Endoscopic surgical treatment of isthmocele and it’s probale link with endometriosis. A 3-years retrospective review of combined laparoscopic and hysteroscopic surgery

Atombosoba Adokiye Ekine, Fülöp István, Rucz Árpád, Tekse István, Nyéky Boldizsár
In: Indian Journal of Obstetrics and Gynecology Research · 2019 · vol. 5(4) , pp. 458–464 · doi:10.18231/2394-2754.2018.0105 · W2912039379
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This retrospective review of 28 patients found combined laparoscopic and hysteroscopic surgery effectively treated isthmocele, with high symptom resolution and fertility return, and noted a high incidence of endometriosis.

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This retrospective study evaluated the efficacy of combined laparoscopic and hysteroscopic surgery for treating isthmocele in 28 patients presenting with symptoms such as bleeding disorders, infertility, and pelvic pain. The procedure resulted in significant resolution of menstrual abnormalities and pain within six months, alongside a high rate of fertility return and overall patient satisfaction. Notably, endometriosis was diagnosed in 57.1% of the cohort, many of whom had no prior history or diagnosis of the condition, suggesting a potential association between the two pathologies. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

The aim, is to share our experience on the efficacy of combined laparoscopic and hysteroscopic surgical treatment of isthmocele, and the possible link with endometriosis. 28 patients with isthmocele, who underwent combined laparoscopic and hysteroscopic repair were retrospectively analysed. Presenting symptoms were; bleeding disorder, infertility, lower abdominal pain, dysmenorrhea and chronic vaginal discharge. All noticeable changes observed in the preoperative symptoms, were evaluated at 1, 3, and 6 months postoperatively, while fertility return within the first 24 months postoperatively was also evaluated. Average age of the patients was 36.9±4.5, fertility return after surgery was 82.4% (n=14/17), post menstrual bleeding disorders was almost completely resolved in all the patients in the 1, 3, and 6 months after surgery, mean bleeding duration was significantly shorter than the preoperative period 3.6±1.1 days as against 10.3±1.7days. There was significant resolution of the other symptoms like dysmenorrhea, chronic vaginal discharge and suprapubic pain at 6 months after surgery. Endometriosis was found in 16 (57.1%) patients, which is remarkably high in patients who had no previous history or diagnosis of endometriosis. The overall patient satisfaction rate was 92.9% (26/28). Our experience shows that, the combined used of hysteroscopy and laparoscopy is very effective in the management of isthmocele with minimal complications. Our findings also suggests a possible link between endometriosis and isthmocele. Further large scale studies may be required to ascertain these findings. Keywords: Endometriosis, Pelvic pain, Dysmenorrhea, Premenstrual syndrome, Abnormal uterine bleeding, Laparoscopy, Hysteroscopy, Caesarean section, Isthmocele.
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- Visibility 482 Views - Downloads 132 Downloads - Permissions - CrossMark - Citation Endoscopic surgical treatment of isthmocele and it’s probale link with endometriosis. A 3-years retrospective review of combined laparoscopic and hysteroscopic surgery - Author Details: - Atombosoba Adokiye Ekine * - Fülöp István - Rucz Árpád - Tekse István - Nyéky Boldizsár The aim, is to share our experience on the efficacy of combined laparoscopic and hysteroscopic surgical treatment of isthmocele, and the possible link with endometriosis. 28 patients with isthmocele, who underwent combined laparoscopic and hysteroscopic repair were retrospectively analysed. Presenting symptoms were; bleeding disorder, infertility, lower abdominal pain, dysmenorrhea and chronic vaginal discharge. All noticeable changes observed in the preoperative symptoms, were evaluated at 1, 3, and 6 months postoperatively, while fertility return within the first 24 months postoperatively was also evaluated. Average age of the patients was 36.9±4.5, fertility return after surgery was 82.4% (n=14/17), post menstrual bleeding disorders was almost completely resolved in all the patients in the 1, 3, and 6 months after surgery, mean bleeding duration was significantly shorter than the preoperative period 3.6±1.1 days as against 10.3±1.7days. There was significant resolution of the other symptoms like dysmenorrhea, chronic vaginal discharge and suprapubic pain at 6 months after surgery. Endometriosis was found in 16 (57.1%) patients, which is remarkably high in patients who had no previous history or diagnosis of endometriosis. The overall patient satisfaction rate was 92.9% (26/28). Our experience shows that, the combined used of hysteroscopy and laparoscopy is very effective in the management of isthmocele with minimal complications. Our findings also suggests a possible link between endometriosis and isthmocele. Further large scale studies may be required to ascertain these findings. Keywords: Endometriosis, Pelvic pain, Dysmenorrhea, Premenstrual syndrome, Abnormal uterine bleeding, Laparoscopy, Hysteroscopy, Caesarean section, Isthmocele. How to Cite This Article Vancouver Ekine AA, István F, Árpád R, István T, Boldizsár N. Endoscopic surgical treatment of isthmocele and it’s probale link with endometriosis. A 3-years retrospective review of combined laparoscopic and hysteroscopic surgery [Internet]. Indian J Obstet Gynecol Res. 2018 [cited 2026 Jun 29];5(4):458-464. Available from: https://doi.org/10.18231/2394-2754.2018.0105 APA Ekine, A. A., István, F., Árpád, R., István, T., Boldizsár, N. (2018). Endoscopic surgical treatment of isthmocele and it’s probale link with endometriosis. A 3-years retrospective review of combined laparoscopic and hysteroscopic surgery. Indian Journal of Obstetrics and Gynecology Research, 5(4), 458-464. https://doi.org/10.18231/2394-2754.2018.0105 MLA Ekine, Atombosoba Adokiye, István, Fülöp, Árpád, Rucz, István, Tekse, Boldizsár, Nyéky. "Endoscopic surgical treatment of isthmocele and it’s probale link with endometriosis. A 3-years retrospective review of combined laparoscopic and hysteroscopic surgery." Indian J Obstet Gynecol Res, vol. 5, no. 4, 2018, pp. 458-464. https://doi.org/10.18231/2394-2754.2018.0105 Chicago Ekine, A. A., István, F., Árpád, R., István, T., Boldizsár, N.. "Endoscopic surgical treatment of isthmocele and it’s probale link with endometriosis. A 3-years retrospective review of combined laparoscopic and hysteroscopic surgery." Indian J Obstet Gynecol Res 5, no. 4 (2018): 458-464. https://doi.org/10.18231/2394-2754.2018.0105

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