Comparison of classic single-layer uterin suture and double-layer purse-string suture techniques for uterus closure in terms of postoperative short-term uterine isthmocele: A prospective randomized controlled trial.

Abstract

To compare the short-term results of classic single-layer uterine closure and double-layer purse-string uterine closure (Turan technique) techniques in cesarean section in terms of the incidence of ischiocele formation. This was a prospective randomized controlled trial study. Participants undergoing first-time cesarean delivery were randomized into two groups. Fifty-eight participants were included in the double-layered uterine closure group (study group), while 53 participants were randomized into the classical single-layered uterine closure group (control group). For comparison of isthmocele formation, transvaginal ultrasound examination was planned in all patients 6 weeks after surgery. The operation data,the formation of isthmocele, its dimensions and volume were recorded. A total of 111 women were included in the study. The incidence of ischiocele at 6 weeks after birth was not significantly different between the groups (p=0.128). Isthmosel was detected in 20.8% of single-layer closures, and this rate was determined as 10.3% in the purse technique. In the Kerr incision made during surgery, the uterine incision size did not differ in either group, but the uterine incision length after suturing was significantly smaller in the purse technique compared with the other group (p<0.001). The incidence of ischiocele formation after cesarean section and the depth of the ischiocele was independent of the uterotomy closure technique.