الفهرس 
Laparoscopy in gynecology
Cesarean sectionOnly 14 pages are availabe for public view
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Abstract
Cesarean delivery is one of the most common surgical procedures in women. As a result of increasing rate of cesarean sections, the rate is rising for cesarean scar defect, Cesarean scar defect forms after cesarean delivery, at the site of hysterotomy or cesarean delivery, on the anterior wall of the uterine isthmus. Patients with cesarean scar defect presented with some symptoms. These symptoms including delayed menstruation through the cervix, resulting in abnormal bleeding, pelvic pain, vaginal discharge, dysmenorrhea, dyspareunia, and infertility Isthmocele can be considered to be a very common iatrogenic condition in the female population because of the high worldwide incidence of this disorder, which leads to adverse anatomic changes in the lower uterine segment. It is unclear as to why only some patients develop adverse post-cesarean anatomic changes. The uterine surgical procedure most often performed in women of childbearing age is the cesarean section, and it is usually made across the lower segment The diagnosis of isthmocele as described in the literature can be accomplished through various imaging techniques: transvaginal ultrasound, hysteroscopy, hysterosalpingography and magnetic resonance imaging. Treatment of isthmocele should be offered to symptomatic patients, who represent 10 % of women with this disease. For women of childbearing age with further reproductive interest, treatment may be indicated as prevention of possible obstetric complications, such as cervical implantation of pregnancy, uterine rupture in the course of pregnancy or during labor, placenta previa, or accrete. This study was conducted on (19) patients with CS defect and two patients were missed in the follow up. Transvaginal U/S and MRI were done pre-operative then diagnostic hysteroscopy and laparoscopic repair of the defect was done using stratafix ampoule suturing. Post-operative follow up after three months was done by U/S and MRI for the residual myometrial thickness and improvement of symtoms. All patients showed relief of symptoms except 2 patients complained from inter-menstrual bleeding and infertility, Also a significant increase of myometrial thickness after repair was observed by both U/S and MRI postoperatively.