Impact of hysteroscopic surgery for isthmocele associated with cesarean scar syndrome
Impact of hysteroscopic surgery for isthmocele associated with cesarean scar syndrome
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DOI：
10.1111/jog.13464
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发表时间：
2018-01-01
影响因子：
1.6
通讯作者：
Murakami, Takashi
中科院分区：
文献类型：
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作者：
Tsuji, Shunichiro;Kimura, Fuminori;Murakami, Takashi
目的剖宫产瘢痕综合征（CSS）的特征是增加经后异常子宫出血、痛经和不孕的风险，这是由于剖宫产后瘢痕缺陷（称为峡部膨出）所致。本研究旨在评估宫腔镜手术对峡部膨出与CSS. MethodsEighth CSS患者的影响。手术方法包括宫腔镜手术切除峡部膨出下缘和浅表烧灼。我们使用磁共振成像评估了宫腔镜手术前后子宫肌层厚度和峡部膨出的残留量。宫腔镜手术后残留的子宫肌层较厚（术前和术后的中位数分别为2.1 mm和4.2 mm; P=0.0001）。宫腔镜手术后峡部膨出体积明显缩小（术前和术后的中位数分别为494.9mm（3）和282.8mm（3）; P=0.0016）。
AimCesarean scar syndrome (CSS) is characterized by increased risk of postmenstrual abnormal uterine bleeding, dysmenorrhea, and infertility, due to a post-cesarean scar defect known as an isthmocele. This study aimed to assess the impact of hysteroscopic surgery on isthmocele associated with CSS.MethodsEighteen patients with CSS were enrolled. Surgical methods included resection of the inferior edge and superficial cauterization of the isthmocele via hysteroscopic surgery. We evaluated the residual myometrial thickness and isthmocele volume using magnetic resonance imaging, before and after hysteroscopic surgery.ResultsAll patients underwent surgery without any complications. The residual myometrium was thicker after hysteroscopic surgery (median: 2.1mm and 4.2mm, before and after surgery, respectively; P=0.0001). Isthmocele volume was significantly reduced after hysteroscopic surgery (median: 494.9mm(3) and 282.8mm(3), before and after surgery, respectively; P=0.0016).ConclusionThis study demonstrated that hysteroscopic surgery is effective in increasing the residual myometrial thickness and reducing the size of isthmocele.