Xuyin Zhang1, Mengyi Yang1, Qing Wang2, Jianliang Chen3, Jingxin Ding1, Keqin Hua4. 1. Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China. 2. Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China; Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Pudong New Area, Shanghai, China. 3. Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China; Department of Obstetrics and Gynecology, First People's Hospital of Xiaoshan Area, Hangzhou, China. 4. Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China. Electronic address: huakeqinjiaoshou@163.com.
Abstract
OBJECTIVE: To evaluate operative and nonoperative therapies for cesarean scar defects (CSDs). METHODS: A prospective study was conducted among patients who underwent treatment of CSDs at a hospital in Shanghai, China, between April 1, 2010, and December 31, 2014. Treatment included laparoscopy (group 1), vaginal surgery (group 2), hysteroscopy (group 3), combined oral contraceptives (group 4), and the levonorgestrel intrauterine system (group 5). RESULTS: Among 142 participants, 119 patients underwent surgical repair and 23 received nonsurgical (conservative) treatment. Operation time, blood loss, and length of hospital stay reported for patients in group 3 (n=19) were all lower than those reported for patients in group 1 (n=86) and group 2 (n=14; P<0.001 for all comparisons). Patients who underwent surgery and those in group 4 (n=18) experienced shortened menstrual periods after treatment (P<0.001 for all comparisons). For group 5 (n=5), the duration of menstruation was similar before and after therapy (P=0.89). All 32 women who desired fertility underwent laparoscopy; 12 (37.5%) became pregnant after this procedure. CONCLUSION: All treatments for CSDs other than the levonorgestrel intrauterine system shortened menstrual periods. Laparoscopic surgery was effective for patients with fertility requirements.
OBJECTIVE: To evaluate operative and nonoperative therapies for cesarean scar defects (CSDs). METHODS: A prospective study was conducted among patients who underwent treatment of CSDs at a hospital in Shanghai, China, between April 1, 2010, and December 31, 2014. Treatment included laparoscopy (group 1), vaginal surgery (group 2), hysteroscopy (group 3), combined oral contraceptives (group 4), and the levonorgestrel intrauterine system (group 5). RESULTS: Among 142 participants, 119 patients underwent surgical repair and 23 received nonsurgical (conservative) treatment. Operation time, blood loss, and length of hospital stay reported for patients in group 3 (n=19) were all lower than those reported for patients in group 1 (n=86) and group 2 (n=14; P<0.001 for all comparisons). Patients who underwent surgery and those in group 4 (n=18) experienced shortened menstrual periods after treatment (P<0.001 for all comparisons). For group 5 (n=5), the duration of menstruation was similar before and after therapy (P=0.89). All 32 women who desired fertility underwent laparoscopy; 12 (37.5%) became pregnant after this procedure. CONCLUSION: All treatments for CSDs other than the levonorgestrel intrauterine system shortened menstrual periods. Laparoscopic surgery was effective for patients with fertility requirements.
Authors: Sanne I Stegwee; Astrid Beij; Robert A de Leeuw; Lidwine B Mokkink; Lucet F van der Voet; Judith A F Huirne Journal: Qual Life Res Date: 2019-12-16 Impact factor: 4.147
Authors: Stavros Karampelas; Georges Salem Wehbe; Laurent de Landsheere; Dominique A Badr; Linda Tebache; Michelle Nisolle Journal: J Clin Med Date: 2021-12-10 Impact factor: 4.241