Liu Yu, Pi Ruyu, Luo Hong, Wang Wei, Zhao Xia, Qi Xiaorong
Department of Gynecology and Obstetrics, Key Laboratory of Obstetrics & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education.
Department of Diagnostic Ultrasound.
Medicine (Baltimore). 2020 Jun 5;99(23):e20638. doi: 10.1097/MD.0000000000020638.
To summarize the clinical features, diagnosis, and treatments of perineal endometriosis (PEM).We retrospectively studied the clinical data of 35 patients with PEM between April 2012 and December 2018 in West China Second Hospital. Patients were divided into the gonadotropins releasing hormone (GnRH) agonist group and non-GnRH agonist group.The main clinical symptom was vulvar painful swellings related to menstrual cycles. Thirty-three patients' lesions (94.29%) were on the episiotomy scar while 1 case was at the opposite side of the scar. We even found 1 nullipara was diagnosed as PEM. Ten patients (28.57%) were found with anal sphincter involvement. All patients received complete excision of PEM. The recurrence rate of GnRH agonist group was 7.69% (1/13), while the rate of non-GnRH agonist group was 18.75% (3/16).Most PEM was associated with episiotomy history, but PEM could also exist in nullipara. Complete excision of PEM was inevitable. The effect of GnRH agonist on recurrence of PEM needs further studies.
总结会阴子宫内膜异位症（PEM）的临床特征、诊断及治疗方法。我们回顾性研究了2012年4月至2018年12月期间在华西第二医院就诊的35例PEM患者的临床资料。将患者分为促性腺激素释放激素（GnRH）激动剂组和非GnRH激动剂组。主要临床症状为与月经周期相关的外阴疼痛性肿胀。33例患者（94.29%）的病灶位于会阴侧切瘢痕处，1例位于瘢痕对侧。我们甚至发现1例未产妇被诊断为PEM。10例患者（28.57%）存在肛门括约肌受累。所有患者均接受了PEM的完整切除。GnRH激动剂组的复发率为7.69%（1/13），而非GnRH激动剂组的复发率为18.75%（3/16）。大多数PEM与会阴侧切病史有关，但PEM也可存在于未产妇中。PEM的完整切除是必要的。GnRH激动剂对PEM复发的影响有待进一步研究。
