The information provided below about medical diseases is not for advertising purposes. These are articles intended to inform and promote patients. If you think you have one of the diseases listed below, we recommend that you be examined by healthcare professionals who specialize in this field for medical advice and treatment.
Although giving birth is a miraculous experience for every woman, sometimes undesirable situations may occur depending on the type of birth. Uterine rupture, perforation, etc. during normal birth. While there are risks such as, in cesarean birth, the incision area does not heal, infection or isthmocele, that is, cesarean scar disease, can often be observed. Many of these complications can affect pregnancy in the future, as well as cause abnormal bleeding and frequent infections. Isthmocele, or cesarean scar disease, which we frequently encounter after cesarean delivery, can prevent pregnancy, as well as cause miscarriages, abnormal placentation, placenta accreta, placenta previa, scar dehiscence, or cesarean scar pregnancy.
I see my patients in my clinic in Ankara as my main center. However, on some days of the month, I see patients who need isthmocele treatment in Istanbul and who live in Istanbul and do not have the opportunity to come to Ankara. For detailed information and an appointment in Ankara or Istanbul, you can contact us via the phone number in the contact section.You can contact us via WhatsApp by clicking here to make your appointment.
What is Isthmocele (Caesarean Section Scar Disease)?
The tunneling that occurs in the anterior muscle tissue of the uterus due to the incomplete healing of the cesarean incision site is called isthmocele. This condition may occur shortly after birth or after a long time. Over time, menstrual blood accumulates in this tunneled area and causes many complaints in women. Isthmocele, which can cause brown, mud-like vaginal discharge and bleeding, especially post-menstrual spotting, can also cause vaginal infections, infertility and pain during sexual intercourse. The blood accumulating in the isthmocele pocket also disrupts the movements of the sperm and may prevent the embryo from settling into the uterus. So, it can also cause infertility. In addition, some pregnancies adhere to this isthmocele area and may lead to situations that threaten the life of the mother. In medical terms, these pregnancies are called cesarean scar pregnancies and must be treated in the early weeks of pregnancy. Because these types of pregnancies can cause bleeding and threaten the life of the mother.
How to Diagnose Isthmocele?
Isthmocele is diagnosed in people who have had a cesarean section even once before. Since there is no incision in people who give birth normally, there will naturally be no isthmocele disease.
How to suspect isthmocele?
If a woman who has given birth by cesarean section at least once before has the following complaints, isthmocele is suspected.
- Presence of brown mud-like discharge that continues for a while after menstruation ends
- Presence of foul-smelling or dark discharge
- Groin pain
- It is suspected if pregnancy cannot be achieved despite not using contraception after cesarean section.
Isthmocele is suspected after the patient’s complaints, and usually only ultrasonography is sufficient for diagnosis. However, in some cases, more detailed examinations can be performed. These;
- Sonohysterography
- Hysterosalpingography (HSG)
- Hysteroscopy
- MRI
How is isthmocele treated?
Isthmocele treatment;
1- Vaginal approach (rarely).
2- Hysteroscopically (Without any incision, an instrument containing an optic is inserted through the vagina and the inside of the uterus is visualized. The isthmocele sac is corrected with the help of this instrument. The duration of the surgery is maximum 20-30 minutes. After the surgery, the patient can go home on the same day)
3- By laparoscopy (An incision of approximately 1 cm is made from the navel, the inside of the abdomen is observed with a laparoscope, that is, a tool containing a camera, then surgical instruments are inserted through 2 additional incisions with a diameter of approximately half a centimeter, and the isthmocele sac is completely removed, and then the healthy tissues are stitched together. The duration of the surgery is approximately 30 minutes. -40 minutes. The patient can go home the same day after the surgery.)
4- By laparotomy (rarely). Nowadays, isthmocele treatment is rarely performed with open surgery.
However, the two most commonly used methods are hysteroscopy and laparoscopy. In both methods, the patient can be discharged and go home on the same day.
Factors affecting which technique will be used;
- Size of the isthmocele defect
- The patient’s main complaint is whether she wants to become pregnant
- It is the thickness of the intact uterine muscle layer seen after the isthmocele defect.
The physician who will perform the surgery must evaluate these factors and choose the surgical technique that will be best for the patient.
However, it should not be forgotten that some cases of untreated isthmocele may threaten women’s lives when pregnancy occurs in the isthmocele area (cesarean scar pregnancy). As seen in a case in which I performed laparoscopic (closed surgery method) surgery in 2017, the link of which I share below, the pregnancy was located on the isthmocele defect and was treated without causing uterine rupture (fragmentation) in the patient and before it reached a level that threatened the patient’s life. In cases without treatment, undesirable consequences such as uterine rupture and bleeding may occur as pregnancy progresses.Stay healthy..
Prof. Dr. H. Onur Topçu
Gynecology & Birth-In Vitro Fertilization and Advanced Gynecological Endoscopy Specialist
Aşağıda paylaştığım bağlantılar ile Instagram üzerinden ilgili paylaşımlara ulaşabilirsiniz.
Prof. Dr. H. Onur Topçu
Gynecology & Obstetrics-In Vitro Fertilization and Advanced Gynecological Endoscopy Specialist
PATIENT COMMENTS
Hello. My discomfort, which started 3 months after my birth, with persistent pain, nausea and bad menstrual periods, lasted for about 5 years. Even though many different doctors I went to told me there was nothing wrong, my discomfort continued to get worse. As a result of my research and with the recommendation of another doctor, I made an appointment with Mr. Onur. First of all, he welcomed us as his guests rather than patients. And the fact that he answered each of our questions one by one, listened to us patiently, and gave me courage that I could recover, all of these were very important. I had my surgery and we are still in contact with him. I am grateful to him and thank you very much again and again, teacher.
Zey*** G***
Onur teacher was very supportive and encouraging at every stage of the process, from the very beginning to after the surgery. He informed us in the best and most accurate way by explaining all the details of the process completely and clearly. I would like to thank my teacher Onur very much and definitely recommend him to those who are looking for a doctor in this field.
Arz*** A***
Onur teacher was very supportive and encouraging at every stage of the process, from the very beginning to after the surgery. He informed us in the best and most accurate way by explaining all the details of the process completely and clearly. I would like to thank my teacher Onur very much and definitely recommend him to those who are looking for a doctor in this field.
Zel*** Ç***
I discovered Dr. Onur Bey by “searching for isthmocele on Google”. Thanks to patient comments, I contacted him without any doubt. Even though it was the weekend, they immediately made a plan and got back to me. We came to Ankara from Denizli. I had been suffering from bleeding due to isthmocele for 10 years, and I thought there was no solution and accepted this situation. Dr. When I saw Mr. Onur’s work, I wanted to have surgery without any doubt. After the examination, the doctor decided to perform hysteroscopy. He asked us to ask all the questions we had in our minds. I trusted him so much that I didn’t even want to ask anything. We felt very special during the hospitalization process, we were as comfortable as at home. I recovered very quickly after the operation, the whole process was incredibly comfortable. I was discharged on the evening of the same day. I walked out very easily. Assoc. Dr. I am grateful to Hasan Onur Topçu and his entire team. Thank you very much for everything. Doctor’s approach was very sincere and sincere. Those who suffer from isthmocele should come and get examined without any doubt. I feel incredibly lucky that our paths crossed.
Isthmocele!! Caesarean section defect, the name of which I heard for the first time and what it is? After the last cesarean section, I went to four different doctors, maybe 15 times, some said menopause, some gave me menstrual pills, some said hormone pills, and when I said enough was enough, God showed me my teacher Onur. He told me immediately at the first ultrasound that the problem was from the cesarean site, performed surgery the next day, repaired the isthmocele and cleared the fibroids that formed. I don’t have any problems right now. My teacher Onur is unique. He is an excellent doctor who answers me immediately every time I call, and when he cannot answer, he calls me back two minutes later, answers every message I receive, and sends me off to the door at his clinic.
min.. k..
First of all, I would like to express my endless gratitude to my teacher Onur. After my caesarean section surgery 4 years ago, I did not go to the doctor because of heavy menstrual bleeding and endless brown mud-like spotting. There was no treatment left that had not been tried. Some said we should try it with hormone medication, some said menopause, and finally they said my uterus would be removed. While I was looking for a new doctor, God Onur. He showed me my doctor and told me with a simple ultrasound that my problem was due to the defect in the cesarean section I had undergone. I had surgery immediately the next day and the defect in the cesarean section was corrected, millions were cleaned, I returned home three hours later as if nothing had happened. It’s been three weeks and thankfully no problems were found in my check-ups. My endless thanks to my teacher Onur. I am forwarding it to you and I insistently recommend it to my relatives who I hear complain about gynecological diseases.
min.. k..
I learned that my teacher Onur is very good at isthmocele surgery, as he is in many areas. There were a lot of positive opinions about him. Moreover, I witnessed him performing this surgery many times on his social media account. For this reason, I made an appointment without hesitation. I had examination, surgery and discharge on the same day. My doctor gave me confidence both for the surgery and the subsequent follow-up of the disease. That’s what I needed most. I would like to thank my doctor and his beautiful team for everything. I’m glad to have you.
şra..mirkirişci
5 yıl önce;sezaryanla doğum yaptım!Sonrasında hiç bitmeyen şikayetlerim oldu!Bulunduğum ilçede,İzmirde vede İstanbulda Sayısızz doktora gittim sonuca ulaşamadım!En son izmirde gittiğim DR.BARIŞ BÜKE’nın tavsiyesi vede yönlendirmesi ile Ankaraya;Doç.dr.Hasan Onur Topçu’ya gittim vede laparoskopi ile ameliyat oldum!Henüz 9 gün olmasına rağmen şikayetlerim bitti!Her iki doktorumdan da Allah razi olsun!
e..demir
After giving birth via cesarean section, my menstrual periods continued to be sporadic and intense over time. These bleedings got longer over time. My periods, which were 4 days long, continued as intermittent bleeding until the 15th day. It affected my quality of life and my health in terms of infection. During this process, I went to many doctors, but they did not recommend any treatment yet. Then, when I changed doctors, they told me that the name of my complaint was ismocele. They said that it would be corrected with surgery and that I should have open surgery again. Frankly, I researched this issue because I was afraid of open surgery. There was a doctor in Elazığ who performed ismocele surgery, but I was going to have open surgery. At the end of my research, I found my teacher Onur Topçu on the internet, I contacted him and explained my complaints to him. He listened to me very attentively and told me that the ismocele could be corrected with hysteroscopy without the need for open surgery and that I could be discharged on the same day. So, without wasting any time, I went to Ankara for the examination of my doctor Onur to have my surgery. After my examination in a very attentive manner, we went to the hospital. Thanks to his smiling face, understanding, interest and care, I overcame my excitement and a perfect surgery was performed. I was discharged on the same day. I returned home. After the surgery, my complaints continued to decrease. During this process, when we met with my teacher Onur, he said that my complaints would completely disappear at the end of the 2.3rd month. It has been 3 months since the operation and today I had a check-up. I couldn’t go to Ankara, but I had my examination in Elazığ. After my examination, my teacher Onur talked to the doctor I was examined with on the phone, listened to my situation, talked to my doctor about everything as if he were examining me himself, I can’t tell you how happy I was when I learned that my ismocele was gone and I was not able to go to him, but he was interested even though I had my examination in a different city. Thank you very much to my teacher Onur. Greetings from Elazığ, stay healthy.
ta…tin
When I learned that I had isthmusemia after 2 unsuccessful in vitro fertilization attempts, I crossed paths with Onur Hodja. Onur Hodja repaired my isthmocele hysteroscopically. I got pregnant spontaneously 3 months after the operation. I still can’t believe I’m pregnant. Onur Hodja is number one for isthmocele surgery. He is currently monitoring my pregnancy.
Çi….em Ka…..öz
Previously, a pregnancy occurred at my cesarean incision site and I had a miscarriage due to this. As soon as I learned that Onur Hodja was number one in cesarean section diseases, I made an appointment with Onur Hodja. He performed my surgery just two days later. I got pregnant spontaneously, without treatment, 3 months after the surgery. I recommend Onur to everyone, he is a very knowledgeable and thoughtful doctor.
Ku…ru Se..inç
After my period ended, I had spotting that lasted 10-15 days. When I researched on the internet, I learned that this could be due to a cesarean section and I made an appointment with Onur Hodja, the best doctor in this regard. As soon as he did an ultrasound, he showed me that I had an isthmocele, and he showed me and explained everything during the ultrasound, even though I had been to so many doctors before, none of them had said that I had an isthmocele. After a very successful surgery, all my complaints disappeared within 2 months and I no longer have any spotting. Teacher Onur, I think this is a chance for the country.
Em….e Ün…ü
There was no medicine left that I did not take for four years. They always told me that it was the beginning of menopause. They recommended Onur Hodja. When I called the doctor, I told him my complaints and he came to me. Dirk, I will perform surgery on you. Thank God, I went and did not keep me waiting and I had the surgery. The result was that I took hormone drugs for four years in vain. Now I am grateful to Onur Hodja. He is an excellent person and doctor. May God bless you a thousand times and the very caring doctor answered every time I called.
İz. ..adeniz
Only Dr. from Izmir to Ankara. I came for Mr. Onur. He found the “isthmocele”, which was the cause of my complaints for 7 years, and operated on it. During this 7-year period, I met many doctors and looked for solutions, but they all resulted in wrong treatments. Mr. Onur immediately understood me with his calmness and knowledge. My surgery went wonderfully. I regained my health, may God bless him. His team, his examination, everything was very good. I received treatment without any problems during this pandemic period. I’m glad to have you, Dr. Onur Topçu, thank you very much for everything.
Ec. ..eren
When I was diagnosed with isthmocele, I had the opportunity to meet my teacher Onur. As a result of my intensive research, I learned that he is one of the most experienced physicians in Turkey regarding isthmocele. He performed my surgery hysteroscopically. I was able to return to Afyon the same day. It has been 3 months since the surgery and I no longer have those bleedings that used to make my life a nightmare. I cannot thank Mr. Onur enough.
N.U.
When I first heard the diagnosis of isthmocele, I couldn’t even pronounce it. As a result of my research, I learned that Onur Hodja is very experienced in isthmocele. My God, he didn’t embarrass me. Thanks to Onur teacher, I was able to return home to my children the same day after the surgery. My spotting, which was now a nightmare, is completely gone. I can’t thank you enough.
B.Y.
I met Mr. Hasan Onur as a result of my research due to my isthmocele condition. From the first moment I met him, he gave me incredible confidence with his approach, understanding and knowledge. I got pregnant before the surgery and now he is monitoring my pregnancy. He is one of our biggest supporters during the pregnancy process. He gracefully answers every possible question before you ask and inspires incredible confidence with his attitude. He answers all my questions with great patience. It facilitates the physically and spiritually difficult pregnancy process. I feel lucky that we had the chance to meet him. I thank you for your interest and support.
lan..NTÜRK
