Abstract

This study aimed to evaluate the clinical and demographic characteristics of patients with scar endometriosis and to investigate the association between systemic inflammatory indices and the development of scar endometriosis, using patients with ovarian endometriosis who did not develop scar endometriosis during follow-up as a reference group. This retrospective study included patients diagnosed with scar endometriosis at a tertiary care centre between 2015 and 2022. The study group comprised patients with scar endometriosis. The control group included patients diagnosed with ovarian endometriosis who had undergone surgery and did not develop scar endometriosis during follow-up. Systemic inflammatory indices derived from complete blood counts were compared between groups. The mean age of patients with scar endometriosis was 32.2 ± 6.1 years. Lesions were most commonly located on the left side (49.3%). The study group comprised 72 patients with scar endometriosis, while the control group consisted of 67 patients. Compared with the control group, patients with scar endometriosis had higher lymphocyte counts and lower monocyte counts. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic inflammatory response index (SIRI), and monocyte-to-platelet ratio (MPR) were significantly lower, whereas lymphocyte-to-monocyte ratio (LMR) was significantly higher in the scar endometriosis group. After adjustment for age, gravida, and number of caesarean sections, only LMR remained independently associated with scar endometriosis (OR: 1.492, 95% CI: 1.075–2.071, p = 0.017). Scar endometriosis is a clinical condition frequently seen after caesarean section. While surgical excision is the basis of treatment, understanding the clinical presentation is essential for timely diagnosis. These findings suggest that scar and ovarian endometriosis may exhibit distinct characteristics in terms of immune system responses and inflammatory processes. The pathogenesis, immune regulation, and inflammatory pathways of these two conditions may differ.

Key words: Scar endometriosis, caesarean section, endometriosis, haematological biomarkers, systemic inflammatory indices