Vaginal Repair of Cesarean Section Scar Diverticula

Luo, Lu; Niu, Gang; Wang, Qiong; Xie, Hong‐Ning; Yao, Shuzhong

doi:10.1016/j.jmig.2012.03.012

Cited by 71 publications

(73 citation statements)

References 19 publications

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“…Instead, the flap-like fibrotic tissue is removed from the bottom of the lesion down to the endocervical canal. This corrects the isthmocele, but the size of the attenuated portion of the anterior uterine wall is actually enlarged [6,10]. Whether hysteroscopic removal of an isthmocele increases the risk of uterine rupture in subsequent pregnancies requires further study.…”

Section: Discussionmentioning

confidence: 99%

“…The procedure used for vaginal isthmocele repair has been previously described [10]. Briefly, after sterile preparation and bladder catheterization, the cervix uteri was visualized using a vaginal retractor, and the anterior lip of the cervix was held with grasping forceps.…”

Section: Methodsmentioning

confidence: 99%

“…In 2008, we began performing vaginal surgery for the correction of cesarean-induced isthmocele. We were able to achieve effective anatomic correction and a symptom-relief rate of up to 92.9% [10]. It is unknown, however, whether the efficacy of vaginal surgery is comparable to that of operative hysteroscopy.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Comparison of Vaginal Surgery and Operative Hysteroscopy for the Treatment of Cesarean-Induced Isthmocele: A Retrospective Review

Xie

Fan

et al. 2014

Gynecol Obstet Invest

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Background/Aims: Cesarean-induced isthmocele can cause heavy or prolonged menses, dyspareunia, and dysmenorrhea. We compared the efficacy of vaginal surgery and operative hysteroscopy for the treatment of cesarean-induced isthmocele. Methods: Seventy-seven women with cesarean-induced isthmocele underwent either vaginal surgery or operative hysteroscopy between August 2008 and December 2011. We evaluated operating time, blood loss, complications, and postoperative pregnancy. Operative efficacy was defined as an improvement in menstrual periods and a change in residual isthmocele nidus size on transvaginal ultrasonography. Results: The operative efficacy of vaginal surgery was superior to that of hysteroscopy (93.5 vs. 64.5%; p < 0.001). However, patients who underwent vaginal surgery had a longer operative time (55 vs. 25 min; p < 0.001) and greater blood loss (50 vs. 10 ml; p < 0.001). Two patients in each group were able to achieve subsequent pregnancy. Patients who had menstrual periods longer than 7 days after surgery were more likely to have a residual nidus. Conclusions: The therapeutic efficacy of vaginal surgery is superior to operative hysteroscopy in the treatment of cesarean-induced isthmocele.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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A Comparison of Vaginal Surgery and Operative Hysteroscopy for the Treatment of Cesarean-Induced Isthmocele: A Retrospective Review

Xie

Fan

et al. 2014

Gynecol Obstet Invest

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“…Mean time of the procedure was 60 minutes (30-90 minutes) and mean hospitalization was 3 days. During long time follow-up resolution of bothersome symptoms was achieved in 93% of patients [28]. This approach was also used by Chen and colleagues in 64 women.…”

Section: Surgical Treatment -Vaginal Approachmentioning

confidence: 94%

When and how should we treat cesarean scar defect — isthmocoele?

Futyma

Gałczyński

Romanek³

et al. 2016

Ginekol Pol

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The reported number of cesarean sections in Poland is approximately 30% and is associated with increasing number of early and late complications. The myometrial discontinuity at the site of previous cesarean section is known in the literature as "isthmocoele", "niche", "pouch" or cesarean scar defect. In most cases presence of isthmocoele has no clinical significance, but in some patients it may cause abnormal uterine bleeding, dysmenorrhea, dyspareunia, pelvic pain or be associated with secondary infertility. This defect may be treated by laparoscopy, hysteroscopy or vaginal surgery.

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“…Multiple techniques have been used for CSD treatment: reconstructive therapies including laparoscopic or robotassisted laparoscopic excision, vaginal repair and channel-like resectoscopic treatment [3][4][5][6]. All these procedures excise or ablate the fibrotic tissue of niche, suggesting that the removal of the local inflamed tissue may contribute to the improvement of symptoms.…”

Section: Introductionmentioning

confidence: 99%

Small Size Resectoscope in Isthmocele Repair: Case Report

Gubbini¹

2017

OGIJ

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The presence of a uterine cesarean scar defect (CSD) is usually asymptomatic or relates to postmenstrual spotting and dark red or brown discharge, pelvic pain or infertility. Since hysteroscopic isthmoplasty has been documented to be minimally invasive and effective for symptomatic relief, we prefer channel-like resectoscopic treatment for symptomatic CDS with small size resectoscope. 16-Fr resectoscope allows us to perform standard maneuvers of resectoscopic CSD repair according to the anatomy of cervical canal with the advantages of miniaturized instrumentation. In the present case report asymptomatic patient underwent hysteroscopic isthmoplasty after shared decision-making and medical treatment have been evaluated.

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Vaginal Repair of Cesarean Section Scar Diverticula

Cited by 71 publications

References 19 publications

A Comparison of Vaginal Surgery and Operative Hysteroscopy for the Treatment of Cesarean-Induced Isthmocele: A Retrospective Review

A Comparison of Vaginal Surgery and Operative Hysteroscopy for the Treatment of Cesarean-Induced Isthmocele: A Retrospective Review

When and how should we treat cesarean scar defect — isthmocoele?

Small Size Resectoscope in Isthmocele Repair: Case Report

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