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      Laparoscopic treatment of cul-de-sac obliteration secondary to retrocervical deep fibrotic endometriosis.

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      The Journal of reproductive medicine

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          Abstract

          One hundred women with cul-de-sac obliteration secondary to retrocervical deep fibrotic endometriosis (48 partial, 52 complete) were treated laparoscopically for infertility (46 cases), pain (46), hypermenorrhea (7) and a mass (1). The surgical techniques included aqua-dissection, electrosurgery, CO2 laser, scissors, probes to identify the upper posterior vagina and rectum, and multiple rectovaginal examinations. In all the procedures the anterior rectum was freed to the loose areolar tissue of the rectovaginal septum prior to excising deep fibrotic endometriosis. The viable intrauterine pregnancy rate among patients with infertility was 70% (32/46). Of patients presenting with pain, 89% (41/46) reported significant relief. The average operating time was 178 minutes. Laparoscopic cul-de-sac dissection, though time intensive, offers increased fertility potential and significant symptom relief.

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          Author and article information

          Journal
          J Reprod Med
          The Journal of reproductive medicine
          0024-7758
          0024-7758
          Jul 1991
          : 36
          : 7
          Affiliations
          [1 ] Wyoming Valley GYN/OB Associates, Kingston, Pennsylvania 18704.
          Article
          1834840

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