The Analysis of Hysteroscopy and Laparoscopy in Diagnosis and Treatment of Previous Cesarean Scar Defect in 21 Cases

［Abstract］Objective　To investigate the effect of hysteroscopy and laparoscopy in the diagnosis and treatment of previous cesarean scar defect．Methods　We retrospectively analyzed the data of 21 patients of previous cesarean scar defect from January 2010 to October 2014，in the Second people's Hospital of Yunnan Province. All patients were examined by hysteroscopy. 12 cases of patients with no fertility requirements were treated by electric cutting and plastic surgery with hysteroscopy. 9 cases of patients with fertility requirements were treated by hysteroscopy combined laparoscopic repair operation. Results The 21 patients were diagnosed by hysteroscopy. Among them，12 patients were treated with electric cutting by hysteroscopy ,the operation time was 25~45min.The average of the operation time was 35±10 min，.The blood loss was 2~10 ml. The average of the blood loss was6±4 ml. Among them，9 patients were treated with hysteroscopy combined laparoscopic，the operation time was 90~165min.The average of the operation time was 127.5±37.5 min.The blood loss was 30～80 mL.The average of the blood loss was 55±25 mL. With postoperative follow-up office visit of 6 months，the postoperative 1 menstrual period of 21 patients recovered back to normal，and all were in the normal range in a half years. After 6 months，recurrence were found in 3 cases with simple hysteroscopic treatment，and no recurrence in the patients treated with hysteroscopycombined laparoscopic treatment. Conclusions Hysteroscopy examination is expected to become the gold standard of examination of the previous cesarean scar defect. Two kinds of operation can effectively relieve symptoms in the short term，and each has advantages. Electrotomy with hysteroscope is convenient in operation，short operation time and less intraoperative bleeding. Repair surgery with hysteroscopy combined laparoscopy has obvious curative effect and low rate of recurrence. The two methods are worthy to be popularized in clinic. But the long-term effect needs to be further observed.