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The treatment of uterine niche ranges from clinical management with expectant or pharmacological treatment, surgical treatment. Approaches for repair include Laparotomy, laparoscopy , hysteroscopy , vaginal. The decision to treat takes into consideration the size of the defect, presence of symptoms, secondary infertility and plans of pregnancy.
All of the approaches have its merits and debates. There is ongoing debate regarding the best surgical approach to managing this condition. To date no randomized controlled trials have been published to settle this debate.
Our study aim is to to evaluate which surgical approach is a preferable option, this study will be conducted to compare the Laparoscopic and transvaginal approaches in several regards, including, operation time, blood loss, perioperative complications, hospital stay length, postoperative increase in residual myometrial thickness during follow-up , clinical efficacy(percentage of patients who subject improvement of symptoms)
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Inclusion criteria
Symptomatic i.e patients having one or more of the following symptoms:
Asymptomatic patients with one of the followings:
the residual myometrial thickness over the niche less than 3 mm previous history of Cesarean Section scar ectopic pregnancy (not managed by resection and repair)
who accept to participate the study.
Exclusion criteria
Asymptomatic patients with residual myometrial thickness more than 3 mm.
No previous Cesarean section.
If the patients symptoms presented before Cesarean section.
Presence of other pathology that explain patient symptoms
Presence of pathology that necessitate laparotomy.
Patient who refuse to participate the study.
Primary purpose
Allocation
Interventional model
Masking
50 participants in 2 patient groups
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Central trial contact
Abdulrahman Muhammad Rageh, M.Sc
Data sourced from clinicaltrials.gov
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