Hysteroscopic Versus Laparoscopic Surgery in the Management of Post Cesarean Symptomatic Uterine Scar Defect: A Systematic Review and Meta-Analysis | ||||
| Evidence Based Women's Health Journal | ||||
| Article 49, Volume 15, Issue 15, January 2025, Page 1-11 PDF (480.58 K) | ||||
| Document Type: Review Article | ||||
| DOI: 10.21608/ebwhj.2024.336308.1385 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Doaa Fouad  1; Hanan Shehata2
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| 1Obstetrics and gynecology department , Faculty of medicine, Ain Shams University | ||||
| 2Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Egypt | ||||
| Abstract | ||||
| Objectives: To assess the safety and effectiveness of laparoscopy and hysteroscopy in treating women with symptoms (e.g: abnormal uterine bleeding, infertility), or to prevent consequences from obstetrics. Methods: Original papers on the surgical therapy of scar defect, published between 1950 and 2023 were systematically searched in PubMed/MEDLINE, Scopus, Embase, Science Direct, and Cochrane Library (no CRD4202417098). MedCalc 16.4.3 was used to perform the data synthesis. The GRADE methodology was employed to evaluate the corpus of evidence. Results: 25 papers were found; 21 of them concentrated on a specific surgical procedure, and 4 of them contrasted several methods. A meta-analysis revealed that 85.00% of women (75.05–92.76%) reported improved symptoms following hysteroscopic correction, and 92.77% (85.53–97.64%) following laparoscopic/robotic correction. The procedure with the least risk of hazards was hysteroscopic surgery (0.76%, 0.20–1.66%). Conclusions: The safest and most successful course of action for patients with sufficient residual myometrial thickness covering the isthmocele may be hysteroscopic repair. When hysteroscopic treatment proves ineffective and a patient has a thinner remaining myometrium (less than 2.5 mm) over the defect, a laparoscopic method might be the better choice. | ||||
| Keywords | ||||
| Hysteroscopy; infertility; laparoscopy; scar defect | ||||
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