Outcomes of Laparoscopic Cesarean Scar Defect Repair: Retrospective and Observational Study

Camran Nezhat, Benjamin Zaghi, Kelly Baek, Azadeh Nezhat, Farr Nezhat, Steven Lindheim, Ceana Nezhat

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Cesarean scar defect, also known as niche, isthmocele, uteroperitoneal fistula and uterine diverticulum, is a known complication after cesarean delivery. Due to the rising cesarean delivery rates, niche has become more common and can present as irregular bleeding, pelvic pain, infertility, cesarean scar pregnancy and uterine rupture. Treatments for symptomatic cesarean scar defect vary and include hormonal therapy, hysteroscopic resection, vaginal or laparoscopic repair, and hysterectomy. We report on the safety and efficacy of our method of repairing cesarean scar defects in 27 patients without adverse outcomes: two-layer repair where the suture does not enter the uterine cavity. Our method of laparoscopic niche repair improves symptoms in nearly 77% of patients, restores fertility in 73% of patients, and decreases the time to conception.

Original languageEnglish
Article number3720
JournalJournal of Clinical Medicine
Volume12
Issue number11
DOIs
StatePublished - Jun 2023
Externally publishedYes

Keywords

  • cesarean scar defect
  • isthmocele
  • niche
  • pregnancy
  • uterine diverticulum
  • uteroperitoneal fistula

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