Hysteroscopic resection of a uterine caesarean scar defect (niche) in women with postmenstrual spotting: a randomised controlled trial

BJOG : an International Journal of Obstetrics and Gynaecology
A J M W VervoortJaf Huirne

Abstract

To compare the effectiveness of a hysteroscopic niche resection versus no treatment in women with postmenstrual spotting and a uterine caesarean scar defect. Multicentre randomised controlled trial. Eleven hospitals collaborating in a consortium for women's health research in the Netherlands. Women reporting postmenstrual spotting after a caesarean section who had a niche with a residual myometrium of ≥3 mm, measured during sonohysterography. Women were randomly allocated to hysteroscopic niche resection or expectant management for 6 months. The primary outcome was the number of days of postmenstrual spotting 6 months after randomisation. Secondary outcomes were spotting at the end of menstruation, intermenstrual spotting, dysuria, sonographic niche measurements, surgical parameters, quality of life, women's satisfaction, sexual function, and additional therapy. Outcomes were measured at 3 months and, except for niche measurements, also at 6 months after randomisation. We randomised 52 women to hysteroscopic niche resection and 51 women to expectant management. The median number of days of postmenstrual spotting at baseline was 8 days in both groups. At 6 months after randomisation, the median number of days of postmenstrual sp...Continue Reading

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Citations

Mar 15, 2018·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·I P M JordansJ A F Huirne
Jun 6, 2019·Revista da Associação Médica Brasileira·Thaysa Guglieri KremerRaquel Papandreus Dibi
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May 15, 2020·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Ning-Ning ZhangQing Yang
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Sep 6, 2020·Journal of Perinatal Medicine·Clarel Antoine, Bruce K Young
Jan 9, 2021·Journal of Obstetrics and Gynaecology of India·Vidushi KulshresthaGarima Kachhawa
Nov 6, 2020·Journal of Minimally Invasive Gynecology·Roy Mashiach, Yechiel Z Burke
Nov 17, 2020·Journal of Minimally Invasive Gynecology·Amélie ZellerPerrine Capmas
Oct 17, 2020·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Chao PengYingfang Zhou
Jun 19, 2021·Gynécologie, Obstétrique, Fertilité & Sénologie·A TorreP Crochet

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Methods Mentioned

BETA
hysterectomy

Software Mentioned

alea

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