Menstruation is not clean after caesarean section

Cesarean section is a very popular method of delivery nowadays, so many people choose to try it. Generally speaking, no matter which method of delivery is used, there will be a period of abnormal menstruation after the pregnant woman gives birth to the baby, so women do not need to worry too much. After taking good care of the body for a period of time, this phenomenon will gradually subside. So, why is the menstrual period always unclean after cesarean section?

Hysterotomy diverticulum is caused by poor healing of the myofascia at the incision site due to various reasons after various hysterectomies (common in cesarean sections), resulting in partial loss of part of the myofascia. Under hysteroscopy, it can be seen that the myometrium at the site of the uterine incision shows varying degrees of sac-like indentation structures, and the surface is covered with a small amount of uterine wall.

Post-cesarean section uterine incision diverticulum is a complication after cesarean section. In recent years, with the increase in cesarean section rates and the improvement of clinicians and ultrasound physicians' understanding of the disease, the number of cases diagnosed with post-cesarean section uterine incision diverticulum has gradually increased, with an incidence rate of 4% to 9%. The cause of its occurrence is still unclear. At present, it is believed to be closely related to factors such as the site of the cesarean section wound, wound tearing, poor wound closure, ischemic wound bleeding, the frequency of cesarean sections, perioperative infection, suturing method and suture line.

From a clinical point of view, most women suffering from this disease are admitted to the hospital due to irregular menstruation and infertility after cesarean section. The menstrual period of these patients reaches 8 to 25 days, and some patients are accompanied by chronic lower abdominal pain or menstrual abdominal pain. Because this type of disease has not been fully taken seriously by clinicians, it is often misdiagnosed as "multifunctional abnormal uterine bleeding disease."

Uterine incision diverticulum after cesarean section can be diagnosed by intravaginal ultrasound, magnetic resonance imaging, hysterography, hysteroscopy, etc. Generally speaking, as long as there are no obvious symptoms, uterine incisional diverticulum can be left untreated and follow-up observation is sufficient. If there are obvious symptoms such as irregular menstruation and infertility, medication or surgery can be used.

The mainstay of medical treatment is contraceptive pills. It should be noted that although the use of contraceptives can alleviate the symptoms of irregular menstruation during the medication period, many people stop taking the medicine due to side effects, and contraceptives are not effective for all patients.

Surgical treatment is an effective way to treat hysteroscopic diverticulum. Hysteroscopy and laparoscopy combined with surgical repair of hysteroscopic diverticulum can significantly improve the patient's symptoms with an efficiency of 90%. Ms. Zhang, as mentioned above, underwent surgery and her symptoms improved greatly. Her menstrual period was shortened to 7 days and she became pregnant after one year of contraceptive measures. Ms. Wang's menstrual period was shortened to 6 days after the surgery, and her and her husband's sexual life became harmonious again. She has never thought about removing her uterus since then.