Cervical Stenosis After Hysteroscopic Surgery for Cesarean Scar Disorder

TL;DR

This paper reports a rare case of cervical stenosis after hysteroscopic surgery for a cesarean scar disorder, highlighting the need for careful surgical techniques and follow-up.

Contribution

The paper presents a novel case of delayed cervical stenosis following hysteroscopic treatment of CSDi.

Findings

Cervical stenosis developed four months after hysteroscopic TCR-CSDi despite no initial complications.

Avoiding circumferential resection and cauterization may reduce the risk of cervical stenosis.

Delayed cervical stenosis should be checked before embryo transfer in patients who had TCR-CSDi.

Abstract

Cesarean scar disorder (CSDi) is a newly recognized cause of secondary infertility. Laparoscopic or hysteroscopic surgery is generally chosen for the surgical treatment of CSDi, depending on the residual myometrial thickness of the cesarean scar. Previously, hysteroscopic transcervical resection for CSDi (TCR-CSDi) has been reported to be a safe procedure, with no cases of postoperative cervical stenosis. Herein, we report a novel case of cervical stenosis after circumferential hysteroscopic TCR-CSDi of an extensive CSDi lesion. Notably, although no cervical stenosis was observed upon postoperative hysteroscopy one month postoperatively, cervical stenosis developed four months after the surgery; therefore, it is important to avoid circumferential resection and cauterization in patients with CSDi, even when abnormal blood vessels are present. Additionally, it is advisable to check for delayed cervical stenosis at least three weeks before embryo transfer in patients who have undergone TCR-CSDi.

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