Therapeutic Role of Danazol in Scar Endometriosis - Evidence from a Favorable Clinical Outcome

Background: Scar endometriosis (SE) is a rare extra-pelvic manifestation of endometriosis, most often associated with prior abdominal surgery, particularly cesarean sections. While surgical excision remains the standard of care, medical therapy such as danazol may offer a valuable alternative in select patients, especially in resource-constrained settings. The objective of the study is to evaluate the clinical efficacy and safety of danazol in the treatment of SE in a large Bangladeshi cohort. Methods & Materials: We conducted a retrospective observational study of 110 women with clinically diagnosed SE treated with danazol 200 mg doses twice per day for six months. Baseline demographics, pain score (VAS), lesion size, and palpability were recorded. Post-treatment outcomes, recurrence at six months, and adverse effects were analyzed using paired t-tests, McNemar’s test, and logistic regression. Results: Pain reduction ≥50% was achieved in 83.6% (p = 0.001), lesion size reduction ≥30% in 77.3% (p = 0.002), and complete clinical resolution in 60.0% (p = 0.015). Recurrence at six months occurred in 10.9% (p = 0.0005). Mean VAS decreased from 7.8 ± 1.2 to 3.2 ± 1.5 (p < 0.001), and mean lesion size from 3.4 ± 1.1 cm to 1.9 ± 0.9 cm (p < 0.001). Most patients (71.8%) reported no adverse effects. Logistic regression identified danazol therapy (OR 4.8), baseline pain ≥7 (OR 1.8), and age ≥30 years (OR 1.2) as significant predictors of favorable outcome. Conclusion: Danazol offers an effective, well-tolerated non-surgical option for SE, with substantial clinical benefits and low short-term recurrence in a Bangladeshi population.