Scar endometriosis: a clinicopathologic study of 17 cases

Clinicopathologic finding are presented from 17 cases of scar endometriosis studied over a 5-year period. Multiparous women in the third decade of life were most frequently affected. Seventy-one percent of the cases followed abdominal hysterotomy, for a 1.08% incidence of scar endometriosis in the patients who underwent hysterotomy during this period. The most common symptom was painful swelling of the scar which waxed and waned with menses. The majority of patients presented from 1 to 2 years after the precipitating operation. Associated pelvic endometriosis was present in 24% of the patients. Therapy with oral progestogen was ineffective, and the treatment of choice was clearly surgical excision. The causal relationship between surgery and subsequent scar endometriosis is discussed. Methods of prevention are suggested.