Our Summary

This research paper talks about a condition called parietal endometrioma, which can occur in women who have had at least one caesarean section birth. This condition can cause chronic, cyclical pelvic pain, often located near the scar from the caesarean section. It can also cause a mass to form in the pelvic wall. This mass can usually be felt during a physical examination.

To confirm the diagnosis, it is recommended to perform a specific type of ultrasound, preferably during menstruation and during a painful episode. However, the ultrasound can also show typical signs of this condition even outside the menstrual period.

The standard treatment for this condition is extensive surgical removal of the affected area, ensuring that the surrounding healthy tissue is not affected. This surgery is performed under general anesthesia.

FAQs

  1. What is parietal endometrioma and how is it related to caesarean section births?
  2. How is parietal endometrioma diagnosed?
  3. What is the standard treatment for parietal endometrioma?

Doctor’s Tip

A tip that a doctor might give to a patient who has had a cesarean section is to be aware of any unusual or persistent pelvic pain near the scar site. If you experience chronic, cyclical pelvic pain or notice a mass forming in the pelvic wall, it is important to seek medical attention promptly. A proper diagnosis, such as through ultrasound imaging, can help determine the best course of treatment, which may include surgery to remove the affected tissue. It is important to communicate openly with your healthcare provider about any concerns or symptoms you may be experiencing.

Suitable For

In general, patients who have had a previous cesarean section and present with symptoms such as chronic pelvic pain, painful scar, or a palpable mass in the pelvic wall may be recommended for a cesarean section. Additionally, patients who have a confirmed diagnosis of parietal endometrioma through ultrasound may also be advised to undergo a cesarean section to remove the affected tissue.

It is important for healthcare providers to carefully assess each patient’s individual case and symptoms to determine the most appropriate treatment plan. In some cases, medication or other non-surgical approaches may be considered before resorting to surgery. Ultimately, the decision to recommend a cesarean section will depend on the specific circumstances of each patient and their overall health and well-being.

Timeline

Before the cesarean section:

  • Patient may have a planned or emergency cesarean section due to various reasons such as breech presentation, fetal distress, or maternal health concerns.
  • Patient will undergo pre-operative preparations, which may include fasting, blood work, and consent forms.
  • Anesthesia options will be discussed with the patient, such as spinal or epidural anesthesia.
  • Patient will be taken to the operating room, where the cesarean section will be performed by the surgical team.
  • Baby will be delivered and handed to the patient for bonding and feeding.
  • Patient will be monitored closely post-operatively for any complications or side effects.

After the cesarean section:

  • Patient will be transferred to a recovery room for monitoring and pain management.
  • Patient will receive instructions on wound care, pain management, and post-operative restrictions.
  • Patient will stay in the hospital for a few days for observation and recovery.
  • Patient will be encouraged to start walking and moving around to prevent blood clots and promote healing.
  • Patient may experience discomfort, pain, and fatigue in the days following the surgery.
  • Patient will have a follow-up appointment with their healthcare provider to monitor healing and address any concerns.
  • Patient may experience long-term effects, such as scar tissue formation and potential complications like parietal endometrioma, as discussed in the research paper.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cesarean section and parietal endometrioma may include:

  1. What are the symptoms of parietal endometrioma and how is it diagnosed?
  2. How common is parietal endometrioma in women who have had a cesarean section?
  3. What are the risks and complications associated with parietal endometrioma?
  4. What are the treatment options for parietal endometrioma and what is the success rate of these treatments?
  5. How long is the recovery period after surgery for parietal endometrioma?
  6. Are there any lifestyle changes or medications that can help manage symptoms of parietal endometrioma?
  7. Are there any long-term effects of parietal endometrioma on fertility or future pregnancies?
  8. Are there any alternative treatments or complementary therapies that may help with symptoms of parietal endometrioma?
  9. How often should follow-up appointments be scheduled after treatment for parietal endometrioma?
  10. Are there any support groups or resources available for women with parietal endometrioma?

Reference

Authors: Delannoy M, Acharian V. Journal: Rev Prat. 2019 Apr;69(4):429-431. PMID: 31626501