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Current surgical treatment of uterine isthmocele: an update of existing literature.

Arch Gynecol Obstet

December 2024

Department of Obstetrics and Gynecology, Spital Männedorf, 8708, Männedorf, Switzerland.

The prevalence of uterine isthmocele, also known as a uterine niche, has risen in parallel with increasing cesarean section (CS) rates, affecting approximately 60% of women depending on their history of cesarean deliveries. This condition, now categorized as cesarean scar disorder (CSD) by the "Delphi consensus," is characterized by one primary or two secondary symptoms. Diagnosis can be made through transvaginal ultrasound, sonohysterography, hysteroscopy, or magnetic resonance imaging (MRI).

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Objectives: To evaluate the reproductive outcomes after different approaches of surgical isthmocele excision in women with secondary infertility.

Methods: The present study was conducted between November 2017 and February 2023 in the Department of Gynecological Endocrinology and Gynecology at Jagiellonian University Medical College, Krakow, Poland. Women with large isthmocele with residual myometrial thickness (RMT) <3 mm and secondary infertility were included in this retrospective study.

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Is Vaginal Repair a Good Option for Severe Cesarean Scar Defect? Comparison of Women With or Without Residual Myometrium.

J Minim Invasive Gynecol

December 2024

Department of Gynecology and Obstetrics, Bicetre Hospital, Le Kremlin Bicetre, France (all authors); Faculty of Medicine, University Paris Saclay, Le Kremlin Bicetre, France (Drs. Fernandez and Capmas); Research Center in Epidemiology and Population Health (Drs. Fernandez and Capmas), U1018, Inserm, Villejuif, France. Electronic address:

Article Synopsis
  • The study aimed to assess the outcomes of vaginal surgery for women with symptomatic cesarean scar defects, comparing those with moderate and severe defects.
  • The findings showed significant improvement in myometrial thickness and reduced abnormal uterine bleeding after surgery in both groups, though pelvic pain alleviation was only noted in the moderate group.
  • Pregnancy rates and complications were comparable between the moderate and severe defect groups, with no cases of uterine rupture reported post-surgery.
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Conservative surgical repair of placenta increta invading into uterine septum: case report.

J Med Case Rep

November 2024

Obstetrics and Gynaecology Department, Faculty of Medicine, University of Alexandria, 22 El-Gaish Rd, Al Azaritah, Alexandria, Egypt.

Background: The prevalence of placenta accreta spectrum is on the rise, primarily as a consequence of an increasing number of Cesarean sections. Nevertheless, uterine anomalies, particularly uterine septum, pose a notable risk factor for its occurrence. While there are limited case reports documenting the association between uterine septum and placenta adherence, most of these cases have been linked to prior hysteroscopic treatment of the septum.

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Caesarean section scar: Histological analysis on hysterectomy specimen. A pilot study.

Eur J Obstet Gynecol Reprod Biol

December 2024

AP-HP, GHU-Sud, Hospital Bicêtre, Department of Gynecology and Obstetrics, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France; Faculty of medicine, University Paris-Sud Saclay, 63 rue Gabriel Péri, 94270 Le Kremlin Bicêtre, France; INSERM, UMR1018, CESP, Hopital Paul Brousse, 12 avenue Paul Vaillant Couturier, 94800 Villejuif, France. Electronic address:

Introduction: In recent years, caesarean section (CS) rate has risen worldwide. Complications associated with CS scars have risen too, such as scar dehiscences and uterine ruptures. Uterine healing is a complex phenomenon still poorly understood.

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