Postgraduate Medical School of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Eur J Obstet Gynecol Reprod Biol. 2010 Sep;152(1):83-5. doi: 10.1016/j.ejogrb.2010.05.001. Epub 2010 May 26.
To estimate the incidence of scar endometriosis after different surgical procedures.
A retrospective study of 72 patients diagnosed with scar endometriosis between 1978 and 2003 was performed. Patient age, site of endometriosis, previous operations, time-gap between last surgery and onset of symptoms, nodule characteristics, and recurrence were evaluated.
Age ranged from 16 to 48 years. Location varied according to the previous surgery: 46 caesarean section, one hysterectomy, one in abdominal surgery, 19 episiotomy, one was a relapse and two pelvic floor procedures, two women with no previous surgery. The incidence of scar endometriosis after caesarean section was significantly higher than after episiotomy (0.2 and 0.06%, respectively: p<0.00001) with a relative risk of 3.3. Pain was the most frequent symptom. The mean time between surgery and onset of symptoms was 3.7 years.
Our findings confirm that scar endometriosis is a rare condition and indicate, probably for the first time, that caesarean section greatly increases the risk of developing scar endometriosis.
评估不同手术方式后瘢痕内异症的发病情况。
回顾性分析 1978 年至 2003 年间诊断为瘢痕内异症的 72 例患者。评估患者年龄、内异症部位、既往手术、末次手术至症状出现的时间间隔、结节特征和复发情况。
年龄 16 至 48 岁。根据既往手术部位，病变位置不同：46 例剖宫产，1 例子宫切除术，1 例腹部手术，19 例会阴切开术，1 例复发，2 例盆底手术，2 例无既往手术。剖宫产术后瘢痕内异症的发病率明显高于会阴切开术（0.2%和 0.06%：p<0.00001），相对风险为 3.3。疼痛是最常见的症状。手术与症状出现之间的平均时间为 3.7 年。
我们的研究结果证实了瘢痕内异症是一种罕见疾病，并首次表明剖宫产大大增加了发生瘢痕内异症的风险。
