Observational studyReproductive biology and endocrinology : RB&E2023
Comparison of clinical effectiveness and subsequent fertility between hysteroscopic resection and vaginal repair in patients with cesarean scar defect: a prospective observational study.
Observational study in Reproductive biology and endocrinology : RB&E, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Cesarean Scar Defect (Isthmocele) and Secondary Infertility: A Systematic Review of Reproductive Significance.Cureus · 2026Review
- Ultrasound-guided bladder localization for predicting abdominal adhesions, bladder injury, and scar healing in repeat cesarean sections: a prospective cohort study.International urology and nephrology · 2026Article
- Comparison of long-term clinical effect and re-pregnant outcomes between hysteroscopic resection and laparoscopic defect repair in patients with non-severe cesarean scar defect: a retrospective study.BMC pregnancy and childbirth · 2025Article
- Pregnancy outcomes in women with cesarean section scar defects and secondary infertility after vaginal repair: a multicenter observational cohort analysis.Frontiers in medicine · 2025Article
- Surgical treatment and reproductive outcomes in caesarean scar pregnancy at a single center.Reproductive biology and endocrinology : RB&E · 2024Article
- Isthmocele and Infertility.Journal of clinical medicine · 2024Review
- Impact of cesarean scar defect on reproductive outcomes after assisted reproductive technology.Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2024Review
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo evaluate the clinical effectiveness and pregnancy rate after hysteroscopic resection (HR) and/or vaginal repair (VR) in patients with cesarean scar defect (CSD).
methodsThis prospective observational study enrolled 191 patients who received CSD surgery in the First affiliated hospital of Sun Yat-sen University between September 2019 to February 2022 (96 in HR and 95 in VR, respectively). Patient follow-up were performed three months after surgery in both groups by transvaginal ultrasound to confirm the presence of fluid in the niche, along with the resolution of prolonged menses at the same time. The primary outcome was the clinical effectiveness between HR and VR, identified by the resolution of prolonged menses.
resultsThe rates of niche-fluid disappearance (70.1% vs 60.2%, P = 0.176) and prolonged menses resolution (74.8% vs 80.0%, P = 0.341) were comparable for HR and VR. A subgroup analysis for niche size revealed that HR provides patients with small niche a more favorable rate of menstrual resolution compared to VR (size of niche ≤ 15 mm
conclusionsHysteroscopic resection is as effective as vaginal repair at relieving symptoms of CSD-associated prolonged menses. Hysteroscopic resection is the modality of choice with an improvement in prolonged menses for small niche, while vaginal might be considered for a large niche. Furthermore, surgical intervention could improve the clinical pregnancy rate of CSD patients. All of these provide evidence for the individualized management of CSD.
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