A Case of Endometriosis in Episiotomy Scar with Anal Sphincter Involvement
ABSTRACT
Endometriosis is defined as the presence of endometrial tissue apart from its usual location (endometrium). It is the second most prevalent benign gynecologic disease after the presence of fibroids in women of childbearing age (incidence of 10% - 25%). Endometriosis predominantly locates on peritoneal surfaces, but it also affects the vagina, vulva, recto-vaginal septum and perineum, usually secondary to surgical or obstetric trauma. We present a case of a patient with perineal endometriosis (single nodule) in the scar of episiotomy and involvement of external anal sphincter with local and catamenial pain but with continence maintained. The endometric nodule was removed, and wide dissection and sphincteroplasty were performed. Afterwards, treatment with GnRh analogues was prescribed for a four-month period. Surgical outcome was successful and the patient was asymptomatic during subsequent menstruations.
Endometriosis is defined as the presence of endometrial tissue apart from its usual location (endometrium). It is the second most prevalent benign gynecologic disease after the presence of fibroids in women of childbearing age (incidence of 10% - 25%). Endometriosis predominantly locates on peritoneal surfaces, but it also affects the vagina, vulva, recto-vaginal septum and perineum, usually secondary to surgical or obstetric trauma. We present a case of a patient with perineal endometriosis (single nodule) in the scar of episiotomy and involvement of external anal sphincter with local and catamenial pain but with continence maintained. The endometric nodule was removed, and wide dissection and sphincteroplasty were performed. Afterwards, treatment with GnRh analogues was prescribed for a four-month period. Surgical outcome was successful and the patient was asymptomatic during subsequent menstruations.
Cite this paper
nullB. Gauna, D. Rodriguez, S. Cabré and J. Callejo, "A Case of Endometriosis in Episiotomy Scar with Anal Sphincter Involvement," International Journal of Clinical Medicine, Vol. 2 No. 5, 2011, pp. 624-626. doi: 10.4236/ijcm.2011.25104.
nullB. Gauna, D. Rodriguez, S. Cabré and J. Callejo, "A Case of Endometriosis in Episiotomy Scar with Anal Sphincter Involvement," International Journal of Clinical Medicine, Vol. 2 No. 5, 2011, pp. 624-626. doi: 10.4236/ijcm.2011.25104.
References
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[1] G. I. Barisic, Z. V. Krivokapic and D. R. Jovanovic, “Perineal Endometriosis in Episiotomy Scar with Anal Sphincter Involvement: Report of Two Cases and Review of the Literature,” International Urogynecology Journal and Pelvic Floor Dysfunction, Vol. 17, No. 6, 2006, pp. 646-649. doi:10.1007/s00192-005-0022-5 [2] A. Ododbasic, A. Pasic, E. Iljazovic-Latifagic, L. Arnatalic, E. Idrizovic, M. Dervisefendic and L. Dedic, “Perineal Endometriosis: A Case Report and Review of the Literature,” Techniques in Coloproctology, Vol. 14, Supplement 1, 2010, pp. 25-27. doi:10.1007/s10151-010-0642-8 [3] C. C. Liang, C. C. Tsai, T. C. Chen and Y. K. Soong, “Management of Perineal Endometriosis,” International Journal of Gynecology & Obstetrics, Vol. 53, No. 3, 1996, pp. 261-265. doi:10.1016/0020-7292(95)02592-8 [4] I. Kanellos, T. Kelpis, T. Zaraboukas and D. Betsis, “Perineal Endometriosis in Episiotomy Scar with Anal Sphinter Involvement,” Techniques in Coloproctology, Vol. 5, No. 2, 2001, pp. 107-108. doi:10.1007/s101510170009 [5] T. Toyonaga, M. Matsushima, Y. Tanaka, M. Nozawa, N. Sogawa, H. Kanyama and M. Tanaka, “Endoanal Ultrasonography in the Diagnosis and Operative Management of Perianal Endometriosis: Report of Two Cases,” Techniques in Coloproctology, Vol. 10, No. 4, 2006, pp. 357-360. doi:10.1007/s10151-006-0309-7