Scar Endometriosis After C-Section: A Lump and Cyclical Pain
Reading time: about 6 minutes. This article is educational and does not replace an individual consultation.
If you have a painful lump near a caesarean section scar that flares around your periods, there is a specific, often-missed explanation: scar endometriosis. It is uncommon, frequently misdiagnosed, and — importantly — usually curable with surgery. This article explains what to look for.
Who this article is for
This is for women in Ahmedabad and Gujarat who have had a caesarean (or other abdominal surgery) and notice a lump or cyclical pain at or near the scar.
What scar endometriosis is
Scar endometriosis (also called abdominal wall endometriosis) occurs when endometrial-type tissue becomes established in a surgical scar — most often a caesarean scar. Like endometriosis elsewhere, this tissue responds to the hormonal cycle, which is why symptoms are typically cyclical [Source: peer-reviewed literature on abdominal wall endometriosis; ESHRE Endometriosis Guideline, 2022].
The tell-tale pattern
The classic picture is a firm lump in or near a caesarean scar that becomes painful and may swell around the time of periods, then settles. Because this pattern is not widely known, it is often mistaken for other lumps such as a hernia or a stitch granuloma, leading to delay [Source: peer-reviewed literature]. The cyclical link to periods is the most useful clue.
How it is diagnosed
Diagnosis is based on the history — particularly the cyclical pattern and a previous caesarean — supported by ultrasound and, where needed, MRI to define the lump and plan treatment. Imaging helps distinguish it from other causes of an abdominal wall lump [Source: ISUOG and radiology literature].
How it is treated
The definitive treatment for scar endometriosis is usually surgical removal of the affected tissue, which is generally effective. Because the goal is complete removal of the deposit, planning the surgery well is important. Hormonal treatment may reduce symptoms temporarily but does not remove the deposit [Source: peer-reviewed literature; ESHRE Endometriosis Guideline, 2022].
What to ask
- Could my scar lump be scar endometriosis, given the cyclical pattern?
- What imaging would help confirm it and plan treatment?
- What does surgical removal involve, and how effective is it?
- Is there any link to endometriosis elsewhere I should be assessed for?
Endometriosis care in Ahmedabad
Recognising scar endometriosis early spares women years of misdiagnosis. Balaji Horizon Women’s Hospital, on Science City Road in Ahmedabad, assesses cyclical scar lumps with appropriate imaging and offers surgical treatment when scar endometriosis is confirmed.
When to seek advice
See a gynaecologist if you have a lump near a caesarean or abdominal scar that hurts or swells around your periods, particularly if it has been attributed to other causes without improvement. The cyclical pattern is worth investigating [Source: ESHRE Endometriosis Guideline, 2022].
A note on next steps
For assessment of a cyclical scar lump, our team can help. Read more on our endometriosis and diagnosis pages.
Frequently asked questions
What does scar endometriosis feel like?
Typically a firm lump in or near a caesarean scar that becomes painful and may swell around periods, then settles. The cyclical link to menstruation is the key clue and helps distinguish it from other lumps [Source: peer-reviewed literature].
Why is scar endometriosis often missed?
Because the condition is uncommon and not widely recognised, scar lumps are often attributed to hernias or stitch reactions. The cyclical pattern, when asked about, points to the correct diagnosis [Source: peer-reviewed literature].
How is it treated?
The definitive treatment is usually surgical removal of the affected tissue, which is generally effective. Hormonal treatment may ease symptoms temporarily but does not remove the deposit [Source: ESHRE Endometriosis Guideline, 2022].
Does scar endometriosis mean I have endometriosis elsewhere?
Not necessarily, but it is reasonable to discuss whether assessment for pelvic endometriosis is warranted, particularly if you also have pelvic symptoms. Your gynaecologist can advise.
Can it come back after surgery?
Complete surgical removal is usually effective, and recurrence is uncommon when the deposit is fully excised. Good surgical planning supports a lasting result.
Disclaimer: This article is for educational purposes only and does not replace a consultation with a qualified gynaecologist.
How scar endometriosis is diagnosed
The history is often distinctive: a firm lump near a caesarean scar that becomes more painful or swollen around the time of your period. Ultrasound, and sometimes MRI, helps confirm it and assess depth, and distinguishes it from other causes of a scar swelling.
Treatment options
Treatment is individualised. Symptomatic and hormonal measures may help, but a well-defined, symptomatic scar nodule is often best managed by careful surgical excision with clear margins. The choice depends on lesion size, symptoms and your plans.
When to see a specialist
If you notice a tender lump near a caesarean scar that flares with your periods, ask for an assessment rather than waiting — early evaluation makes treatment simpler.
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