What is an isthmocele? Isthmocele Treatment
Although becoming a mother is a special experience for every woman, sometimes unwanted complications may arise depending on the type of delivery. While normal delivery carries risks such as tearing, contrary to common belief, cesarean delivery can lead to infections or scar-related conditions. These conditions can frequently cause bleeding and infections. Additionally, the resulting scar disease can prevent pregnancy and lead to miscarriages. If you want to avoid such complications, it is beneficial to undergo isthmocele treatment.
In a cesarean section, when the incision does not heal properly, a tunnel-like formation in the uterine tissue occurs, which is called isthmocele. This condition can develop shortly after delivery or even after a long time. Over time, menstrual blood accumulates in the tunneled area, leading to several complaints. Isthmocele can cause dark brown, thick discharge and bleeding, which may result in infections, infertility, and pain during sexual intercourse. It can also lead to infertility or, in severe cases, pose a life-threatening risk to the expectant mother.
Isthmocele: What Is It, Is It Dangerous, and What Are the Treatment Options?
What Is Isthmocele?
Isthmocele is a condition that occurs in the thin smooth muscle tissue between the cervix and the lower part of the uterus. It connects the uterus and cervix both anatomically and functionally, allowing the passage of menstrual blood. In some cases, isthmocele can cause intrauterine adhesions and scar tissue formation.
Is Isthmocele Dangerous?
Isthmocele is generally considered a harmless and natural condition. However, in some cases, it can lead to the adhesion of tissues and organs within the uterus. This may result in intrauterine adhesions, scar tissue formation, pelvic pain, irregular menstrual bleeding, and infertility. Although isthmocele is not classified as dangerous, if left untreated, it can cause significant problems for some women.
What Happens If Isthmocele Is Left Untreated?
If isthmocele is not treated, it can lead to the following complications:
- Pelvic pain
- Irregular menstrual bleeding
- Infertility
- Formation of intrauterine adhesions and scar tissue
For this reason, women experiencing symptoms of isthmocele should consult a gynecologist or reproductive health specialist.
Isthmocele Surgery
Isthmocele surgery is a procedure aimed at removing intrauterine adhesions and scar tissues. This operation is usually performed using a minimally invasive method called hysteroscopy. A hysteroscope is inserted into the uterus to visualize the tissues, and the surgeon removes the adhesions and scar tissues. Isthmocele surgery can help relieve pelvic pain, regulate menstrual bleeding, and address infertility problems.
How to Suspect Isthmocele?
Women who have undergone at least one cesarean section and experience the following symptoms may have isthmocele. Those experiencing these symptoms should consider isthmocele treatment. These symptoms include:
- Prolonged dark brown (mud-like) discharge after menstruation.
- Pelvic pain
- Foul-smelling and dark-colored discharge
- Pregnancy despite contraceptive measures after a cesarean section
If a person has these symptoms and is suspected of having isthmocele, they should consult a doctor. Ultrasound is usually sufficient for diagnosis. However, in some cases, more detailed examinations may be necessary, such as:
- Sonohysterography
- Hysterosalpingography (HSG)
- Hysteroscopy
- MRI
Isthmocele Treatment
Treatment options for scar-related conditions include:
Over-the-Counter or Prescription Creams, Ointments, or Gels:
These products can be used to reduce scars caused by cuts, cesarean incisions, or wounds. If you are under a doctor’s care and your cesarean scar is a cosmetic or plastic surgery concern, consult your doctor about whether over-the-counter treatment is an option. Treatments often contain steroids or are prescribed for scars that cause sensitivity and itching. Your doctor may also recommend pressure therapy or a silicone gel coating to help treat cesarean scars.
Surgical Removal or Treatment:
Depending on your specific condition, there are several options to treat deeper scars and cesarean section scars. These include skin grafts, dermabrasion, or laser surgery. In a skin graft, the doctor takes skin from another area of your body and uses it on the affected area, a method commonly used for burn victims. If you have a scar that affects function, surgery may help resolve the functional issues. If you have recently undergone a cesarean section and developed a scar, it is recommended to wait at least a year before considering scar treatment. Many cesarean scars fade over time and become less noticeable.
Isthmocele treatment is quick and relatively simple. A camera is inserted into the uterus to reduce the tunnel-like formation in the affected area. The muscle tissue where blood accumulates is cut, and the tunnel is smoothed out to prevent further blood accumulation. This operation takes approximately 45 to 50 minutes. The patient can be discharged on the same day. The recovery period typically lasts between one to two weeks. To speed up recovery, it is recommended to maintain a balanced diet, avoid alcohol and smoking, and refrain from strenuous activities.