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What is Scar Endometriosis?
Endometriosis is when tissue that’s similar to the inner lining of your uterus (called endometrial tissue) grows in places it shouldn’t, like your ovaries, bowel, or even the abdominal wall.This tissue acts just like the lining inside your uterus: it can thicken and even bleed when your period arrives.
After a C-section, it can sometimes end up in or around the scar from the surgery. There are two specific types to know about:
- Incisional endometriosis: This happens when endometrial-like tissue grows in the surgical scar on your abdominal wall.
- Adenomyosis: This is when the tissue grows within the walls of the uterus at the C-section scar.
Why Does Scar Endometriosis Occur?
You might be wondering, “How did this tissue get into my scar?” During a C-section, the surgeon cuts through the uterus to deliver your baby. Sometimes, tiny bits of endometrial lining or tissue can accidentally get carried to the incision site. This can happen through surgical instruments, fluids, or discharges.Once there, the tissue can settle in the scar and start acting like it’s still in the uterus (growing and shedding with your menstrual cycle). This leads to pain or lumps that can get worse during your period, leading to cyclic pain.
Scar Endometriosis Symptoms
Look out for the following signs:- Pelvic pain that might feel worse during your period
- Lump or swelling near your C-section scar
- The scar area might be sensitive or painful if you press on it
- Skin discolouration over the lump or bleeding
How is Scar Endometriosis Diagnosed?
Diagnosis can take time because it’s so rare. Here’s how doctors figure it out:- Medical history and exam: Your doctor will ask about your symptoms, past surgeries, and medical history. They’ll also examine the scar to check for lumps or tenderness.
- Ultrasound: This quick, painless test uses sound waves to look at your uterus and surrounding areas. It can show if there’s a mass near the scar.
- MRI scan: If the ultrasound isn’t clear enough, an MRI can provide a more detailed picture of the lump and its depth.
- CA 125 blood test: This test measures the level of a protein called CA 125 in your blood.
- Biopsy: Your doctor might take a small tissue sample from the lump, usually during surgery. A pathologist looks at it under a microscope to see if it’s endometrial-like tissue.
Treatment for Scar Endometriosis
Your treatment will depend on how severe your symptoms are and whether you want to get pregnant again:- Pain relief: If your symptoms are mild, you might try over-the-counter pain relievers to ease discomfort during your period.
- Hormonal medications: Birth control pills or other hormonal treatments can help control the hormones that cause the tissue to grow and bleed. These might reduce pain, but they won’t get rid of the lump.
- Surgery: The most effective treatment is surgery to remove the endometrial-like tissue. The surgeon will take out the entire lump, along with a small area of healthy tissue around it to make sure it’s all gone. If the surgery leaves a gap in your abdominal muscles, a mesh might be used to strengthen the area and prevent a hernia.
- Hysterectomy: If the endometriosis is severe and you don’t plan to have more children, a hysterectomy (removing the uterus) might be an option.
- Levonorgestrel intrauterine device (IUD) insertion: An IUD is placed in the uterine lining that helps reduce the pain caused by scar endometriosis. Sometimes, the ovaries are removed too (called a bilateral salpingo-oophorectomy), but this comes with other health risks. So be sure to discuss it carefully with your doctor.
How Does Endometriosis After a C-Section Affect Future Pregnancies?
If you’re planning to have more children, you might be worried about how scar endometriosis affects your fertility or future pregnancies.The reassuring news is that incisional endometriosis is usually a localised issue, meaning it’s confined to the scar and doesn’t affect your ability to conceive.
If the tissue is removed through surgery, it rarely causes issues with future C-sections. Still, it’s a good idea to talk to your doctor about the chance of it coming back if you plan to have another C-section.
Recovery After Surgery
If you need surgery for scar endometriosis, recovery is usually faster than with major abdominal surgery. You may feel soreness or notice some bruising at the site for a few days to a week.Most people can return to light activities within 4 to 6 weeks, but heavy lifting or intense exercise should be avoided for at least 6 weeks to allow proper healing. Your doctor will give you specific advice based on your surgery.
Can You Prevent Endometriosis After a C-Section?
There’s no sure way to prevent scar endometriosis because it often happens by accident during surgery. However, surgeons try to reduce the risk by carefully suctioning fluids and washing the surgical site before closing the incision.Experiencing endometriosis after a C-section can feel unexpected, but it doesn’t have to control your life. You can effectively manage the symptoms of this condition and get back to feeling like yourself again with the right care.
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FAQs on Signs of Scar Endometriosis After a C-Section You Shouldn’t Ignore
- How do I know if I have scar endometriosis?
You may notice pain, swelling, or a lump near your C-section scar that worsens during periods. A doctor can confirm it with tests or scans. - How is C-section scar endometriosis treated?
The most effective treatment is surgical removal of the affected tissue. Pain relief medicines may be given, but surgery offers long-term relief.