Abdominal wall endometriosis in Ukraine: A multicenter study

Aidyn G Salmanov; Volodymyr V Artyomenko; Victor O Rud; Vitalii S Strakhovetskyi; Svitlana M Korniyenko; Olga V Gorbunova; Serhii Yu Vdovychenko; Oleksandr V Zabudskyi; Orusia A Kovalyshyn; Olena O Lytvak; Viktor I Litus; Tetiana A Struk; Ihor Paliga; Olexandr P Kononets; Igor V Maidannyk; Olena O Chorna

doi:10.36740/wlek/215796

Endometriosis · Associated Conditions

Abdominal wall endometriosis in Ukraine: A multicenter study

Salmanov AG, Artyomenko VV, Rud VO, Strakhovetskyi VS, Korniyenko SM, Gorbunova OV, Vdovychenko SY, Zabudskyi OV, Kovalyshyn OA, Lytvak OO, Litus VI, Struk TA, Paliga I, Kononets OP, Maidannyk IV, Chorna OO

Wiadomosci lekarskie (Warsaw, Poland : 1960), 2025

DOI 10.36740/wlek/215796 PMID 41620853

RRM Academy Synopsis

Most abdominal wall endometriosis in Ukraine involved cesarean scars

Abdominal wall endometriosis affected about 4 out of 100 women with painful scar masses in a retrospective cohort of 9,157 women at 27 Ukrainian hospitals (2020 to 2024). About 82 out of 100 of the 387 cases were in cesarean scars. The other cases were related to gynecologic surgery.

Key Findings

Of 9,157 women with a painful mass in a surgical scar, 387 (4.2%) had abdominal wall endometriosis.
Of the 387 cases, 318 (82.2%) were cesarean scar endometriosis and 69 (17.8%) were related to gynecologic surgical procedures.
The reported incidence of abdominal wall endometriosis was 6.3% with a history of cesarean section, 2.3% (95% CI, 2.1-2.5) with abdominal hysterectomy and 1.2% (95% CI, 1.1-1.3) with laparoscopic procedures.
Palpable abdominal mass was reported in 100% of women with scar endometriosis, and cyclic pain in 86.8%.
In cesarean scar endometriosis, symptoms began a mean of 31.8 ± 23.6 months after cesarean section, and surgery followed a mean of 28.7 ± 25.4 months after onset.

Interpretation

This retrospective cohort used inpatient records from 27 hospitals in 10 Ukrainian regions. All 9,157 women already had a painful mass in a surgical scar. The 4.2% is therefore the share of these women whose mass proved to be endometriosis. The authors report a histological diagnosis of endometriosis, made by tissue examination. The authors list mostly ultrasound diagnosis as a limitation, since ultrasound alone can miss other conditions. The report counts cases and describes symptoms, and it compares no treatments. The authors call it the first Ukrainian study to publish an incidence for cesarean scar endometriosis.

RRM Context

Restorative reproductive medicine aims to find the cause of symptoms and remove disease where it sits. Excision removes the lesion itself and is the surgical standard for endometriosis. This series reports surgical excision, with a histological diagnosis. Cyclic pain in 86.8% of the women shows what a history built around the menstrual cycle can reveal. A mean of 28.7 months from first symptoms to surgery leaves room for earlier recognition.

Our editorial summary of this paper, not the article's abstract.

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.

Topics

Endometriosis Associated Conditions Extrapelvic Endometriosis

Endometriosis › Associated Conditions › Extrapelvic Endometriosis

Aidyn G Salmanov, Volodymyr V Artyomenko, Victor O Rud, Vitalii S Strakhovetskyi, Svitlana M Korniyenko, Olga V Gorbunova, Serhii Yu Vdovychenko, Oleksandr V Zabudskyi, Orusia A Kovalyshyn, Olena O Lytvak, Viktor I Litus, Tetiana A Struk, Ihor Paliga, Olexandr P Kononets, Igor V Maidannyk, Olena O Chorna

A Salmanov, V Artyomenko, V Rud, V Strakhovetskyi, S Korniyenko, O Gorbunova, S Vdovychenko, O Zabudskyi, O Kovalyshyn, O Lytvak, V Litus, T Struk, I Paliga, O Kononets, I Maidannyk, O Chorna

PMID 41620853 41620853 DOI 10.36740/wlek/215796 10.36740/wlek/215796 Salmanov et al. 2025, Salmanov 2025

Abdominal wall endometriosis in Ukraine: A multicenter study

Most abdominal wall endometriosis in Ukraine involved cesarean scars

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

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