Retrospective Study Of Two Surgical Methods For The Treatment Of Previous Cesarean Scar Diverticulum

Objective: To evaluate the advantages and disadvantages of the two surgical methods for the treatment of previous cesarean scar diverticulum(PCSD).And to compare the efficacy of the two surgical methods in improving clinical symptoms,quality of life and re-pregnancy requirements and so on.The purpose is to provide a valuable evidence for surgical selection of previous cesarean scar diverticulum.Then,to explore the best treatment for previous cesarean scar diverticulum.Methods: From January 2015 to January 2017,there were 44 women patients diagnosed with previous cesarean scar diverticulum who received surgical treatments in Jiangxi Province Maternity and Child Health Hospital.According to the surgical methods,the cases were divided into two groups.One group is named of hysteroscopy combined with laparoscopy operation,which contains 22 cases.The other group named transvaginal operation is made up of 22 cases.Results: There was no significant difference in age,pregnancy,give birth,menstrual period and menstrual extension among all included patients(P>0.05).There was no statistically significant difference in intraoperative blood loss,operation time,and hospital stay after operation between the two groups(P>0.05).The vaginal bleeding after operation of hysteroscopy combined with laparoscopy operation group was significantly better than in transvaginal operation group(P<0.05).The anal exsufflation for first time and hospitalization cost in transvaginal operation group were significantly better than in hysteroscopy combined with laparoscopy operation group(P<0.05).There were no significant differences in menstruation recovery effect and re-pregnancy rate between the two groups after the operation in 3 months,6 months,and 24 months(P>0.05).Conclusion: Both the two surgical methods can effectively improve menstrual symptoms,restore its anatomical structure in some extent and improve the rate of re-pregnancy.Although,the two groups of surgical methods have their own advantages and disadvantages.We should choose an effective,safe and economical individualized treatment plan,which was based on the patient's pregnancy requirements,the illness condition and the medical technology of the local hospital.