Transvaginal 3D Ultrasound Evaluation of Post-Cesarean Section Uterine Diverticulum

Objectives: This study focused on evaluating the value of transvaginal 3Dultrasound for the diagnosis and prognostic assessment of post-cesarean sectionuterine diverticulum. Materials and Methods: We retrospectively analyzed the datafrom 32 patients with post-cesarean section uterine diverticulum over three recentyears. In all patients, transvaginal 3D ultrasound was used to measure the sizeof the uterine diverticulum and the thickness of the lower uterine segment (LUS)and myometrium. Patients with a LUS with a myometrial thickness under 4 mm underwentresection and repair surgery; those with a LUS with a myometrial thickness over4 mm underwent hysteroscopic resection. The postoperative sonograms were comparedwith preoperative images to evaluate the efficacy of various treatments. Results:The mean length, width and depth of the uterine diverticula were 18.30 ± 2.80 mm,9.14 ± 3.20 mm and 11.49 ± 2.71 mm, respectively. The average LUS myometrial thicknesswas 3.40 ± 0.80 mm (with a range of 1.6 mm - 6.3 mm). After surgery, two patients’sonograms still showed diverticula at the post-cesarean section scar, measuring6 mm × 7 mm × 6 mm and 6 mm × 8 mm × 4 mm. There were significant differences inthe size of uterine diverticula between preoperative and postoperative sonograms(P u003c 0.05) and the effective rate of surgery was 93.75% (30/32). Conclusions:Transvaginal 3D ultrasound is an accurate method for detecting post-cesarean sectionuterine diverticulum and is helpful for assessing surgical options and prognosis.The LUS myometrial thickness, which is considered as an optional index of post-cesareansection uterine diverticulum, should be measured routinely.