Istmocele: una revisión sistemática de la literatura

Translated title of the contribution: Istmocele: a systematic review of literature.

Tamar Alkon-Meadows, Martha Luna-Rojas, Carlos Hernández-Nieto, Benjamin Sandler

Research output: Contribution to journalReview articlepeer-review


OBJECTIVE: Review the literature on the prevalence, risk factors, symptoms, diagnoses and treatment of patients with isthmocele. METHOD: An electronic search was performed using the following databases: PubMed, EMBASE and Google Scholar. The following terms, words and their combinations were used: "Cesarean section defect, uterine niche, isthmocele, uterine sacculation, uterine diverticulum, uterine pouch, isthmocele diagnosis, segmentocele y isthmocele treatment”. The primary outcome was the symptoms associated with a cesarean scar defect. The secondary outcomes were prevalence, risk factors, diagnosis and treatment of istomocele. RESULTS: 549 articles were collected, of which 288 were eliminated due to duplication and 228 did not meet the inclusion criteria; In the end, only 33 articles were analyzed. A prevalence of 15 to 84% was found in women with a previous caesarean section. The prevalence of this alteration is correlated with the number of cesarean sections; the greater the number of caesarean sections, the greater the risk of developing an isthmocele. Its presence can be symptomatic or asymptomatic. The most common symptom is abnormal uterine bleeding, occurring in a 28.9% to 82% of the patients. Up to 88% of cases are diagnosed by a transvaginal ultrasound. A surgical hysteroscopy was associated with a 56.9% to a 100% improvement of symptoms. CONCLUSIONS: Isthmocele is commonly identified incidentally through a transvaginal ultrasound and is usually asymptomatic. It can cause abnormal uterine bleeding and secondary infertility. Its prevalence depends on the diagnostic method used. A surgical hysteroscopy is the most effective treatment method.

Translated title of the contributionIstmocele: a systematic review of literature.
Original languageSpanish
Pages (from-to)820-831
Number of pages12
JournalGinecologia y Obstetricia de Mexico
Issue number12
StatePublished - Dec 2019


  • Cesarean section
  • Infertility
  • Isthmocele
  • Prevalence risk factors
  • Uterine diseases
  • Uterine hemorrhage


Dive into the research topics of 'Istmocele: a systematic review of literature.'. Together they form a unique fingerprint.

Cite this