The aim of the present study was to perform a comprehensive review of the literature to provide a complete and clear picture of isthmocele-a hypoechoic area within the myometrium at the site of the uterine scar of a previous cesarean section-by exploring in depth every aspect of this condition.
Methods
A comprehensive review of the literature was performed to identify the most relevant studies about this topic.
Results
Every aspect of isthmocele has been studied and described: pathophysiology, clinical symptoms, classification, and diagnosis. Its treatment, both medical and surgical, has also been reported according to the actual literature data.
Conclusion
Cesarean section is the most common surgical procedure performed worldwide, and one of the consequences of this technique is isthmocele. A single and systematic classification of isthmocele is needed to improve its diagnosis and management. Further studies should be performed to better understand its pathogenesis.
PMID 30646424 30646424 DOI 10.1055/s-0038-1676109 10.1055/s-0038-1676109
Cite this article
Iannone, P., Nencini, G., Bonaccorsi, G., Martinello, R., Pontrelli, G., Scioscia, M., Nappi, L., Greco, P., & Scutiero, G. (2019). Isthmocele: From Risk Factors to Management. *Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia*, *41*(1), 44-52. https://doi.org/10.1055/s-0038-1676109
Iannone P, Nencini G, Bonaccorsi G, Martinello R, Pontrelli G, Scioscia M, et al. Isthmocele: From Risk Factors to Management. Rev Bras Ginecol Obstet. 2019;41(1):44-52. doi:10.1055/s-0038-1676109
Iannone, P., et al. "Isthmocele: From Risk Factors to Management." *Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia*, vol. 41, no. 1, 2019, pp. 44-52.
Bardet L et al., 2024Journal of Minimally Invasive Gynecology
STUDY Objective: To compare outcomes of vaginal surgery in women with moderate or severe symptomatic cesarean scar defect (with or without residual myometrium).
Design: Retrospective cohort study.
Set...
Kremer TG et al., 2019
Open Access
Revista Da Associacao Medica Brasileira (1992)
An isthmocele, a cesarean scar defect or uterine niche, is any indentation representing myometrial discontinuity or a triangular anechoic defect in the anterior uterine wall, with the base communicati...
Tulandi T et al., 2016Journal of Minimally Invasive Gynecology
The objective of this study was to evaluate the prevalence of cesarean scar defects and its clinical manifestations in reproductive-aged women. We performed a systematic review following the Preferred...
Surgery > Uterine Surgery > Cesarean Scar Defect RepairGeneral OB/GYN > Cesarean Complications > Scar Defect ManifestationsInfertility > Uterine Factors > Cesarean Scar Defect and Fertility