SCAR ENDOMETRIOSIS

Background. Scar endometriosis may develop after pelvic operations, su ch as cesarean section, tubal ligation, hysterotomy and hysterectomy. This prompted us to demonstrate the proper diagnosis; management and p rophylactic procedure of scar endometriosis. Methods. Twelve patients with scar endometriosis were diagnosed by clinical symptoms and signs, including a painful scar mass related to the menstrual cycle and cycl ic bleeding from scars. Preoperative ultrasound needle aspiration cyto logy was arranged in three patients without painful mass. The manageme nt comprised complete surgical excision and selective medical treatmen t. Postoperative follow-up was scheduled at six-month intervals. Resul ts, Except for two patients who complained of scar pain but no palpabl e mass during menstruation, there was no evidence of recurrence in the other 10 patients. Conclusions, Diagnosis of scar endometriosis shoul d involve detailed history taking and pelvic examination. Concerning t he role of needle aspiration cytology, it still remains controversial. Several prophylactic procedures have been presented to prevent decidu al contamination of the wound. Complete surgical excision including th e adjacent fascia or skin is the proper treatment of scar endometriosi s.