Abstract
BackgroundThe aim of this study was to evaluate the effect of vaginal repair in patients with cesarean section diverticulum (CSD) who had one or two previous cesarean sections (CSs).MethodsFrom January 2012 to December 2014, 248 women with CSD underwent vaginal repair surgery in Shanghai First Maternity and Infant Hospital. These included 193 women with one previous cesarean section and 55 women with two previous cesarean sections. Excision and suture of CSD was performed through a vaginal approach. The duration of menstruation, the length, width and depth of the CSD and thickness of the remaining muscular layer (TRM) were evaluated before and after surgery by transvaginal three-dimensional (3D) color Doppler ultrasound.ResultsA total of 221 (89.11%) women were followed-up for more than 3 months, and 168 (67.74%) women were followed-up for more than 6 months. There were significant differences in the average duration of menstruation (7.77 ± 2.05 and 8.02 ± 2.06 days VS 13.99 ± 3.71 days), the average size of CSD (5.54*9.19*5.60 and 5.75*9.04*6.18 mm VS 7.99*12.43*6.62 mm) and the TRM (7.61 ± 2.52 and 7.60 ± 3.00 mm VS 2.51 ± 1.02 mm) after surgery compared with those figures before surgery. The results of this study reveal that vaginal repair could shorten the duration of menstruation and improve anatomical defects (P < 0.05). Moreover, there was no significant difference in the effect of clinical repair between women with one or two previous cesarean sections (P > 0.05).ConclusionIn CSD patients, the clinical effectiveness of vaginal repair was equivalent between women with one or two previous cesarean sections.
Highlights
The aim of this study was to evaluate the effect of vaginal repair in patients with cesarean section diverticulum (CSD) who had one or two previous cesarean sections (CSs)
CSD is associated with two primary complications: abnormal uterine bleeding, which mainly presents as a longer duration menstruation period [7], and the thickness of the remaining muscular layer (TRM)
The TRM of those who had two cesarean sections was higher than that found in women who had one prior cesarean section (3.17 ± 1.56 mm) (P < 0.05)
Summary
The aim of this study was to evaluate the effect of vaginal repair in patients with cesarean section diverticulum (CSD) who had one or two previous cesarean sections (CSs). Cesarean section is associated with a three- to six-fold higher risk of severe complications, Wang et al BMC Women's Health (2020) 20:81 and CSD increase the risk of hemorrhoea or uterine rupture, which can threaten both the mother and her fetus’s lives [5, 6]. CSD is associated with two primary complications: abnormal uterine bleeding, which mainly presents as a longer duration menstruation period [7], and the thickness of the remaining muscular layer (TRM). Among these two complications, longer menstrual bleeding is a serious problem for many women. Using sanitary towels over a long period of time can lead to vaginitis and influence their social activities
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