Vaginal Repair of Post Cesarean Istmocele

NCT ID: NCT05125692

Last Updated: 2021-11-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-09-04

Study Completion Date

2022-12-20

Brief Summary

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20 WOMEN WITH SYMPTOMATIC POSTCESAREAN ISTHMOCELE (NICHE) WILL BE RECRUITED EVALUATED AND SUBJECTED TO A VAGINAL REPAIR OF THE DEFECT, RESULTS WILL BE ANALYZED.

Detailed Description

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METHODS:

* Subjects: women in childbearing period with abnormal uterine bleeding or infertility attributed to post cesarean isthmocele (sample size to be calculated)
* Preoperative evaluation: transvaginal ultrasound to exclude any other uterine or adnexal pathology, and to measure:

1. Distance from the external cervical os to the lower end of the isthmocele (A)
2. Distance from the external cervical os to the upper end of the isthmocele(B)
3. Length of the isthmocele (B-A)
4. Residual myometrial thickness (the least) of the isthmocele.
* Routine preoperative workup.
* The technique:

* Postmenstrual
* Spinal anesthesia
* Sterilization of the perineum and vagina
* Cervical dilation up to 8mm using Hegar's dilators
* Marking the previously measured points A \& B
* Making 2 transverse incisions, one 5mm below A and the other 5 mm above B.
* The rectangular area between the 2 incisions is excised while the Hegar's dilator number 8 in in situ.
* Hemostasis is performed using diathermy.
* The upper and lower edges of the incision are approximated using number 2/0 vicryl on cutting needle taking 3 to 4 interrupted sutures
* The patients with uneventful postoperative course are discharged from hospital after 8 hours with doxycycline 100 mg bid for 5 days.
* Sexual intercourse is avoided for 4 weeks postoperative
* postoperative transvaginal ultrasound follow up; at 1 month postoperative.
* Data will be statistically analyzed and results will be tabulated.

Conditions

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Gynecologic Disease

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

WOMEN IN CHILDBEARING PERIOD WITH SYMPTOMATIC POSTCESAREAN ISTHMOCELE
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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women with symptomatic post cesarean Istmocele

vaginal surgical repair of post cesarean symptomatic isthmocele using conventional low cost surgical techniques

Group Type OTHER

vaginal surgical repair of isthmocele

Intervention Type PROCEDURE

after preoperative identification of the borders of the isthmocele using transvaginal ultrasound measurements, the isthmocele is repaired via vaginal approach

Interventions

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vaginal surgical repair of isthmocele

after preoperative identification of the borders of the isthmocele using transvaginal ultrasound measurements, the isthmocele is repaired via vaginal approach

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* women diagnosed with symptomatic post cesarean isthmocele.
* should present with abnormal uterine bleeding .

Exclusion Criteria

* presence of any other uterine pathology,
* presence of adnexal pathology,
* presence of malignancies,
* presence of pregnancy,
* presence of infection in the lower genital tract ,
* general cause of bleeding
* women not accepting the procedure,
* women not consented
Minimum Eligible Age

20 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Mansoura University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Mansoura University Hospitals

Al Mansurah, Dakahlya Governorate, Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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osama M Warda, MD

Role: CONTACT

Phone: 01066153212

Email: [email protected]

Facility Contacts

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osama m warda, MD

Role: primary

Other Identifiers

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osama Istmocele

Identifier Type: -

Identifier Source: org_study_id