Rectovaginal exam can identify areas of tenderness and nodularity along the rectovaginal septum
. Speculum exam may reveal a laterally displaced cervix or blue powder-burn lesions along the cervix or posterior fornix.
endometriosis: an immunohistochemical analysis of 62 cases.
The rectovaginal septum
was dissected down to the level of the pelvic foor muscles.
The authors emphasise how predisposing factors associated with PVF include technical factors (vaginal injuries or rectovaginal septum
at the time of IPAA operation), septic factors (anastomotic leak, pelvic sepsis), and disease-related factors such as late diagnosis of Crohn's disease.
When looked from this point, the rectovaginal septum
is situated between the vaginal wall and the external anal sphincteric musculature surrounding lower rectum.
The following endometriotic lesions were recorded: endometriomas, adenomyosis, and the involvement of the torus uterinus, the uterosacral ligaments (USL), the rectovaginal septum
(RVS), and the bowel.
Caption: With the Vaginal Bowel Control System (pictured above), the patient controls an inflation pump, inflating the balloon to deflect the rectovaginal septum
and interrupt stool passage.
endometriosis of adenomyosis: laparoscopic management in a serie of 231 patients.
In the posterior compartment, the vagina is separated from the rectum by the rectovaginal septum
, which is fused distally with the urogenital diaphragm and perineal body (Level III support).
These include a fixed retroverted uterus, tender adnexal masses, tenderness or nodularity of the uterosacral ligaments, nodules in the rectovaginal septum
, and rarely blue or red lesions in the posterior vaginal fornix.
The purpose of the rectovaginal examination is to identify abnormalities unique to the thin rectovaginal septum
and rectum that are not detected by any diagnostic imaging: abnormalities such as endometriosis, rectal carcinoma, and colon carcinoma, as well as tumor implants.
The American College of Obstetricians and Gynecologists (ACOG) states that transvaginal ultrasound (TVUS) is the, "preferred imaging technique when assessing endometriosis and/or deep endometriosis of the rectum or rectovaginal septum
." (1) In terms of magnetic resonance imaging (MRI), it should be, "reserved for suspected rectovaginal or bladder endometriosis when ultrasonic tests are equivocal." In addition, the American Society of Reproductive Medicine (ASRM) differs.
Rest of the genitalia, including the anterior and lateral fornices, the urethral opening and the rectovaginal septum
was found to be uninjured.
Less frequently, the rectovaginal septum
is involved (Arq.
Surgical management of rectovaginal septum
endometriosis from a continuous series of 50 cases.