A Comparative Study of Transvaginal Repair and Laparoscopic Repair in the Management of Patients With Previous Cesarean Scar Defect.

STUDY

OBJECTIVE

The study objective was to compare transvaginal intervention and laparoscopic repair for correcting the uterine defect in patients with previous cesarean scar defect (PCSD).

DESIGN

Retrospective study (Canadian Task Force classification).

SETTING

Previous studies have reported that transvaginal surgery and laparoscopic surgery are available treatment options for patients with PCSD. However, the two methods have not been compared before.

PATIENTS: A total of 124 patients with PCSD were included in the retrospective study between December 2010 and December 2014.

INTERVENTIONS: In the study, 65 patients received transvaginal repair, and 59 patients received laparoscopic repair.

MEASUREMENTS AND MAIN

RESULTS

Operation time, blood loss, hospital stay length and hospitalization expense, clinical syndromes and healing of uterine defect 3 months postoperatively were compared between the two surgical approaches. Patients receiving transvaginal repair exhibited significantly shorter operation time and lower hospitalization expenses than the patients receiving laparoscopic repair. Follow-up data showed that prolonged menstrual bleeding syndrome was obviously improved in 89% of patients undergoing transvaginal intervention and 86% of patients undergoing laparoscopic repair. The uterine defect disappeared or was substantially reduced in 87% of patients undergoing transvaginal intervention and 86% of patients undergoing laparoscopic repair. The differences between the two surgical approaches were insignificant.

CONCLUSION

Transvaginal repair is comparably effective to the laparoscopic repair and may be a more cost-effective and convenient surgical approach in the management of patients with PCSD.