Aim: This study analyses the effects of surgical indicators and clinical efficacy of different surgical methods for uterine cesarean section scar diverticulum.
Methods: This retrospective cohort study included 65 patients who underwent surgery and postoperative follow-up at Gansu Provincial Maternity and Child-care Hospital from 1 January 2013 to 31 February 2019.
Results: All participants were treated surgically. Among them, patients in Group A underwent combined laparoscopic and hysteroscopic surgery (n = 45), Group B underwent transvaginal surgery (n = 11), Group C underwent laparotomy (n = 9). The primary outcomes were surgical indicators. The secondary outcomes were clinical efficacy. Bleeding, operation time and hospitalization expenses were significantly different among the three groups (P < 0.05). There was no difference in the hospital stay among the three groups P = 0.22). The menstrual period before and after surgery was significantly different among the groups (P < 0.05). The recurrence outcome was no significantly different (P = 0.16), but the pregnancy outcome was not (P = 0.78).
Conclusion: The three surgical methods are effective for treating cesarean section scar diverticulum with favorable effects. Laparoscopic combined with hysteroscopic surgery is minimally invasive with less bleeding compared with the other two techniques and it is easier for patients to accept. It is the most widely used surgical method.
Keywords: combination of laparoscopic and hysteroscopic surgery; laparotomy; pregnancy; transvaginal surgery; uterine cesarean section scar diverticulum.
© 2020 Japan Society of Obstetrics and Gynecology.