Endometriosis of a post-cesarean incompetent of uterine scar: inflammatory or connective tissue dysplasia

Okulova E.O.

Ural Scientific Research Institute of Maternity and Child Care Public Health’s Ministry of the Russian Federation

SPIN RSCI: 5219-8194
Scopus AuthorID: 57211586574
ORCID: 0000-0002-3035-2862

Mikhelson A.A.

Ural Scientific Research Institute of Maternity and Child Care Public Health’s Ministry of the Russian Federation

SPIN RSCI: 9259-0633
Scopus AuthorID: 57221446519
ORCID: 0000-0003-1709-6187

Melkozerova O.A.

Ural Research Institute for Maternity and Child Care, Ministry of Public Health of the Russian Federation

SPIN RSCI: 5782-7283
Scopus AuthorID: 56358107200
ORCID: 0000-0002-4090-0578

Telyakova M.I.

Ural Scientific Research Institute of Maternity and Child Care Public Health’s Ministry of the Russian Federation

Scopus AuthorID: 57221437328
ORCID: 0000-0001-7142-8547

Chistyakova G.N.

Ural Research Institute for Maternity and Child Care, Ministry of Public Health of the Russian Federation

SPIN RSCI: 5436-8941
Scopus AuthorID: 56358317100
ORCID: 0000-0002-0852-6766

Lazukina M.V.

Ural Research Institute of Maternity and Child Care

SPIN RSCI: 4695-5960
Scopus AuthorID: 57221933420
ORCID: 0000-0002-0525-0856

Endometriosis of a post-cesarean incompetent of uterine scar: inflammatory or connective tissue dysplasia

Authors:

Okulova E.O., Mikhelson A.A., Melkozerova O.A., Telyakova M.I., Chistyakova G.N., Lazukina M.V.

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Journal: Russian Journal of Human Reproduction. 2022;28(4): 145‑150

DOI: 10.17116/repro202228041145

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To cite this article:

Okulova EO, Mikhelson AA, Melkozerova OA, Telyakova MI, Chistyakova GN, Lazukina MV. Endometriosis of a post-cesarean incompetent of uterine scar: inflammatory or connective tissue dysplasia. Russian Journal of Human Reproduction. 2022;28(4):145‑150. (In Russ.)
https://doi.org/10.17116/repro202228041145

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OBJECTIVE

To analyze the morpho-functional state of the endometrium and the scar tissue of the myometrium in patients with post-cesarean endometriosis in an incompetent uterine scar.

MATERIAL AND METHODS

The study included 16 patients with histologically confirmed endometriosis of an untenable scar on the uterus and 38 patients with untenable scar on the uterus from cesarean section without endometriosis. Morphological and immunohistochemical studies of excised scar tissue and endometrial samples were performed.

RESULTS

The combination of uterine scar failure with endometriosis was associated with a lower myometrial thickness in the scar area according to MRI data compared to the group without endometriosis. The expression of progesterone receptors of the endometrial glands was significantly reduced in the group of patients with scar endometriosis compared to the group without endometriosis. In the immunohistochemical study of excised untenable scars tissue on the uterus, the expression of CD3, which is a tissue marker of T-lymphocytes, was significantly higher in the endometriosis group than in the comparison group. The expression of vascular-endothelial growth factor VEGFR-1 was higher in the absence of scar endometriosis than in the presence of it. In the scar tissue with endometriosis the expression of type 1 collagen was significantly higher than in the comparison group.

CONCLUSIONS

The combination of failure of the uterine scar from cesarean section with endometriosis is associated with a more significant depletion of the myometrium in the scar area. In endometrioid lesions of the uterine scar its failure may be due to the inflammatory process. If the scar on the uterus fails after cesarean section without endometriosis, there is a defect in collagen synthesis and a violation of vascularization.

Keywords:

uterine scar failure

endometriosis

Authors:

Okulova E.O.

Ural Scientific Research Institute of Maternity and Child Care Public Health’s Ministry of the Russian Federation

SPIN RSCI: 5219-8194
Scopus AuthorID: 57211586574
ORCID: 0000-0002-3035-2862

Mikhelson A.A.

Ural Scientific Research Institute of Maternity and Child Care Public Health’s Ministry of the Russian Federation

SPIN RSCI: 9259-0633
Scopus AuthorID: 57221446519
ORCID: 0000-0003-1709-6187

Melkozerova O.A.

Ural Research Institute for Maternity and Child Care, Ministry of Public Health of the Russian Federation

SPIN RSCI: 5782-7283
Scopus AuthorID: 56358107200
ORCID: 0000-0002-4090-0578

Telyakova M.I.

Ural Scientific Research Institute of Maternity and Child Care Public Health’s Ministry of the Russian Federation

Scopus AuthorID: 57221437328
ORCID: 0000-0001-7142-8547

Chistyakova G.N.

Ural Research Institute for Maternity and Child Care, Ministry of Public Health of the Russian Federation

SPIN RSCI: 5436-8941
Scopus AuthorID: 56358317100
ORCID: 0000-0002-0852-6766

Lazukina M.V.

Ural Research Institute of Maternity and Child Care

SPIN RSCI: 4695-5960
Scopus AuthorID: 57221933420
ORCID: 0000-0002-0525-0856

Received:

18.01.2021

Accepted:

22.05.2022

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