title: Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature.
abstract: OBJECTIVE
  The incidence of scar endometrioma ranges from 0.03 to 3.5%. Certain factors relating to knowledge of the clinical history of the disease make correct diagnosis and treatment difficult. The aim here was to identify the clinical pattern of the disease and show surgical results. The literature on this topic was reviewed.
  
  
  METHODS
  Retrospective descriptive study at Hospital Municipal Maternidade - Escola Dr. Mário de Moraes Altenfelder Silva.
  
  
  METHODS
  Data from the medical records of patients with preoperative diagnoses of scar endometrioma who underwent operations between 2001 and 2007 were surveyed and reviewed. The postoperative diagnosis came from histopathological analysis. The main information surveyed was age, obstetric antecedents, symptoms, tumor location, size and palpation, duration of complaint, diagnosis and treatment. All patients underwent tumor excision with a safety margin.
  
  
  RESULTS
  There were 33 patients, of mean age 30.1 +/- 5.0 years (range: 18-41 years). The total incidence was 0.11%: 0.29% in cesarean sections and 0.01% in vaginal deliveries. Twenty-nine tumors (87.9%) were located in cesarean scars, two (6.0%) in episiotomy scars and two (6.0%) in the umbilical region. The main symptom was localized cyclical pain (66.7%), of mean duration 30.5 months (+/- 23). Surgical treatment was successful in all cases.
  
  
  CONCLUSIONS
  This is an uncommon disease. The most important diagnostic characteristic is coincidence of painful symptoms with menstruation. Patients undergoing cesarean section are at greatest risk: relative risk of 27.37 (P < 0.01). The surgical treatment of choice is excision of the endometrioma with a safety margin.
authors.affiliation: Hospital Municipal Maternidade-Escola Dr. Mário de Moraes Altenfelder Silva, São Paulo, São Paulo, Brazil.
authors.forename: Guilherme Karam Corrêa
authors.initials: GK
authors.lastname: Leite
authors.forename: Luis Fernando Pina de
authors.initials: LF
authors.lastname: Carvalho
authors.forename: Henri
authors.initials: H
authors.lastname: Korkes
authors.forename: Thiago Falbo
authors.initials: TF
authors.lastname: Guazzelli
authors.forename: Grecy
authors.initials: G
authors.lastname: Kenj
authors.forename: Arildo de Toledo
authors.initials: Ade T
authors.lastname: Viana
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000473:pathology*; D004715:Endometriosis / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D017699:Pelvic Pain / Q000473:pathology; D011300:Preoperative Care / Q000592:standards; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult