Effectiveness of Three Steps Hysteroscopic Repair of Post Caesarean Isthmocele in Patients With Post Menstrual Spotting

Not Applicable

• Conditions: Abnormal Uterine Bleeding
• Interventions: Procedure: three steps hysteroscopic resection of an isthmocele

• Registration Number: NCT05062551
• Lead Sponsor: Mervit Sersy

Brief Summary

Isthmocele is one complications of repeat cesarean sections which is considered as a pocket .that accumulate menstrual blood causing post- menstrual spotting Hysteroscopic resection of the edges of the isthmocele is considered the best treatment option available up to date. Aim of the work: Asses the effectiveness of three steps method resection using hysteroscopy of an isthmocele in patients complained of post -menstrual bleeding with confirmed presence of isthmocele.

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Detailed Description

The incidence rate of cesarean deliveries has been dramatically increased in Egypt.(1) Isthmocele is one of the known complications of repeat cesarean sections.(2) Post- menstrual spotting and many other gynecological complains have been correlated to this isthmocele which is considered as a pocket that accumulate menstrual blood. (3) Hysteroscopic resection of the edges of the isthmocele is considered the best treatment option available up to date.(4) Aim of the work: Asses the effectiveness of three steps method resection using hysteroscopy of an isthmocele in patients complained of post-menstrual bleeding with confirmed presence of isthmocele.

Patients: 50 patients complained of post-menstrual bleeding with confirmed presence of isthmocele. After written consent, the patient will be subjected to three steps hysteroscopic resection of an isthmocele by removing the distal edge of the niche then the proximal edge and lastly ball cauterization of the floor of the pouch of the isthmocele. Post-operative trans-vaginal ultrasound and follow up for 2 menstrual cycles.

Study Timeline

• Study Start: 2021-07-16
• Status Verified: 2021-09
• Study First Submitted: 2021-09-21
• Study First Submitted QC: 2021-09-21
• Last Update Submitted: 2021-09-21
• Study First Posted: 2021-09-30
• Last Update Posted: 2021-09-30
• Primary Completion: 2021-10-15
• Study Completion: 2021-12-15

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: Female
• Target Recruitment: 50

Inclusion Criteria

• female
• previous cesarean sections
• complain post menstrual spotting

Exclusion Criteria

• other genital tract abnormality
• other uterine causes pf bleeding residual myometrial thickness less than 3mm

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
intervetion group	three steps hysteroscopic resection of an isthmocele	50 patients complained of post-menstrual bleeding with confirmed presence of isthmocele. After written consent, the patient will be subjected to three steps hysteroscopic resection of an isthmocele by removing the distal edge of the niche then the proximal edge and lastly ball cauterization of the floor of the pouch of the isthmocele. Post-operative trans vaginal ultrasound and follow up for 2 menstrual cycles.

Primary Outcome Measures

Name	Time	Method
size of the the niche post operatively	2 months	effectiveness of three steps method resection using hysteroscopy of an isthmocele

Secondary Outcome Measures

Name	Time	Method
improving of post menstrual bleeding	2months	no more post menstrual spotting

Trial Locations

Locations (1)

Shatby Maternity University Hospital; 🇪🇬 Alexandria, El-Khartoum Square, Egypt