Istmocele: incidence by ultrasound and hysteroscopy and associated clinical symptoms in patients with a history of cesarean section

Abstract

Objective: To determine the incidence of isthmocele by ultrasound and hysteroscopy. Methods: An observational and cross-sectional, descriptive study, was carried out by applying a registration matrix to symptomatic patients who attended the IAHULA gynecological consultation in the period between January-June 2019 to those who underwent pelvic ultrasound and hysteroscopy. Results: A sample of 24 patients was obtained. The average age was 37 years; 91.7 % had pelvic pain, 54.2 % dyspareunia, 50 % SUA and 4.2 % infertility. Of the total sample 18 patients reported isthmocele by ultrasound and 20 by hysteroscopy. Conclusion: It is important that before symptoms such as pelvic pain, abnormal uterine bleeding, infertility and dyspareunia, isthmocele is considered as a possible cause and differential diagnosis, being an easy defect to diagnose and treat. This study demonstrates a very good correlation between the results, with ultrasound reporting a sensitivity of 100 % and specificity of 67 %. The incidence of isthmocele was 75 % by ultrasound and 83.3 % by hysteroscopy.