A new method using a Foley Catheter to locate the diverticulum in laparoscopic repair of uterine cesarean scar defects

Abstract

Objective(s): To introduce a new method using a Foley catheter to locate the diverticulum in laparoscopic repair of uterine cesarean scar defect (CSD), and to evaluate the gynecological outcomes and prognosis of this new procedure.

Study design: Twelve patients with abnormal uterine bleeding or future fertility requirements opted for the laparoscopic repair of CSD. Then we present a series of photographic images before and after placement of the Foley catheter, and their clinical data to evaluate this new surgical technique.

Results: All operations were completed successfully, and a CSD in the posterior lower uterine segment was first reported in our study. In each case, photographic images confirmed that the location, size and boundary of the CSD, and its relationship with the surrounding organs, were clearly marked after placement of the Foley catheter. Mean operation time was 88.2 min and mean blood loss was 25.4 ml; no complications were observed. Of the 12 patients, 8 cases experienced abnormal uterine bleeding. Following laparoscopic repair, 75% of our cases achieved complete remission while 25% showed significant improvement.

Conclusion: Laparoscopic repair represents an effective approach for symptomatic women with CSD. The additional use of a Foley catheter is strongly recommended for identifying and locating the diverticulum, and marking its boundary in the laparoscopic repair of uterine CSD.

Keywords: Cesarean scar defect; Foley catheter; Laparoscopy.