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[Laparoscopic treatment of cesarean scar pouch - A case series study of 9 patients]
M Delaine1, L Lecointre1, C Y Akladios1
1Unité de chirurgie gynécologique, pôle de gynécologie obstétrique, hôpitaux universitaires de Strasbourg, Strasbourg, France.
Objectives:
To study the effects of laparoscopic repair of isthmoceles acquired after a cesarean section on symptoms and fertility.
Methods:
This retrospective case series study included symptomatic women (abnormal uterine bleeding and/or pelvic pain and/or infertility) suffering from a large isthmocele and treated laparoscopically in our center. The surgical procedure consisted in resecting the pouch and suturing the scar in 2 layers. The patient follow-up has been realised through the postoperative control, the medical file and a survey, and concerned the evolution of the symptoms and fertility.
Results:
Nine patients have been included, all suffering from large isthmoceles, diagnosed by transvaginal ultrasound associated with hysteroscopy, hysterosalpingography or MRI. Postoperatively, the symptoms disappeared in 78% of the patients. There have been 4 spontaneous pregnancies in 4 patients, 3 of them had been diagnosed with infertility. The median patient medical follow-up lasted 28 months.
Conclusion:
The diagnosis of a large isthmocele in patients suffering from invalidant symptoms and infertility should lead to consider a surgical treatment which is an efficient and surgically safe procedure.
