Prospective study concerning 71 cases of caesarean scar endometriosis (CSE)

Abstract

A prospective study was undertaken involving 71 patients with caesarean scar endometriosis (CSE) between the years 2007 and 2013. A prospective study enabled us to find out: mean age of patients with CSE; 34.0 years (range 22.0–48.0), time between CS and diagnosis of CSE; 12.0 months (range 19.0–39.0), duration between symptoms and surgery; 24.0 months (range 1.0–204.0), mean operation time; 40.0 min. (range 15.0–160.0), and mean lesion size; 54.4 ± 42.3 mm3. In three patients (4.2%) a large deficit in the abdominal wall was closed by means of polypropylene mesh. One of them conceived a year later. Surgical excision is the only effective treatment in patients with CSE. Wide local excision with clear margins is the key to prevent recurrence. Repair of large post-excisional deficits with mesh may also be offered to woman planning their next pregnancy.Impact statement• What is already known on this subject?Endometriosis in the scar may occur after various abdominal surgeries, more frequently after caesarean sections. The excision of large nodules is connected with suboptimal cosmetic outcomes and the possibility of recurrence.• What the results of this study add?In this study including 71 patients with CSE, wide excision with electrocoagulatory was associated with a single recurrence in 12-month follow-up. In three patients (4.2%) large deficits in the abdominal wall were closed with the use of polypropylene mesh. One of them conceived a year later and had a successful pregnancy.• What the implications are of these findings for clinical practice and/or futher research?Surgical excision is the only effective treatment in patients with CSE. Wide local excision with clear margins is the key to preventing recurrence. Repair of large post excisional deficit with mesh may be offered also to woman planning pregnancy.