title: Successful management of a cesarean scar defect with dehiscence of the uterine incision by using wound lavage.
abstract: Cesarean scar defects (CSDs) that can be visualized using transvaginal ultrasonography (TVUS) may cause prolonged menstruation, irregular genital bleeding, and secondary infertility; surgical repair is sometimes necessary. We present a case of CSD, with dehiscence of the uterine incision, which was managed using wound lavage. A 38-year-old woman (gravida 4, para 4) had delivered her third and fourth children by cesarean section. Upon the resumption of menstruation, 9 months after her second cesarean section, she demonstrated prolonged menstruation and the presence of a menstrual fistula due to dehiscence of the cesarean section incision from the myometrium to the serosa. We treated the defect by lavaging with a physiological saline solution. After lavaging the wound 3 times, spontaneous healing of the dehiscent muscle layer was successfully achieved. The treatment was complication-free and the healing of the muscle layer has been maintained for more than 8 months.
authors.affiliation: Department of Obstetrics and Gynecology, Kobe Adventist Hospital, 4-1 Arinodai, 8-Chome, Kita-ku, Kobe 651-1321, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Ida
authors.affiliation: Department of Obstetrics and Gynecology, Kobe Adventist Hospital, 4-1 Arinodai, 8-Chome, Kita-ku, Kobe 651-1321, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Kubota
authors.affiliation: Department of Obstetrics and Gynecology, Kobe Adventist Hospital, 4-1 Arinodai, 8-Chome, Kita-ku, Kobe 651-1321, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Nosaka
authors.affiliation: Department of Obstetrics and Gynecology, Kobe Adventist Hospital, 4-1 Arinodai, 8-Chome, Kita-ku, Kobe 651-1321, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Obstetrics and Gynecology, Kobe Adventist Hospital, 4-1 Arinodai, 8-Chome, Kita-ku, Kobe 651-1321, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kato
authors.affiliation: Department of Obstetrics and Gynecology, Kobe Adventist Hospital, 4-1 Arinodai, 8-Chome, Kita-ku, Kobe 651-1321, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Tsuji