Correlation or Causation? A Case Report of Endometriosis within a Caesarean Scar Defect

Abstract

Introduction: Caesarean scar defect is a well-recognised complication of caesarean section. It can cause secondary infertility, although the mechanism is still poorly understood. Case description: We present the case of a patient diagnosed with a caesarean scar defect on transvaginal ultrasound, following referral for secondary infertility. During laparoscopy performed with concurrent hysteroscopy, the caesarean scar defect was found to be continuous with an endometriotic nodule in the uterovesical peritoneum. This was excised along with other endometriosis implants. Histopathology of the resected defect also showed endometriosis. Conclusions: This case illustrates a possible link between caesarean scar defect and endometriosis, and highlights the benefit of laparoscopy to allow additional treatment of coexisting pathology, such as endometriosis, that could also contribute to infertility.