Korean J Obstet Gynecol.  2012 Dec;55(12):947-952. 10.5468/KJOG.2012.55.12.947.

The role of gonadotrophin releasing hormone agonist for the treatment of scar endometriosis

• Park SY
• Lee SR
• Chung HW

• KMID: 2274202
• DOI: http://doi.org/10.5468/KJOG.2012.55.12.947

Abstract

OBJECTIVE
To investigate the characteristics and to define the most effective diagnosis and treatment option for the scar endometriosis resulting from abdominal incision or episiotomy.
METHODS
Medical records of thirty women with scar endometriosis who underwent mass excision between 1996 and 2008 in our hospital were reviewed retrospectively. Data on the age, parity, surgical history, symptom, menstrual history, characteristics of the mass, preoperative diagnosis, treatment method and recurrence were analyzed.
RESULTS
Scar endometriosis were developed after Cesarean section in 24 patients and episiotomy in 6 patients. Nearly all patients presented with a palpable mass with or without cyclic pain and mean duration of symptom was 23.8 months. Preoperative imaging study was performed in 14 patients, however there was no one whose preoperative imaging result was endometriosis. All scar endometriosis was completely excised with surrounding tissue. Gonadotrophin releasing hormone (GnRH) agonist was administered in 13 patients pre- or postoperatively. Recurrence of scar endometriosis after wide mass excision was noted in 4 patients (13.3%) who did not receive GnRH agonist therapy pre- or postoperatively.
CONCLUSION
This study supports that scar endometriosis is a result of the transplantation of endometrial tissue during procedures. The contribution of the imaging studies seems to be limited, so surgeon could perform mass excision for diagnosis and treatment with clinical history and physical exam without performing imaging study especially in for small scar endometriosis. Surgical excision accompanied by pre-, or postoperative GnRH agonist therapy may be helpful option for the prevention of recurrence however, we could not find any statistical significance in the effectiveness of GnRH agonist treatment.

Keyword

Endometriosis; Excision; Recurrence; GnRH agonist

MeSH Terms

Cesarean Section
Cicatrix
Endometriosis
Episiotomy
Female
Gonadotropin-Releasing Hormone
Humans
Medical Records
Parity
Pregnancy
Recurrence
Retrospective Studies
Transplants
Gonadotropin-Releasing Hormone

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