| The role of gonadotrophin releasing hormone agonist for the treatment of scar endometriosis. |
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So Yun Park, Sa Ra Lee, Hye Won Chung |
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Department of Obstetrics and Gynecology, Ewha Womans University School of Medicine, Seoul, Korea. sarahmd@ewha.ac.kr |
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| 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. |
| Key Words:
Endometriosis, Excision, Recurrence, GnRH agonist |
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