Prevalence of isthmocele at the Hospital San José de Bogotá, Colombia

Abstract

Objective: To describe the prevalence of isthmocele as an incidental finding in patients with a history of cesarean section and associated clinical symptoms. Methods: Descriptive cross-sectional study using non-probabilistic sampling for convenience in patients with a history of cesarean section, scheduled for hysteroscopy between November 2014 and March 2015, in the gynecological endoscopic surgery service of the Hospital San José de Bogotá, Colombia. Results: 42 patients were eligible for the study because of their previous cesarean section and all were included. The frequency of isthmocele was 83.3[%] in hysteroscopy, with similar localization in the isthmus and cervix. The main clinical characteristic presented by the patients was abnormal uterine bleeding (85.7[%]), while the less common was infertility (7.1[%]). A higher prevalence of dysmenorrhea (65.7[%] vs. 42.9[%]) was observed in patients with isthmocele, a history of 2 or more cesa-reans (60[%] vs. 42.9[%]) and an emergency cesarean section (54, 3[%] vs. 28.6[%]) compared to the group of patients without isthmocele, in the latter group it was noted that 100[%] of the patients had no previous history of labor. In women with a history of cesarean section and presence of symptoms such as abnormal uterine bleeding, dysmenorrhea, pelvic pain, infertility and dyspareunia, the frequency of isthmocele diagnosed by hysteroscopy was greater than 80[%]. Conclusion: Isthmocele is due to abnormal uterine cicatrization after cesarean section, other studies are required to determine not only the prevalence but also the protective factors that reduce its incidence to have a positive impact on this kind of patients.