An Optimal Uterine Closure Technique for Better Scar Healing and Avoiding Isthmocele in Cesarean Section: A Randomized Controlled Study
Objective: The aim of this study is to compare the effects of two different uterine closure techniques, used during cesarean section (CS) operations on isthmocele formation. Material and Methods: This prospective, randomized, controlled study was performed on 138 patients in a university hospital be...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-02-01
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| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08941939.2019.1610530 |
| _version_ | 1797684689937367040 |
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| author | Ziya Kalem Aski Ellibes Kaya Batuhan Bakırarar Alper Basbug Müberra Namlı Kalem |
| author_facet | Ziya Kalem Aski Ellibes Kaya Batuhan Bakırarar Alper Basbug Müberra Namlı Kalem |
| author_sort | Ziya Kalem |
| collection | DOAJ |
| description | Objective: The aim of this study is to compare the effects of two different uterine closure techniques, used during cesarean section (CS) operations on isthmocele formation. Material and Methods: This prospective, randomized, controlled study was performed on 138 patients in a university hospital between the dates December 2016 and August 2017. Uterine closures were performed using the double-layer, far-far-near-near (FFNN) unlocked technique, in the study group (n = 70) and using a single-layer continuous locked (SLL) technique in the control group (n = 68). The presence of isthmocele, residual myometrial thickness (RMT), postmenstrual spotting, dysmenorrhea, chronic pelvic pain and uterus position were evaluated in postoperative sixth month. Results: Isthmocele formation was less frequent and RMT was greater in the study group when compared to the control group (p < 0.001 and p < 0.001, respectively). Duration of operation, amount of blood loss and additional hemostatic suture requirement were not significantly different between the two groups (p = 0.221, p = 0.520 and p = 0.930, respectively). Postmenstrual spotting was less common in FFNN group, while the rates of chronic pelvic pain and dysmenorrhea were not significantly different between the groups (p = 0.002, p = 0.205 and p = 0.490, respectively). Conclusion: The findings of the present study demonstrate that uterine closure using the FFNN technique is beneficial in terms of providing protection from isthmocele formation and ensuring sufficient RMT. This method has the potential to become the optimal uterine closure technique, but the findings of the present study should be supported by large-scale studies in the future. |
| first_indexed | 2024-03-12T00:33:21Z |
| format | Article |
| id | doaj.art-a96824654e1e47eab8f36255af0b0eca |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:33:21Z |
| publishDate | 2021-02-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-a96824654e1e47eab8f36255af0b0eca2023-09-15T10:07:30ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532021-02-0134214815610.1080/08941939.2019.16105301610530An Optimal Uterine Closure Technique for Better Scar Healing and Avoiding Isthmocele in Cesarean Section: A Randomized Controlled StudyZiya Kalem0Aski Ellibes Kaya1Batuhan Bakırarar2Alper Basbug3Müberra Namlı Kalem4Gurgan Clinic IVF and Women Health CenterDuzce UniversityAnkara UniversityDuzce UniversityLiv Hospital AnkaraObjective: The aim of this study is to compare the effects of two different uterine closure techniques, used during cesarean section (CS) operations on isthmocele formation. Material and Methods: This prospective, randomized, controlled study was performed on 138 patients in a university hospital between the dates December 2016 and August 2017. Uterine closures were performed using the double-layer, far-far-near-near (FFNN) unlocked technique, in the study group (n = 70) and using a single-layer continuous locked (SLL) technique in the control group (n = 68). The presence of isthmocele, residual myometrial thickness (RMT), postmenstrual spotting, dysmenorrhea, chronic pelvic pain and uterus position were evaluated in postoperative sixth month. Results: Isthmocele formation was less frequent and RMT was greater in the study group when compared to the control group (p < 0.001 and p < 0.001, respectively). Duration of operation, amount of blood loss and additional hemostatic suture requirement were not significantly different between the two groups (p = 0.221, p = 0.520 and p = 0.930, respectively). Postmenstrual spotting was less common in FFNN group, while the rates of chronic pelvic pain and dysmenorrhea were not significantly different between the groups (p = 0.002, p = 0.205 and p = 0.490, respectively). Conclusion: The findings of the present study demonstrate that uterine closure using the FFNN technique is beneficial in terms of providing protection from isthmocele formation and ensuring sufficient RMT. This method has the potential to become the optimal uterine closure technique, but the findings of the present study should be supported by large-scale studies in the future.http://dx.doi.org/10.1080/08941939.2019.1610530cesareanisthmocelesuturing techniqueresidual myometrial thicknessscar healingdouble-layer suturing |
| spellingShingle | Ziya Kalem Aski Ellibes Kaya Batuhan Bakırarar Alper Basbug Müberra Namlı Kalem An Optimal Uterine Closure Technique for Better Scar Healing and Avoiding Isthmocele in Cesarean Section: A Randomized Controlled Study Journal of Investigative Surgery cesarean isthmocele suturing technique residual myometrial thickness scar healing double-layer suturing |
| title | An Optimal Uterine Closure Technique for Better Scar Healing and Avoiding Isthmocele in Cesarean Section: A Randomized Controlled Study |
| title_full | An Optimal Uterine Closure Technique for Better Scar Healing and Avoiding Isthmocele in Cesarean Section: A Randomized Controlled Study |
| title_fullStr | An Optimal Uterine Closure Technique for Better Scar Healing and Avoiding Isthmocele in Cesarean Section: A Randomized Controlled Study |
| title_full_unstemmed | An Optimal Uterine Closure Technique for Better Scar Healing and Avoiding Isthmocele in Cesarean Section: A Randomized Controlled Study |
| title_short | An Optimal Uterine Closure Technique for Better Scar Healing and Avoiding Isthmocele in Cesarean Section: A Randomized Controlled Study |
| title_sort | optimal uterine closure technique for better scar healing and avoiding isthmocele in cesarean section a randomized controlled study |
| topic | cesarean isthmocele suturing technique residual myometrial thickness scar healing double-layer suturing |
| url | http://dx.doi.org/10.1080/08941939.2019.1610530 |
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