Isthmocele Treatment in India

In most cases, a c-section is the primary cause of isthomocele but there are some other factors that can also impact the healing of the scar. 

Previous Cesarean Section (C-Section)

The most frequent cause of a uterine isthmocele is a caesarean delivery. In caesarean delivery, there is an incision made in the lower part of the uterus for the baby’s delivery. While this incision normally heals without complications, there may be times when the scar from this incision will not heal properly, thus leading to a defect in the wall of the uterus. The possibility of developing this condition increases for women with multiple C-sections, however, it can also occur after one C-section.

Surgical Healing Factors

A number of factors related to surgery and healing may lead to the formation of an isthmocele. These include:

• The position of the uterine incision during the C-section
• The technique used to close the uterine incision
• Infection after surgery
• Delayed or impaired wound healing
• Poor blood supply to the healing tissue
• Formation of excessive scar tissue

These factors can affect how well the uterine muscle heals, resulting in a small defect within the scar.

Risk Factors for Developing Isthmocele

Isthmocele does not develop in every C-section case. However, certain factors may increase the risk, including:

• One or more previous caesarean deliveries
• Closely spaced pregnancies after a C-section
• Retroverted (tilted backwards) uterus
• Labour before the caesarean section
• Thin lower uterine segment during surgery
• Obesity, which may affect wound healing
• Postoperative infection or inflammation
• Conditions that impair tissue healing, such as diabetes or smoking

The best isthmocele treatment depends on several factors, including the size and depth of the scar defect, symptoms, thickness of the remaining uterine muscle, and whether you wish to become pregnant in the future.

Hysteroscopic Isthmocele Repair

Hysteroscopic surgery is a less invasive surgery, which is usually suggested for small isthmoceles and also when there is enough thickness of the uterine muscle. In this case, a thin telescope is inserted through the cervix into the uterus where the scar defect is reshaped to help better flow of menstrual blood and prevent fluid retention. No external incisions are made and recovery is also faster with a shorter hospital stay. 

Laparoscopic Isthmocele Repair

Laparoscopic surgery is mostly advised in cases of big-sized isthmoceles or in cases where the walls of the uterus are very thin and women want to have another baby. The surgery involves small abdominal incisions to remove the scar defect and restore the uterine wall, helping restore its strength while relieving symptoms and improving reproductive outcomes.

Combined Surgical Approaches

In some selected cases, the hysteroscopy and laparoscopy can be combined for more accurate treatment. This is because the surgeon will be able to examine both the internal and external uterine cavities, which makes it particularly effective for complicated defects or patients with infertility issues. The procedure used depends on the patient’s specific clinical indications and fertility goals. 

It is important to select the right clinic or hospital for isthmocele treatment, particularly if you plan to conceive again or face any problems related to fertility. At Birla Fertility & IVF, our team includes expert gynaecologists and fertility doctors with experience in treating uterine scar defects, who offer advanced diagnostics, minimally invasive procedures and fertility management under one roof.

Here is why patients trust us: 

• Experienced gynaecologists and fertility specialists with experience in uterine scar defects management
• Advanced imaging methods for precise diagnosis
• Minimally invasive hysteroscopic and laparoscopic surgeries
• Personalised treatment according to symptoms, fertility concerns and reproductive health
• Multidisciplinary approach, including experts from fertility, laparoscopy, embryology, and counselling whenever required
• State-of-the-art OT facility and infrastructure for advanced surgeries
• Professional support through the entire treatment process
• Fertility planning and pregnancy guidance post-isthmocele treatment