Патогенетичні особливості та передумови розвитку ендометріозу післяопераційного рубця

Postoperative scar endometriosis (PSE) is a rare form of extragenital endometriosis, occurring in 0.03–1.5% of women.The objective: to determine the pathogenetic features and background for the formation of PSE based on the clinical and statistical analysis of the examined women.Materials and methods. Analysis of anamnestic data and examination of 30 women with PSE after a cesarean section (CS), who were included in the study group, was conducted. Control group consisted of 30 gynecologically healthy non-pregnant women with a scar on the anterior abdominal wall after a CS.Results. Рathogenetic features, factors and prerequisites for the formation of PSE in the study group were identified: a history of CS, a hereditary predisposition, a high frequency of medical abortions and spontaneous miscarriages. This category of women has a low health index, which is presented by a high incidence of gynecological and extragenital pathology, and a high frequency of childhood and respiratory diseases in the history. Surgical interventions on the uterus and ovaries contribute to the occurrence and progression of PSE. The most common clinical manifestation of PSE is a tumor-like formation in the area of the scar, compacted, painful during menstruation.Conclusions. Analysis of anamnestic data and examination of women allowed us to identify factors for the formation of PSE: electrovacuum aspiration (46.7%); cervical surgery (26.7%); complicated gynecological heredity (63.3%), in particular, a presence of endometriosis (50.0%) and uterine leiomyoma (30.0%) in close relatives; high infectious index (93.3%); concomitant and previous extragenital diseases (36.7%); abnormal uterine bleeding (36.7%); inflammatory processes of the genital organs (40.0%); cervical pathology (33.3%); medical (63.3%) and spontaneous (16.7%) abortions.