Abstract

Background: Endometriosis is a presence of ectopic endometrial tissue outside the uterine cavity. Scar endometriosis occurs most commonly in the abdominal wall scar after cesarean section, and rarely after hysterectomy, laparoscopy or amniocentesis.

Aim: To study the clinical profile and the outcome of treatment in patients with endometriosis.

Methodology: It was a retrospective observational study done in cohort of patients with scar endometriosis from Jan 2011 till March 2019. The parameters analyzed were: age, obstetric history, presenting symptoms, time interval between the primary surgery and symptom development, time interval between symptom development and surgical excision, Ultra sonogram (USG) findings, location of the lesion, size of the lesion, treatment given, pathological findings and the outcome.

Results: 31 women had scar endometriosis during the study period. Mean age was 33.52 � 5.80 years. Majority of the patients (N = 29/31) presented with features of swelling over the scar. 71% patients had cyclical menstrual pain and rest were asymptomatic. 87% patients had scar endometriosis over the C-section and 10% had over the episiotomy site. 5% had port site scar endometriosis and 5% over hysterotomy scar. Mean time between the surgery and the onset of symptoms was 36.5 � 34.9 months. Besides clinical examination, USG was used as a primary imaging modality in all cases. Wide excision of the lesion was done in all the cases. There was no recurrence or malignant transformation on histopathological examination. Conclusion: Clinicians should strongly suspect scar endometriosis whenever there is a painful mass over the previous scar. Wide excision offers complete cure.