Isthmoceles: A Growing Concern

An isthmocele is described as a pouch-like defect in the uterus with a thin roof formed by inadequate healing of the smooth muscle of the anterior uterine wall at the site of a hysterotomy. With increased rates of deliveries by cesarean section, isthmoceles are becoming a more common cause of gynecologic and obstetric complications. Gynecologic issues include pelvic pain, postmenstrual bleeding, and reduced fertility or infertility. Therefore, it is important that providers consider these defects in their differential diagnosis as their presentation can mimic other gynecologic conditions, such as endometriosis. Fortunately, many effective treatment options are available, such as conservative hormonal treatment or surgical repair by laparoscopic, hysteroscopic, or transvaginal methods.