Potential Complication of Cesarean: Endometriosis after C-section

Rishabh Mehta
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Dr. Kaushal

Review medical content on WOW Rx Pharmacy, so that accurate drug use information is easily accessible to everybody.
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endometriosis after c section

Endometriosis, as we know, is the growth of endometrial-like tissue outside the uterus and typically occurs in the pelvic region.

However, like with any other condition, Endometriosis has rare complications of manifesting after C-section delivery. 

Women do not need to have a history of Endometriosis before pregnancy in order to develop scar endometriosis following a cesarean section (C-section).

In this article, we aim to explore the causes, symptoms, diagnostic methods, and preventive measures for Endometriosis after C-section.

What is Cesarean Scar Endometriosis

Cesarean Scar Endometriosis is a rare condition where endometrial tissue starts to grow in or around the scar tissue from a cesarean section.

This tissue can then grow and lead to pain, swelling, or forming a mass or nodule in the abdominal area near the C-section scar. 

The symptoms may become more noticeable and problematic during menstruation.

Cesarean Scar Endometriosis is a rare complication of reported cases, around 0.03-0.45%. 

Symptoms of Endometriosis after C-section

menstrual cycles in womenSource: Mehaniq
Menstrual pads on a calendar

The symptoms associated with Endometriosis after a C-section can include:

  • Visible mass or lump
  • Swelling
  • Brownish discharge near the C-section scar during the menstrual period
  • Tenderness and lower abdominal discomfort
  • Chronic or cyclical pain 

The discomfort and pain associated with Endometriosis after C-section are often linked to the hormonal changes that occur during the menstrual cycle.

Causes of Cesarean Scar Endometriosis

Endometriosis after a C-section occurs when endometrial tissue migrates to the incision site created during the surgery. 

The exact reasons why some women develop Endometriosis after a C-section are not fully understood. 

However, some factors can contribute to Cesarean Scar Endometriosis. These include:

  • Estrogen stimulation post-delivery
  • Imbalance in the formation of new blood vessels
  • Chronic inflammation
  • Altered immunity

Diagnosis of Cesarean Scar Endometriosis

Doctor writing prescriptionSource: South_agency_from_Getty_Images
Consult a doctor

Diagnosing Endometriosis can be challenging due to its rarity and limited awareness. 

If you feel pain around your C-section scar or notice a swelling or lump, contact your doctor. 

They will typically begin with a thorough medical history and pelvic exam. 

Diagnostic tools such as abdominal ultrasonography, Magnetic Resonance Imaging (MRI), and Computed Tomography (CT) will be used to visualize the uterus and surrounding structures. 

In some cases, Fine-Needle Aspiration (FNA) biopsy or exploratory surgery, such as Laparoscopy, can differentiate CSE from other conditions.

In some rare cases, C-section scar Endometriosis can transform into a type of cancer called Clear Cell Carcinoma (CCC) with a high risk of death. So, if you notice any symptoms, consult your healthcare provider promptly.

Treatment options

In cases of Endometriosis post-C-section, surgical intervention is often recommended to remove the inflammatory endometrial tissue. 

This becomes particularly crucial for individuals planning to conceive again. 

Alternative treatments may include hormonal birth control pills or other hormonal contraceptives to manage symptoms. 

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In severe cases, individuals who do not wish to conceive may opt for a hysterectomy, potentially combined with the removal of ovaries.


Endometriosis after a C-section is a rare yet noteworthy condition that can develop after a C-section delivery.

Certain factors, such as Estrogen stimulation post-delivery, blood vessel formation imbalance, chronic inflammation, and altered immunity, may contribute to its occurrence.

Recognizing the symptoms, including visible masses, swelling, brownish discharge during menstruation, and abdominal discomfort, is crucial for early detection. 

Diagnosing it can be challenging, but a thorough medical history, pelvic exam, and imaging techniques like ultrasonography, CT, or MRI can aid in diagnosis.

Treatment options often involve surgical intervention to remove the inflammatory endometrial tissue, especially for individuals planning future pregnancies. 

Further research is needed to know the causes and preventive measures for Cesarean Scar Endometriosis for more effective strategies for tackling this rare complication.

Frequently Asked Questions

Can C-section cause Endometritis?

Yes, a C-section can be a risk factor for Endometritis. It can occur as a complication of any surgical procedure involving the uterus, including C-sections. The risk increases when an infection is introduced during the surgery or if proper postoperative care is not followed.

How common is Endometriosis after C-section?

Overall, the occurrence of surgically confirmed Endometriosis in scars is reported to be within the range of 0.03% to 1%. Endometriosis after C-section is relatively uncommon, with a prevalence ranging from 0.03% to 0.04% based on surgically proven cases.

What are the symptoms of scar Endometriosis?

Scar Endometriosis symptoms are pain or tenderness at the site of the C-section scar, accompanied by swelling or the development of a palpable lump. Additional symptoms include brownish discharge near the C-section and chronic menstrual pain. 

Could a hard lump in the stomach after a C-section be Endometriosis?

A hard lump in the stomach after a C-section could be due to various factors, and it doesn’t necessarily indicate Endometriosis. It could be a result of scar tissue or hernia. However, if the lump is associated with pain, tenderness, or brownish discharge from the C-section scar, it can be Endometriosis. 

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