Matalliotakis Michail, Matalliotaki Charoula, Zervou Maria I, Krithinakis Konstantinos, Goulielmos George N, Kalogiannidis Ioannis
Third Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece; Section of Molecular Pathology and Human Genetics, Department of Internal Medicine, School of Medicine, University of Crete, Greece; Department of Obstetrics and Gynaecology, Venizeleio and Pananio General Hospital of Heraklion, Greece.
Third Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece; Section of Molecular Pathology and Human Genetics, Department of Internal Medicine, School of Medicine, University of Crete, Greece; Department of Obstetrics and Gynaecology, Venizeleio and Pananio General Hospital of Heraklion, Greece.
Eur J Obstet Gynecol Reprod Biol. 2020 Sep;252:225-227. doi: 10.1016/j.ejogrb.2020.06.054. Epub 2020 Jun 26.
OBJECTIVE(S): Abdominal and perineal scar endometriosis usually develop in association with a prior surgical scar. The purpose of the study was to detect and review patients' characteristics of these women over a long period.
We retrospectively review the clinical records of 860 women with endometriosis between 1989 and 2019. Data were collected and analyzed from medical and pathological reports of 40 patients with abdominal and perineal scar endometriosis.
26 patients (3,0 %) were detected in the abdominal wall endometriosis group (AWE) (mean age 36,5 ± 3,4 years) and 14(1,6 %) cases in the perineal endometriosis (PE) group (32,5 ± 2,4 years), respectively. We observed that 92,3 % of women with AWE had undergone at least 1 cesarean section. Moreover, the majority of patients presented with abdominal pain (77, 0 %) and sensation of a mass (96,2 %). 15,4 % of cases had concurrent pelvic endometriosis and the recurrent rate of the disease was 15,4 %. All cases with perineal scar endometriosis were multiparous and delivered vaginally with episiotomy. 92,8 % of patients presented with cyclical pain and swelling. 3 cases suffered from perineal endometriosis combined with pelvic endometriosis. There was a recurrence of perineal endometriosis in 2 women (14,2 %). Surgical excision was the standard treatment of this condition and tissue biopsy confirmed the diagnosis.
Abdominal wall and perineal scar endometriosis are rare, multifactorial entities which are associated mainly with cesarean section and vaginal episiotomy. Clinicians should be aware of these conditions among all women of reproductive age presenting with cyclic or non-cyclic pain and swelling at the incision sites.
腹壁和会阴瘢痕子宫内膜异位症通常与既往手术瘢痕相关。本研究的目的是长期检测并回顾这些女性患者的特征。
我们回顾性分析了1989年至2019年间860例子宫内膜异位症女性的临床记录。收集并分析了40例腹壁和会阴瘢痕子宫内膜异位症患者的医学和病理报告数据。
腹壁子宫内膜异位症组（AWE）检出26例患者（3.0%）（平均年龄36.5±3.4岁），会阴子宫内膜异位症（PE）组检出14例（1.6%）（32.5±2.4岁）。我们观察到，92.3%的AWE女性至少接受过1次剖宫产。此外，大多数患者表现为腹痛（77.0%）和肿物感（96.2%）。15.4%的病例合并盆腔子宫内膜异位症，疾病复发率为15.4%。所有会阴瘢痕子宫内膜异位症病例均为经产妇，经阴道分娩并行了会阴切开术。92.8%的患者表现为周期性疼痛和肿胀。3例患者会阴子宫内膜异位症合并盆腔子宫内膜异位症。2例女性（14.2%）会阴子宫内膜异位症复发。手术切除是本病的标准治疗方法，组织活检确诊了诊断。
腹壁和会阴瘢痕子宫内膜异位症较为罕见，是多因素导致的疾病，主要与剖宫产和会阴切开术有关。临床医生应在所有出现手术切口部位周期性或非周期性疼痛及肿胀的育龄女性中留意这些情况。
