{"paper_id":"6976df4c-f84a-4129-9957-67378f61391e","body_text":"Abstract\nPerineal endometriosis with anal sphincter involvement is a rare occurrence with only nine cases reported so far. Two such cases are presented, and the literature is reviewed. In presented cases, diagnosis was suspected at clinical exam. Anal manometry was performed in both cases and endoanal ultrasound in one case. Wide surgical excision of endometriotic mass together with part of external anal sphincter was carried out in both cases. The procedure was followed by anal sphincter reconstruction in an “overlapping” fashion in the first and “apposition” technique in the second case. Histopathologic tests confirmed endometriosis. The recovery was uneventful in both cases with excellent functional results. Two years after the operation, patients are asymptomatic and fully continent. According to the literature and our own experience, wide excision of endometrioma with primary sphincteroplasty seems to be the best chance of cure with satisfactory functional results and should be recommended.\nSimilar content being viewed by others\nReferences\nPunnonen R, Klemi PJ, Nikkanen V (1980) Postmenopausal endometriosis. Eur J Obstet Gynecol Reprod Biol 11:195–200\nHenriksen E (1955) Endometriosis. Am J Surg 90:331–337\nRanney B (1971) Endometriosis. 3. Complete operations. Reasons, sequelae, treatment. Am J Obstet Gynecol 109:1137–1144\nSchickele M (1923) Les pseudolipomes du ligament large. Bull Mem Soc Anat Paris 20:603–605\nSampson JA (1921) Perforating hemorrhagic (chocolate) cysts of the ovary: their importance and especially their relation to pelvic adenomas of endometrial type. Arch Surg 3:245\nBeischer NO (1966) Endometriosis of an episiotomy scar cured by pregnancy. Obstet Gynecol 28:15–21\nHeaps JM, Nieberg RK, Berek JS (1990) Malignant neoplasms arising in endometriosis. Obstet Gynecol 75:1023–1028\nDougherty LS, Hull T (2000) Perineal endometriosis with anal sphincter involvement: report of a case. Dis Colon Rectum 43:1157–1160\nDeCherney AH, Pernall ML (1995) Current obstetric and gynecologic diagnosis and treatment. Appleton & Lang, Norwalk, pp 801–807\nSperoff L, Glass RH, Kase NG (1994) Clinical gynecologic endocrinology and infertility, 5th ed. Williams & Wilkins, pp 853–865\nMatigbay PM, Heppel J, Leslie KO (2001) Endometriosis-associated invasive adenocarcinoma involving the rectum in a postmenopausal female. Dis Colon Rectum 44:1530–1533\nKanellos I, Kelpis T, Zaraboukas T, Betsis D (2001) Perineal endometriosis in episiotomy scar with anal sphincter involvement. Tech Coloproctol 5:107–108\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nBarisic, G.I., Krivokapic, Z.V. & Jovanovic, D.R. Perineal endometriosis in episiotomy scar with anal sphincter involvement: report of two cases and review of the literature. Int Urogynecol J 17, 646–649 (2006). https://doi.org/10.1007/s00192-005-0022-5\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00192-005-0022-5","source_license":"CC0","license_restricted":false}