IMR Press / CEOG / Volume 43 / Issue 5 / DOI: 10.12891/ceog3118.2016

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Original Research
Abdominal wall endometriosis occurring after cesarean section: an underestimated complication
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1 Department of Obstetrics and Gynecology, The Second Hospital of Anhui Medical University, Hefei
2 Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei
3 Department of Ultrasonography, The Second Hospital of Anhui Medical University, Hefei (China)
Clin. Exp. Obstet. Gynecol. 2016, 43(5), 678–684; https://doi.org/10.12891/ceog3118.2016
Published: 10 October 2016
Abstract

The aim of the study was to review patients characteristics, describe the exact anatomic locations and size of the endometriosis in the abdominal wall, and discuss the factors that may contribute to mesh use during abdominal wall endometriosis (AWE) resection. Materials and Methods: Patients diagnosed with AWE in their surgical scars from January 2008 to December 2014 were documented. Descriptive data was collected and analyzed. Results: A total of 95 patients with an age ranging from 26 to 48 years, with a mean age of 33.5 ±5.0 years at the time of excision were analyzed. The mean diameter of the mass was 3.25 cm in the present series with an average of 4.97 cm in the mesh group by ultrasound. A total of 18 patients had mesh therapy for fascia defect compared with 77 non-mesh therapy patients. The size of the lesions, the mean duration of symptoms for painful mass, and level of the serum CA125 were statistically different between mesh group and non-mesh group (p < 0.05). Cases of endometriosis lesions limited to the adipose layer had significant lower chance of using mesh (p < 0.05). However, adipose layer endometriosis lesions that had penetrated through the fascia layer and invaded into rectus abdominis muscle layer with/without peritoneum layer had significant higher chance of using mesh (p < 0.05). Conclusions: The more common position for scar endometriosis may be in the adipose layer at the corner of the surgical scar. Mesh therapy should be considered before surgery when the diameter of the abdominal wall mass detected by ultrasound is more than five cm and/or when the lesions invade into rectus abdominis muscle with/without peritoneum tissues from adipose and fascia layers.
Keywords
Abdominal wall endometriosis
Surgical scar
Mesh
CA 125
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