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<p>Isthmocele is a&#xa0;structural defect of the cesarean section scar, appearing as a&#xa0;niche in the anterior myometrium at the site of the previous uterine incision. The defect arises from an incomplete or insufficient postoperative wound healing. With the globally increasing rates of cesarean sections of currently more than 20%, the incidence of isthmocele is also rising. Isthmocele can lead to a&#xa0;complex gynecological condition that can have a relevant impact on the quality of life and fertility. Risk factors include a&#xa0;history of multiple cesarean sections, obesity, perioperative infections and uterine adenomyosis. Another highly debated risk factor for the development of isthmocele is the surgical approach in the cesarean section and the closure technique after the uterotomy. The diagnosis of isthmocele is typically made using transvaginal ultrasound, which should preferably be conducted in symptomatic women. There are several medicinal and surgical treatment options that need to be carefully chosen depending on the symptoms and the desire for future fertility.</p>

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Diagnostik und Therapie der Isthmozele

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月14日

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  • Sabrina Einig,
  • Heike Willi,
  • Gwendolin Manegold-Brauer

摘要

Isthmocele is a structural defect of the cesarean section scar, appearing as a niche in the anterior myometrium at the site of the previous uterine incision. The defect arises from an incomplete or insufficient postoperative wound healing. With the globally increasing rates of cesarean sections of currently more than 20%, the incidence of isthmocele is also rising. Isthmocele can lead to a complex gynecological condition that can have a relevant impact on the quality of life and fertility. Risk factors include a history of multiple cesarean sections, obesity, perioperative infections and uterine adenomyosis. Another highly debated risk factor for the development of isthmocele is the surgical approach in the cesarean section and the closure technique after the uterotomy. The diagnosis of isthmocele is typically made using transvaginal ultrasound, which should preferably be conducted in symptomatic women. There are several medicinal and surgical treatment options that need to be carefully chosen depending on the symptoms and the desire for future fertility.