Umbilical endometriosis after unprotected removal of uterine pieces through the umbilicus.
We reviewed the frequency of umbilical endometriosis after laparoscopic-assisted subtotal hysterectomy with unprotected removal of uterine segments through the umbilical incision. Retrospective analysis of surgical records was followed by recall and clinical examination of 10 patients. Two women developed umbilical endometriosis. One was the only patient operated during menstruation. The other was one of two women operated in the late luteal phase and with subsequent adequate exposure to endogenous or exogenous estrogens. From 1976-1997, 22 reports of umbilical endometriosis were published: 18 cases were spontaneous, 2 occurred after ring sterilization, and 2 after diagnostic laparoscopy. These data lend support to the concept that implantation and the potential development of menstrual endometrium are increased after surgery. It is speculated that procedures that expose menstrual endometrial cells to nonepithelialized areas could be associated with an increased risk of endometriosis.
Koninckx
P R
PR
University Hospital Gasthuisberg, Department of Obstetrics and Gynecology, Herestraat 49, Leuven, B-3000 Belgium.
Donders
G
G
Vandecruys
H
H
D000328:Adult; D004715:Endometriosis / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D010535:Laparoscopy / Q000009:adverse effects*; D008598:Menstruation; D008875:Middle Aged; D012189:Retrospective Studies; D014472:Umbilicus