ORIGINAL ARTICLE   

Minerva Surgery 2022 April;77(2):139-46

DOI: 10.23736/S2724-5691.21.08999-1

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

An analysis of curative effect of combined transvaginal and hysteroscopic electrocauterization of partial endometrium to treat previous cesarean scar diverticulum

Li DAI ¹, Hui WANG ¹, Xiaoxiao XING ², Yan PENG ³, Qing WANG ¹, Qin LI ¹, Dan LUO ¹, Hongyan GAO ¹ ✉, Guohua JIANG ¹

¹ Department of Gynecology and Obstetrics, The Third Affiliated Hospital of Soochow University, Changzhou, China; ² Department of Medical Imaging, The Third Affiliated Hospital of Soochow University, Changzhou, China; ³ Department of Pathology, The Third Affiliated Hospital of Soochow University, Changzhou, China

BACKGROUND: To explore the curative effect of the combined transvaginal and hysteroscopic electrocauterization of partial endometrium to treat previous cesarean scar diverticulum.
METHODS: The retrospective study method is adopted. 28 cases of cesarean scar diverticulum patients were selected as research objects and divided into two groups: one is combined hysteroscopic and transvaginal surgery group (N.=15) and the other is hysteroscopic electrocauterization group (N.=13). The curative effects of the two groups are observed and compared, including clinical treatment indicators (operation duration, intraoperative blood loss, fever, length of hospital stay (LOS), etc.), and follow-up visits are carried out to check the differences of diverticulum repair and menostaxis improvement one to six months after surgery.
RESULTS: The average operation duration, length of stay, and hospitalization expenses for the hysteroscopic electrocauterization group are 28.84±12.61 min, 2.93±1.04 days, and 7916.57±1948.45 yuan, respectively, all significantly lower than the combined hysteroscopic and transvaginal surgery group, those are respectively 73.93±15.46 min, 5.93±1.22 days, and 10,130.10±1037.75 yuan. The differences are statistically significant (P<0.05). The follow-up visits in six months after operation find that the effective rate of menstrual period (menostaxis) improvement of the combined hysteroscopic and transvaginal surgery group is 93.3% (14/15), and that of scar diverticulum repair is 73.3% (11/15), which are notably higher than the hysteroscopic electrocauterization group, those are respectively 46.2% (6/13) and 23.1% (3/13). The differences are also statistically significant (P<0.05).
CONCLUSIONS: The repairing effect of the combined transvaginal and hysteroscopic electrocauterization of partial endometrium to treat previous cesarean scar diverticulum [previous cesarean scar defect (PCSD)] is obvious. As it can fully remove previous cesarean scars and the surrounding ectopic intimae and reduce the recurrence rate, it is worthy of clinical promotion and application.

KEY WORDS: Hysteroscopy; Electrocoagulation; Endometrium; Diverticulum