{"paper_id":"2711f7c6-e0be-4392-8a71-fc77c0bdd97c","body_text":"~ 474 ~ \n International Journal of Homoeopathic Sciences 2025; 9(1): 474-478 \n \nE-ISSN: 2616-4493 \nP-ISSN: 2616-4485 \nwww.homoeopathicjournal.com \nIJHS 2025; 9(1): 474-478 \nReceived: 07-11-2024 \nAccepted: 18-12-2024 \n \nDr. Beena Rani M \nMD (HOM), Head of the \nDepartment, Professor (CAP), \nDepartment of Obstetrics and \nGynaecology, Government \nHomoeopathic Medical College, \nKerala University of Health \nSciences, Thiruvananthapuram, \nKerala, India \n \nDr. Filsidas TG \nMD Scholar, Government \nHomoeopathic Medical College, \nKerala University of Health \nSciences, Thiruvananthapuram, \nKerala, India \n \nDr. Abdul Vahab CP \nAssistant Professor, \nDepartment of Obstetrics and \nGynaecology, \nGovernment Homoeopathic \nMedical College, \nThiruvananthapuram, Kerala, \nIndia \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \nCorresponding Author: \nDr. Beena Rani M \nMD (HOM), Head of the \nDepartment, Professor (CAP), \nDepartment of Obstetrics and \nGynaecology, Government \nHomoeopathic Medical College, \nKerala University of Health \nSciences, Thiruvananthapuram, \nKerala, India \n \nA case of scar endometriosis treated with \nhomoeopathy \n \nBeena Rani M, Filsidas TG and Dr. Abdul Vahab CP \n \nDOI: https://doi.org/10.33545/26164485.2025.v9.i1.G.1393  \n \nAbstract \nScar endometriosis is an uncommon condition characterized by the ingrowth of endometrial tissues in \nscars from surgical procedures such as a caesarean section, episiotomy, hysterectomy, salpingostomy \nor herniorrhaphy. A 35 year old female patient presented in gynaecology OPD on 15/01/2024 with the \ncomplaints of pain in left lower abdomen especially around the caesarean scar a day before the \ncommencement of menstrual cycle and for the first four\n days of menstruation. She was diagnosed with \nscar endometriosis . Individualized homoeopathic medicine was given by considering the totality of \nsymptoms of the patient . Silicea 200 along with Thiosinaminum 3X was prescribed for the patient and \nshe showed a marked improvement. The outcome assessment of the case was done by USG before and \nafter treatment. \nThis case study demonstrate the role of individualized homoeopathic medicine in the management of \nrare conditions like scar endometriosis. \n \nKeywords: Scar endometriosis, individualization, Silicea, Thiosinaminum, Homoeopathy \n \nIntroduction \nScar endometriosis is the term for the presence of endometrial-like tissue outside the uterine \ncavity in the scar area after abdominal or pelvic surgery. It is an extra-pelvic endometriosis \nsubtype [1]. \nEndometriosis, which is thought to impact nearly 10% of the reproductive age group, usually \nhappens around the uterus and uterine ligaments, but it can also happen in the lungs, brain, \nurinary tracts, abdominal wall, spleen, gastrointestinal tracts [2]. \nScar endometriosis has been associated with caesarean sections, vaginal deliveries in \nepisiotomy sites, tubectomy, ectopic pregnancies, laparotomies or laparoscopic port sites for \nhysterectomy, ovarian cystectomies, hernial repair sites, and even needle tracking following \namniocentesis [3]. \nCompared to a caesarean delivery at full term during pregnancy, an early hysterectomy \nduring pregnancy is a risk factor for scar endometriosis because the endometrium from an \nearly pregnancy is more conducive to implantation than the endometrium from a late \npregnancy, according to de Oliveira [4]. \nAccording to reports, the prevalence of scar endometriosis in women who have had obstetric \nor gynecologic procedures ranges from 0.03% to 3.5%, and it is rising as more caesarean \ndeliveries and laparoscopies are performed [5]. \nThe exact etiology of surgical scar endometriosis is unknown. Several hypothesis are there to \nexplain its development. The most widely recognized explanation for scar endometriosis is \niatrogenic implantation [6]. \nCommon manifestations include cyclical pain and swelling in the scar area, which are \nusually related to the menstrual cycle [7]. \nA well-defined lump within the surgical scar that may indicate abdominal wall endometriosis \ncan be found with the help of imaging tests like magnetic resonance imaging or ultrasound in \naddition to clinical suspicion. A histological analysis of the removed tissue is necessary for a \nconclusive diagnosis [8]. \nSurgical excision is the primary treatment modality for scar endometriosis [9]. As a holistic \nmedical system, homeopathy offers more potential for managing scar endometriosis because \nit allows for the use of a constitutional approach. Homoeopathy can provide a higher quality \nof life and it prevent the recurrence of the condition.\n \n\nInternational Journal of Homoeopathic Sciences https://www.homoeopathicjournal.com \n~ 475 ~ \nPatient information \nA 35 year old female patient presented in Gynaecology \nOPD on 15/01/2024 with the complaints of pain in left \nlower abdomen especially around the caesarean scar a day \nbefore the commencement of menstrual cycle and for the \nfirst 4 days of menstruation. She had her LSCS about four \nyears back and the presenting complaint started on a gradual \nonset 2 years back as a lump on caesarean scar and recently \nshe had pain in left lower abdomen around the caesarean \nscar especially a day before and four days after menses \nstarts. \nExamination revealed a tender, puckered, subcutaneous \nmass beneath the caesarean scar. \nTransabdominal ultrasound on 21/11/2022 showed a 1.4 \ncm×o.75cm, oval shaped heterogeneous mass in left lower \nabdominal wall at left LSCS scar suggestive of scar \nendometriosis. she took hormonal medications to stop \nmenses for 3 months (February, march, April of 2023). \nShe did transabdominal USG again on 22/05/2023 which \nrevealed a 1.3×0.6 cm, oval shaped heterogeneous mass in \nleft lower abdominal wall at left LSCS scar.  \nThe patient was advised for surgery. Her generals were \ndisturbed during this time. She has low appetite but \nincreased thirst. Sweat is increased. She also had a great \ndesire for sour things. Patient was mentally very anxious \nabout her illness. \n \nGeneral physical examination \nThe patient was moderately built. No pallor, icterus, \ncyanosis, clubbing, oedema or lymphadenopathy were \nobserved. Her pulse rate was 73 / min, blood pressure \n120/80 mm of Hg, temperature 37°C and respiratory rate \n14/min.  \n \nAnalysis of the case \nAfter analysing the disease condition and considering the \ntotality of the patient, an individualised homoeopathic \nmedicine was selected after repertorisation using \nHOMPATH software and further consultation with the \nmateria medica.  \nSilicea 200 was given as the first prescription with \nThiosinaminum 3X as an add on remedy.  \n \n \n \nFig 1: Silicea 200 was given as the first prescription with Thiosinaminum 3X \n \nFollow up \n \nDate Symptoms Prescription \n19/02/2024 Amelioration of complaints Silicea 200 / 1 dose \n26/03/2024 Amelioration of complaints Silicea 200/1 dose \n1/05/2024 Amelioration of complaints, generals were normal Sac lac /4 dose \n2/06/2024 Amelioration of complaints Silicea 1M /1 dose \n \n\nInternational Journal of Homoeopathic Sciences https://www.homoeopathicjournal.com \n~ 476 ~ \nDiagnosis and clinical assessment \n \n \n \nFig 2: USG Before treatment \n \n \n \nFig 3: USG before treatment \n\nInternational Journal of Homoeopathic Sciences https://www.homoeopathicjournal.com \n~ 477 ~ \n \n \nFig 4: USG after treatment \n \nDiscussion \nAn uncommon but clinically relevant disease called scar \nendometriosis results from the ectopic development of \nendometrial tissue in surgical scars after obstetric or \ngynaecological surgeries [4]. \nTenderness along the scar line, persistent pelvic pain, or \neven skin abnormalities like ecchymosis at the scar site \nduring menstruation or scar hyperpigmentation (with or \nwithout tiny local nodules) are some of the symptoms that \npatients display [10]. \nMalignant transformation and recurrence are the side effects \nof surgical scar endometriosis [3]. \nThe primary option for management is between medical and \nsurgical intervention. Surgical excision with broad excision \nmargins has been advised to avoid local recurrence. But not \nevery patient will be open to surgery. \nHomeopathy provides better care for those types of \npatients.This case report showed the classical symptoms of \nscar endometriosis, which was treated with the help of \nindividualised homoeopathic medicine Silicea 200 along \nwith an add on remedy called Thiosinaminum 3X.  \nAccording to William Boericke Silicea can stimulate the \norganism to reabsorb fibrotic conditions and scar tissue [11]. \nThiosinaminum is an effective remedy for dissolving scar \ntissue according to various studies [12]. \nThe USG scan showed no sonological abnormalities after 6 \nmonths of effective homoeopathic treatment. Silicea 1M is \ngiven to prevent the further recurrences of the condition.  \nThis case study shows the effectiveness of homoeopathic \nremedy in managing rare diseases like scar endometriosis.  \nConclusion \nThe effectiveness of homeopathic therapy in treating scar \nendometriosis is illustrated by this case study. It also \nsuggests that homeopathy would be the best option in \nsurgical circumstances like these. \n \nConflict of Interest \nNot available  \n \nFinancial Support \nNot available \n \nReferences \n1. Gruber TM, Lange K, Ebeling GS, Henrich W, \nMechsner S. Scar endometriosis, a form of abdominal \nwall endometriosis-a neglected obstetrical \ncomplication? Arch Gynecol Obstet [Internet]. 2024 \nNov 28 [cited 2025 Jan 25]; Available from: \nhttps://doi.org/10.1007/s00404-024-07834-2 \n2. Nepali R, Upadhyaya Kafle S, Pradhan T, Dhamala JN. \nScar Endometriosis: A Rare Cause of Abdominal Pain. \nDermatopathology. 2022 May 5;9(2):158-63. \n3. Durairaj A, Sivamani H, Panneerselvam M. Surgical \nScar Endometriosis: An Emerging Enigma. Cureus. \n2023 Feb;15(2):e35089. \n4. Mistrangelo M, Gilbo N, Cassoni P, Micalef S, Faletti \nR, Miglietta C, et al. Surgical scar endometriosis. Surg \nToday. 2014 Apr 1;44(4):767-72. \n5. Zhong Q, Qin S, Lai H, Yao S, Chen S. Risk factors for \npostoperative recurrence of cesarean scar \n\nInternational Journal of Homoeopathic Sciences https://www.homoeopathicjournal.com \n~ 478 ~ \nendometriosis. AJOG Glob Rep. 2024 May \n1;4(2):100349. \n6. Liang CC, Liou B, Tsai CC, Chen TC, Soong YK. Scar \nendometriosis. Int Surg. 1998;83(1):69-71. \n7. Kyejo W, Moshi B, Massanga E, Ntiyakunze G, \nMgonja M, Kaguta M, et al . Abdominal wall \nendometriosis in cesarean scar: A case report. SAGE \nOpen Med Case Rep. 2024 Jan \n1;12:2050313X241237333. \n8. Rodrigo SNK, Kumarasinghe I, Gunasekera ED. \nCaesarean scar endometriosis: how to make an accurate \ndiagnosis. BMJ Case Rep CP. 2024 Nov \n1;17(11):e261053. \n9. Zhang P, Sun Y, Zhang C, Yang Y, Zhang L, Wang N, \net al. Cesarean scar endometriosis: presentation of 198 \ncases and literature review. BMC Womens Health. \n2019 Jan 18;19(1):14. \n10. Sihag P, Kudri B, Chandel M, Tandon A, Chowdhary \nR. Scar Endometriosis: A Black and White Review of a \nRed Giant. 2024. \n11. Boericke W. Silicea terra - homoeopathic materia \nmedica. [Internet]. [cited 2025 Jan 26]. Available from:  \nhttp://www.homeoint.org/books/boericmm/s/sil.htm \n12. Boericke W. Thiosinaminum - homoeopathic materia \nmedica. [Internet]. [cited 2025 Jan 26]. Available from : \nhttp://www.homeoint.org/books/boericmm/t/thiosin.ht\nm \n \nHow to Cite This Article \nRani BM, Filsidas TG , A Vahab CP  A case of scar endometriosis \ntreated with homoeopathy . International Journal of Homoeopathic \nSciences. 2025;9(1):474-478. \n \n \nCreative Commons (CC) License \nThis is an open access journal, and articles are distributed under the  \nterms of the Creative Commons Attribution-NonCommercial-\nShareAlike 4.0 International (CC BY-NC-SA 4.0) License, which \nallows others to remix, tweak, and build upon the work non-\ncommercially, as long as appropriate credit is given and the new \ncreations are licensed under the identical terms.","source_license":"CC0","license_restricted":false}