Management of perineal endometriosis

Objective: To demonstrate the appropriate diagnosis and management of perineal endometriosis. Method: Six patients with perineal endometriosis were diagnosed according to their clinical symptoms and signs which included cyclic perineal pain and a tender perineal mass coinciding with the menstrual cycle. Diagnostic tools used included ultrasonography, computerized tomography, fine needle aspiration cytology and laparoscopy, Management comprised both surgical and medical treatment. Postoperative follow-up was carried out at 3-monthly intervals. Results: All six patients were cured following surgical excision of the endometrioma. Conclusion: A detailed history, thorough pelvic examination and sonographic investigation are essential in diagnosing perineal endometriosis. The role of other diagnostic tools remains controversial. Treatment of extrapelvic endometriosis includes surgical intervention and hormonal suppression. If hormonal suppression fails; surgical excision of the perineal endometrioma should be carried out.