Perineal endometriosis: a case report and review of the literature

Abstract

Endometriosis is the presence of endometrial-like tissue outside the uterine cavity, which most commonly affects peritoneal surfaces, ovaries and uterine ligaments. Even it is quite rare, endometriosis may affect the vulva, vagina, rectovaginal septum or perineal region, generally secondary to obstetric or surgical trauma. In this case report, we present a patient with perineal endometriosis in an episiotomy scar. Diagnostic tools used included transvaginal and endorectal ultrasonography (USG), magnetic resonance imaging (MRI) and biopsy. The endometriotic mass was wide-excised together with episiotomy scar. The recovery was uneventful with excellent functional and esthetic results. Six months after operation, woman is asymptomatic. According to the literature and our own experience, wide excision of endometriotic tissue seems to be the best chance of cure with satisfactory functional results and should be recommended.

Perineal scar endometriosis: a comparison of two cases

“…There was no discolouration of the perineal skin, no local swelling or periodic leakage of dark coloured fluid. In some cases, bloody discharge oozing out from the scar has been reported,2 while a visible swelling was present in one case 3…”

Recurrent Scar Endometriosis Developing in the episiotomy

“…However, incisional endometriosis as a result of recurrent caesarean sections laparoscopic surgery and also endometriosis on scars of trocar site have been reported. Also, literature reveals cases of episiotomy scar endometriosis developing on the scars of episiotomy incision performed during vaginal birth 2,3 . Laadi et al 4 have reported the case of deep endometriosis developing in the episiotomy scar.…”

Spontaneous hymeneal endometriosis: a rare cause of dyspareunia

“…Endometriosis is characterised by ectopic growth of endometrial tissue outside the uterine cavity5 and can cause dyspareunia when it affects the perineum and the vulva 2. Vulvar endometrial lesions usually occur after surgery6 or trauma7 but rarely spontaneously 8–10. The most common sites are episiotomy scars,6 11 Bartholin’s gland12 and more rarely labia majora2 or labia minora 13…”