Effectiveness of vaginal metroplasty for treating cesarean scar defect: a comparative analysis of techniques
12.01.2026
14:52
Russian researchers conducted a study aimed to evaluate the effectiveness of metroplasty via vaginal access in patients with uterine scar after cesarean section (CS).
This comparative prospective study included 100 patients with a confirmed diagnosis of cesarean scar defect who were planning to become pregnant. The first group of patients (n=50) underwent metroplasty using vaginal access, 10 patients underwent laparotomy (group 2), and the third group (n=40) underwent metroplasty using traditional laparoscopic access. A comparative analysis of the results of the three surgical treatment methods was conducted.
The analysis indicates that vaginal access for cesarean scar defect metroplasty is an effective and minimally invasive alternative to laparoscopic surgery. Compared with other surgical correction methods, it shows superior results in several key criteria: reduced operation duration, minimal blood loss, and low severity of postoperative pain. The effectiveness of the correction was validated by a significant increase in the thickness of the residual myometrium, alongside the elimination or considerable reduction in the severity of the niche.
In contrast to laparoscopy, vaginal access does not necessitate expensive equipment or complex endoscopic procedures, does not require general anesthesia, and avoids trauma to the abdominal cavity, making it a safe and accessible option even for patients with concurrent somatic diseases.
Therefore, vaginal metroplasty can be regarded as the method of choice for patients with clinically significant cesarean scar defects, especially in contexts where minimizing invasiveness, reducing hospitalization duration, and decreasing the resource intensity of surgical treatment are priorities. The data collected support the recommendation for broader implementation of this approach in clinical practice, given that the patient selection criteria and appropriate surgeon training are adhered to.
