Characterising umbilical abdominal wall endometriosis as a distinct subgroup of abdominal wall endometriosis - retrospective cohort study

Hum Fertil (Camb). 2024 Dec;27(1):2309389. doi: 10.1080/14647273.2024.2309389. Epub 2024 Feb 6.

Abstract

Abdominal wall endometriosis (AWE) is one of the rarest forms of endometriosis. Little is known about differences between umbilical AWE (U-AWE) and non-umbilical AWE (non-U-AWE) patients. This retrospective cohort study included patients treated for AWE at tertiary endometriosis centre between 2012 and 2020. Patients were divided into two groups - umbilical AWE and non-umbilical AWE.We identified 14 U-AWE and 45 non-U-AWE patients who mostly had lesions in caesarean section scar (38, 64.4%), rarely at other locations (7, 11.9%). Infertility rates for U-AWE patients and non-U-AWE patients were 57.1% and 17.8%, respectively. Concurrent or previous peritoneal endometriosis was noted in 85.7% of U-AWE and 24.4% of non-U- AWE patients. In addition, U-AWE patients and non-UAWE patients significantly differed in following: parity, number of previous caesarean sections, lesion size, prevalence of concurrent or previous deep infiltrating endometriosis, bleeding from abdominal wall, cyclic pain, continuous pain.Infertility and pelvic endometriosis were more prevalent in U-AWE patients. Our data suggests that U-AWE may be a specific marker for a patient highly prone to pelvic endometriosis and subsequent infertility. Findings suggests that clinician should consider comprehensive evaluation of U-AWE patients.

Keywords: Abdominal wall endometriosis; caesarean section; deep infiltrating endometriosis; infertility; pelvic endometriosis; peritoneal endometriosis; umbilical endometriosis.

MeSH terms

  • Abdominal Wall* / pathology
  • Cesarean Section / adverse effects
  • Endometriosis*
  • Female
  • Humans
  • Infertility* / etiology
  • Pain / etiology
  • Pain / pathology
  • Pregnancy
  • Retrospective Studies