Uterine niche: Difference between revisions
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{{Infobox medical condition | |||
[[File:Uterine_Niche.png| | | name = Uterine niche | ||
| image = [[File:Uterine_Niche.png|250px]] | |||
| caption = Diagram of a uterine niche | |||
| field = [[Obstetrics]] and [[Gynecology]] | |||
| synonyms = Cesarean scar defect, isthmocele | |||
| symptoms = Abnormal uterine bleeding, pelvic pain, infertility | |||
| complications = [[Infertility]], [[ectopic pregnancy]], uterine rupture | |||
| onset = Post-cesarean section | |||
| duration = Chronic | |||
| causes = [[Cesarean section]] | |||
| risks = Multiple cesarean sections, surgical technique | |||
| diagnosis = [[Ultrasound]], [[Hysteroscopy]], [[Magnetic resonance imaging|MRI]] | |||
| differential = [[Adenomyosis]], [[Endometriosis]], [[Uterine fibroids]] | |||
| prevention = Optimal surgical technique during cesarean section | |||
| treatment = [[Hysteroscopic surgery]], [[Laparoscopic surgery]] | |||
| medication = [[Hormonal therapy]] | |||
| frequency = Common in women with previous cesarean sections | |||
}} | |||
A '''uterine niche''' is a defect in the [[myometrium]] at the site of a previous [[cesarean section]] scar. It is also known as a cesarean scar defect or isthmocele. This condition can lead to various gynecological symptoms and complications, including abnormal uterine bleeding, pelvic pain, and secondary infertility. | A '''uterine niche''' is a defect in the [[myometrium]] at the site of a previous [[cesarean section]] scar. It is also known as a cesarean scar defect or isthmocele. This condition can lead to various gynecological symptoms and complications, including abnormal uterine bleeding, pelvic pain, and secondary infertility. | ||
== Anatomy and Pathophysiology == | == Anatomy and Pathophysiology == | ||
The uterine niche is typically located at the lower segment of the [[uterus]], where the cesarean section incision was made. The defect occurs when the myometrial tissue does not heal properly, resulting in a pouch or indentation. This can cause the endometrial lining to become trapped, leading to the accumulation of menstrual blood and other symptoms. | The uterine niche is typically located at the lower segment of the [[uterus]], where the cesarean section incision was made. The defect occurs when the myometrial tissue does not heal properly, resulting in a pouch or indentation. This can cause the endometrial lining to become trapped, leading to the accumulation of menstrual blood and other symptoms. | ||
== Clinical Presentation == | == Clinical Presentation == | ||
Patients with a uterine niche may present with: | Patients with a uterine niche may present with: | ||
* [[Abnormal uterine bleeding]], particularly postmenstrual spotting | * [[Abnormal uterine bleeding]], particularly postmenstrual spotting | ||
* [[Pelvic pain]] | * [[Pelvic pain]] | ||
| Line 18: | Line 29: | ||
* [[Dyspareunia]] | * [[Dyspareunia]] | ||
* Secondary [[infertility]] | * Secondary [[infertility]] | ||
== Diagnosis == | == Diagnosis == | ||
The diagnosis of a uterine niche is typically made using imaging techniques such as: | The diagnosis of a uterine niche is typically made using imaging techniques such as: | ||
* [[Transvaginal ultrasound]] | * [[Transvaginal ultrasound]] | ||
* [[Sonohysterography]] | * [[Sonohysterography]] | ||
* [[Magnetic resonance imaging]] (MRI) | * [[Magnetic resonance imaging]] (MRI) | ||
These imaging modalities can help visualize the defect and assess its size and depth. | These imaging modalities can help visualize the defect and assess its size and depth. | ||
== Treatment == | == Treatment == | ||
Treatment options for a uterine niche depend on the severity of symptoms and the patient's reproductive plans. They may include: | Treatment options for a uterine niche depend on the severity of symptoms and the patient's reproductive plans. They may include: | ||
* [[Hysteroscopic surgery]] to resect the niche | * [[Hysteroscopic surgery]] to resect the niche | ||
* [[Laparoscopic surgery]] for more extensive repair | * [[Laparoscopic surgery]] for more extensive repair | ||
* Hormonal therapy to manage symptoms | * Hormonal therapy to manage symptoms | ||
== Prognosis == | == Prognosis == | ||
The prognosis for patients with a uterine niche varies. Surgical repair can alleviate symptoms and improve fertility outcomes, but the success rate depends on the size and location of the niche. | The prognosis for patients with a uterine niche varies. Surgical repair can alleviate symptoms and improve fertility outcomes, but the success rate depends on the size and location of the niche. | ||
== See also == | |||
== | |||
* [[Cesarean section]] | * [[Cesarean section]] | ||
* [[Myometrium]] | * [[Myometrium]] | ||
* [[Endometrium]] | * [[Endometrium]] | ||
* [[Infertility]] | * [[Infertility]] | ||
[[Category:Gynecology]] | [[Category:Gynecology]] | ||
Latest revision as of 19:34, 8 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Uterine niche | |
|---|---|
| |
| Synonyms | Cesarean scar defect, isthmocele |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Abnormal uterine bleeding, pelvic pain, infertility |
| Complications | Infertility, ectopic pregnancy, uterine rupture |
| Onset | Post-cesarean section |
| Duration | Chronic |
| Types | N/A |
| Causes | Cesarean section |
| Risks | Multiple cesarean sections, surgical technique |
| Diagnosis | Ultrasound, Hysteroscopy, MRI |
| Differential diagnosis | Adenomyosis, Endometriosis, Uterine fibroids |
| Prevention | Optimal surgical technique during cesarean section |
| Treatment | Hysteroscopic surgery, Laparoscopic surgery |
| Medication | Hormonal therapy |
| Prognosis | N/A |
| Frequency | Common in women with previous cesarean sections |
| Deaths | N/A |
A uterine niche is a defect in the myometrium at the site of a previous cesarean section scar. It is also known as a cesarean scar defect or isthmocele. This condition can lead to various gynecological symptoms and complications, including abnormal uterine bleeding, pelvic pain, and secondary infertility.
Anatomy and Pathophysiology[edit]
The uterine niche is typically located at the lower segment of the uterus, where the cesarean section incision was made. The defect occurs when the myometrial tissue does not heal properly, resulting in a pouch or indentation. This can cause the endometrial lining to become trapped, leading to the accumulation of menstrual blood and other symptoms.
Clinical Presentation[edit]
Patients with a uterine niche may present with:
- Abnormal uterine bleeding, particularly postmenstrual spotting
- Pelvic pain
- Dysmenorrhea
- Dyspareunia
- Secondary infertility
Diagnosis[edit]
The diagnosis of a uterine niche is typically made using imaging techniques such as:
These imaging modalities can help visualize the defect and assess its size and depth.
Treatment[edit]
Treatment options for a uterine niche depend on the severity of symptoms and the patient's reproductive plans. They may include:
- Hysteroscopic surgery to resect the niche
- Laparoscopic surgery for more extensive repair
- Hormonal therapy to manage symptoms
Prognosis[edit]
The prognosis for patients with a uterine niche varies. Surgical repair can alleviate symptoms and improve fertility outcomes, but the success rate depends on the size and location of the niche.
