Prevalence, definition, and etiology of cesarean scar defect and treatment of cesarean scar disorder: A narrative review

Background Cesarean scar defects (CSD) are caused by cesarean sections and cause various symptoms. Although there has been no previous consensus on the name of this condition for a long time, it has been named cesarean scar disorder (CSDi). Methods This review summarizes the definition, prevalence,...

Full description

Saved in:
Bibliographic Details
Published in:Reproductive medicine and biology 2023-01, Vol.22 (1), p.e12532-n/a
Main Authors: Tsuji, Shunichiro, Nobuta, Yuri, Hanada, Tetsuro, Takebayashi, Aike, Inatomi, Ayako, Takahashi, Akimasa, Amano, Tsukuru, Murakami, Takashi
Format: Article
Language:English
Subjects:
Causes and theories of causation
cesarean scar defect
cesarean scar disorder
Cesarean section
Diseases
Etiology
Fetuses
Fibrosis
Gynecology
Hysterectomy
hysteroscopic surgery
Infertility
Laparoscopy
Magnetic resonance imaging
Menstruation
Regression analysis
Review
Reviews
Risk factors
secondary infertility
Surgery
Systematic review
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Cesarean scar defects (CSD) are caused by cesarean sections and cause various symptoms. Although there has been no previous consensus on the name of this condition for a long time, it has been named cesarean scar disorder (CSDi). Methods This review summarizes the definition, prevalence, and etiology of CSD, as well as the pathophysiology and treatment of CSDi. We focused on surgical therapy and examined the effects and procedures of laparoscopy, hysteroscopy, and transvaginal surgery. Main findings The definition of CSD was proposed as an anechoic lesion with a depth of at least 2 mm because of the varied prevalence, owing to the lack of consensus. CSD incidence depends on the number of times, procedure, and situation of cesarean sections. Histopathological findings in CSD are fibrosis and adenomyosis, and chronic inflammation in the uterine and pelvic cavities decreases fertility in women with CSDi. Although the surgical procedures are not standardized, laparoscopic, hysteroscopic, and transvaginal surgeries are effective. Conclusion The cause and pathology of CSDi are becoming clear. However, there is variability in the prevalence and treatment strategies. Therefore, it is necessary to conduct further studies using the same definitions. The chronic inflammation that occurs in cesarean scar defect spreads into the uterine cavity and reduces fertility. Such secondary infertility has been termed cesarean scar disorder. This condition can be cured by endoscopic surgery.
ISSN:1445-5781
1447-0578
DOI:10.1002/rmb2.12532