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. 2025 Jul;312(1):1-8.
doi: 10.1007/s00404-024-07834-2. Epub 2024 Nov 28.

Scar endometriosis, a form of abdominal wall endometriosis-a neglected obstetrical complication?

T M Gruber  1 , K Lange  2 , G S Ebeling  2 , W Henrich  2 , S Mechsner  3
Affiliations

Scar endometriosis, a form of abdominal wall endometriosis-a neglected obstetrical complication?

T M Gruber et al. Arch Gynecol Obstet. 2025 Jul.

Abstract

Background: Scar endometriosis (EM) is defined by the presence of endometrial-like tissue outside the uterine cavity within the scar region after abdominal or pelvic surgery. It is a form of abdominal wall EM. This systematic review addresses the question of whether women after cesarean delivery (CD) are more frequently affected by scar EM than women after other pelvic surgical procedures. The primary aim is to analyze the distribution of previous operations in patients with scar EM. Secondarily, symptoms, diagnosis, and treatment are described.

Methods: A systematic literature search in MEDLINE (Pubmed) was performed. Twelve studies were included.

Results: The terminology of scar EM is unspecific and the descriptions are, therefore, of limited comparability among authors. In 64-96%, patients with scar EM had a history of CD, followed by laparoscopy, laparotomy, and episiotomy. The main symptoms were pain, often cyclical, and the presence of local swelling. For diagnosis ultrasound, CT scan and MR imaging were used. All patients had undergone surgical resection and the diagnosis was confirmed.

Conclusion: Most often scar EM develops after CD. Diagnosis and treatment are often delayed. As an objective classifications system is missing, we propose a simple objective descriptive tool for abdominal wall EM.

Keywords: Abdominal wall endometriosis; Cicatrix; Post-operative complication; Scar.

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Conflict of interest statement

Declarations. Competing interests: The authors have no financial or proprietary interests in any material discussed in this article.

Figures

Fig. 1
Fig. 1
Intraoperative presentation of scar EM after surgery with a size of 7 cm, measured after local excision
Fig. 2
Fig. 2
Flowchart of selection process of scientific literature for the review
See this image and copyright information in PMC

References

    1. Zondervan KT, Becker CM, Koga K, Missmer SA, Taylor RN, Viganò P (2018) Endometriosis. Nat Rev Dis Primer. 10.1038/s41572-018-0008-5 - PubMed
    1. Carsote M, Terzea DC, Valea A, Gheorghisan-Galateanu AA (2020) Abdominal wall endometriosis (a narrative review). Int J Med Sci 17(4):536–542. 10.7150/ijms.38679 - PMC - PubMed
    1. Vercellini P, Viganò P, Somigliana E, Fedele L (2014) Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol 10(5):261–275. 10.1038/nrendo.2013.255 - PubMed
    1. Bernuit D, Ebert AD, Halis G, Strothmann A, Gerlinger C, Geppert K et al (2011) Female perspectives on endometriosis: findings from the uterine bleeding and pain women’s research study. J Endomet 3(2):73–85. 10.5301/je.2011.8525
    1. Mechsner S (2016) Endometriose: eine oft verkannte schmerzerkrankung [endometriosis : an often unrecognized pain disorder]. Schmerz 30(5):477–490. 10.1007/s00482-016-0154-1 - PubMed

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