💡 C-Section Niche (Isthmocele): A Hidden Cause of Post-Cesarean Symptoms

A C-section niche  also called an isthmocele  is a small pouch or defect that forms at the site of a previous cesarean-section scar within the uterine wall.

It occurs when the myometrial layer doesn’t heal completely, leaving a thin or recessed area along the scar.

🔬 Why It Happens

Incomplete healing of the uterine incision

Infection or inflammation during recovery

Multiple cesarean sections.

Closure technique or suturing method

A very thin lower uterine segment at the time of surgery.

⚠️ Possible Symptoms

-Spotting or brown discharge after menstruation.

-Pelvic pain or a feeling of heaviness

-Difficulty conceiving (secondary infertility)

-Rarely, scar pregnancy or abnormal implantation.

🩺 Diagnosis

Usually detected by:

-Transvaginal ultrasound (TVS)

-Saline infusion sonography (SIS) for better visualization

-Sometimes confirmed by hysteroscopy if intervention is planned.

💊 Management

Depends on the size and symptoms:

Observation if asymptomatic

Hormonal therapy to regulate bleeding

Hysteroscopic repair for small defects

Laparoscopic or combined repair for larger niches causing infertility.

✅ Key Message

C-section niche is not rare  it’s just under-diagnosed.

Every woman with unexplained spotting, pelvic pain, or infertility after cesarean delivery should be evaluated for this condition.

Early detection prevents chronic discomfort and improves reproductive outcomes.

#DrRababCares 

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#WomenHealth 

 #GynecologyAwareness 

#UterineHealth