Evaluation of cases of abdominal wall endometriosis at Universidade Estadual de Campinas in a period of 10 Years
Open accessAbstract
Purpose To determine the clinical and epidemiological characteristics of abdominal wall endometriosis (AWE), as well as the rate and recurrence factors for the disease. Methods A retrospective study of 52 women with AWE was performed at Universidade Estadual de Campinas from 2004 to 2014. Of the 231 surgeries performed for the diagnosis of endometriosis, 52 women were found to have abdominal wall endometriosis (AWE). The frequencies, means and standard deviations of the clinical characteristics of these women were calculated, as well as the recurrence rate of AWE. To determine the risk factors for disease recurrence, Fisher's exact test was used. Results The mean age of the patients was 30.71 ± 5.91 years. The main clinical manifestations were pain (98%) and sensation of a mass (36.5%). We observed that 94% of these women had undergone at least 1 cesarean section, and 73% had used medication for the postoperative control of endometriosis. The lesion was most commonly located in the cesarean section scar (65%). The recurrence rate of the disease was of 26.9%. All 14 women who had relapsed had surgical margins compromised in the previous surgery. There was no correlation between recurrent AWE and a previous cesarean section (p = 0.18), previous laparotomy (p = 0.11), previous laparoscopy (p = 0.12) and postoperative hormone therapy (p = 0.51). Conclusion Women with previous cesarean sections with local pain or lumps should be investigated for AWE. The recurrence of AWE is high, especially when the first surgery is not appropriate and leaves compromised surgical margins.
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Written from the paper’s full text.
TL;DR
This retrospective study of 52 women with abdominal wall endometriosis at Universidade Estadual de Campinas (2004–2014) found pain and a mass as the main symptoms, mostly in cesarean-section scars, with a 26.9% recurrence rate. All 14 recurrences had compromised surgical margins in the previous surgery, though no significant correlation was found with prior cesarean, laparotomy, laparoscopy, or postoperative hormone therapy.
Key findings
- Mean age was 30.71 ± 5.91 years; mean BMI was 26.48 ± 5.24 kg/m²; main manifestations were nodule pain (98%) and sensation of a mass (36.5%); mean symptom duration was 39.83 ± 34.09 months.
- 94% had undergone at least 1 cesarean section; the lesion was most commonly located in the cesarean section scar (65.4%); mean lesion size was 2.52 ± 1.21 cm on ultrasound and 3.98 ± 1.72 cm intraoperatively.
- The recurrence rate was 26.9%; all 14 women who relapsed had compromised surgical margins in the previous surgery.
- No correlation was found between recurrent AWE and previous cesarean section (p = 0.18), previous laparotomy (p = 0.11), previous laparoscopy (p = 0.12), or postoperative hormone therapy (p = 0.51).
Methods
- Retrospective study at Universidade Estadual de Campinas from January 2004 to December 2014; 917 surgeries were assessed, 231 were selected for endometriosis removal, 56 AWE cases were identified, and 4 were excluded for insufficient chart data or lack of histopathological confirmation, leaving 52 women for analysis.
- Variables analyzed included age, pregnancies, parity, cesarean section, abortion, BMI, symptoms (pelvic pain, mass, bleeding), symptom duration, associated diseases, postsurgical menstrual-suppression medication, and size and location of the endometrioma.
- Frequencies, means, and standard deviations were calculated; Fisher’s exact test was used to determine recurrence factors; SAS version 9.4 was used. The study was approved by the institutional Research Ethics Committee under number 342430/2013.
Limitations
- The paper states that its retrospective nature made data collection and complete data acquisition more difficult, and suggests a prospective study.
- The text makes evident that the study was single-center at a tertiary hospital, with 52 women and only 14 recurrence cases, limiting generalizability and statistical power for recurrence-factor analysis.
- The text makes evident that recurrence-factor analysis used Fisher’s exact test without multivariable adjustment; no further limitations are stated in the paper.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Cites
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Claims the paper makes
0 of 21 cited sources checked · 0 supported · 0 flagged
- Findingown data
The precise relationship between cesarean section and abdominal wall endometriosis could not be established in this study.
“In the present study, the precise relationship between cesarean section and AWE could not be established, despite the high rate of cesarean sections in patients with AWE.”
Quote in the paperSubstantial claim - Findingown data
There was no correlation between recurrent abdominal wall endometriosis and postoperative hormone therapy (p = 0.51).
“There was no correlation between recurrent AWE and a previous cesarean section (p = 0.18), previous laparotomy (p = 0.11), previous laparoscopy (p = 0.12) and postoperative hormone therapy (p = 0.51).”
Quote in the paperSubstantial claim - Findingown data
The mean age of the 52 women with abdominal wall endometriosis was 30.71 ± 5.91 years.
“The mean age of the women was 30.71 ± 5.91 years.”
Quote in the paperNot a substantial claim - Findingown data
Sensation of a mass was a clinical manifestation in 36.5% of the women with abdominal wall endometriosis.
“The main clinical manifestations were nodule pain (98%) and the sensation of a mass (36.5%).”
Quote in the paperNot a substantial claim - Findingown data
There was no correlation between recurrent abdominal wall endometriosis and previous laparoscopy (p = 0.12).
“There was no correlation between recurrent AWE and a previous cesarean section (p = 0.18), previous laparotomy (p = 0.11), previous laparoscopy (p = 0.12) and postoperative hormone therapy (p = 0.51).”
Quote in the paperSubstantial claim
- Findingown data
All 14 women who had relapsed had surgical margins compromised in the previous surgery.
“All 14 women who had relapsed had surgical margins compromised in the previous surgery.”
Quote in the paperSubstantial claim - Findingown data
94% of the women with abdominal wall endometriosis had undergone at least 1 cesarean section.
“Of the total number of women evaluated, 94% had undergone at least 1 cesarean section, and 73% had used medication for the control of endometriosis in the postoperative period.”
Quote in the paperNot a substantial claim - Findingown data
73% of the women with abdominal wall endometriosis had used medication for postoperative control of endometriosis.
“Of the total number of women evaluated, 94% had undergone at least 1 cesarean section, and 73% had used medication for the control of endometriosis in the postoperative period.”
Quote in the paperNot a substantial claim - Findingown data
Nodule pain was a clinical manifestation in 98% of the women with abdominal wall endometriosis.
“The main clinical manifestations were nodule pain (98%) and the sensation of a mass (36.5%).”
Quote in the paperNot a substantial claim - Findingown data
The lesion was most commonly located in the cesarean section scar (65%).
“The lesion appeared most commonly in the cesarean section scar (65%)”
Quote in the paperNot a substantial claim - Findingown data
The recurrence rate of abdominal wall endometriosis was 26.9%.
“The recurrence rate of the disease was of 26.9%.”
Quote in the paperSubstantial claim - Findingown data
There was no correlation between recurrent abdominal wall endometriosis and previous laparotomy (p = 0.11).
“There was no correlation between recurrent AWE and a previous cesarean section (p = 0.18), previous laparotomy (p = 0.11), previous laparoscopy (p = 0.12) and postoperative hormone therapy (p = 0.51).”
Quote in the paperSubstantial claim - Findingown data
There was no correlation between recurrent abdominal wall endometriosis and a previous cesarean section (p = 0.18).
“There was no correlation between recurrent AWE and a previous cesarean section (p = 0.18), previous laparotomy (p = 0.11), previous laparoscopy (p = 0.12) and postoperative hormone therapy (p = 0.51).”
Quote in the paperSubstantial claim - Interpretationown data
The recurrence of abdominal wall endometriosis is high.
“The recurrence of AWE is high, especially when the first surgery is not appropriate and leaves compromised surgical margins.”
Quote in the paperSubstantial claim - Interpretationown data
The recurrence of abdominal wall endometriosis is especially high when the first surgery is not appropriate and leaves compromised surgical margins.
“The recurrence of AWE is high, especially when the first surgery is not appropriate and leaves compromised surgical margins.”
Quote in the paperSubstantial claim - Premisecitation
In the literature, there was no significant evidence that the clinical course of the patient was better with the use of hormones after surgery.
“In the literature, there was no significant evidence that the clinical course of the patient was better with the use of hormones after surgery, which is in agreement with our study.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [24] J D Horton, 2008, Abdominal wall endometriosis: a surgeon's perspective and review of 445 cases, Am J Surg source
Not checked in the free run.
- Premisecitation
Despite surgical removal of abdominal wall endometriosis, there may be a recurrence rate of 1.5 to 9.1%.
“In spite of the surgical removal of the lesion, there may be a recurrence rate of 1.5 to 9.1%.”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [20] G KC Leite, 2009, Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature, Sao Paulo Med J source
Not checked in the free run.
- cites [21] Y Ding, 2013, A retrospective review of abdominal wall endometriosis in Shanghai, China, Int J Gynaecol Obstet source
Not checked in the free run.
- cites [22] F L Vilarino, 2011, [Surgical scar endometriosis: a series of 42 patients], Rev Bras Ginecol Obstet
Not checked in the free run.
- Premisecitation
Cesarean section indicated after the onset of contractions seems to offer protection against abdominal wall endometriosis compared with elective cesarean section.
“Cesarean section indicated after the onset of contractions also seems to offer protection against the disease, compared with elective cesarean section.28”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [28] L Wicherek, 2007, The obstetrical history in patients with Pfannenstiel scar endometriomas--an analysis of 81 patients, Gynecol Obstet Invest source
Not checked in the free run.
- Classified as probably not a substantial claim. 14
- The quote only partly states this claim. 3
- May combine two claims. 5
Probably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThe mean body mass index of the women with abdominal wall endometriosis was 26.48 ± 5.24 kg/m2.
“The mean BMI was 26.48 ± 5.24 kg/m2”
Quote in the paperNot a substantial claimThe quote only partly states this claim.
Findingown dataThe mean size of the endometrioma on ultrasound was 2.52 ± 1.21 cm.
“the mean size of the lesion was 2.52 ± 1.21 cm on ultrasound, and 3.98 ± 1.72 cm in the intraoperative period”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataOnly one woman had a painless mass.
“Only one woman had a painless mass”
Quote in the paperNot a substantial claimThe quote only partly states this claim.
Findingown dataThe mean size of the endometrioma in surgery was 3.98 ± 1.72 cm.
“the mean size of the lesion was 2.52 ± 1.21 cm on ultrasound, and 3.98 ± 1.72 cm in the intraoperative period”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based). The quote only partly states this claim.
Findingown dataThe mean duration of clinical manifestations was 39.83 ± 34.09 months.
“The mean duration of the clinical treatment was 39.83 ± 34.09 months.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationEndometriosis is characterized by the presence of endometrial tissue with glands and stroma implanted outside the uterine cavity, which responds to ovarian hormone stimulation.
“Endometriosis is a disease characterized by the presence of endometrial tissue with glands and stroma implanted outside the uterine cavity, which responds to ovarian hormone stimulation.”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationExtrapelvic endometriosis occurs in 9-15% of endometriosis cases.
“The disease is less commonly (9–15%) located outside the pelvic cavity, and is termed extrapelvic endometriosis.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [3] C Douglas, 2004, Extragenital endometriosis--a clinicopathological review of a Glasgow hospital experience with case illustrations, J Obstet Gynaecol source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe incidence of abdominal wall endometriosis is rare, occurring in 0.03-3.5% of cases, with some studies reporting up to 12%.
“The incidence of abdominal wall endometriosis (AWE) is rare. The disorder occurs in 0.03–3.5% of cases, and some studies have reported a rate of up to 12%.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [12] N S Nominato, 2010, Caesarean section greatly increases risk of scar endometriosis, Eur J Obstet Gynecol Reprod Biol source
Not checked in the free run.
- cites [15] Y Chang, 2009, Abdominal wall endometriomas, J Reprod Med
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningA limitation of the study is its retrospective nature, which makes data collection and complete data acquisition more difficult.
“A limitation of the study is its retrospective nature, which makes data collection and complete data acquisition more difficult.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationEndometriosis affects women of reproductive age and is more common in multiparous women aged 25 to 35 years.
“According to the literature, endometriosis affects women of reproductive age. It is more common in multiparous women aged 25 to 35 years.25”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [25] X Zhao, 2005, Abdominal wall endometriomas, Int J Gynaecol Obstet source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationOther therapeutic options for abdominal wall endometriosis are suppression of menstruation with progestins or a gonadotropin-releasing hormone (GnRH) analogue.
“Other therapeutic options are the suppression of menstruation with progestins or a gonadotropin-releasing hormone (GnRH) analogue.20”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [20] G KC Leite, 2009, Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature, Sao Paulo Med J source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAbdominal wall endometriosis mostly affects patients with a history of cesarean section.
“The disease mostly affects patients with a history of cesarean section.17”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [17] T Wasfie, 2002, Abdominal wall endometrioma after cesarean section: a preventable complication, Int Surg
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationAlcohol consumption and heavy menstrual bleeding may be risk factors for abdominal wall endometriosis, while multiparity may be a protective factor.
“A study indicated that alcohol consumption and heavy menstrual bleeding may be risk factors for the development of AWE. In contrast, multiparity may be a protective factor.27”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [27] M A de Oliveira, 2007, Risk factors for abdominal scar endometriosis after obstetric hysterotomies: a case-control study, Acta Obstet Gynecol Scand source
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationTo prevent recurrence of abdominal wall endometriosis, surgical resection with free margins should be performed.
“To prevent this occurrence, surgical resection with free margins should be performed.20 21 22 23”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [20] G KC Leite, 2009, Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature, Sao Paulo Med J source
Not checked in the free run.
- cites [21] Y Ding, 2013, A retrospective review of abdominal wall endometriosis in Shanghai, China, Int J Gynaecol Obstet source
Not checked in the free run.
- cites [22] F L Vilarino, 2011, [Surgical scar endometriosis: a series of 42 patients], Rev Bras Ginecol Obstet
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationAbdominal wall endometriosis is associated with a history of obstetric or gynecologic procedures, although some cases occur spontaneously.
“It is associated with a history of obstetric or gynecologic procedures,2 12 although some cases occur spontaneously.16”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites [2] H Bektaş, 2010, Abdominal wall endometrioma; a 10-year experience and brief review of the literature, J Surg Res source
Not checked in the free run.
- cites [12] N S Nominato, 2010, Caesarean section greatly increases risk of scar endometriosis, Eur J Obstet Gynecol Reprod Biol source
Not checked in the free run.
- cites [16] T S Papavramidis, 2009, Spontaneous abdominal wall endometriosis: a case report, Acta Chir Belg source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe preferential treatment for abdominal wall endometriosis is surgery, and the diagnosis is confirmed by histopathology.
“The preferential treatment is surgery, and the diagnosis is confirmed by histopathology.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [20] G KC Leite, 2009, Scar endometrioma following obstetric surgical incisions: retrospective study on 33 cases and review of the literature, Sao Paulo Med J source
Not checked in the free run.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The age of 33.23 years represents the stage in which the woman is reproductively active.
“This age represents the stage in which the woman is reproductively active, initially described by Chun, Nelson and Maull (1990) 24 and also found in more recent studies 12,35,38 .”
From Abdominal Wall Endometriosis: Experience of the General Surgery Service of the Antônio Pedro University Hospital of the Universidade Federal Fluminense (2020) · cites this paper as [35]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Age standard deviation differs between results and Table 1
MinorThe results give the age standard deviation as 5.91 years, while Table 1 gives 5.92 years.
“The mean age of the women was 30.71 ± 5.91 years.”
“| Age (years) | 30.71 ± 5.92 |”
Laparotomy percentage does not match its count
MinorTable 3 reports 5 of 14 patients in the laparotomy "Yes" category as 25.19%; 5 divided by 14 is approximately 35.71%.
Reported 25.19 · recomputed 35.714286
“| Yes | 5(25.19) | | | |”
Cesarean-section history reported as both 51% and 94%
MinorThe discussion says that only 51% of patients in this study had a cesarean delivery, whereas the results report 94%. The discrepancy affects a characteristic emphasized in the conclusion.
“In this study, only 51% of the patients had a history of at least 1 cesarean delivery”
“Of the total number of women evaluated, 94% had undergone at least 1 cesarean section”
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Mascarenhas, W. P., Moura, S. S., Maia, L. B., et al. (2020) · Amadeus International Multidisciplinary Journal · doi:10.14295/aimj.v4i8.102 · Cited by 2 · see citing works
The challenge in diagnosing abdominal wall endometriosis; a series of three cases
Muhtaseb, M. S. E., Daradkeh, H. T., Sunoqrot, M., et al. (2022) · International Journal of Surgery Case Reports · doi:10.1016/j.ijscr.2022.106787 · Cited by 1 · see citing works
“Hence, patients who choose to be on hormonal therapy must be closely monitored for recurrence or incases of incessant cutaneous manifestations, malignancy must be ruled out [9,10].”
BackgroundAn unusual case of laparoscopic appendicectomy scar site endometriosis
Kala, P. G., Elumalai, N., Sridharan, S., & Bupathy, A. (2022) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20221953 · Cited by 1 · see citing works
Localized endometrioid cancer in the abdominal wall with synchronous early-stage endometrial cancer
Şahin, O., Tokgözoğlu, N., & Taşçı, T. (2021) · Journal of Turkish Society of Obstetric and Gynecology · doi:10.4274/tjod.galenos.2021.85530 · Cited by 1 · see citing works
“cavity, which respond to ovarian hormone stimulation(1).”
The role of inflammatory markers in the diagnosis of extraperitoneal endometriosis
Gülücü, S., & Gümüşburun, N. (2022) · Journal of Experimental and Clinical Medicine · doi:10.52142/omujecm.39.4.15 · Cited by 1 · see citing works
Rare case of scar endometriosis
Shetty, S., & Anitha, S. (2021) · International Journal of Clinical Obstetrics and Gynaecology · doi:10.33545/gynae.2021.v5.i5a.1007
“stated that ultimate treatment is achieved through a total surgical removal of the mass together with at least 1 cm of surrounding healthy tissue, without impairing the integrity of the mass [8].”
BackgroundErdoğan, P., Erdoğan, A., Bolat, H., & Özbey, C. (2022) · Journal of Endometriosis and Pelvic Pain Disorders · doi:10.1177/22840265221093818
Endometriosis de la Pared Abdominal en Relación con Cicatriz de Operación Cesárea. Serie de Casos
Manterola, C., & Espinosa, M. E. (2022) · International Journal of Morphology · doi:10.4067/s0717-95022022000300608
Silveira, Z. P., Henriques, A. M. A., Bregalda, F., et al. (2022) · doi:10.22533/at.ed.7572219083
TRANSTORNO DO PÂNICO E ANSIEDADE: UM RELATO DE CASO
Miranda, J. P. L., Trindade, J. P. M., Matsuda, M. H., et al. (2022) · doi:10.22533/at.ed.75722190810
de Morais, V. G., Guareschi, S., Machado, R. A. A., et al. (2022) · doi:10.22533/at.ed.7572219087
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CITOLOGIA ONCÓTICA: FATORES QUE OCASIONAM A NÃO ADESÃO DAS MULHERES AO EXAME
Maximiano, L. C. D. S., Nunes, M. J. M., Marcos, G. V. T. D. M., et al. (2022) · doi:10.22533/at.ed.7572219089
A PARALISIA INFANTIL E SUAS CONSEQUÊNCIAS PSICOSSOCIAIS NO IDOSO, ASSOCIADO A INSTITUCIONALIZAÇÃO
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REAÇÕES ALÉRGICAS E TESTE CUTÂNEO DE DIAGNÓSTICO
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PERFIL DE PACIENTES COM DIAGNÓSTICO DE HANSENÍASE NO ESTADO DA BAHIA
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PERFIL EPIDEMIOLÓGICO DA HANSENÍASE NA IX REGIÃO DE SAÚDE DE PERNAMBUCO
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PANORAMA SÓCIO ETÁRIO E CULTURAL DA ENDOMETRIOSE NO ESTADO DE SÃO PAULO
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As repercussões da endometriose na qualidade de vida das mulheres brasileiras
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- Authors
- Yela, D. A., Trigo, L., & Benetti-Pinto, C. L.
- Affiliations
- Universidade Estadual de Campinas (UNICAMP) (BR)
- Department of Obstetrics and Gynecology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil
- Venue
- Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics
- Published
- 2017-06-21
- Volume
- 39
- Issue
- 08
- Pages
- 403-407
- ISSN
- 0100-7203 (ISSN-L)
- 1806-9339
- PMC
- PMC10309296
- OpenAlex
- W2665280447
- Semantic Scholar
- 352836c91693dbdb6169d4d24a8c5a30f68147e4
- Cited by
- 35
- References
- 32
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 22 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 2 · 2017: 1
- FWCI
- 2.22
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Revista Brasileira Ginecologia e Obstetrícia (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (publishedVersion, other-oa)
- Americanae (AECID Library) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
- Keywords
- abdominal wall endometriosis, endometriosis recurrence, cesarean section scar, surgical margins, recurrence risk factors, postoperative pain, postoperative hormone therapy, laparotomy, laparoscopy, clinical features
- MeSH terms
- Adult, Brazil, Endometriosis, Female, Humans, Muscular Diseases, Recurrence, Retrospective Studies, Time Factors, Universities, Abdominal Wall
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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