Long term follow-up of inguinal endometriosis

Abstract

Background Inguinal endometriosis (IEM) is a rare extra pelvic endometriosis. Here, we study the clinical characteristics, management strategies, and long-term gynecological outcomes of IEM patients at Beijing Chaoyang Hospital. Case presentation Three patients presented with a total of four lesions (one on the left side, one on the right side, and one bilaterally). The diameters of the four lesions were 2 cm, 2 cm, 3.5 cm and 1.5 cm, respectively. Two patients were admitted with inguinal hernias. Two patients were admitted with endometrioses—one with ovarian endometriosis and one with pelvic endometriosis. The hernia sac was repaired concomitantly via excision of the round ligament in two patients. One patient underwent a concomitant laparoscopy for gynecologic evaluations, including an ablation to the peritoneal endometriosis, and resection of the left uterosacral ligament endometriosis and pelvic adhesiolysis. All lesions were located on the extraperitoneal portion of the round ligament and were diagnosed histologically. No recurrence was observed in the inguinal region. All patients diagnosed with adenomyosis were treated with medication alone without any complaints. Conclusions Inguinal endometriosis can occur simultaneously with pelvic endometriosis. In most cases, a concomitant hernia sac appears together with groin endometriosis. Clinical management should be individualized and performed in tandem with general practitioners and obstetrics & gynecology experts. Pelvic disease, in particular, should be followed-up by a gynecologist.

Surgical management of inguinal endometriosis: Case report and surgical video

“…Observant management should be preferentially reserved for asymptomatic patients. Hormonal treatment has been underreported as a therapeutic strategy for inguinal endometriosis [14,15], and is typically reserved for patients who decline surgical management. In a small retrospective study, oral contraceptives were effective in symptomatic treatment of 1 of 4 patients without significant adverse effects, whereas dienogest effectively improved pain in 6 of 7 cases [4].…”

Hormonal Therapy for Inguinal Endometriosis

“…Catamenial symptoms (e.g., variations in mass size and tenderness) and magnetic resonance (MR) imaging findings can raise suspicion for inguinal endometriosis [4]. Frequently, patients undergo surgical procedures with a preoperative diagnosis of hernia, and endometriosis is incidentally discovered or identified through histologic examination [6,16]. Surgical excision may be the treatment of choice for inguinal endometriosis, but hormone medications can alleviate symptoms associated with endometriosis and serve as an alternation for patients who do not want surgery.…”

Estrogen Regulates the Expression and Function of lncRNA-H19 in Ectopic Endometrium

“…In the future estrogen/lncRNA-H19/miR-124-3p/ITGB3 pathway studies should be conducted in ecEECs and further in-vivo studies are also required. (3) The study had a relatively small sample size, especially in the control group, due to time and funding constraints. More studies with larger sample sizes are needed to confirm the conclusion.…”

“…Endometriosis is one of the most prevalent gynecological disorders in women of reproductive age, 1,2 and is defined as the presence of endometrial-like tissue at sites other than the uterine cavity. [3][4][5][6] At present, the pathogenesis of endometriosis is still not understood well, 7 but ectopic endometrium will atrophy and the progress of endometriosis can be prevented by inhibiting ovarian function and decreasing estrogen level, suggesting that endometriosis is an estrogen-dependent disorder. At the same time, some previous studies showed that there was an increase estrogen level in endometriosis lesions, which explained the pathogenesis of postmenopausal endometriosis.…”