OBJECTIVE: To investigate outcomes following incisional endometrioma after cesarean section and correlate the role of predisposing factors. STUDY DESIGN: Chart review of patients from a 7-year period noting surgical history, previous incisions, uterine exteriorization, and wound irrigation at cesarean section, preoperative and final endometrioma size, mass location, fascial involvement, and mesh placement. RESULTS: All 16 patients had cesarean section as their last surgery and 15 of 16 had transverse incisions. Patients averaged 29.2 years of age, had two prior surgeries with time to symptoms of 25.9 months. Endometriomas were primarily left of midline, extrafascial in 10 patients and intrafascial 3 patients, and involved fascia and muscle in 3 patients. Estimated and actual sizes were similar (p = 0.54) and not correlated with mesh placement (p = 0.21). No patient had concomitant pelvic endometriosis. CONCLUSION: Incisional endometriomas developing after cesarean section occur primarily on the left of transverse incisions. Endometrioma size estimates correlate well with surgical findings but not with the need for mesh placement.
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