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Retained Intrauterine Sutures for 6 Years
Mukhit Sarsembayev1, Svetlana Shikanova1, Bakyt Karimova1
1Department of Obstetrics and Gynecology №1, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.
Gynecology and Minimally Invasive Therapy
|October 26, 2020
Summary
Retained intrauterine sutures after cesarean section (CS) can cause inflammation and infertility. Operative hysteroscopy successfully removed sutures retained for 6 years, restoring fertility.
Area of Science:
- Reproductive Medicine
- Gynecologic Surgery
- Suturing Materials Science
Background:
- Cesarean section (CS) commonly utilizes Vicryl or chromic catgut sutures for uterine closure.
- Suture material properties, including chemistry and polymer morphology, influence their in vivo performance and absorption rates.
- Inappropriate suture hydrolysis and absorption can lead to retained intrauterine foreign bodies.
Observation:
- A rare case of intrauterine sutures retained for six years following a prior CS is presented.
- The retained sutures were attached to the uterine wall, potentially causing inflammation and infertility.
- The patient presented with symptoms suggestive of retained foreign material within the uterine cavity.
Findings:
- Operative hysteroscopy enabled the precise identification, incision, and release of the retained intrauterine sutures.
- Retained sutures can act as a foreign body, inducing intrauterine inflammation and potentially interfering with sperm transport and embryo implantation.
- This case demonstrates a long-term consequence of suture material behavior within the uterine cavity.
Implications:
- Retained intrauterine sutures are a potential cause of abnormal uterine bleeding (AUB) and infertility post-CS.
- Operative hysteroscopy is highlighted as the gold standard diagnostic and therapeutic tool for evaluating the uterine cavity in cases of AUB and infertility.
- This case underscores the importance of complete suture absorption and the potential long-term complications of retained foreign materials in gynecologic surgery.
