Immunohistopathologic Findings and Surgical Repair of Cesarean Scar Niche Using Hysteroscopy Study of Tissue Changes and Symptom Improvement in Women with Cesarean Scar Defects

What this Trial Is About

Researchers are studying women with symptomatic uterine scar niches, which are pouch-like defects on the anterior wall of the uterine isthmus where a previous cesarean section (CS) scar was made. These niches are defined as depressions in the myometrium of at least 2 mm. The study aims to identify the histopathologic characteristics of cesarean scar niche specimens removed by hysteroscopy and to help gynecologists understand the effectiveness of hysteroscopic repair for improving symptoms and fertility. The surgical treatment involves operative hysteroscopy performed postmenstrual. Patients receive cervical preparation with misoprostol before surgery. During the procedure, a resectoscope is used to trim the lower edge of the niche and coagulate the base. The removed tissue is collected for detailed histopathological and immunohistochemical examination, including analysis of inflammation, fibrosis, and immune markers. Follow-up occurs three months after surgery. Participants are assessed with transvaginal ultrasound to measure niche dimensions and residual myometrial thickness. Clinical data such as age, parity, previous surgeries, and symptoms are collected. After three months, symptom improvement and quality of life are evaluated through ultrasound and questionnaires. Researchers measure pathological variations in niche specimens to better understand causes of uterine scar thinning and monitor patient outcomes.

Immunohistopathologic Findings of Cesarean Scar Niche