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Cited by 29Endometriosis Research and TreatmentGynecological conditions and treatmentsEctopic Pregnancy Diagnosis and Management

Inguinal endometriosis, a rare entity of which surgeons should be aware: clinical aspects and long-term follow-up of nine cases

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Wolfhagen, N., Simons, N. E., de Jong, K. H., van Kesteren, P. J. M., Simons, M. P.·2018·Hernia
DOI 10.1007/s10029-018-1797-x
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Abstract

Introduction Inguinal endometriosis is a rare disease and often misdiagnosed for other, more common groin pathology. We present nine cases of women with inguinal endometriosis with long-term follow-up.Methods In this retrospective case series, the Dutch PALGA system was searched for all patients diagnosed with extrapelvic endometriosis located in the groin in the OLVG hospital, Amsterdam, between 2000 and 2016. Relevant information regarding pre- and postoperative characteristics and symptoms was collected. Follow-up consisted of a telephone call from the attending surgeon.Results None of the patients had a history of pelvic endometriosis. Typically, they presented with a right-sided swelling in the groin. Preoperative ultrasound and MRI were in most cases inconclusive. In one of two patients fna indicated endometriosis. In only three patients the surgeon considered the diagnosis endometriosis preoperatively. Surgical removal was effective with no reported complications. A coexisting hernia sac was resected in four cases, and there was a suspicion of a persistent processus vaginalis (canal of Nuck) in three, suggesting that a persistent processus vaginalis is possibly an important key to the pathogenesis. In none of the cases there was an indication for mesh implantation. One patient was later diagnosed with pelvic endometriosis.Conclusion Follow-up by a gynecologist is advised to check for intra-abdominal disease and inform patients on fertility perspective. Surgeons should be aware of the possibility of inguinal endometriosis in fertile women with a lump in the groin.

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Authors
Wolfhagen, N., Simons, N. E., de Jong, K. H., van Kesteren, P. J. M., & Simons, M. P.
Affiliations
  • Flevoziekenhuis (NL)
  • Amsterdam UMC Location University of Amsterdam (NL)
  • OLVG (NL)
Corresponding author
Simons, M. P.
ORCID
Venue
Hernia
Publisher
Springer Science and Business Media LLC
Published
2018-08-04
Volume
22
Issue
5
Pages
881-886
ISSN
  • 1248-9204 (ISSN-L)
  • 1265-4906
DOI
10.1007/s10029-018-1797-x
OpenAlex
W2885376165
Cited by
29
References
31
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 4 · 2020: 5 · 2019: 7
FWCI
4.27
Type
journal article
Language
en
Open access
Licence
Locations
  • Hernia (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
Keywords
inguinal endometriosis, extrapelvic endometriosis, groin swelling, processus vaginalis, canal of Nuck, hernia sac, misdiagnosis, surgical excision, long-term follow-up, fertility, pelvic endometriosis, preoperative diagnosis
MeSH terms
Adult, Dysmenorrhea, Endometriosis, Female, Follow-Up Studies, Hernia, Inguinal, Humans, Inguinal Canal, Retrospective Studies, Abdominal Pain

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