Cesarean Scar Defects: An Underrecognized Cause of Abnormal Uterine Bleeding and Other Gynecologic Complications

Should Laparoscopy be the Gold Standard for Isthmocele?

“…Hence, the prevalence of the condition has huge variations. Some have a vague definition ie a U-, V-, or triangular-shaped anechoic or hypoechoic fluid collection 17 seen on scan or SIS 21 is simply considered as a niche. No standardized definition is found in the literature.…”

“…All studies agree that all women who have the scar defect are not symptomatic. Tower and Frishman 21 found the prevalence of symptomatic CSD could be as low as 19.4% to as high as 88%.…”

Incidental Findings of Caesarean Section Scar Defect - Case Reports and a Review of its Investigations and Management

“…Many studies had advocated the use of ultrasound investigation in the diagnosis and assessment of CSD [5][6][7]. Tower and Frishman proposed that a CSD can be diagnosed through transvaginal saline sonohysterography by revealing a triangular hypoechoic defect in the myometrium at the site of the previous hysterotomy scar [8]. Although there have been many reports on this condition, many inexperienced gynaecologists could still miss the defect during routine ultrasound scanning because of a lack of high index of suspicion.…”

A Growing Concern: Cesarean Scar Defect and Massive Uterine Bleeding

“…These include conditions such as scar pregnancy, placenta accreta, placenta previa, and uterine rupture in subsequent pregnancies [2,3]. The CSD is also associated with abnormal bleeding, dysmenorrhea, pelvic pain, adenomyosis, infertility, abscess formation, post-coital bleeding during the non-pregnant state [4][5][6]. Of note, the most common clinical symptom is abnormal bleeding, and the correlation with CSDs has been well established.…”