A Rare Case of Episiotomy Scar Endometriosis.

Thirty-eight-year-old lady, mother of two children, came to OPD with history of cyclic pain in the perineal region which was gradually increasing in intensity and duration for 1 year. Pain was intense in last 4 months. Pain was related to her menstrual cycles. She also gave history of itching over perineal region. She delivered her first child 10 years back with right mediolateral episiotomy followed by one more full-term normal delivery with episiotomy 7 years back. Her menstrual history was normal, and her last menstrual period was 10 days back. On examination, her vitals were within normal range and systemic examination did not reveal any abnormality. Locally on inspection, previously healed episiotomy scar was seen. Perineal skin looked healthy. On palpation, a tender induration was felt along the entire episiotomy scar. Clinically, episiotomyscar endometriosiswasdiagnosed, and she was prepared for surgical excision of endometriotic nodule. Excision was done under anaesthesia. Excised tissue consisted of cystic spaces filled with chocolate-coloured fluid. Wound was repaired with proper haemostasis. Skin was closed with silk no.1. Histopathology confirmed scar endometriosis (Figs. 1 and 2). Patient was injected with Leupride 11.25 mg post-operatively. She resumed her cycles after 4 months postDr. Shanti Jeyaseelan, MD Obstetrics and Gynecology, Head of Department, Holy Family Hospital; Dr. Neha Kwatra, DNB Resident, Holy Family Hospital, Room No. 101, Aradhana Bhawan, Okhla Road, Delhi, 110025, India.