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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2015

Open Access 01-12-2015 | Case report

Successful treatment of atypical cesarean scar defect using endoscopic surgery

Authors: Hirotaka Masuda, Hiroshi Uchida, Tetsuo Maruyama, Kenji Sato, Suguru Sato, Mamoru Tanaka

Published in: BMC Pregnancy and Childbirth | Issue 1/2015

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Abstract

Background

Cesarean scar syndrome results from a postoperative defect of the uterine isthmus, also known as an isthmocele. Patients present with gynecological symptoms, such as abnormal genital bleeding or infertility, after cesarean delivery. Although the cesarean rate is increasing worldwide, this syndrome is not widely known.

Case presentation

A 43-year-old G2P1 Japanese woman with atypical cesarean scar syndrome had a 3-year history of secondary infertility and postmenstrual brown discharge. Laparoscopic and hysteroscopic exploration revealed a cesarean scar defect connected to a small cavity in the myometrium: this was not an endometrial cavity or a uterine diverticulum. After endoscopic excision of the cavity, the brown discharge resolved, and the patient achieved ongoing pregnancy on her third attempt at intrauterine insemination.

Conclusion

Consensus is still lacking regarding the diagnosis and treatment of cesarean scar defect. However, the gynecologists should be aware that cesarean scar syndrome can have scar defects forming cavities of unusual shapes and features. Surgical correction of these defects will often improve postmenstrual bleeding and subfertility in these cases.
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Metadata
Title
Successful treatment of atypical cesarean scar defect using endoscopic surgery
Authors
Hirotaka Masuda
Hiroshi Uchida
Tetsuo Maruyama
Kenji Sato
Suguru Sato
Mamoru Tanaka
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2015
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-015-0730-x

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