient might also have infertility issues after successful treatment of Rectovaginal Endometriosis. In such a case, they can visit an IVF Center so that they can get the right Infertility treatment and can conceive successfully through IVF.





Related Videos about What is Rectovaginal Endometriosis :

Endometriosis Symptoms and Causes: A Meet Our Researchers Video


Endometriosis 101: Moderate To Severe?


Endometriosis : rectovaginal nodule + vaginal colectomy


Rectovaginal endometriosis and Fertility


What is Endometriosis & its management? – Dr. B Ramesh


Causes of endometriosis


What is Rectovaginal Endometriosis

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