Clinical Analysis And Related Histiopathological Factors Investigate Of Incision Endometriosis

Object:To investigate the clinical characteristics,treatments ,preventions and morbility correlation factors of incision endometriosis.Methods : Primary part:In order to investigate the clinical characteristics , treatments and recidivation of incision endometriosis,a retrospective analysis and follow-up was performed on 30 patients with incision endometriosis hospitalized in Obstetric & Gynecologic Department of The First Affiliated Hospital of Fujian Medical University.Second part: The expression of VEGF, aromatase cytochrome P540 in the incision endometriosis lump and aromatase cytochrome P540 in the subcutaneous fatty tissue of the incision endometriosis , uterine-incision delivery and normal labor perineotomy was detected by immunohistochemical analysis. In order to approach the morbility correlation factors of incision endometriosis.Results:1. 30 patients with incision endometriosis , 29 had a history of caesarean section , Their mean age was (31.0±3.5) years. 93.33% of patient s had a mense-related cyclical painful mass. The eclipse period is about 2 years(mean 23.5 months),75% patients with the transverse incision,especially its right lateral horn(76.2%),79.3% of the focuses located on subcutaneous fatty tissue.The delitescence was related with the time of postpartum menstrual onset,lactation .The delitescence in the patients those uterine- incision delivery post-labor was much shorter than those pre-labor(P<0.05).The recurrence was correlated to the size of goitre and the depth of infiltrate,but the level of CA125.2. Aromatase cytochrome P450 was signifiant strongerly expressed in the subcutaneous fatty tissue of the incision endometriosis than uterine-incision delivery and normal labor perineotomy(P<0.05),furthermore its expression in uterine-incision delivery stronger than normal labor perineotomy(P<0.05).There were not apparentely ovarian intermittent differences in the Aromatase cytochrome P450 expression of incision endometriosis,yet expression of VEGF in the follicular phase was stronger than the luteal phase(P<0.05),moreover, the expression of recidavist and bigger was obviously stronger than non-recidavisd and smaller(P<0.05).Conclusions:The generation of incision endometriosis was associated with medical factors as well as personal factors. Sugery on delivery period was more likely to get incision endometriosis than the perineotomy,presumed it was concerned with the different levels of the expression of Aromatase cytochrome P450 that was higher on the abdominal wall fat layer in the gestational period than the nongestational period and perineal tissue. Effective prevention was to degrade caesarean incidence,avoid and decrease the endometrium dispersion left on the incision and. lactate more than six-months after partuition. Surgical treatment was the most available choice. The premenarche was a good operation period when the expression of VEGF was at a low level,which conduce to reduce recidivation, especially deeper and major lump that was more obvious in the the premenarche was easy to resect the enough spread. Keeping the incision clean was the most important point to avoid recurrence.