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- W2070514882 abstract "We thank Dr Yazicioǧlu for his comments and interest in our article on the correlation between Cesarean scar defects and clinical symptoms1. Dr Yazicioǧlu proposed in his study that the suturing technique might affect the healing of the uterine scar after Cesarean section2. We agree with this point of view. However, all women who undergo Cesarean section in our hospital have their uteri sutured with the same technique of double-layer continuous sutures, sometimes with additional interrupted suture as needed. On the other hand, women who are referred from other hospitals often lack information regarding myometrial suturing technique. For this reason, we did not explore the relationship between different suturing techniques and defect formation in our study. In our article on Cesarean scar defects, ultrasound images of all women who underwent Cesarean section (regardless of whether they had Cesarean delivery in our hospital or were referred from other institutions) were collected and analyzed together with associated clinical symptoms. We observed that abnormal symptoms were related to the depth (D) of the scar defect, but were unrelated to the depth of the remaining myometrium (T). We agree that further analysis using the equation T/(T + D) would offer additional information on the issue of correlation between the size of defect and clinical symptoms. Dr. Yazicioǧlu proposed that Cesarean scar defects may act like a reservoir, propelling menstrual blood as the uterus contracts, and histopathological examination cannot entirely explain the spectrum of clinical symptoms. As the factor of uterine contraction is constant across all patients and cannot be quantified, our study only analyzed the relationship between size of Cesarean scar defects and presence of abnormal symptoms, i.e. prolonged postmenstrual spotting, chronic pelvic pain, dysmenorrhea and dyspareunia. The three mechanisms proposed in the histopathological study of Morris3 may help to explain the presence of the aforementioned symptoms. C.-B. Wang*, * Department of Obstetrics & Gynecology, Chang Gung Memorial Hospital at Chiayi and Chang Gung University, 6, Section West, Chia Pu Road, Pu Tz City, Chiayi, Taiwan, 613" @default.
- W2070514882 created "2016-06-24" @default.
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- W2070514882 date "2010-02-01" @default.
- W2070514882 modified "2023-09-27" @default.
- W2070514882 title "Reply by Dr Wang" @default.
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- W2070514882 doi "https://doi.org/10.1002/uog.7541" @default.
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