Rectovaginal endometriosis is a severe variant of endometriosis. Common 
presenting symptoms for endometriosis include dysmenorrhoea, pelvic pain and 
dyspareunia. It is now recognised that there are other less traditional symptoms 
of endometriosis that are also relatively common. The aim of this study is to 
assess the relative strength of each of the potential symptoms of rectovaginal 
endometriosis and compare these with the laparoscopic and histological findings. 
In this retrospective, observational study the overall prevalence of 
rectovaginal endometriosis in the group was 31.4%. The presence of dyschesia 
gave a likelihood ratio of 1.27 (95% CI: 0.56 - 2.89) with a predictive 
prevalence of rectovaginal endometriosis of 37%. Apareunia and nausea or 
abdominal bloating were particularly strong markers for rectovaginal disease 
with a predictive prevalence of 87% and 89%, respectively. The classical 
symptoms often attributed to irritable bowel syndrome are also common in women 
with rectovaginal disease.