Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2021; 9(5): 1037-1047
Published online Feb 16, 2021. doi: 10.12998/wjcc.v9.i5.1037
Clinical characteristics of perineal endometriosis: A case series
Yan Liang, Duo Zhang, Ling Jiang, Yuan Liu, Jian Zhang
Yan Liang, Duo Zhang, Jian Zhang, Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, Shanghai 200030, China
Yan Liang, Duo Zhang, Ling Jiang, Yuan Liu, Jian Zhang, Shanghai Key Laboratory Embryo Original Diseases, China
Ling Jiang, Department of Radiology, International Peace Maternity and Child Health Hospital, Shanghai 200030, China
Yuan Liu, Department of Pathology, International Peace Maternity and Child Health Hospital, Shanghai 200030, China
Author contributions: Zhang J developed the study and revised the manuscript; Liang Y was responsible for study development, data collection and manuscript writing; Zhang D analyzed the data and revised the manuscript; Jiang L and Liu Y analyzed the imaging results and histopathologic findings, respectively; and all authors have approved the final version of the manuscript.
Supported by Medical-Engineering Cross Fund from Shanghai Jiaotong University, No. ZH2018QNB17; and National Natural Science Foundation of China, No. 81801400.
Institutional review board statement: This study has been approved by the ethic committee of International Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiaotong University, No. GKLW 2019-08.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Liang Y and Zhang D have received research funding from the medical-engineering cross fund from Shanghai Jiaotong University, No. ZH2018QNB17; and Natural Science Foundation of China, No. 81801400.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Zhang, MD, Chief Doctor, Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, No. 910 Hengshan Road, Xuhui District, Shanghai 200030, China. zhangjian_ipmch@sjtu.edu.cn
Received: July 22, 2020
Peer-review started: July 22, 2020
First decision: November 3, 2020
Revised: November 20, 2020
Accepted: December 16, 2020
Article in press: December 16, 2020
Published online: February 16, 2021
Processing time: 190 Days and 20.4 Hours
ARTICLE HIGHLIGHTS
Research background

Perineal endometriosis (PEM) seriously affects the quality of life and physical and mental health of patients due to pain including menstrual-related pain, varying degrees of pain in the lesions, radiation pain, dyspareunia, and defecation pain. However, there are few clinical studies on the incidence and clinical characteristics of PEM. The prevalence of PEM is low among women with endometriosis treated by surgery. PEM manifests as hard or cystic nodules with pain in the perineal wounds and surrounding areas. Implantation theory is regarded as the main pathogenesis of PEM. There are few clinical studies on the incidence and clinical characteristics of PEM. This study aimed to summarize the clinical data of 14 PEM cases and analyze the factors that may be related to the incubation period and pain.

Research motivation

We analyzed the factors that may be related to the incubation period and pain to provide suggestions for the prevention and treatment of PEM.

Research objectives

To analyze the medical history, clinical manifestations, diagnosis, treatment and treatment effect of PEM.

Research methods

This is a case series. We collected the clinical data of 14 patients with PEM who visited The International Peace Maternal and Child Health Hospital Affiliated to Shanghai Jiaotong University from January 2009 to December 2019 who were followed up after treatment. Paired t test and Pearson correlation analysis were used for statistical analysis.

Research results

Body mass index (BMI) at delivery and BMI within 1 mo after delivery were negatively correlated with the latent period, respectively (R2 = 0.53/0.86, P < 0.05). The average visual analog scale score in lesions at the third month after surgery was 0.57 ± 1.28 for all patients, which was significantly lower than that prior to surgery (P < 0.05).

Research conclusions

The higher the BMI during delivery and within 1 mo after delivery, the shorter the incubation period of PEM. It is very important to evaluate the location of lesions before surgery. Surgical resection of the lesion is the best treatment for PEM which significantly alleviates the symptoms.

Research perspectives

When PEM is diagnosed, immediate surgery is recommended. The prevention and occurrence of PEM requires further study.