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- During the last decades, laparoscopic surgery has been accepted as the technique of choice for the treatment of endometriosis, because it provides long-term outcomes comparable to those achieved by laparotomy, with the established advantages of a minimally invasive technique, including better visualization, shorter hospital stay, faster recovery and better cosmetic results (Adamson et al., 1992; Daraï et al., 2010; Luciano et al., 1992; Vercellini et al., 2003).
- The relationship between rectovaginal–bowel endometriosis and fertility is unclear. Nevertheless, extirpative surgery, including colorectal resection, is being fostered as a fertility-enhancing procedure. Adenomyosis and deep endometriosis often coexist. As the uterine condition may further impact on reproductive outcome, this work performed a systematic literature review with the objective of identifying all English-language reports on surgical treatment for rectovaginal and colorectal endometriosis, including bowel resection, in which participants were screened preoperatively for uterine adenomyosis.
- The effect of rectovaginal endometriosis on fertility is unclear. Several authors foster radical surgery, including colorectal resection, as a fertility-enhancing procedure. However, interpretation of data is difficult, as the baseline fertility status is often undefined and it is not always possible to discriminate between spontaneous conceptions and those resulting from IVF. A systematic literature review was performed with the aim of defining the pregnancy rate specifically in patients who were infertile before surgery and who sought spontaneous pregnancy.