SCAR ENDOMETRIOMA FOLLOWING CAESAREAN SURGERY ANALYSIS OF 6 CASES

  • Dr. Lakshmi Rathna Markani Nice hospital of women, children & newborns at Shanthinagar, Hyderabad, Telangana, India
  • Dr. Reshma Nice hospital of women, children & newborns at Shanthinagar, Hyderabad, Telangana, India
  • Dr. Nidhi Saluja Nice hospital of women, children & newborns at Shanthinagar, Hyderabad, Telangana, India
Keywords: Endometrioses, Cesarean section, postoperative complications, Treatment outcome

Abstract

Objective:-

1. To See the incidence of scar endometrioma in our gynaec outpatient clinic.

2. To identify the clinical pattern of the disease.

3. Incidence of symptomatic relief post resection.

4. Post resection need for medical therapy.

Design and Setting:- Retrospective descriptive study of the etiology and prospective analysis of scar endometriosis and symptoms on pain scale, at Nice hospital of women, children & newborns at Shanthinagar Hyderabad, Telangana, India.

Methods: - Data from the medical records of patients from OPD Clinics and IP Records during Jan 2013 to Oct 2016 with pre operative diagnosis of scar endometrioma who underwent surgery between 2013 to 2016 were survey and reviewed .Current data of confirmation of diagnosis by High-Resolution Ultrasound Scan and MRI and histopathological examination of respected mass. The main information surveyed was age, obstetric antecedents, symptoms, tumor location, size& palpation, duration of complaint, diagnosis, and treatment. All underwent tumor excision with a safety margin.

Results: - There were 6 patients , a mean age 30.1+ 5.0yrs plus or minus (Range 18-40 yrs) 100% located in and around cesarean scars. The main symptom was localized cyclical pain (80- 100%) of mean duration 20-24 months , the interval between LSCS and onset of Scar Endometrioma was between 3yrs to 7yrs. Surgical treatment was successful in all cases.

Conclusion: - This is an uncommon disease. Most important a diagnostic criterion is a Cyclical pain at the local site during menstruation. Patient undergoing cesarean section is at the greatest risk. The surgical treatment of choice is excision of the endometrioma with a safety margin. Post-operatively medical therapy given in all cases. The patient is followed up every 6 months to assess any recurrence.

Downloads

Download data is not yet available.

References

1. Jubanyik KJ, Comite F. Extrapelvic endometriosis. Obstet Gynecol Clin North Am. 1997;24(2):411-40.
2. Cárdenas-Lailson L, Berlanga-Ramírez F, Athié-Athié A, Gonzáles-Parada F, Villanueva-Egan L. Endometrioma de pared abdominal: Características clínicasy resultados Del tratamiento quirúrgico [Abdominal wall endometrioma: clinical characteristics and results of surgical treatment]. Cirujano General. 2002;24(4):295-9. Available from: http://www.medigraphic.com/ingles/i-htms/i-cirgen/i-cg2002/i-cg02-4/imcg024h.htm. Accessed in 2009 (Oct 21).
3. Nominato NS, Prates LFVS, Lauar I, Morais J, Maia L, Geber S. Endometriose de cicatriz cirúrgica: estudo retrospective de 72 casos [Scar endometriosis: a retrospective study of 72 patients]. Rev Bras Ginecol Obstet. 2007;29(8):423-7.
4. Meirelles M, Losano R, Viana AT. Endometrioma de cicatriz: estudo de 14 casos [Scar endometriosis: study of 14 cases]. Arq Med Hosp Fac Cienc Med Santa Casa São Paulo. 2005;50(3):92-6. Available from: http://intranet.fcmscsp.edu.br/files/file/vlm50n3_2.pdf. Accessed in 2009 (Oct 20).
5. Esquivel-Estrada V, Briones-Garduño JC, Mondragón-Ballesteros R. Implante de endometriosis en cicatriz de operación cesárea. Cirugía e Cirujanos. 2004;72(2):113-5. Available from: http://www.medigraphic.com/espanol/e-htms/e-circir/e-cc2004/e-cc04-2/emcc042g.htm. Accessed in 2009 (Oct 20).
6. Higginbottom J. Termination of pregnancy by abdominal hysterotomy. Lancet. 1973; 1(7809):937-8
7. Chatterjee SK. Scar endometriosis: a clinicopathologic study of 17 cases. Obstet Gynecol. 1980;56(1):81-4.
8. Gunes M, Kayikcioglu F, Ozturkoglu E, Haberal A. Incisional endometriosis after cesarean section, episiotomy and other gynecologic procedures. J Obstet
Gynaecol Res. 2005;31(5): 471-5.
9. Picod G, Boulanger L, Bounoua F, Leduc F, Duval G. Endométriose pariétale sur cicatrice de césarienne: à propos de 15 cas [Abdominal wall endometriosis after caesarean section: report of fifteen cases]. Gynecol Obstet Fertil. 2006;34(1):8-13.
10. Ding DC, Hsu S. Scar endometriosis at the site of cesarean section. Taiwan J Obstet Gynecol. 2006;45(3):247-9.
11. Purvis RS, Tyring SK. Cutaneous and subcutaneous endometriosis. Surgical and hormonal therapy. J Dermatol Surg Oncol. 1994;20(10):693-5.
12. Patterson GK, Winburn GB. Abdominal wall endometriomas: Report of eight cases. Am J Surg 1999;65:36-9
13. Koger KE, Shatney CH, Hodge K, McClenathan JH. Surgical scar endometrioma. Surg Gynecol Obstet 1993;177:243-6.
14. Wolf Y, Haddad R, Werbin N, Skornick Y, Kaplan O. Endometriosis in abdominal scars: A diagnostic pitfall. Am Surg 1996;62:1042-4
15. Aydin O. Scar endometriosis - A gynaecologic pathology often presented to the general surgeon rather than the gynaecologist: Report of two cases. Langenbecks Arch Surg 2007;392:105- 9.
16. Gunes M, Kayikcioglu F, Ozturkoglu E, Haberal A. Incisional endometriosis after cesarean section, episiotomy and other gynecologic procedures. J Obstet
Gynaecol Res 2005;31:471-5.
17. de Oliveira MA, de Leon AC, Freire EC, de Oliveira HC. Risk factors for abdominal scar endometriosis after obstetric hysterotomies: A case-control study. Acta Obstet Gynecol Scand 2007;86:73-80.
18. Ideyi SC, Schein M, Niazi M, Gerst PH. Spontaneous endometriosis of the abdominal wall. Dig Surg 2003;20:246- 8.
19. Oner A, Karakucuk S, Serin S. Nasolacrimal endometriosis. A case report. Ophthalmic Res 2006;38:313-4.
20. Roncoroni L, Costi R, Violi V, Nunziata R. Endometriosis on laparotomy scar. A three-case report. Arch Gynecol Obstet 2001;265:165-7.
21. Seltzer VL, Benjamin F, Deutsch S. Perimenopausal bleeding patterns and pathologic fi ndings. J Am Med Womens Assoc 1990;45:132-4
22. Blanco RG, Parithivel VS, Shah AK, Gumbs MA, Scheinz M, Gerst PH. Abdominal wall endometriomas. Am J Surg 2003;185:596-8
23. Ridley JH, Edwards IK. Experimental endometriosis in the human. Am J Obstet Gynecol. 1958;76(4):783-90;discussion 789-90.
24. Steck WD, Helwig EB. Cutaneous endometriosis. Clin Obstet Gynecol. 1966;9(2):373-83.
25. Majeski J, Craggie J. Scar endometriosis developing after an umbilical hernia repair with mesh. South Med J. 2004;97(5):532-4.
26. Wicherek L, Dutsch-Wicherek M, Galazka K, et al. Comparison of RCAS1 and metallothionein expression and the presence and activity of immune cells in
human ovarian and abdominal wall endometriomas. Reprod Biol Endocrinol. 2006;4:41.
27. Hensen JH, Van Breda Vriesman AC, Puylaert JB. Abdominal wall endometriosis: clinical presentation and imaging features with emphasis on sonography. AJR Am J Roentgenol. 2006;186(3):616-20.
28. Kinkel K,Frei KA. Balleyguier C, Chapron C. Diagnosis of endometriosis with imaging: A Review. Eur Radiol 2006; 16:285-98
29. Balleyguier C, Chapron C, Chopin N, Hélénon O, Menu Y. Abdominal wall and surgical scar endometriosis: Results of magnetic resonance imaging. Gynecol
Obstet Invest 2003;55:220-4.
30. Crum CP. The female genital tract. In: Crotran RS, Kumar V, Collins V, editors. Robbin’s Pathologic Basis of Disease. 6th ed. Philadelphia, Pa, USA: Saunders; 1999.
31. Meti S, Weiner JJ. Scar endometriosis: A diagnostic dilemma. Eur Clin Obstet Gynaecol 2006;2:62-4.
32. Rivlin ME, Das SK, Patel RB, Meeks GR. Leuprolide acetate in the management of cesarean scar endometriosis. Obstet Gynecol 1995;85:838-9
33. Rani PR, Soundararaghavan S, Rajaram P. Endometriosis in abdominal scars – review of 27 cases. Int J Gynaecol Obstet 1991; 36:215-8.
How to Cite
1.
Dr. Lakshmi Rathna Markani, Dr. Reshma, Dr. Nidhi Saluja. SCAR ENDOMETRIOMA FOLLOWING CAESAREAN SURGERY ANALYSIS OF 6 CASES. Med. res. chronicles [Internet]. 2017Feb.28 [cited 2021Oct.21];4(01):40-7. Available from: https://medrech.com/index.php/medrech/article/view/215
Section
Original Research Article