Episiotomy scar endometriosis: A case report and review of literature

Endometriosis is defined as the presence and growth of endometrial tissue implants, outside the uterine cavity. It is in a episiotomy scar endometriosis that is extremely rare but can lead to significant morbidity in patients due to local infiltration. This condition usually presents with a clinical triad of history of episiotomy, tender nodule at the scar site, and cyclical pain. Here, we report one such rare case of episiotomy scar endometriosis in the perineum of a 30-year-old young female (P1L1) who presented with swelling and pain in the perineal region. The clinical examination and ultrasonography corroborate with the diagnosis of episiotomy scar endometriosis. Excision was done and histopathological examination confirmed the diagnosis. Episiotomy scar endometriosis should always be kept in the differential diagnosis when a lady presents with painful perineal swelling which increases during menstruation. Wide local excision is the treatment of choice and confirmation of the lesion can be done with histopathological examination. If the lesion is not diagnosed within a stipulated period of time, can progress with the involvement of the anal sphincters, and may also turn into a malignant lesion.

A Case of Perineal Endometriosis at the Site of Episiotomy Scar / 대한산부인과학회잡지

Endometriosis generally occurs in the pelvis, particularly in the broad ligament, round ligament, ovaries, fallopian tubes or uterosacral ligament. However, many unusual sites have been described, including the umbilicus, cesarean section scars, hernia sacs, appendix, vagina, vulva, omentum and perineum. We experienced a case of perineal endometriosis diagnosed according to cyclic perineal pain associated with menstration and report it with brief review of literature.

Two Cases of Endometriosis at the site of Episiotomy Scar and Abdominal Scar following Cesarean Section / 대한산부인과학회잡지

The most frequent ectopic locations of endometriosis include, in descending order of frequency, the ovaries, uterine ligaments, the rectovaginal septum, and peritoneum covering the pelvic organs, that is, uterus, fallopian tubes, rectum, sigmoid colon, and bladder. Endometriosis at the site of episiotomy scar and abdominal scar following cesarean section are very rare conditions among the extrapelvic endometriosis. We have experienced two cases of endometriosis. One occurred from episiotomy scar and the other occurred from abdominal scar following cesarean section. The diagnosis of scar endometriosis is suggested if the symptoms are cyclic or in association with the patient's menstrual cycle. We can use ultrasonography, computerized tomography, magnetic resonance imaging to differentiate from other tumors. Surgical excision is the method of choice for diagnosis and treatment. We report the two cases with review of rare extrapelvic endometriosis.

Five Cases of Endometriosis at the Site of Abdominal Scar following Cesarean Section and Episiotomy Scar / 대한산부인과학회잡지

Endometriosis at the site of episiotomy scar following vaginal delivery and abdominal scar following cesarean section are rare conditions among the extrapelvic endometriosis implantation. We have experienced five cases of extrapelvic endometriosis : four cases at the site of abdominal scar following cesarean section, and one case at the site of episiotomy scar following vaginal delivery. We report the five cases with brief review of the concerned literature.