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Ginecología y obstetricia de México

versión impresa ISSN 0300-9041

Resumen

MELO-CERDA, I. Gynecological importance of the isthmocele ¿When and how to treat?. Ginecol. obstet. Méx. [online]. 2017, vol.85, n.2, pp.55-63. ISSN 0300-9041.

OBJECTIVE:

The Cesarean Scar Defect (CSD) has been underestimated in frequency and importance. Is necessary to know its incidence, the symptoms, and analyze new therapeutic procedures.

MATERIAL AND METHODS:

Observational, prospective and comparative study of patients with defects in the closure of hysterorrhaphy, attended at the Colposcopy Clinic of the State Oncology Center of the State of Sonora between January 1, 2013 and December 31, 2015. Inclusion criteria: Patients with abnormal cytology and previous cesarean section, who were: colposcopy, endocervicocolposcopy and hysteroscopy. Exclusion criteria: technical problems that prevented observation of the endocervical canal or hysteroscopy, postmenopausal patients, and those with a colposcopic diagnosis of invasive cancer.

RESULTS:

We found in 65.2%, spotting in a 73.3%, polymenorrhea at 31.3%, and to dysmenorrhea in 32.3%. Only 20% of the symptomatic patients referred the symptom as Relevant. We found "CSDs producers of bleeding" that are related to the patients more systematic.

CONCLUSIONS:

The cesarean scar defects are frequent cause of gynecological symptomatology that is irrelevant most of the time. A small number of patients needs treatment, we found CSD that produce bleeding, this cases present relevant symptomatology and require treatment. It is necessary to take this into account to choose the best therapeutic approach.

Palabras llave : Isthmocele; Cesarean scare defect; Cesarean scare; Abnormal uterine bleeding; Postmenstrual spotting; Wound dehiscence.

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