{"paper_id":"d2f0e2b9-39de-46f6-b019-da7cbb598aa8","body_text":"Abstract\nIt is difficult to conduct studies with larger series in rarely observed diseases. We report our experience in managing cesarean scar endometriosis (CSE) and emphasize the diagnosis and treatment options. The objective of our study is to review the clinical characteristics of CSE and to evaluate our surgical outcomes. We have collected and documented a case series of 12 patients who underwent surgical wide en bloc excision with surrounding clear margins for CSE. Patients’ demographic features, symptoms, and clinical and operative findings were evaluated. The mean age was 34.6 years. Cyclical pain was documented in seven patients, while three patients presented with noncyclical pain. Menstrually-related enlargement of the nodule was observed in four patients, and only one patient had a complaint of dark brown leakage. The mean operation time was 26 min. The endometriotic lesions ranged from a diameter of 2 to 8 cm in size. Patients recovered completely, and no recurrence was observed. To prevent iatrogenic transplantation, additional attention is needed during surgery that exposes endometrial tissue. Complete wide excision of CSE is both diagnostic and therapeutic. To avoid unnecessary referrals, awareness of its typical clinical manifestations remains the mainstay for intervention. The most important issues to be considered during surgery is nonspreading endometriosis while manipulation.\nSimilar content being viewed by others\nReferences\nPaşalega M, Mirea C, Vîlcea ID et al (2011) Parietal abdominal endometriosis following cesarean section. Rom J Morphol Embryol 52:503–508\nde Oliveira MA, de Leon AC, Freire EC, de Oliveira HC (2007) Risk factors for abdominal scar endometriosis after obstetric hysterotomies: a case–control study. Acta Obstet Gynecol Scand 86:73–80\nLeite GK, Carvalho LF, Korkes H, Guazzelli TF, Kenj G, Viana Ade T (2009) Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature. Sao Paulo Med J 127:270–277\nWang PH, Juang CM, Chao HT, Yu KJ, Yuan CC, Ng HT (2003) Wound endometriosis: risk factor evaluation and treatment. J Chin Med Assoc 66:113–119\nAl-Jabri K (2009) Endometriosis at caesarian section scar. Oman Med J 24:294–295\nFrancica G (2012) Reliable clinical and sonographic findings in the diagnosis of abdominal wall endometriosis near cesarean section scar. World J Radiol 4:135–140\nChang Y, Tsai EM, Long CY, Chen YH, Kay N (2009) Abdominal wall endometriomas. J Reprod Med 54:155–159\nNominato NS, Prates LF, Lauar I, Morais J, Maia L, Geber S (2010) Caesarean section greatly increases risk of scar endometriosis. Eur J Obstet Gynecol Reprod Biol 152:83–85\nChatzikokkinou P, Thorfinn J, Angelidis IK, Papa G, Trevisan G (2009) Spontaneous endometriosis in an umbilical skin lesion. Acta Dermatovenerol Alp Panonica Adriat 18:126–130\nDelicata RJ, Clark GW, Roy MK, Shaw RW, Carey PD (1996) Presentation of endometriosis to general surgeons: a 10-year experience. Br J Surg 83:711\nOlejek A, Zamlynski J, Podwinska, Horak S, Paliga-Zytniewska M, Kellas-Sleczka S (2008) Abdominal wall endometrioma in the cesarean section scar. Ginekol Pol 79:612–615\nChiang DT, Teh WT (2006) Cutaneous endometriosis—surgical presentations of a gynaecological condition. Aust Fam Physician 35:887–888\nGunes M, Kayikcioglu F, Ozturkoglu E, Haberal A (2005) Incisional endometriosis after cesarean section, episiotomy and other gynecologic procedures. J Obstet Gynaecol Res 31:471–475\nPicod G, Boulanger L, Bounoua F, Leduc F, Duval G (2006) Abdominal wall endometriosis after caesarean section: report of fifteen cases. Gynecol Obstet Fertil 34:8–13\nMinaglia S, Mishell DR Jr, Ballard CA (2007) Incisional endometriomas after cesarean section: a case series. J Reprod Med 52:630–634\nWasfie T, Gomez E, Seon S (2002) Abdominal wall endometrioma after cesarean section: a preventable complication. Int Surg 87:175–177\nWicherek L, Klimek M, Skret-Magierlo J et al (2007) The obstetrical history in patients with Pfannenstiel scar endometriomas—an analysis of 81 patients. Gynecol Obstet Invest 63:107–113\nSengul I, Sengul D, Kahyaoglu S, Kahyaoglu I (2009) Incisional endometriosis: a report of 3 cases. Can J Surg 52:444–445\nJamabo RS, Ogu RN (2008) Abdominal scar endometriosis. Indian J Surg 70:184–187\nDouglas C, Rotimi O (2004) Extragenital endometriosis—a clinicopathological review of a Glasgow hospital experience with case illustrations. J Obstet Gynaecol 24:804–808\nConflict of Interest\nWe declare that we have no conflicts of interest and no funding was received for this work.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nUçar, M.G., Şanlıkan, F. & Göçmen, A. Surgical Treatment of Scar Endometriosis Following Cesarean Section, a Series of 12 Cases. Indian J Surg 77 (Suppl 2), 682–686 (2015). https://doi.org/10.1007/s12262-013-0978-1\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s12262-013-0978-1","source_license":"CC0","license_restricted":false}