Surgical Scar Endometriosis: An Emerging Enigma
Anitha Durairaj1, Harini Sivamani1, Mahalakshmi Panneerselvam1
1Obstetrics and Gynaecology, Velammal Medical College Hospital and Research Institute, Madurai, IND.
Cureus
|March 22, 2023
Summary
Cesarean sections increase the risk of surgical scar endometriosis, often presenting as cyclical pain. Wide local excision is the recommended surgical treatment for this condition.
Area of Science:
- Gynecology
- Surgical Pathology
Background:
- Surgical scar endometriosis is a form of extra-pelvic endometriosis occurring at incision sites.
- The incidence of surgical scar endometriosis is rising, correlating with increased rates of Cesarean sections.
Purpose of the Study:
- To describe the clinical characteristics of surgical scar endometriosis.
- To outline the management strategies for surgical scar endometriosis.
Main Methods:
- A cross-sectional, observational study was conducted over eight years (2015-2022) in a tertiary care center.
- Data from 32 patients with pathologically diagnosed scar endometriosis were analyzed, including demographics, symptoms, lesion characteristics, and surgical techniques.
- Statistical analysis involved descriptive statistics using SPSS version 21.
Main Results:
- The mean age of participants was 34 years; 90.6% were multiparous, with 77.7% having delivered via Cesarean section.
- Cyclical pain (90.4%) and swelling (81.25%) at the scar site were the most common symptoms.
- The subcutaneous tissue (90.6%) was the most frequently involved layer, and wide local excision was the primary surgical approach (78%).
Conclusions:
- Cesarean section is a significant risk factor for developing surgical scar endometriosis.
- Clinicians should suspect scar endometriosis in women with cyclic scar pain; ultrasound is a reliable diagnostic tool.
- Wide local excision, with or without mesh repair, is the preferred surgical management.
