An increasing trend of iatrogenic scar endometriosis after lower segment cesarean section

Abstract

Cesarean scar endometriosis is an uncommon disorder developed due to iatrogenic implantation of endometrial tissues in the cesarean incision site. The frequency of the scar endometriosis is assumed to increase because of the increasing trend of lower segment cesarean section in modern obstetric practice. Cesarean section might be a great risk factor for the development of scar endometriosis due to higher exposure of endometrial cells to the subcutaneous tissue during the procedure. Prevention of decidual cell contamination to the superficial abdominal layers may reduce the occurrence of iatrogenic scar endometriosis. We reported a 21-year old para 2 woman with a history of cesarean section 2.5 years back who presented with a small mass at the middle of the cesarean scar which was associated with pain and blood-stained discharge during menstruation. Based on clinical and USG findings the provisional diagnosis was made scar endometriosis and subsequently we managed her by wide local excision of the lesion followed by adjuvant hormone therapy. No recurrence of scar endometriosis was observed during her follow up period.