Endometriosis of the anterior abdominal wall after delivery. Causes, treatment and prevention

Objective. To reduce the risk of recurrence of endometriosis of the anterior abdominal wall after surgical treatment by clarifying the pathogenesis, developing diagnostic and treatment algorithms. Materials and methods. A retro-prospective study was conducted, including 120 patients with endometriosis of the anterior abdominal wall who were treated in the Department of Operative Gynecology with Oncogynecology and Day Hospital of the V.I. Krasnopolsky” Moscow Regional Research Institute of Obstetrics and Gynecology in the period from 2015 to 2023, in addition, 25 patients delivered by caesarean section were additionally examined. Results. Risk factors for the development of endometriosis of the anterior abdominal wall are identified. Diagnosis of endometrioid infiltrates is usually delayed, which is due to the late appearance of complaints and a late visit to the gynecologist. Ultrasound allows us to determine the size, localization and structure of the infiltrate. In the presence of multiple foci of different sizes, especially recurrent ones, magnetic resonance imaging is preferable. Treatment of patients with endometriosis of the anterior abdominal wall should be surgical. Conclusion. Endometriosis of the anterior abdominal wall after abdominal delivery is a delayed complication. However, in patients with certain risk factors, with the use of preventive measures, it is possible to reduce the likelihood of this disease. A thorough diagnosis based on instrumental research methods makes it possible to optimize surgical treatment tactics. Hormone therapy for endometrioid infiltrates of the anterior abdominal wall at the pre- and postoperative stages does not lead to a clinically significant change in the course of the disease, only compliance with the technology of surgical removal of the formations reduces the risk of recurrence of the disease.