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scar endometrosis on the perineum after episiotomy
Discussion in 'All Categories' started by Vishnudas - Oct 3rd, 2012 3:26 am.
My wife (Age 44) is suffering from scar endometrosis for the last 15 years. Scar endometrosis on the perineum after episiotomy is the problem. Sever pain duing the mensus has crippled her life. Inspite of hormanal tratment(Denazol/GnRH), the problem is continueing with vengence. Kindly advise whether there is any surgial treatment for the same.
re: scar endometrosis on the perineum after episiotomy by Dr M. K. Gupta - Oct 11th, 2012 1:52 pm
Dr M. K. Gupta
Dr M. K. Gupta
Dear Vishnudas

Endometriosis, in patients with scars, is more common in the abdominal skin and subcutaneous tissue compared to muscle and fascia. Endometriosis involving only the rectus muscle and sheath is very rare. The simultaneous occurrence of pelvic endometriosis with scar endometriosis has been found to be infrequent. Scar endometriosis is rare and difficult to diagnose, often confused with other surgical conditions.

Endometriosis is a common gynecological condition which is sometimes presented to general surgeons as a lump in the abdomen. It can pose a diagnostic dilemma and should be in the differential diagnosis of lumps in the abdomen in females. Diagnosis is usually made following histological examination. This is a case report of abdominal wall endometriosis following caesarian section. This report discusses and evaluates the incidence, pathophysiology, course, diagnosis, treatment and prevention of this condition.

The treatment of choice is always total wide excision of the lesion, which is diagnostic and therapeutic at the same time. Medical treatment with the use of progestogens, oral contraceptive pills, and danazol is not effective and gives only partial relief in symptoms and does not ablate the lesion. Moreover due to side effects such as amenorrhea, weight gain, hirsutism, and acne, compliance is unlikely. Recently, there have been reports of the use of the gonadotrophin agonist like Leuprolide acetate, but it has been found to provide only prompt improvement in symptoms with no change in the lesion size.

So I will advice you to contact some good gynecologist and start treatment,

With regards
M.K. Gupta
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