CESAREAN SCAR ENDOMETRIOSIS: PRESENTATION OF 10 CASES AND LITERATURE REVIEW

Öz

Objective: Endometriosis, characterized by the presence of functioning endometrial tissue in non-uterine locations, is a relatively common disease in women of reproductive age (10-15%). Besides that, cesarean scar endometriosis (CSE) is rarely seen; the clinical presentation of the disease is mainly in the form of a painful mass at the cesarean incision site. Method: Ten patients, whose diagnosis was confirmed histopathologically by surgery with CSE anterior chamber, were evaluated in terms of clinical and histopathological features. Results: The mean age of patients was 35 (min-max:22-45). Six (75%) of patients with pain symptoms were cyclic, and 2 (25%) were noncyclic. The mean latency period (time from last cesarean section to the beginning of symptoms) was 44,6 (min-max:6-88) months, and the mean duration between symptoms and surgery was 28,9 (min-max:2-60) months. Six (60%) of endometriomas were located right corner of the incision, and 4 (40%) were at the left. All of the endometriomas were solitary. The mean hospitalization time was 2,5 (min-max:1-6) days. Conclusion: Excision of endometriotic foci within 1 cm safety margins may be an appropriate curative treatment option.

Anahtar Kelimeler

• Cesarean Section
• Endometriosis
• Cicatrix
• Pelvic Pain
• Dysmenorrhea

SEZARYEN SCAR ENDOMETRİOZİS: 10 OLGUNUN SUNUMU VE LİTERATÜR İNCELEMESİ

Öz

Amaç: Endometriozis, endometrial dokunun uterus dışı yerleşimlerde varlığı ile karakterize olup, üreme çağındaki kadınlarda nispeten sık görülen bir hastalıktır (%10-15). Bunun yanında sezaryen skar endometriozisi (CSE) nadiren görülür; hastalığın klinik görünümü esas olarak sezaryen insizyon hattında ağrılı bir kitle şeklindedir. Yöntem: CSE ön tanısı ile opere edilerek tanının histopatolojik olarak doğrulandığı 10 hasta klinik ve histopatolojik özellikleri açısından değerlendirildi. Bulgular: Hastaların yaş ortalaması 35 (min-maks:22-45) idi. Ağrı semptomları hastaların altısında (%75) siklik, 2'sinde (%25) nonsiklik karakterdeydi. Ortalama hastalığın görülme süresi (son sezaryen ile semptomların başlangıcına kadar geçen süre) 44,6 (min-maks:6-88) ay ve semptomlar ile ameliyat arasındaki ortalama süre 28,9 (min-maks:2-60) ay idi. Altı hastada (%60) endometrioma insizyonun sağ köşesinde, 4 hastada ise (%40) soldaydı. Endometriomaların tamamı soliter yapıda izlendi. Ortalama hastanede kalış süresi 2,5 (min maks:1-6) gündü. Sonuç: Endometriotik odakların, 1 cm güvenlik sınırı ile eksizyonu uygun bir küratif tedavi seçeneği olabilir.

Anahtar Kelimeler

• Sezaryen
• Endometriozis
• Sikatris
• Pelvik Ağrı
• Dismenore

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