Prevalence, definition, and etiology of cesarean scar defect and treatment of cesarean scar disorder: A narrative review

S Tsuji, Y Nobuta, T Hanada… - Reproductive …, 2023 - Wiley Online Library
S Tsuji, Y Nobuta, T Hanada, A Takebayashi, A Inatomi, A Takahashi, T Amano, T Murakami
Reproductive medicine and biology, 2023Wiley Online Library
Background Cesarean scar defects (CSD) are caused by cesarean sections and cause
various symptoms. Although there has been no previous consensus on the name of this
condition for a long time, it has been named cesarean scar disorder (CSDi). Methods This
review summarizes the definition, prevalence, and etiology of CSD, as well as the
pathophysiology and treatment of CSDi. We focused on surgical therapy and examined the
effects and procedures of laparoscopy, hysteroscopy, and transvaginal surgery. Main …
Background
Cesarean scar defects (CSD) are caused by cesarean sections and cause various symptoms. Although there has been no previous consensus on the name of this condition for a long time, it has been named cesarean scar disorder (CSDi).
Methods
This review summarizes the definition, prevalence, and etiology of CSD, as well as the pathophysiology and treatment of CSDi. We focused on surgical therapy and examined the effects and procedures of laparoscopy, hysteroscopy, and transvaginal surgery.
Main findings
The definition of CSD was proposed as an anechoic lesion with a depth of at least 2 mm because of the varied prevalence, owing to the lack of consensus. CSD incidence depends on the number of times, procedure, and situation of cesarean sections. Histopathological findings in CSD are fibrosis and adenomyosis, and chronic inflammation in the uterine and pelvic cavities decreases fertility in women with CSDi. Although the surgical procedures are not standardized, laparoscopic, hysteroscopic, and transvaginal surgeries are effective.
Conclusion
The cause and pathology of CSDi are becoming clear. However, there is variability in the prevalence and treatment strategies. Therefore, it is necessary to conduct further studies using the same definitions.
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