Uterine Adherence to the Abdominal Wall Following Caesarean Section Presenting as a Cause of Chronic Pelvic Pain—a Cohort Study

Background: The most common major abdominal operation done on women is Caesarean section. Over the past century delivery by Caesarean section has been increased in both developed and developing countries. Various abdominal incisions have been used for Cesarean delivery. Today most of the caesarean section are performed with either a vertical infra umbilical midline incision [VIUI] or pfannenstiel incision. Both the skin incisions possess some benets and drawbacks. Methods: This study was a prospective cohort study conducted in the department of Gynaecology & Obstetrics, Burdwan Medical College & Hospital, Burdwan, West Bengal a tertiary teaching institute, from July, 2017 to November, 2018. 142 mothers were included in the study after informed consent from the patient about being a part of this study. Among them, 37 were with midline vertical skin incision, 51 were with transverse skin incision, and 54 were primigravida. Categorical variables are expressed as Number of patients and percentage of patients and compared across the groups using Pearson's Chi Square test for Independence of Attributes/ Fisher's Exact Test as appropriate. Results: 57.41% of primigravida are in 18 to 20 years age group, 42.59 % in 21-25 years, no women was over 25 years. women with previous vertical incision 27.03% have no adhesion, 59.46 % have mild adhesion, and 13.51% have severe adhesion. In women with previous transverse incision 21.57% have no adhesion, 47.06% have mild adhesion and 31.37%have severe adhesion. 34.7% adhesion are between uterus and bladder, 26.5% adhesion are between uterus and omentum, 20.4% adhesion are between uterus and abdominal wall, 12.2% adhesion between omentum and abdominal wall, 6.2% adhesion are in others organ Conclusions: There was signicant delay in delivery of neonates in post caesarean mothers with previous transverse skin incision than vertical incision. Previous transverse skin incision is associated with more severe adhesion than vertical skin incision

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Can specific pain symptoms help in the diagnosis of endometriosis? A cohort study of women with chronic pelvic pain

Fertility and Sterility ◽

10.1016/j.fertnstert.2009.01.164 ◽

2010 ◽

Vol 94 (1) ◽

pp. 20-27 ◽

Cited By ~ 31

Author(s):

Karen Ballard ◽

Hazel Lane ◽

Gernot Hudelist ◽

Saikat Banerjee ◽

Jeremy Wright

Keyword(s):

Cohort Study ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Pain Symptoms

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Clinical and sonographic signs to diagnose uterocervical adhesions to the abdominal wall following caesarean section

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2011.03186.x ◽

2011 ◽

Vol 119 (1) ◽

pp. 117-117

Author(s):

E Saridogan ◽

SA El-Shawarby ◽

R Salim ◽

S Lavery

Keyword(s):

Caesarean Section ◽

Abdominal Wall ◽

Wall Following

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Treatment of C-section diverticula with hysteroscopic resection in women without childbearing intention: a retrospective cohort study

10.21203/rs.2.14905/v1 ◽

2019 ◽

Author(s):

Hui Shi ◽

Jingyan He ◽

Yunhe Gao ◽

Shuang Qin ◽

Jiaying Fan ◽

...

Keyword(s):

Cohort Study ◽

Cesarean Section ◽

Pelvic Pain ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Chronic Pelvic Pain ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Timing Of Surgery ◽

Hysteroscopic Resection

Abstract Background: Diverticulum, one of the long-term squelae of cesarean section, can cause abnormal uterine bleeding, dysmenorrhea and chronic pelvic pain. Hysteroscopic resection of diverticula is thought to reduce abnormal uterine bleeding and chronic pelvic pain. In this study, we aim to describe the improvement after hysteroscopic resection of cesarean section diverticula hysteroscopic resection of cesarean section diverticula (CSD) in women without childbearing intention, and to explore the variables associated with poor prognosis.Methods: A retrospective cohort study of women aged 25-48 with CSD diagnosis by transvaginal ultrasonography (TVS) and hysteroscopy that were enrolled at Guangzhou Women and Children’s Medical Center between June 2017 and December 2018. A total of 124 women met the inclusion criteria and all patients had undergone hysteroscopic resection and accepted a follow-up interview at the 3rd and 6th months postoperatively to record symptom improvement.Result: The mean of intraoperative blood loss and operative time of hysteroscopic resection were (12.94±12.63) ml and (33.63±6.87) min in 124 patients. Overall observed improvement rates of CSD symptom were 47.2% and 65.6% in the first 3 and 6 months, respectively. Multivariable logistic regression models revealed that timing of surgery <14 days was a good prognostic factor associated with both 3-month improvement (OR, 16.59; 95% CI, 2.62-104.90; P=0.003) and 6-month improvement (OR, 15.51; 95%CI, 1.63-148.00; P=0.02); Patients with numbers of cesarean section(CS) ≥2 had a lower rate of improvement after 6 months of CSD repair surgery compared with patients who underwent one CS(OR, 8.29; 95%CI, 1.05-65.75; P=0.04).Conclusions: A hysteroscopic repair might be an appropriate method for CSD in women who no childbearing intentions. The timing of surgery and the number of CS seems to be factors influencing the postoperative improvement of CSD.

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