EXTRAGENITAL ENDOMETRIOSIS: CLINICAL AND ANAMNESTIC FEATURES

In: Medicine in Kuzbass; Том 20, № 2 (2021): июнь; 47-49 · 2021 · W4392284086
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This retrospective study analyzed 30 women with extragenital endometriosis, finding that lesions in the anterior abdominal wall were exclusively associated with prior cesarean sections.

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This retrospective study analyzed the clinical and anamnestic characteristics of thirty women diagnosed with extragenital endometriosis between 2017 and 2020. The findings indicated that all patients had undergone cesarean sections, with lesions predominantly located in anterior abdominal wall postoperative scars or soft tissues. Ultrasound examinations revealed hypoechoic formations within these scar structures, confirming the direct association between surgical interventions, particularly operative childbirth, and the development of this pathology. This paper is centrally about endometriosis — specifically focusing on the rare presentation of extragenital disease arising from prior surgical sites such as cesarean section scars.

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Abstract

Objective – to determine the clinical and anamnestic features of women with extragenital endometriosis. Materials and methods. 150 medical histories of women with endometriosis were retrospectively studied, 30 of them were women with extragenital endometriosis, treated in the KKB of the M.A. Podgorbunsky SMP for 2017-2020. The average age of the patients was 36.9 ± 14.31 years. Results. According to the localization of extragenital endometriosis, a lesion of the anterior abdominal wall was found: postoperative scar – 23 cases (76.6 %), soft tissue – 7 cases (23.3 %). From the life history of these patients, it was found that all of them were delivered by cesarean section, in an emergency – 20 women (66.6 %), in a planned – 10 (33.4 %). Concomitant gynecological pathology in the form of abnormal uterine bleeding was in 5 women (16.6 %), PCOS – in 5 (16.6 %), primary infertility – in 4 (13.3 %), uterine fibroids – in 2 (6.6 %). All patients were examined on an outpatient basis and sent for planned surgical treatment. According to the results of ultrasound of the pelvic organs, hypoechoic formations up to 2 cm in size were found in the structure of the anterior abdominal wall in the area of the postoperative scar in 21 cases (70 %), from 2 to 3.5 cm – in 9 (30 %). When performing surgical treatment of a postoperative scar with laparotomic access along the old scar, a dense scar was found in women Conclusion. Extragenital endometriosis is a fairly rare pathology. Endometriosis of the postoperative scar and soft tissues is undoubtedly directly related to surgical interventions, primarily operative childbirth.
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Abstract

Objective – to determine the clinical and anamnestic features of women with extragenital endometriosis.

Materials

and methods. 150 medical histories of women with endometriosis were retrospectively studied, 30 of them were women with extragenital endometriosis, treated in the KKB of the M.A. Podgorbunsky SMP for 2017-2020. The average age of the patients was 36.9 ± 14.31 years. Results. According to the localization of extragenital endometriosis, a lesion of the anterior abdominal wall was found: postoperative scar – 23 cases (76.6 %), soft tissue – 7 cases (23.3 %). From the life history of these patients, it was found that all of them were delivered by cesarean section, in an emergency – 20 women (66.6 %), in a planned – 10 (33.4 %). Concomitant gynecological pathology in the form of abnormal uterine bleeding was in 5 women (16.6 %), PCOS – in 5 (16.6 %), primary infertility – in 4 (13.3 %), uterine fibroids – in 2 (6.6 %). All patients were examined on an outpatient basis and sent for planned surgical treatment. According to the results of ultrasound of the pelvic organs, hypoechoic formations up to 2 cm in size were found in the structure of the anterior abdominal wall in the area of the postoperative scar in 21 cases (70 %), from 2 to 3.5 cm – in 9 (30 %). When performing surgical treatment of a postoperative scar with laparotomic access along the old scar, a dense scar was found in women Conclusion. Extragenital endometriosis is a fairly rare pathology. Endometriosis of the postoperative scar and soft tissues is undoubtedly directly related to surgical interventions, primarily operative childbirth.

Keywords

Article Details Information about financing and conflict of interests The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article. This work is licensed under a Creative Commons Attribution 4.0 License. How to Cite

References

Parazzini F, Esposito G, Tozzi L, Noli S, Bianchi S. Epidemiology of endometriosis and its comorbidities. Eur J Obstet Gynecol Reprod Biol. 2017; 209: 3-7. DOI: 10.1016/j.ejogrb.2016.04.021 Cozzolino M, Coccia ME, Lazzeri G, Basile F, Troiano G. Variables Associated with Endometriosis-related Pain: A Pilot Study using a Visual Analogue Scale. Rev Bras Ginecol Obstet. 2019; 41(3): 170-175. DOI: 10.1055/s-0039-1679879 Guideline N. Endometriosis: diagnosis and management. 2017 Van den Bosch T, Van Schoubroeck D. Ultrasound diagnosis of endometriosis and adenomyosis: State of the art. Best Pract Res Clin Obstet Gynaecol. 2018; 51: 16-24. DOI: 10.1016/j.bpobgyn.2018.01.013 Noventa M, Saccardi C, Litta P, Vitagliano A, D'Antona D, Abdulrahim B, et al. Ultrasound techniques in the diagnosis of deep pelvic endometriosis: algorithm based on a systematic review and meta-analysis. Fertil Steril. 2015; 104(2): 366-383.e2. DOI: 10.1016/j.fertnstert.2015.05.002 Barbieri R. L. Why are there delays in the diagnosis of endometriosis? OBG OBG Manag. 2017; 29(3): 8, 10-11 Tomassetti C, Bafort C, Meuleman C, Welkenhuysen M, Fieuws S, D'Hooghe T. Reproducibility of the Endometriosis Fertility Index: a prospective inter-/intra-rater agreement study. BJOG. 2020; 127(1): 107-114. DOI: 10.1111/1471-0528.15880 Anglesio MS, Yong PJ. Endometriosis-associated Ovarian Cancers. Clin Obstet Gynecol. 2017; 60(4): 711-727. DOI: 10.1097/GRF.0000000000000320 Clinical guidelines. Obstetrics and gynecology. 4th ed. /ed. VN Serova, GT Suchich. M.: GEOTAR-Media, 2014. 1024 p. Russian (Клинические рекомендации. Акушерство и гинекология. 4 е изд. /под ред. В.Н. Серова, Г.Т. Сухих. М.: ГЭОТАР-Медиа, 2014. 1024 с.) Clinical guidelines «Endometriosis». LLC «ROAG», 2020. 60 p. Russian (Клинические рекомендации «Эндометриоз». ООО «РОАГ», 2020. 60 с.)

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