Prospective evaluation of five methods used to treat cesarean scar defects

Zhang, Xuyin; Yang, Miaomiao; Wang, Qing; Chen, Jianliang; Ding, Jingxin; Hua, Keqin

doi:10.1016/j.ijgo.2016.04.011

Cited by 57 publications

(81 citation statements)

References 17 publications

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“…There are several ways for the treatment for the CSD symptoms. Oral contraceptive pills provide an option for conservative management a CSD . Hysteroscopy can either ablate the lesion or reshape the CSD to enhance drainage during menstruation .…”

Section: Discussionmentioning

confidence: 99%

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Comparison of transvaginal repair versus laparoscopic repair of lower‐segment cesarean scar defects

Zhang

Liang

Zhu

2019

Intl J Gynecology & Obste

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Objective To evaluate transvaginal repair versus laparoscopic repair of cesarean scar defects (CSDs). Methods A retrospective cohort study was conducted among 67 symptomatic women with CSDs who attended a tertiary hospital in Beijing, China, between July 1, 2013, and March 31, 2017. The participants underwent either transvaginal repair (n=31) or laparoscopic repair (n=36). Medical costs, perioperative outcomes, and surgical outcomes were compared. Results No statistically significant between‐group differences were found at baseline. The mean thickness of the residual myometrium increased from 1.71 ± 0.67 mm before surgery to 4.41 ± 2.09 mm after surgery in the transvaginal repair group (P<0.001), and from 1.81 ± 0.93 to 4.68 ± 1.96 mm in the laparoscopic repair group (P<0.001). The duration of menses after surgery was less than 10 days in both the transvaginal repair group (n=30, 96.3%) and the laparoscopic repair group (n=30, 83.9%; P=0.113). Operative time and medical costs were both lower in the transvaginal repair group than in the laparoscopic repair group (P<0.001). Conception rates for the two groups were similar among women who desired fertility. Conclusion Transvaginal repair of CSD was associated with reduced operative times and medical costs when compared with laparoscopic repair.

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Section: Discussionmentioning

confidence: 99%

“…Oral contraceptive pills provide an option for conservative management a CSD. 8,9 Hysteroscopy can either ablate the lesion or reshape the CSD to enhance drainage during menstruation. [10][11][12] By contrast, the CSD can be reconstructed and replaced with thick and strong tissue by using a laparoscopic or transvaginal approach.…”

Section: Discussionmentioning

confidence: 99%

Comparison of transvaginal repair versus laparoscopic repair of lower‐segment cesarean scar defects

Zhang

Liang

Zhu

2019

Intl J Gynecology & Obste

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“…▪ Medical treatment: Medical treatment is the best for women with isthmocele who do not desire to get pregnant seems to be oral contraception. Zhang et al [18], have published a survey on the role of oral contraceptives with estrogen and progesterone in 18 patients and have found it to be effective regarding the duration of flow (reducing from 10 days to 5 days). Other authors [19] have also described oral contraceptives to be efficacious in reducing bleeding disorders.…”

Section: Treatments ▪mentioning

confidence: 99%

“…The mattress suture was used in the second layer, and the vaginal epithelium was then continuously sutured using 0 absorbable sutures. Finally, the vagina was packed with 2 pieces of iodoform gauze, which were removed after 24 to 48 hours [18]. Zhang reported no complications (14 patients).…”

Section: Treatments ▪mentioning

confidence: 99%

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Niche After Cesarean Section

EL-Gharib

2019

O J Gyencol Obset Res

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A uterine niche, also calld cesarean scar defect, or cesarean scar dehiscence, uterine diverticulum, uterine sacculation or isthmocele. It is a man made pouchlike defect of the anterior uterine isthmus occurs at the site of a prior cesarean section. Its occurrence has been increased in the last years secondary to the increased incidence of cesarean section. Many patients with isthmocele are asymptomatic. The most frequent complaint relates to intermittent postmenstrual bleeding as the isthmocele functions as a reservoir collecting blood during menstruation, with irregular menses that can run for 2 to 12 days. Various sources have described isthmocele as a case of infertility, pain and dysmenorrhea. An isthmocele is typically diagnosed on transvaginal sonography, hysterosalpinography and hysteroscopy. Magnetic resonance tomography is useful to measure the thickness of the lower uterine segment, the profundity of the isthmocele. The treatment of isthmocele includes laparotomy, laparoscopy, hysteroscopy, vaginal repair, and several combined techniques with no statistically superior outcome noted in the literature. In that respect is no gold standard treatment for isthmocele.

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Postoperative morphologic changes of the isthmocele and clinical impact in patients treated by channel‐like (360°) hysteroscopic technique

Casadio

Raffone

Alletto

et al. 2022

Intl J Gynecology & Obste

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Prospective evaluation of five methods used to treat cesarean scar defects

Abstract: All treatments for CSDs other than the levonorgestrel intrauterine system shortened menstrual periods. Laparoscopic surgery was effective for patients with fertility requirements.

Cited by 57 publications

References 17 publications

Comparison of transvaginal repair versus laparoscopic repair of lower‐segment cesarean scar defects

Comparison of transvaginal repair versus laparoscopic repair of lower‐segment cesarean scar defects

Niche After Cesarean Section

Postoperative morphologic changes of the isthmocele and clinical impact in patients treated by channel‐like (360°) hysteroscopic technique

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