Perineal scar endometriosis: A rare cause of severe dyspareunia and chronic perineal pain

Abstract

Perineal scar endometriosis remains a rare diagnosis. We report a chronic symptomatic case of scar endometriosis, where provisional diagnosis was established prior to surgery due to high level of clinical suspicion. The patient presented with a history of perineal pain for ten years associated with severe superficial dyspareunia. Clinical examination revealed tender nodules at episiotomy scar area with fibrosis. Complete deep triangular excision was performed and tissue histopathology confirmed diagnosis of endometriosis with CD4 cell markers. Postoperative period was uneventful and oral progesterone was used as a preventive measure for 3 months without pain recurrence.