Recep ERİN, Yeşim BAYOĞLU TEKİN, Kübra BAKİ ERİN, Deniz KULAKSIZ

Epizyotomi skarında gelişen endometriozis: Olgu sunumu

Fonksiyonel endometrial dokunun uterin kavite dışında bulunmasına endometriozis denir. Over ve viseral peritoneal yüzeyler en sık tutulan yerlerdir. Ekstrapelvik bölgelerde özellikle sezaryen ve histerektomiyi takiben skar bölgelerinde ve epizyotomili vajinal doğum sonrasında perineal endometriozis görülebilir. Perineal bölgede endometrial dokunun bulunması perineal endometriozis olarak adlandırılır. Otuz beş yaşında, G2P2, vajinal yolla iki doğumu olan kadın hasta, perineal bölgede şişlik ve ağrı şikayetiyle hastanemize başvurdu. Semptomları beş yıldır mediolateral epizyotomi skarına uygun yerde, mentrüasyonla artan ağrı şeklinde idi. Muayenede skar hattında 2.5x2x 2 cm boyutlarında, semi-mobil yumuşak kıvamda kitle tespit edildi. Perineal kitle cerrahi olarak çıkartıldı ve patoloji sonucu endometriozis olarak rapor edildi. Perineal endometriozis tedavisinde cerrahi eksizyon iyi bir tedavi alternatifidir. Perineal endometriozis bu bölgede kitle ve ağrı şikayeti olan hastalarda ayırıcı tanıda düşünülmelidir.

Anahtar Kelimeler:

Endometriozis, Epizyotomi, Perineal ağrı, Kitle

Endometriosis refers to the presence of functional endometrial tissue outside the uterine cavity. The most common sites of endometriosis are the ovaries and visceral peritoneal surfaces. Endometriosis may also occur in extrapelvic sites and abdominal or episiotomy scar due to hysterectomy, cesarean section and vaginal birth. Perineal endometriosis is defined as the presence of endometrial tissues in the perineum. A-35-year old, G2P2 woman with a history of two vaginal births was admitted to our hospital with a complaint of perineal pain and mass. She has been symptomatic for five years following her last vaginal birth. Her pain was located in her mediolateral episiotomy scar. She reported worsening pain during menstruation. The examination revealed a semi-mobile, soft mass measuring 2.5x2x2 cm at the episiotomy scar. Surgical excision of the mass was performed, and histopathology revealed perineal endometriosis. Surgical excision of the endometriotic implant is an excellent option to treat perineal endometriosis. Perineal endometriosis should be kept in mind in patients with a perineal mass and pain.

Keywords:

Endometriosis, Episiotomy, Perineal pain, Mass,

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