Li Juanqing, Shi Yifu, Zhou Caiyun, Lin Jun
Gynecology Department, Women's Hospital of Zhejiang University, 1st xueshi road, Hangzhou, 310006, China.
Arch Gynecol Obstet. 2015 Dec;292(6):1295-9. doi: 10.1007/s00404-015-3756-4. Epub 2015 Jun 4.
To demonstrate the appropriate diagnosis and treatment of perineal endometriosis.
Seventeen patients who presented with a tender perineal mass coinciding with the menstrual cycle on the scar of a previous vaginally procedure were examined retrospectively. Their clinical features and treatment were analyzed.
All patients presented with a palpable painful lesion. All of them had had vaginal delivery with episiotomy. The mean age of the patients was 34.35 years. The mean latent period was 46.82 months. The mean size was 2.38 cm. Thirteen patients presented with one subcutaneous nodule and four had multiple nodules. Color Doppler ultrasound revealed a subcutaneous nodule with an irregular outline and echo-complex density underlying the episiotomy scar. Only one patient suffered from perineal endometriosis combined with pelvic endometriosis. All endometriotic masses in perineum were completely excised and cured, and confirmed by the microscopic examination.
A detailed history and thorough pelvic examination are essential in diagnosing perineal endometriosis. Surgical intervention is the first choice of treatment.
阐述会阴子宫内膜异位症的恰当诊断与治疗方法。
对17例因既往阴道手术瘢痕处出现与月经周期相符的会阴部压痛性肿块前来就诊的患者进行回顾性研究。分析其临床特征及治疗情况。
所有患者均有可触及的疼痛性病变。她们均有会阴侧切的阴道分娩史。患者的平均年龄为34.35岁。平均潜伏期为46.82个月。平均大小为2.38厘米。13例患者表现为单个皮下结节，4例有多个结节。彩色多普勒超声显示会阴侧切瘢痕下方有一个轮廓不规则、回声复杂的皮下结节。仅1例患者患有会阴子宫内膜异位症合并盆腔子宫内膜异位症。所有会阴部的子宫内膜异位肿块均被完整切除并治愈，且经显微镜检查确诊。
详细的病史和全面的盆腔检查对诊断会阴子宫内膜异位症至关重要。手术干预是首选的治疗方法。
