Hysteroscopic sterilization may be associated with a higher rate of pregnancy, more menstrual dysfunction, more hysteroscopic surgeries, less pelvic pain, and fewer intra-abdominal gynecologic surgeries than laparoscopic sterilization. Pregnancy rates appear to be similar for women who completed their postprocedure hysterosalpingogram, but only 66% of women did so.

(Abstracted from Obstet Gynecol 2016;128:843–852) The contraceptive method chosen by nearly 10 million US women is female tubal sterilization. This procedure can be performed either laparoscopically or hysteroscopically.

The measurement of the area of the defect permitted to classify isthmoceles in 3 grades: 1st grade < 15 mm2, 2nd grade between 16-24 mm2 and 3rd grade > 25 mm2. We found seven 1st grade isthmoceles, six 2nd grade, nineteen 3rd grade. In 24 cases the procedure was performed using a bipolar resectoscope loop, and in 8 patients using bipolar 5Fr electrode, we found no differences between this two techniques. All the patients discharged the same day of the surgery. We had no complications. Follow up was performed one and two months after the surgery. In all cases the abdominal pain had disappeared in the first month after the surgery. In 87.5% of the patients AUB was resolved within the first month, 96.8% in the second month and one needed a second surgery to eliminate the symptoms. SymptomsSymptoms before surgery 1 month after surgery 2 month after surgery AUB 100% (32) 12.5% (4) 3.1% (1) Abdominal pain 40.6% (13) 0 0Conclusion: Hysteroscopic correction of symptomatic isthmoceles seems to be a safe and effective technique for those patients who present AUB and pelvic pain due to the cesarean scar defect.