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February 28-March 01, 2019 | Paris, France

Palliative Care, Obstetrics and Gynecology

Stroke and Clinical Trials

International Conference on

Joint Event on

International Conference on

Journal of Research and Reports in Gynecology and Obstetrics | Volume: 3

Isthmocele: Problem and solution

Vidakovic Snezana, Tijana Janjic

University of Belgrade, Serbia

ith the incidence of caesarean section raising worldwide,

there is an emerging number of its various both short

and long-term complications. One of these complications

is isthmocele – a pouchlike defect in the myometrium of the

anterior uterine wall at the site of the previous caesarean

section. According to the available literature, the prevalence

of isthmocele varies significantly, but is reported to be as high

as 60-70% after a primary section, reaching 100% after three

consecutive sections.

The majority of isthmoceles are asymptomatic. However, in

patients with previous caesarean section and abnormal uterine

bleeding, dysmenorrhoea, dyspareunia, or chronic pelvic pain

– an anterior uterine wall defect is frequently encountered.

Additionally, there is a correlation between secondary infertility

and the presence of isthmocele. Rarely, caesarean scar ectopic

pregnancy and uterine rupture present themselves as serious

complications of caesarean scar defect.

The treatment of symptomatic isthmocele is surgical, the main

principle being resection of the defect and reconstruction

of the myometrium. In addition to the classic abdominal

via laparotomy and vaginal route, both laparoscopy and

hysteroscopy were recently established as safe, efficacious and

less invasive approach in the surgical restoration of the uterine

wall.

Its high prevalence, potentially serious morbidity and significant

impact on the quality of life, bring the spotlight to the entity

of isthmocele and its related consequences. The emphasis

is put on establishing its risk factors, determining prevention

strategies and the most appropriate treatment methods.

Res Rep Gynaecol Obstet, Volume 3

DOI: 10.4066/2591-7366-C1-003