Objective: To evaluate transvaginal repair versus laparoscopic repair of cesarean scar defects (CSDs).
Methods: A retrospective cohort study was conducted among 67 symptomatic women with CSDs who attended a tertiary hospital in Beijing, China, between July 1, 2013, and March 31, 2017. The participants underwent either transvaginal repair (n=31) or laparoscopic repair (n=36). Medical costs, perioperative outcomes, and surgical outcomes were compared.
Results: No statistically significant between-group differences were found at baseline. The mean thickness of the residual myometrium increased from 1.71 ± 0.67 mm before surgery to 4.41 ± 2.09 mm after surgery in the transvaginal repair group (P<0.001), and from 1.81 ± 0.93 to 4.68 ± 1.96 mm in the laparoscopic repair group (P<0.001). The duration of menses after surgery was less than 10 days in both the transvaginal repair group (n=30, 96.3%) and the laparoscopic repair group (n=30, 83.9%; P=0.113). Operative time and medical costs were both lower in the transvaginal repair group than in the laparoscopic repair group (P<0.001). Conception rates for the two groups were similar among women who desired fertility.
Conclusion: Transvaginal repair of CSD was associated with reduced operative times and medical costs when compared with laparoscopic repair.
Keywords: Abnormal uterine bleeding; Cesarean scar defect; Laparoscopic repair; Menstruation; Thickness of the residual myometrium; Transvaginal repair.
© 2019 International Federation of Gynecology and Obstetrics.