Endometriosis in an episiotomy scar: a case report

Endometriosis is defined as the presence of functioning endometrial tissue in an anatomical location other than the uterine cavity. The episiotomy scar is a fairly rare site for endometriosis. The authors present the case of a 42-year-old woman referred 7 years ago for the development of a tender perianal mass at the episiotomy site associated with perianal pain and pruritus which varied in relation to menses, becoming most intense just before and immediately after the onset of menstrual bleeding. Anal endosonography performed with a B&K mechanical probe rotating through 360 degrees with a frequency of 7 and 10 Mhz showed a hypoechoic area with a diameter of 3 cm not involving the external sphincter and extending from the perianal skin to the mid third of the anal canal. Proctosigmoidoscopy findings were normal. A complete local excision was performed. Complete surgical excision of perineal endometriomas should be curative. Recurrence, supposedly due to incomplete removal, usually appears within one year.