Massimiliano MistrangeloNicholas GilboPaola CassoniSalvatore Micalef • Riccardo FalettiClaudio MigliettaRaffaele BrustiaGisella Bonnet •

Gianluca GregoriMario Morino
2014 · W2547902779
article OA: closed CC0 Metadata only
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This retrospective study reviewed five scar endometriosis cases after cesarean section, confirming diagnosis histologically and finding surgical excision with free margins necessary to prevent recurrence.

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Abstract

Endometriosis is a common disorder in females of reproductive age. Surgical scar endometri- oma after cesarean section develops in 1-2 % of patients, and usually presents as a tender and painful abdominal wall mass. The diagnosis is suggested by pre or perimenstrual pelvic pain and is often estab- lished only by histology. In this retrospective obser- vational cohort study, we reviewed the medical records of five patients with a histopathological diagnosis of scar endometriosis. A scar mass was found on a pre- vious Pfannenstiel incision in four patients and in a median cesarean section in one patient. The mean age at diagnosis (38.6 years, median 38) was older than reported elsewhere. A histological examination of the surgical specimen confirmed the diagnosis of endometriosis in all cases. During the follow-up period (mean 34.6 months), local recurrence (n = 1) and pelvic recurrence (n = 1) were treated surgically. Surgery is the treatment of choice for surgical scar endometriosis. Excision with histologically proven free surgical margins of 1 cm is mandatory to prevent recurrence. As scar endometriosis may be associated with pelvic localization, explorative abdominal lapa- roscopy may be indicated to exclude the intraperitoneal spread of the disease in symptomatic patients.

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endometriosis

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