Abdominal Wall Endometriosis : What is it and How is it Treated

Healthline Asks Heather Jeffcoat About Abdominal Wall Endometriosis

What is abdominal wall endometriosis?

In a recent interview with Healthline, I mention that Endometriosis is a condition that can develop in the fallopian tubes or ovaries. Though in some occasions the uterine-like cells grow outside the uterus and into other parts of the body. This condition can sometimes occur in rare forms, including a form consisting of cell growth along or within the abdominal wall known as abdominal wall endometriosis (AWE).

What are symptoms of abdominal wall endometriosis?

While some individuals with AWE may not experience any symptoms at all, those that do exhibit common signs that include abdominal swelling, tenderness, or bruising, pelvic pain (especially during menstruation), and the presence of a noticeable lump in the abdomen. As I mentioned during the interview,  “Due to the scar tissue that can develop when you have abdominal wall endometriosis, many people also feel restrictions in movement with certain positions, such as trunk rotation or extension.”

What causes abdominal wall endometriosis?

The exact cause of AWE remains unclear, but a study  published in 2022 points to a commonality with individuals who have a history of gynecological or obstetrical surgeries, particularly cesarean sections. Some theories suggest that endometrial tissue may be inadvertently implanted during abdominal surgeries or that menstrual blood may flow backward through the fallopian tubes, leading to the condition.

How is abdominal wall endometriosis diagnosed?

Diagnosis of abdominal wall endometriosis often involves a laparoscopic surgical biopsy, which I consider the gold standard. Though the surgery is considered minimally invasive, there has been a push for clinicians to consider alternative diagnostic methods, such as symptom tracking and various imaging technologies like ultrasounds, MRIs, and CT scans.

What treatment options are there?

While there is no cure for endometriosis yet, there is still hope as there are several treatment options available. Full excision surgery, involving the removal of affected tissues and surrounding areas, is typically the most effective for pain reduction. “But while excision surgery is a critical intervention, pain is complex, and at the point where the pain has become chronic, there’s rarely a single intervention that reverses an individual’s pain,” which I state in the interview.

The management of chronic pain may require a multifaceted approach that includes working with a team of  healthcare professionals like the pelvic floor therapists that practice at Femina Physical Therapy, acupuncturists, chronic pain specialists, and nutritionists. Medications, like hormonal contraceptives and nonsteroidal anti-inflammatory drugs, can also be implemented in the treatment plan.

What are the complications of AWE?

Abdominal wall endometriosis can lead to painful menstruation, adhesions, and skin changes. It may also be associated with infertility, although more research is needed to determine the extent of its impact on fertility.

Final thoughts for those living with AWE:

Despite the challenges, individuals with abdominal wall endometriosis can find relief from symptoms and continue to lead fulfilling lives with appropriate care and support. If you suspect that you may have symptoms related to abdominal wall endometriosis, consult with one of our practitioners at Femina Physical Therapy today for a specialized treatment plan. 

For more on abdominal wall endometriosis continue to the full Healthline article here.