Prospective evaluation of five methods used to treat cesarean scar defects

Abstract Objective To evaluate operative and nonoperative therapies for cesarean scar defects (CSDs). Methods A prospective study was conducted among patients who underwent treatment of CSDs at a hospital in Shanghai, China, between April 1, 2010, and December 31, 2014. Treatment included laparoscop...

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Bibliographic Details
Published in:International journal of gynecology and obstetrics 2016-09, Vol.134 (3), p.336-339
Main Authors: Zhang, Xuyin, Yang, Mengyi, Wang, Qing, Chen, Jianliang, Ding, Jingxin, Hua, Keqin
Format: Article
Language:English
Subjects:
Adult
Cesarean scar defect
Cesarean Section
China
Cicatrix - pathology
Cicatrix - surgery
Combined oral contraceptives
Female
Gynecologic Surgical Procedures - methods
Humans
Hysteroscopy
Laparoscopy
Length of Stay
Levonorgestrel intrauterine system
Obstetrics and Gynecology
Pregnancy
Prospective Studies
Treatment Outcome
Uterine Diseases - pathology
Uterine Diseases - surgery
Vaginal surgery
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Summary:Abstract Objective To evaluate operative and nonoperative therapies for cesarean scar defects (CSDs). Methods A prospective study was conducted among patients who underwent treatment of CSDs at a hospital in Shanghai, China, between April 1, 2010, and December 31, 2014. Treatment included laparoscopy (group 1), vaginal surgery (group 2), hysteroscopy (group 3), combined oral contraceptives (group 4), and the levonorgestrel intrauterine system (group 5). Results Among 142 participants, 119 patients underwent surgical repair and 23 received nonsurgical (conservative) treatment. Operation time, blood loss, and length of hospital stay reported for patients in group 3 (n = 19) were all lower than those reported for patients in group 1 (n = 86) and group 2 (n = 14; P < 0.001 for all comparisons). Patients who underwent surgery and those in group 4 (n = 18) experienced shortened menstrual periods after treatment ( P < 0.001 for all comparisons). For group 5 (n = 5), the duration of menstruation was similar before and after therapy ( P = 0.89). All 32 women who desired fertility underwent laparoscopy; 12 (37.5%) became pregnant after this procedure. Conclusion All treatments for CSDs other than the levonorgestrel intrauterine system shortened menstrual periods. Laparoscopic surgery was effective for patients with fertility requirements.
ISSN:0020-7292
1879-3479
DOI:10.1016/j.ijgo.2016.04.011