Incisional endometriosis after cesarean section, episiotomy and other gynecologic procedures

Güneş, Müzeyyen; Kayıkçıoğlu, Fulya; Öztürkoğlu, Esmen; Haberal, Alı

doi:10.1111/j.1447-0756.2005.00322.x

Cited by 160 publications

(98 citation statements)

References 13 publications

(30 reference statements)

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“…25 Since then, this has been the main theory accepted by several authors in relation to the genesis of this disease. 11,12,26 The result from the current study corroborates the theory of iatrogenic cell transportation. On the other hand, this theory alone is not enough to completely explain the physiopathology, given the low incidence of this disease and the reports on skin endometriosis without previous surgery, or scar endometriosis without opening the peritoneal or uterine cavities.…”

Section: Discussionsupporting

confidence: 86%

“…Abdominal wall ultrasound shows a solid, hypoechogenic and vascularized image, with the possibility of cyst components of mixed echogenicity. Although ultrasound is nonspecific, findings close to cesarean section scars strongly suggest a diagnosis of endometrioma 8,11,21 (Figure 4). Because of the highly specific resolution of magnetic resonance imaging (MRI), this technique makes it possible to identify smaller lesions and distinguish signs of organized hemorrhage within endometriomas, thereby suggesting this diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…6 The theory of iatrogenic implantation is the one most accepted by several authors, and other theories are secondary to this, in order to explain the physiopathology. 11,12 Certain factors relating the knowledge of the clinical background of the disease make correct diagnosis difficult, especially among general surgeons, who most commonly make mistakes during diagnosis. 13 There is no need for advanced propaedeutics, and the diagnosis may be made solely based on anamnesis and physical examination, aided by ultrasound in some special cases.…”

Section: Introductionmentioning

confidence: 99%

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Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature

Leite¹,

Carvalho²,

Korkes³

et al. 2009

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: The incidence of scar endometrioma ranges from 0.03 to 3.5%. Certain factors relating to knowledge of the clinical history of the disease make correct diagnosis and treatment difficult. The aim here was to identify the clinical pattern of the disease and show surgical results. The literature on this topic was reviewed. DESIGN AND SETTING:Retrospective descriptive study at Hospital Municipal Maternidade -Escola Dr. Mário de Moraes Altenfelder Silva. idade, antecedentes obstétricos, sintomatologia, localização, tamanho e palpação do tumor, duração da queixa, diagnóstico, tratamento. Todas as pacientes foram submetidas a exerese da massa tumoral com margem de segurança. METHODS: RESULTADOS:Foram encontrados 33 pacientes com média de idade 30,1 (± 5,0), variando de 18 a 41 anos. A incidência total foi de 0,11%, nas cesarianas foi de 0,29% e nos partos vaginais, 0,01%. Localização do tumor: 29 casos em cicatriz de cesária (87,9%), dois em região umbilical (6,0%) e dois em cicatriz de episiotomia (6,0%). A principal sintomatologia foi dor cíclica localizada (66,7%), com duração média de 30,5 meses (± 23). O tratamento cirúrgico foi realizado com sucesso em todas as pacientes.CONCLUSÃO: Trata-se de uma doença incomum. O dado de maior importância diagnóstica foi: coincidência da sintomatologia dolorosa com a menstruação. Pacientes submetidas a cesariana têm maior risco (risco relativo = 27,37 e P < 0,01). O tratamento cirúrgico de escolha é exerese do endometrioma com margem de segurança.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature

Leite¹,

Carvalho²,

Korkes³

et al. 2009

Sao Paulo Med. J.

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“…During caesarean section, endometrial tissue might be seeded into the wound, and under estrogen influence these cells proliferates. 18 The decidua in the early period of pregnancy has more pleuripotential capabilities and can result in cellular replication producing endometriosis thus explaining the higher incidence of endometriosis seen after hysterotomy done for mid-trimester abortions. 19 Incidence of scar endometriosis following hysterotomy is 1.08%-2% whereas after caesarean section the incidence is 0.03%-0.4%.…”

Section: Discussionmentioning

confidence: 99%

Endometriosis: an enigmatic disease with many faces

Limbachiya¹,

Agrawal²

2017

Int J Reprod Contracept Obstet Gynecol

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Endometriosis is a benign disease defined by the presence of the endometrial glands and stroma outside of the uterus, both at pelvic and extra pelvic sites. We are reporting 4 unusual cases of endometriosis that are unique on their own due to site of endometriosis, presenting symptoms, complications and treatment. Endometriosis was present at post caesarean scar site in one case, at vault site in another case, in bladder in third case and in the last case it caused frozen pelvis with hydroureter, hydronephrosis and possibly infertility. All four patients have been treated laparoscopically and have been following up with no recurrence of its symptoms. The purpose of this article is to create awareness among Doctors about endometriosis, which is more common than previously thought as. Endometriosis has been rightly summed up in the phrase “The clock is definitely ticking, as we know millions of women still live lives awash in anguish, just as they did thousands of years ago and just as they will centuries from now unless we steer ourselves faster toward the long-elusive cure. Four thousand years is long enough; the time has come to end the empire of endometriosis”.

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“…1 The prevalence of abdominal wall scar endometriosis following gynaecological and obstetrical surgeries was found to be 1.6%. 2 It is easily confused with stitch granulomas, abscess, haematoma and keloids. The three cases that we are reporting are in parous women following caesarean sections.…”

Section: Introductionmentioning

confidence: 99%