Surgical management of inguinal endometriosis: Case report and surgical video

Abstract

Introduction: Inguinal endometriosis is a rare type of extra-pelvic endometriosis, which may occur in the absence of symptoms of intra-pelvic endometriosis. This case report highlights the importance of considering inguinal endometriosis in the workup of an inguinal mass and demonstrates a step-by-step surgical approach to management, with an accompanying video. Case Report: We encountered a case of a 31-year-old nulligravid woman who presented with a painful right inguinal mass. The patient underwent diagnostic laparoscopy, which was notable for Stage 1 intra-pelvic endometriosis, without involvement of the internal inguinal ring or round ligament. The inguinal mass was carefully resected from nearby vessels, muscles, and nerves. Pathology confirmed endometriosis. Conclusion: Gynecologists, in collaboration with a multidisciplinary team, should be prepared to workup, diagnose, and surgically manage inguinal endometriosis. When this condition is suspected, imaging should be obtained, and tissue biopsy may be considered, provided that a hernia has been ruled out. Surgical management is typically recommended and should entail diagnostic laparoscopy and excisional surgery.