Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature

Sao Paulo Medical Journal

Guilherme Karam Corrêa Leite¹  Luis Fernando Pina De Carvalho¹  Henri Korkes¹  Thiago Falbo Guazzelli¹  Grecy Kenj¹  Arildo De Toledo Viana¹ 

[1] ,Hospital Municipal Maternidade-Escola Dr. Mário de Moraes Altenfelder SilvaSão Paulo São Paulo ,Brazil

关键词: Endometriosis;    Cicatrix;    Cesarean section;    Postoperative complications;    Treatment outcome;    Endometriose;    Cicatriz;    Cesárea;    Complicações pós-operatórias;    Resultado de tratamento;   

DOI  :  10.1590/S1516-31802009000500005

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: The incidence of scar endometrioma ranges from 0.03 to 3.5%. Certain factors relating to knowledge of the clinical history of the disease make correct diagnosis and treatment difficult. The aim here was to identify the clinical pattern of the disease and show surgical results. The literature on this topic was reviewed. DESIGN AND SETTING: Retrospective descriptive study at Hospital Municipal Maternidade - Escola Dr. Mário de Moraes Altenfelder Silva. METHODS: Data from the medical records of patients with preoperative diagnoses of scar endometrioma who underwent operations between 2001 and 2007 were surveyed and reviewed. The postoperative diagnosis came from histopathological analysis. The main information surveyed was age, obstetric antecedents, symptoms, tumor location, size and palpation, duration of complaint, diagnosis and treatment. All patients underwent tumor excision with a safety margin. RESULTS: There were 33 patients, of mean age 30.1 ± 5.0 years (range: 18-41 years). The total incidence was 0.11%: 0.29% in cesarean sections and 0.01% in vaginal deliveries. Twenty-nine tumors (87.9%) were located in cesarean scars, two (6.0%) in episiotomy scars and two (6.0%) in the umbilical region. The main symptom was localized cyclical pain (66.7%), of mean duration 30.5 months (± 23). Surgical treatment was successful in all cases. CONCLUSION: This is an uncommon disease. The most important diagnostic characteristic is coincidence of painful symptoms with menstruation. Patients undergoing cesarean section are at greatest risk: relative risk of 27.37 (P < 0.01). The surgical treatment of choice is excision of the endometrioma with a safety margin.

【 授权许可】

CC BY   
 All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License