A COMPARATIVE STUDY OF HYSTEROSCOPIC REPAIR AND TRANSVAGINAL REPAIR IN THE MANAGEMENT OF PATIENTS WITH POST CESAREAN SCAR DEFECT

Abstract

To compare hysteroscopic repair and transvaginal repair for correcting uterine defect in patients with post cesarean scar defect (PCSD). Patients had a history of transverse lower uterine segment cesarean section, meeting the inclusion criteria and exclusion criteria were enrolled. 79 patients were finally included in the study, of which 39 patients received hysteroscopic repair and 40 patients received transvaginal repair. All patients signed the informed consent and the study was approved by the Ethics Committee of the Sixth Affiliated Hospital, Sun Yat-sen University (trial No 2015-122). Shorter surgery time and less postoperative hospital stay but higher hospitalization expenses were found in patients receiving hysteroscopic repair than those received transvaginal repair. Follow-up data showed that there were significant differences of pre-operative and post-operative menstrual durations between the two groups. 84.6% of patients in hysteroscopic repair group were observed improvement of prolonged menstrual bleeding syndrome while 87.5% found in transvaginal intervention group (p＞0.05). Proportions of patients with disappeared or reduced uterine defect were 84.6% and 85% in operative hysteroscopic repair and transvaginal repair groups, respectively (p＞0.05). Hysteroscopic repair and transvaginal repair can achieve similar short-term results in improving abnormal menstruation and pregnant outcome by resection of PCSD lesions. Shorter operation time and less postoperative hospital stay would make hysteroscopic repair a better choice for PCSD patients who want to get pregnant urgently.