What it is
What is Iatrogenic Endometriosis?
Iatrogenic endometriosis is a form of endometriosis which is caused by any uterine surgery, in most cases a cesarean section. Iatrogenic “originating from a physician” endometriosis is a preventable condition in women with no concomitant pelvic endometriosis. An endometrioma mass in the incisional scar and in the abdominal wall following a cesarean section is the result of the direct implantation of the endometrium tissue (uterus lining) outside the uterus. Iatrogenic endometriosis and is a well-established entity by itself known to the medical field.
How do these endometrium tissue cells get transferred?
During a cesarean section surgery an incision is made to the abdomen and into the uterus then the new born is lifted out through the abdomen. This may cause the endometrial tissue to become dislodged from the endometrium (uterus lining) and it could easily be implanted outside the uterus in the pelvic, abdominal wall cavity, abdominal rectus muscle and along the incision scar. The lack of secure closure of the parietal and visceral peritoneum during cesarean section and reduced care to avoid dissemination of endometrial cells may also be associated with endometriosis at the surgical scar.
From puberty to the menopause the endometrium is subject to cyclic changes under the influence of the same hormones that regulate ovulation. Endometrium tissue cells (uterus lining) renew monthly, as part of the reproductive cycle. The body builds up a dense layer of tissue which could support a fetus, and if a woman is not impregnated, it is shed and exits the body in the form of a menstrual cycle.
How do these misplaced cells thrive outside the uterus?
Outside the uterus, endometrium tissue cells respond to female hormones in-synced with the lining of the uterus. However, during each menstrual cycle, external endometrium tissue cells are shed and have no way of exiting the body. They become trapped and each month growing forming a mass and attaching to any surrounding organs. Overtime they become lesions that form nerves tying themselves into the central nervous system. Incisional endometriosis is progressive disease; symptoms and pain get worse over time as the mass grows.
Depending on the location of the mass and the female “host” hormones, symptoms might be different for all iatrogenic endometriosis suffers. Growths of endometriosis masses are benign (not cancerous). But they still can cause many problems for much different reasons. Endometriosis tends to be a progressive disease, which means that symptoms usually get worse over time as the mass grows. In my case the symptoms started right after my cesarean section and progressed with time. I would compare the pain experienced monthly as intense as passing kidney stones (a pain that is described by many being worse than child birth).
The list of symptoms I experienced after the cesarean while the mass was growing:
- Lump above cesarean incision scar, a slow growing mass, painful and tender to the touch with time
- Abdominal and surrounding area inflammation
- Abdominal swelling and bloating
- Constant lower back pain
- Sciatica pain
- Abdominal pain and or discomfort when coughing or sneezing
- Discomfort when doing any type of activity using core muscles
- Cramping of abdomen rectus muscle
- Overall weakness of abdominal muscles
- Denser and tender breast
- Weight gain
- Cystic acne
- Other unexplained discomfort in the surrounding area caused by nerve cells
During menstrual cycle and follicular phase:
- Lower abdominal aching, dull, sharp pain that starts few days before menstrual and intensify few days after menstrual cycle
- Internal heat during menstrual and follicular phase around the lump in abdomen area
- Intense cramps in the abdominal muscle during menstrual cycle and follicular phase
- Periodic sharp stabbing pain in the muscle during menstrual and it intensifies during follicular phase
- Lower back and hips radiating pain during menstrual cycle and it intensifies during follicular phase
- Itching of the lower abdomen area that would start during menstrual cycle and intensifies after the end of menstrual cycle
- Intestinal pain, nausea, constipation and diarrhea during menstrual cycle and follicular phase
- Breast size would increase by 1 cup size up during menstrual cycle
- Overall body swelling