ABDOMINAL WALL ENDOMETRIOSIS: A MULTIDISCIPLINARY APPROACH (Literature review)

Abstract. Introduction. Abdominal wall endometriosis characterized by the presence of ectopic endometrial glands or stroma in the abdominal wall, is a rare form of extragenital endometriosis, but can have a significant negative impact on the quality of women’s life. Abdominal wall endometriosis is mostly iatrogenic and is associated with cesarean section or gynecological operations involving hysterotomy. Given the steady increase in the frequency of cesarean sections, it is expected that the number of cases of abdominal wall endometriosis will continue to grow. Aim: To provide updated information on abdominal wall endometriosis from an interdisciplinary perspective. Materials and Methods. A review of publications based on research using the keywords endometriosis, abdominal wall endometriosis, scar endometriosis, cesarean section scar endometriosis, umbilical endometriosis, and inguinal endometriosis, based on search results in electronic resources in Russian and international systems (eLibrary, PubMed, MedLine, and Crossref) for the last 7 years, from 2017 to 2024. Results and Discussion. Abdominal wall endometriosis occurs with a frequency of 0.04%–5.5%. A typical manifestation is a painful formation in the abdominal wall. The pain syndrome intensity may be determined by the menstrual cycle phase. Endometrioid foci can develop primarily (spontaneously) and secondarily in the postoperative scar area. By localization, abdominal wall endometriosis is divided into cicatricial, umbilical, and inguinal. The average age as of diagnosis is 32-36 years, while the time from surgery to endometriosis identification varies from 3 months to 2 decades. Clinically, the diagnosis is established in 20-50% of cases, and with using additional imaging methods, such as ultrasound, CT, and MRI, this level reaches 70%. Cases of malignant transformation are extremely rare and amount to about 1%. The question remains controversial regarding the relationship of abdominal wall endometriosis to the presence of other concomitant endometriosis forms. Currently, the gold standard of treatment is wide excision of endometrioid foci, including the surrounding fibrous tissue. The recurrence rate varies from 1.5 to 28.6%. Conclusion. Interdisciplinary collaboration involving gynecologists, surgeons, imaging specialists, and pathologists is necessary for early diagnosis and optimization of abdominal wall endometriosis patient treatment.