会阴子宫内膜异位症20例分析

Perineal endometriosis;Clinical analysis of 20 cases.

会阴子宫内膜异位症２０例，年龄２６～４８岁，平均３５．１岁。１８例发生于会阴侧切伤口，首发症状至侧切时间为１个月～９年，平均３．５年。主要临床表现为会阴侧切疤痕硬结处周期性疼痛及肿胀，部分患者伴性交痛，１例硬结处溃破出血。另２例中１例发生于分娩时的会阴裂伤处；１例于首发症状前５年已行全子宫切除术，表现为阴道少量出血，阴道左侧壁后方有一硬结。１９例行异位病灶切除术，１例累及肛门括约肌，切除病灶后修补括约肌，效果良好，２例术后复发。

bjective:To investigate the symptoms and signs of perineal endometriosis and the effect of treatment.Design 20 cases of perineal endometriosis diagnosed by history was retrospectively studied.Results:Eighteen patients had endometriosis at the site of episiotomy.The major Symptoms were pain and swelling at the episiotomy scar mass during menstruation and with dyspareunia in some patients.Two had perineal endometriosis at non-episiotomy sites,one at the site of perineal laceration and another at the posterior portion of left vaginal wall with small vaginal bleeding periodically.All but one were managed surgically.Follow-up discovered two recurrences.Conolusion:The symptoms and signs of perineal endometriosis may be diverse and the endometriosis focus should be excised. \ \