Isthmocele: The “Hot Air Balloon Sign,” a Gynecologic Consequence of an Obstetric Procedure

Abstract

Cesarean section is the most common surgical procedure performed on women of reproductive age [1]. Occasionally, the hysterotomy incision's healing leaves areas of myometrial loss of continuity creating pouchlike defects known as isthmocele. Such defects function as reservoir collecting menstrual blood generating postmenstrual spotting, pelvic pain, dyspareunia, and secondary infertility among other symptoms [2]. Saline infusion sonogram is an effective imaging modality [3]. Both surgical and nonsurgical options have been recommended for the treatment of patients with symptomatic isthmocele [4].