By Dr Moamar Al-Jefout, MD, PhD

Assistant Professor in Reproductive Medicine & Endoscopic Surgeon.

Department of Obstetrics & Gynaecology, Mutah Medical Faculty, Mutah University, Jordan

A presentation at the Society of Gynecological Investigation Annaul Meeting, Miami, USA March 2011

Abstract

Background: Abdominal wall endometriosis is not as uncommon as used to be in part because of the increased rates of surgical scars in obstetrics and gynecology especially caesarian sections. The standard treatment is surgical excision of the lesion. However, some cases may reoccur and usually accompanied by cyclical abdominal wall and discomfort. The case: the author reports a case diagnosed with recurrent abdominal wall endometriosis (initial size at the first visit on U/S scan 8 cm by 7 cm) which underwent one attempt of wide surgical excision, and then was treated medically with GnRH agonists for three months with no sustainable improvement. The case was successfully treated with subdermal implant (Implanon) with the addition of oral progestogen. After one year follow up the patient is pain free and the mass has substantially reduced in size, last measurements 3cm by 2 cm on U/S scan. Conclusion: The use of subdermal implants can be used as an option for the treatment of abdominal wall endometriosis. Up to my knowledge, this is the first case abdominal wall endometriosis to be treated subdermal implant containing subdermal progestogen. However, more cases are needed.