Characteristics and long-term outcomes of perineal endometriosis: A retrospective study

Abstract

To summarize the clinical features, diagnosis, and treatments of perineal endometriosis (PEM).We retrospectively studied the clinical data of 35 patients with PEM between April 2012 and December 2018 in West China Second Hospital. Patients were divided into the gonadotropins releasing hormone (GnRH) agonist group and non-GnRH agonist group.The main clinical symptom was vulvar painful swellings related to menstrual cycles. Thirty-three patients' lesions (94.29%) were on the episiotomy scar while 1 case was at the opposite side of the scar. We even found 1 nullipara was diagnosed as PEM. Ten patients (28.57%) were found with anal sphincter involvement. All patients received complete excision of PEM. The recurrence rate of GnRH agonist group was 7.69% (1/13), while the rate of non-GnRH agonist group was 18.75% (3/16).Most PEM was associated with episiotomy history, but PEM could also exist in nullipara. Complete excision of PEM was inevitable. The effect of GnRH agonist on recurrence of PEM needs further studies.

Figure 1

The typical ultrasonographic images of perineal endometriosis patients. The presentation of perineal endometriosis on ultrasound examination could be irregular hypoechoic without blood flow signal around (A), or a cyst with clear border and vascular signals around (B).

Figure 2

The pathology of perineal endometriosis lesions. Pathologic examination of excised lesion at perineum showed endometrial glands and stroma infiltrated into the muscle under microscope: 100X(A), 200X(B).