BACKGROUND Iatrogenic endometriosis is the presence of endometrial glands and stroma out of the uterus following certain surgical interventions. The rate of iatrogenic endometriosis after gynecologic surgeries due to benign uterine disease is 1-2%. Laparoscopic supracervical hysterectomy is also a part of frequently used surgical treatment of apical pelvic organ prolapse, which is followed by sacrocervicopexy. However, there are no data about iatrogenic endometriosis after apical prolapse surgery in the current literature. Herein, we present a case report of a patient diagnosed with de novo endometriosis 1 year after laparoscopic supracervical hysterectomy and sacrocervicopexy. CASE PRESENTATION A 46-year-old parous Slavic woman who underwent laparoscopic supracervical hysterectomy and sacrocervicopexy secondary to grade 3 symptomatic apical prolapse 1 year earlier was admitted to the same clinic with pelvic pain that had started 6 months following surgery. Deep vaginal palpation was painful. Transvaginal ultrasonography revealed an area with hypervascularization on the sacral promontory. She was scheduled for diagnostic laparoscopy. A 2 × 2-cm solid, wine-colored, hypervascular hemorrhagic lesion was seen on the sacral promontory. The lesion and the peritoneal layer behind it were totally excised. The patient was discharged on the first postoperative day, without any complications. Pathologic examination revealed foci of endometriosis comprising endometrial glands and stroma within the connective tissue, along with hemosiderin-laden macrophages. The symptoms of the patient resolved after the surgery, and no further adjuvant treatment was needed. CONCLUSION Although the rate of iatrogenic endometriosis is low after laparoscopic supracervical hysterectomy and sacrocervicopexy, the possibility of the occurrence of iatrogenic endometriosis should be discussed with patients who are diagnosed with apical prolapse to determine the type of surgical intervention. Iatrogenic endometriosis should be kept in mind for differential diagnosis in case of pain after laparoscopic supracervical hysterectomy and sacrocervicopexy.

中文翻译：

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顶端盆腔器官脱垂手术后医源性子宫内膜异位症：病例报告。


背景医源性子宫内膜异位症是指在某些手术干预后子宫内膜腺体和间质出现在子宫外。因良性子宫疾病而进行妇科手术后医源性子宫内膜异位症的发生率为1-2%。腹腔镜宫颈上子宫切除术也是治疗顶端盆腔器官脱垂的常用手术方法的一部分，其次是骶宫颈固定术。然而，目前文献中尚无有关根尖脱垂手术后医源性子宫内膜异位症的数据。在此，我们介绍一例腹腔镜宫颈上子宫切除术和骶宫颈固定术一年后诊断为新发子宫内膜异位症的患者的病例报告。病例介绍 一名 46 岁的斯拉夫妇女，一年前因 3 级症状性根尖脱垂而接受腹腔镜宫颈上子宫切除术和骶宫颈固定术，因术后 6 个月开始出现盆腔疼痛而入院。阴道深部触诊有疼痛感。经阴道超声检查显示骶骨岬上有一个血管丰富的区域。她被安排进行诊断性腹腔镜检查。在骶骨岬处可见 2 × 2 厘米的酒色、血管丰富的实性出血性病变。病变及其后面的腹膜层被完全切除。患者术后第一天就出院了，没有出现任何并发症。病理检查显示子宫内膜异位病灶包括结缔组织内的子宫内膜腺体和间质，以及富含含铁血黄素的巨噬细胞。手术后患者症状消失，无需进一步辅助治疗。 结论 虽然腹腔镜宫颈上子宫切除术和骶宫颈固定术后医源性子宫内膜异位症的发生率较低，但应与诊断为根尖脱垂的患者讨论医源性子宫内膜异位症发生的可能性，以确定手术干预的类型。如果腹腔镜宫颈上子宫切除术和骶宫颈固定术后出现疼痛，应牢记医源性子宫内膜异位症以进行鉴别诊断。