What is uterine scar diverticulum?

Many women are not very familiar with uterine scar diverticulum. Uterine scar diverticulum is a complication that occurs after cesarean section, and the harm caused by uterine scar diverticulum is also very much. For example, some patients will mainly show symptoms of irregular menstruation. If they have fertility function, the pregnancy rate will be reduced, and even if they become pregnant, they may experience miscarriage.

What is uterine scar diverticulum?

Uterine scar diverticulum occurs during cesarean section due to poor healing of the uterine scar and is a complication of cesarean section. In clinical medicine, if there are no conditions for cesarean section, it is recommended to choose natural delivery as much as possible to prevent the formation of scar diverticulum. The clinical symptoms of uterine scar diverticulum are prolonged menstruation and continuous and unclean bleeding. The normal menstrual period of the patient is 2 to 7 days, while the patient with uterine scar diverticulum usually has dripping bleeding for more than ten days.

If the symptoms are more serious, hysteroscopy can be performed to understand the shape of the uterus and the size of the scar diverticulum, and to eliminate abnormal uterine bleeding caused by other diseases. Surgical treatment is feasible, such as hysteroscopy to electrocoagulate the bottom of the scar diverticulum and destroy the diverticulum endometrium, or laparoscopic surgery to remove the scar diverticulum and suture it.

The treatment methods for uterine scar diverticulum mainly include the following two categories:

1. Treatment with medication.

Hormones are an effective conservative treatment for uterine scar diverticulum. If patients with uterine scar diverticulum have already experienced severe menstrual disorders and the patient does not want to become pregnant. You can start with short-term contraceptive pills for treatment. If there is no recurrence after 3 to 6 months of stopping the pills, you can stop the treatment.

2. Surgical treatment.

(1) At present, there is no unified surgical indication for the treatment of uterine scar diverticulum in clinical medicine. It should be mentioned that the size of the scar diverticulum is not the only indication for surgical treatment. If the patient has typical symptoms or has already developed infertility, miscarriage and other problems, surgical treatment should be actively adopted. Secondly, clinical medicine also believes that when the thickness of the uterine muscle wall tissue above the diverticulum is less than or equal to 2.5mm, and the depth of the uterine incision diverticulum exceeds or is equal to 80% of the thickness of the uterine muscle wall, it is suitable for surgical treatment.

(2) Common surgical treatment methods in clinical medicine at present include hysteroscopy, laparoscopy, vaginal scar diverticulum removal, etc. Relatively speaking, these three surgical treatment methods are very simple and the cure rate is also very high. However, each surgical treatment also has its advantages and disadvantages. For example, vaginal scar diverticulectomy causes less trauma and lower surgical costs, but the clinic is also limited and the surgical exposure area is also limited. During actual treatment, the best surgical method can be selected according to the specific situation.

What is a scar diverticulum?

1. During cesarean section, the upper edge of the uterine wound is thick and short, and the lower edge is shallow and long. It is easy to sew loosely. If the sutures are too dense, it is easy to cause ischemic necrosis of the wound, and even rupture to form a diverticulum.

2. The uterine wall is not cleaned in time during the operation, resulting in endometriosis to the wound. Long-term endometrial hyperplasia falls off and bleeds, increasing the pressure in the uterine cavity and causing rupture to form a uterine incision diverticulum;

3. Infection: Intrauterine infection may be caused by various factors such as placental abruption, gestational diabetes, etc., or the patient's poor recovery after surgery and decreased immunity may lead to infection.

Clinical symptoms of scar diverticulum:

The patient's menstrual cycle, menstrual period and menstrual volume were all normal before cesarean section. After cesarean section, the menstruation started and the cycle was normal, with the specific manifestations of excessive menstrual flow, prolonged menstruation, and vaginal bleeding. The longest menstrual period was nearly 20 days, and there was no obvious abdominal pain. Gynecological examination: no significant positive signs.