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Chinese Journal of Clinicians(Electronic Edition) ›› 2022, Vol. 16 ›› Issue (12): 1243-1247. doi: 10.3877/cma.j.issn.1674-0785.2022.12.016

• Clinical Research • Previous Articles     Next Articles

Efficacy of transvaginal uterine diverticulum repair combined with hysteroscopic electrocauterization for treatment of previous cesarean scar diverticulum

Li Dai1, Hongyan Gao1,(), Xiaoxiao Xing2, Qing Wang1, Yan Peng3, Qin Li1, Hui Wang1   

  1. 1. Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
    2. Department of Medical Imaging, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
    3. Department of Pathology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
  • Received:2022-03-29 Online:2022-12-15 Published:2023-04-11
  • Contact: Hongyan Gao

Abstract:

Objective

To explore the curative effects of transvaginal uterine diverticulum repair combined with hysteroscopic electrocauterization in the treatment of previous cesarean scar diverticulum (PCSD).

Methods

This is a retrospective study in which 24 PCSD patients were selected from December 2017 to June 2021 as the research subjects. The curative effects were assessed with regard to clinical manifestation, clinical treatment indicators (operation duration, intraoperative blood loss, fever, etc.), uterine diverticulum defect size, thickness of the remaining myometrium (TRM), and menstrual duration. Follow-up visits were carried out to check the therapeutic effect of diverticulum repair and menostaxis improvement one to six months after surgery.

Results

The follow-up visits at one to six months after operation showed that the duration of menstruation was significantly shortened compared with that before surgery (P<0.05) .The TRM measured by three-dimensional transvaginal ultrasound at 6 months after surgery was significantly thicker than that before surgery [(0.19±0.16) cm vs (0.80±0.34) cm, P<0.01]. The effective rate of transvaginal uterine diverticulum repair combined with hysteroscopic electrocauterization was 87.5% (21/24), and the symptoms of prolonged menstrual period were not significantly improved in 3 patients.

Conclusion

The curative effects of transvaginal uterine diverticulum repair combined with hysteroscopic electrocauterization in treating PCSD is obvious, because it can locate the cesarean scars accurately, remove the diverticulum and surrounding hyperplastic endometrium fully, and reduce the recurrence rate.

Key words: Previous cesarean scar diverticulum, Transvaginal surgery, Hysteroscopy

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