Transvaginal Isthmocele Repair With Temporary Occlusion of Uterine Vessels in Caesarean Scar Pregnancy

Abstract

A uterine scar defect, or isthmocele, is one of the known complications of cesarean delivery. It can cause obstetric as well as gynecological problems. Diagnosis can be suspected based on complaints such as abnormal uterine bleeding, pelvic pain, dysmenorrhea, and subfertility. It can be investigated by transvaginal ultrasound and MRI hysteroscopy. A hysteroscopy gives a confirmatory diagnosis. Isthmoplasty may be offered to avoid future obstetric complications and treat symptoms. In the present case report, a patient with prolonged postmenstrual dark-colored spotting underwent isthmocele repair by a procedure that could be unique, which is transvaginal isthmocele repair with temporary occlusion of uterine vessels. This procedure offers efficacy, safety, good outcomes, and prospects. Cesarean scar pregnancy (CSP) is a rare but potentially serious complication of cesarean section deliveries. We describe the efficacy, safety, outcomes, and prospects of transvaginal Isthamocele repair with temporary occlusion of uterine vessels to manage CSP.