Clinical profile and outcome of scar endometriosis in a tertiary care centre of Northern India

Sunil Kumar Juneja, Pooja S. Tandon, Anshu Sharma, Anjali Sharma
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2020 · vol. 9(2) , pp. 744 · doi:10.18203/2320-1770.ijrcog20200370 · W3003634292
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study reviewed eight scar endometriosis cases in Northern India, finding that patients, mostly post-cesarean, presented with tender nodules and cyclical pain exacerbated during menstruation.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This retrospective study from a tertiary care center in Northern India reviewed the demographic profile, clinical presentation, treatment modalities, and outcomes of patients diagnosed with scar endometriosis between January 2014 and December 2018. Eight patients were identified, most with prior cesarean section scar sites (six) and two at episiotomy sites, and all presented with tender nodules and pain that became exaggerated during menstruation. The authors conclude that a high index of suspicion is warranted when patients present with cyclical pain and a tender mass linked to a scar, reflecting the paper’s main limitation of small sample size and retrospective design. This paper is centrally about endometriosis — specifically scar endometriosis in surgical incision sites and its clinical outcomes.

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Abstract

Background: Endometriosis is defined as the presence and proliferation of the endometrium outside the uterine cavity affecting an estimated 89 million women of reproductive age worldwide. Endometriosis occurs in 5% to 10% of all women, often resulting in debilitating pain and infertility, endometriosis at the scar site known as Scar endometriosis has also been described following obstetrical and gynecological surgery. Scar endometriosis has a much rarer incidence with an illusive presentation and is often misdiagnosed and definitive treatment gets delayed. Objectives of this study was to review the demographic profile, clinical presentation, treatment modalities and outcome in patients with scar endometriosis.Methods: The retrospective study of patients with scar endometriosis managed at DMCH during January 2014 to December 2018 was done.Results: Eight patients of scar endometrosis were diagnosed and operated in our institution over a period of five years. All patients (six with previous caesarean section scar site and two at episiotomy site) presented with tender nodules with pain which got exaggerated during menstruation.Conclusions: A high index of suspicion of scar endometriosis should be kept in patients presented with cyclical pain and tender mass getting exaggerated during menstruation.
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Background

Endometriosis is defined as the presence and proliferation of the endometrium outside the uterine cavity affecting an estimated 89 million women of reproductive age worldwide. Endometriosis occurs in 5% to 10% of all women, often resulting in debilitating pain and infertility, endometriosis at the scar site known as Scar endometriosis has also been described following obstetrical and gynecological surgery. Scar endometriosis has a much rarer incidence with an illusive presentation and is often misdiagnosed and definitive treatment gets delayed. Objectives of this study was to review the demographic profile, clinical presentation, treatment modalities and outcome in patients with scar endometriosis.

Methods

The retrospective study of patients with scar endometriosis managed at DMCH during January 2014 to December 2018 was done.

Results

Eight patients of scar endometrosis were diagnosed and operated in our institution over a period of five years. All patients (six with previous caesarean section scar site and two at episiotomy site) presented with tender nodules with pain which got exaggerated during menstruation.

Conclusions

A high index of suspicion of scar endometriosis should be kept in patients presented with cyclical pain and tender mass getting exaggerated during menstruation. Metrics

References

Wolf G, Singh K. Cesarean scar endometriosis: a review. Obstet Gynecol Surv. 1989;44:89-95. Joly D, Harden H, Huguet C. Endometriosis of the abdominal pario in the long-term consequences of a cesarean. Lyon Chir. 1988;84(2):106-8. Blumenthal RD, Samoszuk M, Taylor AP, Brown G, Alisauskas R, Goldenberg DM. Degranulating eosinophils in human endometriosis, Am J Pathol. 2000;156(5):1581-8. Botha AJ, Halliday AE, Flanagan JP, Endometriosis in gluteus muscle with surgical implantation. A case report. Acta Orthop Scand. 1991;62(5):497-9. Ali T, Mohammed F, Hoford R, Maharaj D, Sookhoo S. Extrapelvic endometriosis presenting as unusual swellings of the buttock and thigh, west Indian. Med J. 2001;50(4):328-30. Sirito R, Puppo A, Centurioni MG, Gustavino C. Incisional hernia on th 5-mm trocar port site and subsequent wall endometriosis on the same site: a case report. Am J Obstet Gynecol. 2005;193(3pt 1):878-80. Patterson GK, Winburn GP. Abdominal wall endometriomas: report of eight cases. Am J Surg. 1999;65:36-9. Rani PR, Soundararaghavan S, Rajaram P. Endometriosis in abdominal scars - review of 27 cases. Int J Gynaecol Obstet. 1991;36:215-8. Wang PH, Juang CM, Chao HT, Yu KJ, Yuan CC, Ng HT. Wound endometriosis: risk factor evaluation and treatment. J Chin Med Assoc. 2003;66(2):113-9. Petakovic S, Perunicic P, Cuk D. Perineal endometriosis at the site of an episiotomy scar. Med Pregl. 1997;50(3-4):125-7.

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