Association rate between incisional and pelvic endometriosis

Purpose: To investigate the association rate between abdominal wall and pelvic endometriosis in a population of Iranian patients, in University and private hospitals of Shiraz University of Medical Sciences. Methods: 30 women were diagnosed as abdominal wall endometriosis according to the clinical signs and symptoms (dysmenorrhea, dyspauronia and pelvic pain) and the sonographic findings. The mean age of the patients was 30.5 +/- 3.3 (range 21-35) years. All the patients underwent resection of abdominal wall mass and investigation of the pelvic cavity for detecting pelvic endometriosis by laparoscopy. The pelvic endometriosis was scored and the stage was determined. Results: 28 (93.3%) patients were found to have concomitant pelvic endometriosis. The mean score of pelvic endometriosis was 9.3 +/- 6.6 (range 3-33). Of the patients, 10 (33.3%) suffered from stage I endometriosis, 16 (53.3%) from stage II, and 2 (6.7%) from stage III. Only 2 (6.7%) patients did not have concomitant pelvic endometriosis. The abdominal wall mass was successfully excised in all the cases. The histopathology diagnosis was confirmed in all the cases. Conclusions: The association rate between abdominal wall and pelvic endometriosis is higher than that previously reported, up to 90%. Thus, routine investigation of the pelvic cavity is recommended in all the patients with abdominal wall endometriosis.