2014 Update on minimally invasive gynecology
The cesarean scar defect: A common etiology of abnormal uterine bleeding
CESAREAN SCAR DEFECT DIAGNOSED WITH HYSTEROSCOPY
Videos courtesy of Amy Garcia, MD
WHAT THIS EVIDENCE MEANS FOR PRACTICE
• A critical systematic review of available data suggests that there is not enough clinical evidence to support surgical intervention for the treatment of CSD for women symptomatic with AUB.
• Recommended nonhysterectomy treatments for AUB associated with CSD include oral contraceptives or expectant management.
• Surgical treatment should be limited to the research environment in the form of RCT to assess the long-term outcomes of intervention.
• An RCT of the LNG-IUS for the treatment of AUB associated with CSD is needed.
Acknowledgments
The author would like to thank Andrew Brill, MD, Lee Sloan-Garcia, MD, and William Parker, MD, for their thoughtful review of this manuscript.
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