Findings in Patients with Postmenstrual Spotting with Prior Cesarean Section

Study Objective: Throughout the gears, patients previously submitted to C-sections may have abnormal uterine bleeding (AUB) of the post-menstrual spotting type. This symptom has been correlated to an anatomical defect on the anterior uterine wall. The objective of the present investigation was to assess the hysteroscopy findings of women at reproductive age, previously submitted to cesarean sections and complaining of post-menstrual spotting, stressing the diagnosis of isthmocele. Design: Prospective study (Canadian Task Force II). Setting: State public hospital Department of Gynecological Endoscopy. Patients: Forty-three patients at reproductive age previously submitted to one or more cesarean sections, complaining of AUB of the post-menstrual spotting type, were submitted to diagnostic hysteroscopy in order to assess the presence of anterior uterine wall isthmocele. Interventions: Hysteroscopic diagnoses. Measurements and Main Results: The mean number of previous C-sections was 2, the average time of post-menstrual spotting observation was 6 years and the mean duration of each episode was 6 days. The hysteroscopic diagnosis of isthmocele was conclusive in 38 patients (88.37%). Conclusion: Patients with previous C-sections complaining of postmenstrual spotting type of AUB have a high prevalence of isthmocele, and this condition is likely diagnosed through diagnostic hysteroscopy. Journal of Minimally Invasive Gynecology (2010) 17, 361-364 (C) 2010 AAGL. All rights reserved.