Uterine isthmocele

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Uterine isthmocele, also cesarean scar pouch, niche, cesarean scar defect, is a pseudocyst that arises from cesarean section at uterine incision site.


  • Clinical diagnosis.
  • Common (minor) complication of cesarean section; possibly, may be reduced by surgical technique.[1]
  • High prevalence - one estimate is 63% cesarean section patients have an isthmocele.[2]
  • It may be associated with secondary infertility;[3] thus, it may be surgically removed.



  • Smooth muscle with fibrosis/scar.
  • +/-Chronic inflammation.


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Submitted as "Isthmocele", Excision:
     - Benign smooth (uterine) muscle with scant endometrial tissue 
       and scar, compatible with isthmocele/cesarean scar.

See also


  1. Yazicioglu, F.; Gökdogan, A.; Kelekci, S.; Aygün, M.; Savan, K. (Jan 2006). "Incomplete healing of the uterine incision after caesarean section: Is it preventable?". Eur J Obstet Gynecol Reprod Biol 124 (1): 32-6. doi:10.1016/j.ejogrb.2005.03.023. PMID 16023780.
  2. Melo-Cerda, I. (Aug 2014). "[Cesarean scar defect].". Ginecol Obstet Mex 82 (8): 530-4. PMID 25282945.
  3. Florio, P.; Filippeschi, M.; Moncini, I.; Marra, E.; Franchini, M.; Gubbini, G. (Jun 2012). "Hysteroscopic treatment of the cesarean-induced isthmocele in restoring infertility.". Curr Opin Obstet Gynecol 24 (3): 180-6. doi:10.1097/GCO.0b013e3283521202. PMID 22395067.