OBJECTIVE To study reproductive outcomes, and pregnancy and delivery complications after conservative or operative treatment of rectovaginal endometriosis during long-term follow-up. DESIGN Retrospective cohort study. SETTING University hospital. PATIENT(S) Women with rectovaginal endometriosis referred to hospital due to any indication from 2004 to 2013 (N = 543) who were treated initially either conservatively (group CONS, n = 183), or operatively (OPER, n = 360) either with resection of rectovaginal nodule (RVR, n = 192) or with concomitant bowel resection (BR, n = 132). INTERVENTION(S) Conservative or operative management. MAIN OUTCOME MEASURE(S) Clinical pregnancy rate, live-birth rate, and assessment of the complications during pregnancy and delivery. RESULTS(S) Between women in the CONS group or OPER group, no differences were found in either clinical pregnancy rate (56%, n = 102 vs. 50%, n = 181) or live-birth rate (48%, n = 87 vs. 42%, n = 153). Of the pregnancies, 64% (n = 65) and 49% (n = 89), respectively, started after medically assisted reproduction. No differences emerge in the subanalysis of women <40 years-old who wished to conceive. The most common pregnancy complication was preterm birth: 15% (n = 13) in the CONS group and 20% (n = 30) in the OPER group. The cesarean delivery rate also was high (46%, n = 40 vs. 49%, n = 76). Complications emerged in 21% (n = 10) versus 29% (n = 23) of vaginal deliveries and 45% (n = 18) versus 53% (n = 40) of cesarean deliveries. The most common delivery complication was excessive bleeding. The follow-up period was 4.9 years in the CONS group and 5.6 years in the OPER group. CONCLUSION(S) Women with rectovaginal endometriosis have comparable and good reproductive prognosis regardless of the treatment method.

中文翻译：

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保守或手术治疗直肠阴道子宫内膜异位症妇女的妊娠和分娩结果

目的 长期随访研究直肠阴道子宫内膜异位症保守或手术治疗后的生殖结局、妊娠和分娩并发症。设计 回顾性队列研究。设置大学医院。患者 (S) 2004 年至 2013 年因任何适应症转院的直肠阴道子宫内膜异位症女性 (N = 543)，最初接受保守治疗（CONS 组，n = 183）或手术治疗（OPER，n = 360）直肠阴道结节切除术（RVR，n = 192）或伴随肠切除术（BR，n = 132）。干预 (S) 保守或运营管理。主要结局指标 (S) 临床妊娠率、活产率以及妊娠和分娩期间并发症的评估。结果 (S) 在 CONS 组或 OPER 组中的女性之间，在临床妊娠率（56%，n = 102 vs. 50%，n = 181）或活产率（48%，n = 87 vs. 42%，n = 153）方面没有发现差异。在这些怀孕中，分别有 64% (n = 65) 和 49% (n = 89) 在医学辅助生殖后开始。在希望怀孕的 <40 岁女性的亚组分析中没有出现差异。最常见的妊娠并发症是早产：CONS 组为 15% (n = 13)，OPER 组为 20% (n = 30)。剖宫产率很高（46%，n = 40 vs. 49%，n = 76）。并发症出现在 21% (n = 10) 与 29% (n = 23) 的阴道分娩和 45% (n = 18) 与 53% (n = 40) 的剖宫产中。最常见的分娩并发症是出血过多。CONS 组的随访期为 4.9 年，OPER 组为 5.6 年。