Cesarean scar endometriosis – yes, it’s a thing

Cesarean section scar endometriosisalso called incisional endometriosis, is considered quite rare.

But with multiple Reddit threads calling for discussion, sharing of experiences and support, as well as this 2023 study telling us that the prevalence is increasing, is it really as rare as we might think?

We have said it before and we will continue to say it. As with many aspects of endometriosis and wider women’s health issues, there is a disappointing (but not surprising) lack of real research here.

We are fighting for more awareness and growing our library of educational content to support those going through this experience – from how to find a specialist has navigating silent endometriosisguides on how to be diagnosed and more.

Here’s what we currently know about C-sections, scarring and endometriosis.

What is cesarean scar endometriosis?

Caesarean section scar endometriosis occurs when endometrial cells are found in scar tissue from a cesarean section.

These are thought to be transferred from existing endometrial cells to the incision site during surgery.

Over time, these endometrial cells can respond to your menstrual cycle, causing endometriosis symptoms to appear around your scar.

This can develop for months or even years after abdominal surgeryespecially among those who have a cesarean delivery history.

Endometriosis in Cesarean Scar Symptoms​

Symptoms may appear slowly, and there are two things to watch for:

• Pain or tenderness around your scarespecially (but not limited to) during your period
• A bump in or near your scar it’s noticeable

What does an endometriosis bump look like on a C-section scar?

An endometriosis bump on a cesarean scar is usually firm, small and tender. The lump may increase in size or become more painful during your period.

Note – If you have a lump in your scar, it is not certain that it is related to endometriosis.

Other conditions that appear as lumps include keloid scars, incisional hernias And large bruisesand it’s important to have any bumps examined by your doctor, especially if they are painful, growing, or bleeding.

Diagnosing scar endometriosis by cesarean section

A healthcare professional should take a complete history of your C-section experiences and ask you about your pain patterns.

X-ray, specifically ultrasoundcould then be used to first examine a suspected endometriotic mass on a cesarean scar. The right specialist can then identify irregular tissue or nodules embedded in the scar.

In some cases, further imaging such as MRI may be recommended as a second-line approach, but a small surgical biopsy is the only way to confirm the diagnosis.

Treatment of scarring endometriosis by cesarean section

For those wondering about treating scarring endometriosis with cesarean section, the answers here are frustrating and murky.

Here’s what most sources suggest. These treatments could be offered to you individually or in combination:

• Pain management options, including painkillers
• Hormonal therapyincluding birth control
• Surgical removal mass or tissue

A small study tells us that after surgical removal, no recurrence of endometriosis by cesarean section was observed, suggesting that surgery is the most useful option here.

Quick FAQ about Caesarean Section Endometriosis

1. What is incisional endometriosis?

Incisional endometriosis is endometrial tissue that grows in a surgical scar, most commonly a cesarean section. It usually reacts to hormonal changes, causing pain, tenderness, or bumps in the scar.

2. Can a cesarean section cause endometriosis?​

Yes, a C-section can give endometrial cells a place to grow in your scar. It is not generally thought to trigger endometriosis elsewhere in the body, but it could cause local scarring endometriosis.

3. Should I have a C-section if I already have endometriosis?

No, you won’t always need a cesarean delivery if you have endometriosis, but it may increase the likelihood.

Research tells us that women with endometriosis face double the cesarean section ratethought to be linked to the slightly higher incidence of complications of pregnancy and childbirth.

That said, many of us with endometriosis will have successful vaginal births.

4. Can endometriosis get worse after a C-section?​

Sometimes. Although there is little research on this, some say their pain is worse.

5. Can a doctor examine my endometriosis during a cesarean section?

Your doctor will not look for endometriosis during a cesarean section, but it may be visible depending on the stage and number of adhesions.

6. Can endometriosis be removed during a cesarean section?

Usually, no. Endometriosis will not be removed during a cesarean section due to the increased risks. However, it may sometimes be necessary to remove adhesions during the procedure if they are present in the abdominal wall or blocking the uterus.

Did you like this feature? Read this next: 11 Rare or Uncommon Symptoms of Endometriosis (Create a Journal for Your Obstetrician)