{
    "abstract": "To evaluate the changes in (1) residual myometrial thickness (RMT), (2) cesarean scar defect (CSD) size, and (3) clinical symptoms, before and after channel-like (360\u00b0) hysteroscopic resection for the treatment of CSD.\nA single-center, observational, prospective, cohort study was carried out enrolling all symptomatic patients of childbearing age, diagnosed with CSD and routinely scheduled for channel-like (360\u00b0) hysteroscopic resection from July 2020 to July 2021 at the Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Univeristaria di Bologna. University of Bologna, Italy. The primary outcome was the difference in mean RMT before and after the procedure. Secondary outcomes were the differences before and 4\u00a0months after the surgery in: (1) CSD size measured by transvaginal ultrasound, (2) visual analog scale (VAS) scores for the symptoms, and (3) abnormal uterine bleeding (AUB) rate. Lastly, patients' satisfaction was assessed by the global impression of improvement (PGI-I) score.\nWe found a significant difference before and after the procedure in: (1) mean RMT (+2.0\u2009mm; P\u00a0<\u20090.001); mean size of the CSD (base: +1.6\u2009mm; height: -2.5\u2009mm; transverse diameter: -3.2\u2009mm; volume: -263.7\u2009mm\nChannel-like (360\u00b0) hysteroscopic resection for the treatment of patients with symptomatic CSD may lead to an increase in RMT, decrease in CSD, and improvement of symptoms after the procedure, with high patient satisfaction.",
    "authors": [
        {
            "affiliation": "Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.",
            "firstname": "Paolo",
            "initials": "P",
            "lastname": "Casadio"
        },
        {
            "affiliation": "Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.\nDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.",
            "firstname": "Antonio",
            "initials": "A",
            "lastname": "Raffone"
        },
        {
            "affiliation": "Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.\nDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.",
            "firstname": "Andrea",
            "initials": "A",
            "lastname": "Alletto"
        },
        {
            "affiliation": "Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.\nDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.",
            "firstname": "Francesco",
            "initials": "F",
            "lastname": "Filipponi"
        },
        {
            "affiliation": "Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.",
            "firstname": "Diego",
            "initials": "D",
            "lastname": "Raimondo"
        },
        {
            "affiliation": "Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.\nDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.",
            "firstname": "Alessandro",
            "initials": "A",
            "lastname": "Arena"
        },
        {
            "affiliation": "Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.\nDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.",
            "firstname": "Mariangela",
            "initials": "M",
            "lastname": "La Rosa"
        },
        {
            "affiliation": "Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.\nDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.",
            "firstname": "Agnese",
            "initials": "A",
            "lastname": "Virgilio"
        },
        {
            "affiliation": "Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.\nDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.",
            "firstname": "Camilla",
            "initials": "C",
            "lastname": "Franceschini"
        },
        {
            "affiliation": "Department of Gynecology, Madre Fortunata Toniolo Clinic, Bologna, Italy.",
            "firstname": "Giampietro",
            "initials": "G",
            "lastname": "Gubbini"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Tuscany Health Agency, Florence, Italy.",
            "firstname": "Mario",
            "initials": "M",
            "lastname": "Franchini"
        },
        {
            "affiliation": "Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.",
            "firstname": "Roberto",
            "initials": "R",
            "lastname": "Paradisi"
        },
        {
            "affiliation": "Section of Hygiene, Public Health and Medical Statistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy.",
            "firstname": "Jacopo",
            "initials": "J",
            "lastname": "Lenzi"
        },
        {
            "affiliation": "Anatomic Pathology Unit, Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Naples, Italy.",
            "firstname": "Antonio",
            "initials": "A",
            "lastname": "Travaglino"
        },
        {
            "affiliation": "Gynecology and Obstetrics Unit, Department of Medicine, Surgery and Dentistry \"Schola Medica Salernitana\", University of Salerno, Baronissi, Italy.",
            "firstname": "Antonio",
            "initials": "A",
            "lastname": "Mollo"
        },
        {
            "affiliation": "Obstetrics, Gynecology and Reproductive Science Department, University of Miami, Miller School of Medicine, Miami, Florida, USA.",
            "firstname": "Jos\u00e8",
            "initials": "J",
            "lastname": "Carugno"
        },
        {
            "affiliation": "Division of Gynaecology and Human Reproduction Physiopathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.\nDepartment of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.",
            "firstname": "Renato",
            "initials": "R",
            "lastname": "Seracchioli"
        }
    ],
    "conclusions": "Channel-like (360\u00b0) hysteroscopic resection for the treatment of patients with symptomatic CSD may lead to an increase in RMT, decrease in CSD, and improvement of symptoms after the procedure, with high patient satisfaction.",
    "copyrights": "\u00a9 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.",
    "doi": "10.1002/ijgo.14387\n10.1007/s00404-016-4245-0\n10.1016/j.jmig.2018.06.012\n10.1016/j.jmig.2012.12.006\n10.1016/j.jmig.2016.03.012\n10.1080/01443615.2021.2003310\n10.1016/j.jmig.2014.09.011\n10.1016/j.jmig.2004.12.023\n10.1016/j.jmig.2012.03.010\n10.1016/j.ijgo.2010.05.013\n10.1016/j.jmig.2013.11.004\n10.1111/jog.12738\n10.1111/1471-0528.14733\n10.1016/j.ijgo.2016.04.011\n10.1016/j.ejogrb.2010.10.016",
    "journal": "International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics",
    "keywords": [
        "bleeding",
        "cesarean section",
        "cesarean section scar",
        "defect",
        "hysteroscopy",
        "isthmocele",
        "metroplasty",
        "niche",
        "pain",
        "treatment",
        "uterus"
    ],
    "methods": null,
    "publication_date": "2022-08-06",
    "pubmed_id": "35929843\n27393285\n18312986\n7883420\n19565535\n32856326\n32228874\n24373597\n30646424\n20034000\n22399223\n31992102\n30837118\n31059782\n32512208\n17938396\n22395067\n28892298\n27342045\n34384777\n27885429\n29944931\n23357466\n27006058\n35014923\n25285773\n15904593\n22621994\n20624621\n24280360\n26111547\n28504857\n27473332\n24458087\n21074310\n9952074\n19318145\n24310769\n29680233\n21315334\n31077871",
    "results": "We found a significant difference before and after the procedure in: (1) mean RMT (+2.0\u2009mm; P\u00a0<\u20090.001); mean size of the CSD (base: +1.6\u2009mm; height: -2.5\u2009mm; transverse diameter: -3.2\u2009mm; volume: -263.7\u2009mm",
    "title": "Postoperative morphologic changes of the isthmocele and clinical impact in patients treated by channel-like (360\u00b0) hysteroscopic technique.",
    "xml": "<Element 'PubmedArticle' at 0x788504bcac50>"
}