Abstract
Background.The aim of this paper is to present a clinical case of laparoscopic repair of a uterine scar defect, to assess the effectiveness of treatment reviewing the latest literature sources, and to provide recommendations of uterine scar defect management.Materials and methods.We report the case of a 33-year-old woman with an insufficient uterine scar and one-year history of secondary infertility. Following this, she underwent corrective laparoscopic repair, successfully got pregnant two months later and carried pregnancy to full term. We discuss the prevalence of caesarean scar defects, their clinical symptoms, diagnostic methods, various treatment techniques, and their outcomes.Results and conclusion.Caesarean scar defects, insufficient uterine scars, isthmocele or scar dehiscence following a caesarean section involve myometrial discontinuity at the site of a scar previous caesarean section. These anatomical defects associated with prolonged menstrual bleeding, chronic pelvic pain, dysmenorrhea, dyspareunia and secondary infertility. Laparoscopic repair of the uterine scar defect is an effective method of treatment of secondary infertility. Patients with a previous history of caesarean section who present complaints of secondary infertility, need a detailed evaluation of the uterine scar before planning future pregnancies
Highlights
Caesarean section is the most frequently per formed surgery in obstetrics, which has increased in incidence over the recent decades
The uterine scar insufficiency is diagnosed in about 1.9% of women who have undergone a cae sarean section [4]
Uterine scar defects associated with abnormal bleed ing symptoms have already been mentioned in liter ature since 1975 [9]
Summary
Caesarean section is the most frequently per formed surgery in obstetrics, which has increased in incidence over the recent decades. The uterine scar insufficiency is diagnosed in about 1.9% of women who have undergone a cae sarean section [4]. The uterine scar defect, called the uterine scar insufficiency, isthmocele, or scar dehiscence (“opening”), is a breakdown of my ometrium along the scar defect [3]. 92% of women success fully get pregnant after endoscopic treatment of the scar defect [8]. The aim of this paper is to present a clinical case of laparo scopic repair of a uterine scar defect, to assess the effectiveness of treat ment reviewing the latest literature sources, and to provide recommenda tions of uterine scar defect management
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