{"paper_id":"0872dd3e-9321-4601-b0a4-931962fbf5f1","body_text":"Abstract\nPurpose\nTo demonstrate the appropriate diagnosis and treatment of perineal endometriosis.\nMethods\nSeventeen patients who presented with a tender perineal mass coinciding with the menstrual cycle on the scar of a previous vaginally procedure were examined retrospectively. Their clinical features and treatment were analyzed.\nResults\nAll patients presented with a palpable painful lesion. All of them had had vaginal delivery with episiotomy. The mean age of the patients was 34.35 years. The mean latent period was 46.82 months. The mean size was 2.38 cm. Thirteen patients presented with one subcutaneous nodule and four had multiple nodules. Color Doppler ultrasound revealed a subcutaneous nodule with an irregular outline and echo-complex density underlying the episiotomy scar. Only one patient suffered from perineal endometriosis combined with pelvic endometriosis. All endometriotic masses in perineum were completely excised and cured, and confirmed by the microscopic examination.\nConclusions\nA detailed history and thorough pelvic examination are essential in diagnosing perineal endometriosis. Surgical intervention is the first choice of treatment.\nSimilar content being viewed by others\nReferences\nGiudice LC, Kao LC (2004) Endometriosis. Lancet 364:1789–1799\nCai SQ, Zheng M, Man XY (2014) Perineal endometriosis: a case report. Int J Clin Exp Med 7:2939–2940\nBuda A, Ferrari L, Marra C, Passoni P, Perego P, Milani R (2008) Vulvar endometriosis in surgical scar after excision of the Bartholin gland: report of a case. Arch Gynecol Obstet 277:255–256\nNasu K, Okamoto M, Nishida M, Narahara H (2013) Endometriosis of the perineum. J Obstet Gynecol Res 39:1095–1097\nZhu L, Lang J, Wang H, Liu Z, Sun D, Leng J, Zhou H, Cui Q, Wong F (2009) Presentation and management of perineal endometriosis. Int J Gynaecol Obstet 105:230–232\nWatanabe M, Kamiyama G, Yamazaki K, Hiratsuka K, Takata M, Tsunoda A, Shibusawa M, Kusano M (2003) Anal endosonography in the diagnosis and management of perineal endometriosis: report of a case. Surg Today 33:630–632\nGunes M, Kayikcioglu F, Ozturkogu E, Haberal A (2005) Incisional endometriosis after cesarean section, episiotomy and other gynecologic procedures. J Obstet Gynaecol Res 31:471–475\nAudebert AJ (1990) External endometriosis: histogenesis, etiology and natural course. Rev Prat 40:1077–1081\nHaley JC, Mirowski GW, Hood AF (1998) Benign vulvar tumors. Semin Cutan Med Surg 17:196–204\nCinardi N, Franco S, Centonze D, Giannone G (2011) Perineal scar endometriosis ten years after Mile’s procedure for rectal cancer: case report and review of the literature. Int J Surg Case Rep 2:150–153\nDragoumis K, Mikos T, Zafrakas M, Assimakopoulos E, Stamatopoulos P, Bontis J (2004) Endometriotic uterocutaneous fistula after cesarean section. Gynacol Obstet Invest 57:90–92\nSavelli L, Manuzzi L, Di Donato N, Salfi N, Trivella G, Ceccaroni M, Seracchioli R (2012) Endometriosis of the abdominal wall: ultrasonographic and Doppler characteristics. Ultrasound Obstet Gynecol 39:336–340\nZorbas KA, Economopoulos KP, Vlahos NF (2015) Continuous versus cyclic oral contraceptives for the treatment of endometriosis: a systematic review. Arch Gynecol Obstet. doi:10.1007/s00404-015-3641-1\nAndres MP, Lopes LA, Baracat EC, Podgaec S (2015) Dienogest in the treatment of endometriosis: systematic review. Arch Gynecol Obstet. doi:10.1007/s00404-015-3681-6\nChene G, Darcha C, Dechelotte P, Mage G, Canis M (2007) Malignant degeneration of perineal endometriosis in episiotomy scar, case report and review of the literature. Int J Gynecol Cancer 17:709–714\nConflict of interest\nAll authors declare no conflict of interests and funding in the manuscript, including financial, consultant, institutional and other relationships that might lead to bias.\nEthical standards\nThe manuscript does not contain clinical studies or patient data.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nLi, J., Shi, Y., Zhou, C. et al. Diagnosis and treatment of perineal endometriosis: review of 17 cases. Arch Gynecol Obstet 292, 1295–1299 (2015). https://doi.org/10.1007/s00404-015-3756-4\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-015-3756-4","source_license":"CC0","license_restricted":false}