Prevalence of Cesarean Section Scar Endometriosis: Ten-Year Experience of a Tertiary Center and Retrospective Evaluation of 40 Cases
1Department of General Surgery, Ömer Halisdemir University Training and Research Hospital, Niğde, Turkey
2Department of Obstetrics and Gynecology, Private Practice, Niğde, Turkey
J Clin Pract Res 2021; 43(3): 255-260 DOI: 10.14744/etd.2020.12269
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Abstract

Objective: Cesarean scar endometriosis (CSE) is the presence of ectopic endometrial tissue at the site of the previous cesarean section (CS) scar. The prevalence varies between 0.04 and 0.53. We aimed to evaluate the women with CSE in the past 10 years in Niğde.
Materials and Methods: The medical records of Ömer Halisdemir University Training and Research Hospital and the single private hospital were retrospectively analyzed through electronic databases between January 2010 and January 2020. Pathological reports with the diagnosis of abdominal wall endometriosis were distinguished. The ones excised from a CS scar were included into the study. For each patient clinical, obstetric and surgical characteristics were recorded.
Results: Forty women were included into the study with an average age of 31.6±5.9 years. The diameter of the CSE lesion was positively correlated in medium strength with body mass index (BMI) at the time of CS (r=0.448, p=0.019). Similarly, the diameter of the lesion and weight gain during pregnancy was correlated in medium strength (r=0.423, p=0.014). The onset of symptoms was correlated in medium strength with lactation period (r=0.539, p=0.001). The rate of correct initial diagnosis was significantly higher in years 2015–2019 than in years 2010–2014 (p=0.004). The CSE prevalence was 0.15 in the present study.
Conclusion: High BMI values at the time of CS and weight gain during pregnancy might be contributors of CSE development. Furthermore, lactation might have protective effects against CSE.