Katsura Daisuke, Tsuji Shunichiro, Hoshiyama Takako, Zen Rika, Inatomi Ayako, Murakami Takashi
Department of Obstetrics and Gynecology, Shiga University of Medical Science Hospital, Otsu 520-2192, Japan.
Yonago Acta Med. 2023 Apr 10;66(2):287-291. doi: 10.33160/yam.2023.05.004. eCollection 2023 May.
Cesarean section can lead to residual myometrial thickness thinning and cesarean scar syndrome. We report a novel trimming technique for residual myometrial thickness recovery in women with cesarean scar syndrome. Case 1: A 33-year-old woman who developed cesarean scar syndrome (CSS) and abnormal uterine bleeding post-cesarean scar became pregnant following hysteroscopic treatment. The myometrium at previous scar was dehiscent; therefore, a transverse incision was made above the scar. Post-operative uterine recovery failed owing to lochia retention, and developed cesarean scar syndrome again. Case 2: A 29-year-old woman who developed cesarean scar syndrome post-cesarean section became pregnant spontaneously. The myometrium at the previous scar was dehiscent like case 1. Scar repair was performed using a trimming technique during cesarean section; there were no subsequent complications and she conceived again spontaneously. Performing this novel surgical procedure during cesarean section may contribute to residual myometrial thickness recovery in women with cesarean scar syndrome.
剖宫产可导致子宫肌层残余厚度变薄及剖宫产瘢痕综合征。我们报告一种用于剖宫产瘢痕综合征女性子宫肌层残余厚度恢复的新型修剪技术。病例1：一名33岁女性，剖宫产瘢痕处出现剖宫产瘢痕综合征（CSS）及剖宫产术后异常子宫出血，经宫腔镜治疗后怀孕。既往瘢痕处子宫肌层裂开；因此，在瘢痕上方做一横切口。术后因恶露潴留子宫恢复不佳，再次发生剖宫产瘢痕综合征。病例2：一名29岁女性，剖宫产术后发生剖宫产瘢痕综合征，自然受孕。既往瘢痕处子宫肌层与病例1一样裂开。剖宫产时采用修剪技术进行瘢痕修复；术后无并发症，她再次自然受孕。剖宫产时实施这种新型手术可能有助于剖宫产瘢痕综合征女性子宫肌层残余厚度的恢复。
