Razi Journal of Medical Sciences

  Background: Endometriosis is a benign disease of female genital system, which often occurs in the reproductive age and it is defined by the presence of tissue resembling endometrial glands and stroma outside the uterine cavity. Endometriosis is found in two types of pelvic and extrapelvic. The most common type of extrapelvic endometriosis is cutaneous endometriosis which can occur either spontaneously or secondary to abdomino-pelvic surgeries. Abdominal wall endometriosis is the most common type of cutaneous endometriosis that its diagnosis is difficult. The purpose of this study is to determine the prevalence of abdominal wall endometriosis in patients with endometriosis.

  Methods: In this retrospective cross-sectional study, 323 patients with endometriosis and definite histopathological diagnosis who admitted in Rasool-Akram, Shariati and Atieh Hospitals during 1384 to 1389, were enrolled. The sampling method was census and the study variables included patient age, history of pelvic or abdominal surgery, history of cesarean section and the delivery frequency of patients, location of endometriosis and its clinical presentation. Information was gathered from medical records of patients. Finally, data analysis was performed using SPSS software.

  Results : The prevalence of Extra Pelvic endometriosis was calculated 14.8% (48 cases that 40 cases were abdominal wall endometriosis, 5 cases cervical endometriosis, vaginal endometriosis in 1 case and 2 cases of perineal endometriosis). The prevalence of abdominal wall endometriosis was 12.3 percent of all cases of endometriosis in which cesarean scar endometriosis and umbilical endometriosis were found in 38 cases (11.7 %) and 2 cases (0.6%) respectively. History of previous cesarean section in patients with abdominal wall endometriosis was significantly more than patients with other types of endometriosis (100% vs. 24.6%) (p=0.0001). Average number of delivery and cesarean section in patients with abdominal wall endometriosis were significantly higher than other patients (p= 0.002 and p= 0.0001 respectively). Infertility in patients with endometriosis in other places was significantly higher than patients with abdominal wall endometriosis (p= 0.01). The predominant symptom in patients with abdominal wall endometriosis was, localized pain and swelling in abdominal wall at the surgical scar that become worse during menstruation.

  Conclusion : abdominal wall endometriosis is seen in two forms of surgical scar and umbilical endometriosis. The prevalence of abdominal wall endometriosis among all types of endometriosis was 12.3% and all the cases of abdominal wall endometriosis have the positive history of cesarean section. The mean age of these patients was 34 years, and attention to this prevalence, predominant symptoms, prevalent age, and history of cesarean section in patients, will help and facilitate the diagnosis.