Cesarean section scar diverticulum: Appearance on hysterosalpingography

OBJECTIVE. The purpose of this study was to characterize the frequency and appearance of hysterotomy defects on hysterosalpingography in patients with a history of cesarean section. MATERIALS AND METHODS. We reviewed the hysterosalpingograms of 150 women with a history of cesarean section. The incidence, location, and appearance of defects at the expected location of a hysterotomy scar were evaluated. RESULTS. Of the 148 patients with history of cesarean section and technically adequate hysterosalpingograms, 89 (60%) had defects that were in the expected location of a hysterotomy incision. Fifty-eight (65%) of the diverticula were focal outpouchings, and 31 (35%) were thin linear defects. Forty-eight (54%) of the diverticula were located at the lower uterine cavity, 32 (36%) at the uterine isthmus, and nine (10%) at the upper endocervical canal. CONCLUSION. A diverticulum at the lower uterine cavity, uterine isthmus, or upper endocervical canal is a common finding on hysterosalpingography in patients with a history of cesarean section.