Endometriosis is a common cause of cyclical abdominal pain and infertility in young women. A small proportion of women with more severe forms of endometriosis have disease, which affects the rectum or other parts of the intestine. This may cause painful bowel movements, cyclical changes in bowel function, severe constipation or diarrhoea. Intestinal endometriosis may be difficult to diagnose prior to surgery as it is not readily detected at colonoscopy or on CT or MRI scans. Even at laparoscopy inexperienced operators may find some forms of endometriosis difficult to detect.
When endometriosis affects the intestine, we see plaques or nodules of hard fibrous tissue infiltrating into the muscle layers of the bowel. It does not separate easily from the bowel wall. For women with severe symptoms or infertility, surgery to remove part of the rectum, colon or small bowel may be needed to adequately treat these patients. This type of surgery can be performed laparoscopically (keyhole surgery) but it greatly increases the complexity of the operation. Women may stay in hospital for around 6 days and it may take up to 8 weeks to recover from the surgery. Bowel function may be permanently altered. Although complications from this type of surgery are rare, they may sometimes be very serious. It is important you discuss these risks fully with your surgeon prior to proceeding with an operation.