Menstruating Skin: Utero-Cutaneous Fistula Coexisting with Scar Endometriosis: A Case Report

Abstract Scar endometriosis and utero-cutaneous fistula (UCF) complicating cesarean section is a rare occurrence, and only a few cases have been reported in the literature. The patient developed cyclical bleeding from the previous operation site associated with abdominal pain. The bleeding occurred whenever she was having her menstrual period. At presentation, an initial diagnosis of scar endometriosis was made. She had surgical excision of the fibrotic subcutaneous tissue and rectus sheath with the repair of the fistulous uterus. The result of the histopathological examination was scar endometriosis and UCF. She did well post-surgery and was discharged home, and the follow-up clinic visits were not eventful. Cesarean section wound infection is a risk factor for UCF formation and scar endometriosis. Meticulous excision of the endometriotic skin, the fistulous tract, and repair of the fistulous uterus is an effective management modality.