Post-cesarean scar endometriosis

Endometriosis is seen in women during their reproductive period, where stromal tissue and functional endometrial glands of the uterus are observed outside the uterine cavity. In this study, we aimed to identify the clinical characteristics of our patients who underwent surgery with scar endometriosis and to discuss the surgical results in light of the literature.

A total of 24 patients who underwent surgery and diagnosed as having endometriosis as the result of a pathologic examination were retrospectively evaluated.

The mean age of the patients was 31 years. Thirteen presented to general surgery and 11 presented to gynecology outpatient clinics. The pain was cyclical in 19 patients. There was history of cesarean section in 9 patients, twice in 12, and 3 times in three patients. The mean diameter was 39.1 mm on ultrasound, and 37.5 mm on magnetic resonance imaging. Endometriosis was on the left side of the incisions in 13, whereas it was on the right in 11. The mean weight of the lesions was 61.6 grams.

The occurrence of endometriosis is supported by the iatrogenic implantation theory. In the event of a mass in the abdominal wall, previous obstetric and gynecologic operations and a history of a painful mass during menstruation periods must be questioned. In the treatment of scar endometriosis, excision is required by obtaining secure margins. If diagnosis can be established preoperatively, unnecessary surgeries can prevented.