Scar Endometriosis: Our Experience at Rural Setup with Review of Literature

Introduction Endometriosis was first described by Rokitansky in 1860. It is the presence and proliferation of the endometrium outside the uterine cavity. Objectivesto identify risk factors and show the clinical patterns and other forms of presentation of scar endometriosis, through publishing the results from our experience of surgical management of these conditions. MATERIALS AND METHODSThis is a descriptive, observational, retrospective study performed at R. L. JALAPPA HOSPITAL & RESEARCH CENTRE. It consisted of surveying and reviewing data from the medical records of patients diagnosed with surgical scar endometrioma prior to their surgery. These operations took place between July 2006 and May 2016. RESULTSA total of 15 patients who had presented to our clinic with symptoms of swelling and pain in 13 caesarean section and 2 episiotomy scars between January 2006 and May 2016 were evaluated. All patients received a provisional diagnosis of obstetric incision scar endometriosis preoperatively due to their history and examination characteristics. The mean age was 39.6 and the median being 38 (SD=5.9) with range from 30 to 49 years, and the mean number of pregnancies was 2.53 and the median being 2 (SD=1.35), with range from 1 to 6 pregnancies. CONCLUSIONEndometriosis, although an uncommon condition in general surgery, should be included in the differential diagnosis of women presenting with swellings related to surgical scars over the abdomen and pelvis, especially if symptoms are cyclical. High suspicion and confirmation of such condition leads on to good clinical outcome of the patient.