Resectoscopic treatment combined with sonohysterographic evaluation of women with postmenstrual bleeding as a result of previous cesarean delivery scar defects

OBJECTIVE: The objective of this study was to assess the detection rate of previous cesarean delivery scar (PCDS) defect by transvaginal ultrasonography (TVU) and to evaluate the effectiveness of resectoscopic surgery to correct this anatomic defect. STUDY DESIGN: In all, 57 women were included in our study. A diagnosis of a PCDS defect was established by TVU. We used resectoscopy to remove the flaplike fibrotic tissue that appeared underneath the pouchlike defect. RESULTS: A total of 22 patients received resectoscopic treatment. The detection rate of PCDS defects was 88% by TVU. The duration of postmenstrual bleeding shortened significantly after resectoscopic therapy. CONCLUSION: TVU examination performed during the period of postmenstrual bleeding allows us to readily identify this anatomic defect. Resectoscopy, in our opinion, should be considered the first choice to correct this defect because it is minimally invasive and yields good therapeutic results.