CLINICAL AND ANAMNESTIC FEATURES OF WOMEN WITH POSTOPERATIVE SCAR ENDOMETRIOSIS

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Relevance. Endometriosis is an urgent problem of modern gynecology, as it affects up to 10% of women of reproductive age [1]. It is known that this pathology negatively affects both the quality of life of women and their reproductive function. In addition, this pathology requires large financial expenditures on the part of the healthcare system [2]. In recent years, endometriosis of the postoperative scar has been a frequent and insufficiently studied form of the disease, which requires identification of the main risk factors for its development and clinical and anamnestic features of these patients [3].
Goal. To identify the clinical and anamnestic features of women with postoperative scar endometriosis.
Materials and methods. We examined 68 women diagnosed with postoperative scar endometriosis, the average age was 35.4±0.9 years. All patients underwent surgical treatment on the basis of the V.N. Gorodkov Iv Research Institute of M and D of the Ministry of Health of the Russian Federation in the period from 2018 to 2022. In addition to collecting anamnesis and a standard gynecological examination, we analyzed the birth histories of women, as well as carried out statistical data processing using Microsoft Excel, Statistica 13.0 program.
Results. In the main group of women, endometrioma in relation to the scar was more often on the right – 53.8%, on the left – 30.8%, central localization was in 15.4% of patients. The endometrioma was located above the scar in 61.3% of cases, 15.4% directly in the scar, 23.07% below, and had a multiple character in 7.9% of cases. During menstruation, there was an increase in the size of the formation in 35.3% of cases, a change in the color of the skin – 7.69%. The average size of the pathological formation according to ultrasound data was 18.574.5±3.754.9 mm3 with fluctuations in individual indicators from 1.400.0 to 64.152.0 mm3. Cesarean section was performed on all patients during delivery according to the classical method with a Pfannenstiel incision of the anterior abdominal wall, however, in 28.4% of cases, the operation was performed before the full 37 weeks of pregnancy due to indications: preeclampsia, fetal distress, incorrect fetal position, complicated myopia, decompensated placental insufficiency, scar on the uterus, clinical inconsistency. In addition to surgical delivery, 77.3% of women underwent surgical interventions: 1 surgical intervention was carried out by 31.8% of patients, 2 interventions – 13.6%, 3 or more interventions - 9.1%.
Conclusions. Postoperative scar endometriosis is currently not a rare form of endometriosis, while it is not associated with classical endometriosis and has separate predisposing factors: features of cesarean section surgery (contact of wound edges with intrauterine contents), surgical interventions before cesarean section, hypertensive disorders during pregnancy, early delivery.

About the authors

Aleksey Mihailovich Gerasimov

Ivanovo State Medical Academy; Ivanovo Research Institute of Motherhood and Childhood named after V. N. Gorodkov

Email: quake98@mail.ru
ORCID iD: 0000-0002-6254-1385
Russian Federation, 8 Sheremetyevo Avenue, Ivanovo, Russia, 153012; 20 Pobedy str., Ivanovo, Russia, 153045

Daria Andreevna Malyshkina

Ивановская государственная медицинская академия; Ивановский научно-исследовательский институт Материнства и Детства им. В. Н. Городкова

Email: nidsumi@mail.ru
ORCID iD: 0000-0002-1200-3570
Russian Federation, 8 Sheremetyevo Avenue, Ivanovo, Russia, 153012; 20 Pobedy str., Ivanovo, Russia, 153045

Anastasiya Vladimirovna Smirnova

Ivanovo State Medical Academy; Ivanovo Research Institute of Motherhood and Childhood named after V. N. Gorodkov

Email: anguseva@yandex.ru
ORCID iD: 0000-0002-6811-6830
Russian Federation, 8 Sheremetyevo Avenue, Ivanovo, Russia, 153012; 20 Pobedy str., Ivanovo, Russia, 153045

Darya Igorevna Milovanova

Ivanovo State Medical Academy

Email: dashamlsmi@gmail.com
ORCID iD: 0000-0002-7332-4351
Russian Federation, 153012, Russian, Ivanovo, Sheremetevskiy prospekt, 8

Alina Sergeevna Kiseleva

Ivanovo State Medical Academy

Email: sleft070@gmail.com
ORCID iD: 0000-0002-3077-9372
Russian Federation, 153012, Russian, Ivanovo, Sheremetevskiy prospekt, 8

Alina Alekseevna Prusova

Ivanovo State Medical Academy

Author for correspondence.
Email: alinaprusova@incloud.com
ORCID iD: 0000-0001-7268-0832
Russian Federation, 8 Sheremetyevo Avenue, Ivanovo, Russia, 153012

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