title: Sonographic evaluation of surgical repair of uterine cesarean scar defects.
abstract: BACKGROUND
  The aim of the study was to assess the clinical outcomes of surgical repair of uterine cesarean scar defects with sonography (US).
  
  
  METHODS
  Seven nonpregnant women with history of cesarean section and a large uterine scar defect were enrolled. The surgical repair was performed by minilaparotomy. The US assessment of the uterine scar was performed using a standardized approach at baseline, then at a first visit 2-3 days following the surgical intervention (V1) and at a follow-up visit 3 months later (V2). Residual myometrial thickness (RMT), width, and depth of the scar defect were measured.
  
  
  RESULTS
  The mean RMT increased significantly from 1.9 mm at baseline to 8.8 mm at V1 and 8.0 mm at V2. No intraoperative complications were observed. Postmenstrual spotting and abdominal pain reported preoperatively resolved after the operation.
  
  
  CONCLUSIONS
  A surgical repair procedure for an incompletely healed uterine cesarean scar is effective in increasing RMT thickness, decreasing the depth of the scar, and reducing symptoms related to the cesarean section scar defect. Further studies on post-repair pregnancy outcomes are required to evaluate whether the procedure affects the rate of cesarean scar pregnancy, morbidly adherent placenta, and/or uterine scar dehiscence and rupture. The repair of a cesarean scar defect is recommended only for symptomatic women. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:455-460, 2017.
authors.affiliation: 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland.
authors.forename: Michal
authors.identifier: http://orcid.org/0000-0002-4501-353X
authors.initials: M
authors.lastname: Pomorski
authors.affiliation: 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Fuchs
authors.affiliation: 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Rosner-Tenerowicz
authors.affiliation: 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Ul. Borowska 213, 50-556, Wroclaw, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Zimmer
mesh_terms: D000328:Adult; D002585:Cesarean Section; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006417:Hematuria / Q000000981:diagnostic imaging; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*; D014599:Uterus / Q000000981:diagnostic imaging* / Q000601:surgery*
keywords: cesarean scar defect; cesarean section; minimally invasive surgery; ultrasonography; uterine scar repair