Endometriosis cases that occurred at the incision site after cesarean section; Single-center experience

Abstract

Objective: Endometriosis is the growth of functional endometrial gland and stroma outside the uterine cavity. Scar endometriosis is a very rare disease and is diagnosed by histopathologic examination. Endometriosis may be detected in the scar tissue after a previous gynecological operation. Scar endometriosis is a mass consisting of endometrial glands and stroma that may develop in the incision scar tissue or in the neighborhood after gynecologic procedures performed especially by cesarean section. We aimed to present the patients who had a history of gynecologic surgery, who presented with mass and/or pain complaints especially in the corner regions of the previous incision line, and underwent surgical excision and reported as endometriosis as a result of postoperative pathology.

Materials and Methods: Patients who presented to the general surgery outpatient clinic between September 2018 and December 2019 with complaints of palpable mass, pain and swelling at the edge of the pfannenstiel incision were evaluated. The records of patients who underwent surgery with a preliminary diagnosis of endometriosis and reported as endometriosis as a result of pathology were reviewed retrospectively.

Results: Surgical excision was performed in 14 patients with a preliminary diagnosis of endometriosis. The mean age of the patients was 29.5 (min: 18-max: 39 years). All patients had a history of cesarean section as a history of abdominal surgery. When the pathology results were examined, all the reports were endometriosis externa. In the pathology reports, the mean diameter of the lesion was 25x20x17mm (min: 10- max: 40).

Result: Endometriosis should be considered in patients with a history of palpable mass and pain around the incision site in patients with a history of gynecologic surgery.