Endometriosis is a condition in which the tissue lining the uterine cavity, known as the endometrium, starts growing outside of the uterus. It can spread to the ovaries, the fallopian tubes, and other organs as well. When endometriosis affects the abdominal wall, it usually occurs in surgical scars from previous or current obstetrical and gynecological procedures like a cesarean section scar. Known as cesarean section scar endometriosis (CSE), this condition occurs after a C-section. Let us understand about endometriosis at C-section site, its diagnosis and treatment.
Endometriosis at C-Section Site
Under normal conditions, endometrial tissue is present inside the uterus. This tissue supports pregnancy and also sheds itself during the monthly menstrual cycle. Endometrial tissue plays an important role in your fertility and when you are trying to conceive. However, there are certain conditions that can make this endometrial tissue start growing outside the uterus. When endometrial tissue begins to grow outside the uterus, it is called endometriosis. The tissue can grow in the vagina, cervix, bowel, bladder, abdominal wall, and even the lungs. This condition generally affects women in reproductive ages. Endometriosis can even affect the lungs, bladder, kidneys, the bowel, lymph nodes, and even the abdominal wall.
While it is a rare possibility, the endometrial tissue can grow at the incision site of the abdomen following a cesarean section surgery. This is a very rare condition, causing doctors to often misdiagnose the situation after pregnancy.
Signs and Symptoms of Endometriosis at C-Section Site
One of the most common sign of endometriosis at C-section site is the formation of a sizeable lump or mass at the surgical scar. This lump tends to vary in size and is usually painful. The area around it can bleed, which causes irritation to the abdominal wall and organs due to in endometriosis at C-section site. Initially, it may be difficult to understand and is often mistaken as an improperly healed scar. Bleeding may be worse during menstrual periods. On the other hand, many women do not experience any of these symptoms and just have a noticeable mass at the C-section incision site.
Just because you have a lump or mass growing C-section area, it does not necessarily mean that you have endometriosis at C-section site. Some other conditions that may present a similar picture must be considered before suspecting endometriosis at C-section site.
- An incisional hernia
- Soft tissue tumor
- Suture granuloma
However, it is also important that your doctor considers endometriosis as one possibility for the pain, mass, and bleeding occurring at the C-section delivery incision site.
Diagnosis of Endometriosis at C-Section Site
If you suspect that you may be having endometriosis at C-section site, then you must voice your concerns to your doctor. One of the most reliable methods for diagnosis of endometriosis at C-section site is to take a sample of the tissue. This is done by a pathologist, who will then analyze the sample under a microscope to determine if the cells look similar to those present in the endometrial tissue.
Your doctor will first rule out any other likely causes for the mass in the stomach with the use of imaging studies. Some of these tests may include:
- Ultrasound: This may be used to first rule out a hernia and to determine whether the mass is solid or not.
- CT Scan: During a CT scan, the affected tissue may appear to have distinctive streaks on it that look like the endometrium, thus helping with the diagnosis.
- MRI: Many doctors prefer to run an MRI test as the results of an MRI are more sensitive to detecting endometrial tissue.
While these imaging studies help the doctor get closer to a diagnosis of endometriosis at C-section site, ultimately the sure shot way of known is to actually test the tissue for endometrial cells.
Treatment of Endometriosis at C-Section Site
The treatment of endometriosis at C-section site depends on your symptoms. If the area affected by endometriosis is relatively small and if your discomfort level is mild then you may not require any invasive treatment. You may just need an over-the-counter (OTC) pain reliever whenever it pains.
The primary treatment of endometriosis begins with medications such as birth control pills. These pills work by controlling the hormones that cause bleeding. However, these medications may not be always effective in treating endometriosis at C-section site. In such cases, your doctor may recommend surgery. During this, the endometrial tissue will be removed surgically. There are very small chances of endometriosis returning after surgery.
If you start to notice a painful region of scar tissue after having a C-section delivery, you must immediately consult your doctor. While there is no reason to immediately suspect endometriosis at C-section site, it is important that you pay attention to your symptoms, particularly if they start getting worse during your periods. If you are diagnosed with endometriosis at C-section site, it is necessary to evaluate the best possible treatment and follow medical advice.
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