Abdominal wall endometriosis in Ukraine: A multicenter study

Abstract

Aim: To estimate the incidence of abdominal walls endometriosis in Ukraine and review the clinical findings, imaging results, and histopathology of patients who have had cesarean scar endometriosis. Materials and Methods: We performed multicentre retrospective cohort study from January 2020 to December 2024. The study involved 27 hospitals from 10 regions of Ukraine and included 9,157 reproductive women who had a painful mass in their previous abdominal surgery scar area. Definitions of endometriosis were adapted from the WHO. Results: Among 9,157 patients, 387 (4.2%) abdominal walls endometriosis (AWE) were observed.Of all cases 82.2% women had cesarean scar endometriosis and 17.8% had scar endometriosis related to gynecologic surgical procedure. The incidence of AWE associated with history of cesarean section, gynecological abdominal hysterectomy and laparoscopic procedures was 6.3%, 2.3%, and 1.2%, respectively. The main symptoms of scar endometriosis were palpable abdominal mass (100%) and cyclic pain (86.8%). The latency period between cesarean section procedure and of cesarean scar endometriosis (CSE) symptom onset was 31.8±23.6 months. The duration between the onset of symptoms of CSE and this surgery was 28.7±25.4 months. The diagnosis of CSE was made through a histopathological examination. Conclusions: In Ukraine abdominal wall endometriosis (AWE), is a relatively uncommon entity that usually develops at the site of a surgical scar that occurs after obstetric or gynecologic surgeries. In our study the most frequently of all AWE cases was cesarean scar endometriosis.