Isthmocele: From Risk Factors to Management

Abstract Objective The aim of the present study was to perform a comprehensive review of the literature to provide a complete and clear picture of isthmocele-a hypoechoic area within themyometriumat the site of the uterine scar of a previous cesarean section-by exploring in depth every aspect of this condition. Methods A comprehensive review of the literature was performed to identify the most relevant studies about this topic. Results Every aspect of isthmocele has been studied and described: pathophysiology, clinical symptoms, classification, and diagnosis. Its treatment, both medical and surgical, has also been reported according to the actual literature data. Conclusion Cesarean section is the most common surgical procedure performed worldwide, and one of the consequences of this technique is isthmocele. A single and systematic classification of isthmocele is needed to improve its diagnosis and management. Further studies should be performed to better understand its pathogenesis.

摘要 目的 本研究旨在对相关文献开展全面回顾，通过深入探析该病症的各个层面，完整清晰地呈现剖宫产术后子宫瘢痕憩室（isthmocele）——即既往剖宫产子宫瘢痕处子宫肌层内的低回声区域——的全貌。方法 本研究通过全面检索相关文献，筛选出与该主题相关性最高的研究，开展系统回顾。结果 本研究对子宫瘢痕憩室的各个维度均进行了研究与阐述，涵盖病理生理学、临床症状、分类及诊断方式；同时依据现有文献数据，对其内科与外科治疗方案进行了归纳报道。结论 剖宫产术是全球范围内最常开展的外科手术，该术式的常见并发症之一即为子宫瘢痕憩室。目前亟需建立统一且系统化的子宫瘢痕憩室分类标准，以提升其诊断与临床管理水平；未来还需开展更多研究，以进一步阐明其发病机制。