Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature

Abstract

CONTEXT AND OBJECTIVE: The incidence of scar endometrioma ranges from 0.03 to 3.5%. Certain factors relating to knowledge of the clinical history of the disease make correct diagnosis and treatment difficult. The aim here was to identify the clinical pattern of the disease and show surgical results. The literature on this topic was reviewed. DESIGN AND SETTING:Retrospective descriptive study at Hospital Municipal Maternidade -Escola Dr. Mário de Moraes Altenfelder Silva. idade, antecedentes obstétricos, sintomatologia, localização, tamanho e palpação do tumor, duração da queixa, diagnóstico, tratamento. Todas as pacientes foram submetidas a exerese da massa tumoral com margem de segurança. METHODS: RESULTADOS:Foram encontrados 33 pacientes com média de idade 30,1 (± 5,0), variando de 18 a 41 anos. A incidência total foi de 0,11%, nas cesarianas foi de 0,29% e nos partos vaginais, 0,01%. Localização do tumor: 29 casos em cicatriz de cesária (87,9%), dois em região umbilical (6,0%) e dois em cicatriz de episiotomia (6,0%). A principal sintomatologia foi dor cíclica localizada (66,7%), com duração média de 30,5 meses (± 23). O tratamento cirúrgico foi realizado com sucesso em todas as pacientes.CONCLUSÃO: Trata-se de uma doença incomum. O dado de maior importância diagnóstica foi: coincidência da sintomatologia dolorosa com a menstruação. Pacientes submetidas a cesariana têm maior risco (risco relativo = 27,37 e P < 0,01). O tratamento cirúrgico de escolha é exerese do endometrioma com margem de segurança.

Abdominal wall endometriosis: an update in clinical, imagistic features, and management options

“…The prevalence of AWE is generally estimated to be between 0.03% and 1% [4,5]. Leite et al estimate that AWE will appear in 0.03 to 3.5% of cases after obstetric procedures [3]. It is expected that its frequency will rise along with the increasing rate of cesarean deliveries being performed.…”

“…Abdominal wall endometriosis (AWE) may be an underreported pathology, partly because it has scarcely received attention in the radiologic literature. Dissemination of information regarding AWE outside the field of obstetrics and gynecology may be useful for guiding other physicians regarding the correct therapeutic approach to adopt, thus preventing re currence and malignant disease [3].…”

Painless Mass in Episiotomy Scar: A Different Presentation of Endometriosis

“…2 Vajinal doğum sonrasında epizyotomi skarında endometriyoz görülme sıklığı yaklaşık %0,01 olarak bildirilmiştir. 6 Ayrıca vajinal doğumda oluşabi-lecek perineal travma, özellikle perine yırtığı ve epizyotomi ile bu oranın artabileceği gösterilmiş-tir. 7 Olgumuzdaki perineal endometriyozun vajinal doğum sırasında implantasyon sonucu olduğunu ve epizyotominin bu durumu artırıcı etkisi olduğunu düşünmekteyiz.…”

Intramuscular Abdominal Wall Endometriosis Treated by Ultrasound-Guided Ethanol Injection

“…The mean time between clinical presentation and surgery was found to be 3.6 years. 4 A retrospective study with 33 patients by Leite et al 6 reported that endometriosis incidence caused by Caesarean scar was 0.29%, and endometriosis incidence caused by episiotomy Endometriosis treated by ethanol injection scar after vaginal delivery was 0.01%. It should be noted that pain cannot be cyclic at all times.…”