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Clinical aspects and management of inguinal endometriosis: A case series of 20 patients
Author(s) -
Arakawa Tomoko,
Hirata Tetsuya,
Koga Kaori,
Neriishi Kazuaki,
Fukuda Shinya,
Ma Suke,
Sun Hui,
Nagashima Natsuki,
Harada Miyuki,
Hirota Yasushi,
WadaHiraike Osamu,
Fujii Tomoyuki,
Osuga Yutaka
Publication year - 2019
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14059
Subject(s) - medicine , endometriosis , dienogest , surgery , magnetic resonance imaging , hormonal therapy , adverse effect , round ligament , inguinal ligament , radiology , breast cancer , cancer , uterus
Aim This study aimed to describe the clinical presentation, diagnostic evaluation, and operative or medical management of inguinal endometriosis. Methods In this study, we retrospectively reviewed 20 cases of inguinal endometriosis in our facility, particularly on the clinical characteristics, diagnosis, and surgical and medical treatment. Results We retrospectively investigated the following items for each patient: age at diagnosis, surgical history, presence of extragenital endometriosis, symptoms, imaging modalities, surgical therapy, hormonal therapy, follow‐up period, postoperative recurrence and time to recurrence. We identified 20 cases of inguinal endometriosis in our facility. First, 75% of the patients had right inguinal endometriosis. Second, T1‐weighted or fat‐saturated T1‐weighted images showed hyperintensity in the lesions in 17 patients (17/18 patients, 94.4%). Third, in 5 of 6 patients who underwent surgical therapy, we performed radical surgery to excise the inguinal lesion including the round ligament. One patient had disease relapse. Fourth, in 6 of 7 cases, dienogest effectively improved pain without significant adverse effects, but oral contraceptive was effective in 1 of 4 patients without significant adverse effects. Conclusion We retrospectively reviewed 20 patients with inguinal endometriosis in our facility. We have shown that magnetic resonance imaging can be a useful imaging modality to obtain a specific diagnosis of this disease. In addition, inguinal endometriosis can be managed with radical surgery to resect lesions including the round ligament and with hormonal treatment. In particular, dienogest ameliorated symptoms, which can be an option for patients who do not want surgery.