Patient: Description of condition (onset, main symptoms, hospital visited, etc.): Since I had a cesarean section in 2006, I have been having some difficulty with the left side of my abdomen, and my abdomen hurts during menstruation. What is the difference between endometriosis and incisional endometriosis? How should I treat it? Do you want to remove the nodes? You don’t need to remove the uterus, right? Answer: Normal endometrium should grow inside the uterine cavity and be shed every month with menstruation and eliminated from the body through the vagina. If the endometrium appears outside the uterine cavity and also has a growth function, it is called endometriosis. The most common sites include the ovaries, where it grows into cysts called ovarian endometrial cysts (commonly known as chocolate cysts, because the ectopic endometrium bleeds in the ovarian centimeters and cannot be eliminated, so it accumulates as a cyst, and the fluid inside the cyst looks like chocolate), in the myometrium, where it forms adenomyosis, in the caesarean incision, and in the intestines, where it regularly bleeds in the stool and in the eyes, which are of course less common. The etiology is unclear, so why the endometrium can be running to other parts of the body and still continue to grow, and also prone to recurrence, which gives gynecologists all over the world a headache. Your cause is cesarean section (so, still normal delivery, but some normal delivery endometrium can still ectopic to the vagina, I have seen ectopic to the top of the vaginal lateral incision), making the endometrium grow in the abdominal wall incision. Nowadays, because of the high number of cesarean section patients, there are more endometriosis in the incision. The surgery is simple – the lesion is removed, just like removing a fatty tumor, all without going into the abdominal cavity, and certainly without removing the uterus.