Hysteroscopic surgery treatment for cesarean scar diverticulum
LI Wang
ZOU Ling-xiao
PAN Qiong
QIN Xian
Arvind Burjoo
WAN Ya-jun
XU Da-bao
Abstract：Cesarean scar diverticulum (CSD) is one of the long-term complications after cesarean section, and it is formed by poor healing of the uterine incision in cesarean section.The reasons for its formation are complicated.There are many misunderstandings about CSD.The treatment for CSD is not needed for the asymptomatic CSD generally, however, it varies when it comes to the symptomatic CSD.Therefore, how to choose the appropriate treatment for CSD is not only related to the understanding of gynecologists but also directly affects its therapeutic efficacy.There is a special type of CSD that has a flap at the lower edge of the incision scar that prevents the menstrual blood flowing out of the diverticulum due to the flap action, causing symptoms (usually prolonged menstruation).The asynchronism of the growth of ectopic endometrium in the diverticulum and the eutopic endometrium in the uterine cavity may also lead to abnormal vaginal bleeding.Nowadays, academic community has a professional term for this particular type of CSDs, that is the previous cesarean scar defect (PCSD).For the PCSDs whose residual muscular layer is thick enough, hysteroscopic resection of the valve located at the lower edge of the cesarean scar and coagulation of the ectopic endometrium in the diverticulum may achieve therapeutic efficacy.For the CSDs without the characteristics of PCSD, hysteroscopic surgery is less effective, and hysteroscopic surgery is generally not recommended.This article will elaborate on the issues related to hysteroscopic surgery for PCSD.
Keywords：abnormal uterine bleedingcomplicationscesarean scar diverticulumprevious cesarean scar defect
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 865-869 )