@article{oai:shiga-med.repo.nii.ac.jp:00004491,
 author = {辻, 俊一郎 and 信田, 侑里 and 米岡, 完 and 中村, 暁子 and 天野, 創 and 竹林, 明枝 and 花田, 哲郎 and 村上, 節 and TSUJI, Shunichiro and NOBUTA, Yuri and YONEOKA, Yutaka and NAKAMURA, Akiko and AMANO, Tsukuru and TAKEBAYASHI, Akie and HANADA, Tetsuro and MURAKAMI, Takashi},
 journal = {Journal of minimally invasive gynecology},
 month = {Mar},
 note = {application/pdf, Study objective:
Hysteroscopic surgery criteria for patients with cesarean scar defect (CSD) are unclear. Therefore, this study aimed to explore the indication of hysteroscopic surgery for secondary infertility owing to CSD., Design:
Retrospective cohort study., Setting:
Single university hospital., Patients:
Seventy patients with secondary infertility owing to symptomatic CSD who underwent hysteroscopic surgery under laparoscopy between July 2014 and February 2022 were included., Interventions:
Clinical data, including basic patient information, preoperative residual myometrial thickness (RMT), and postoperative pregnancy status, were collected from medical records. Patients were divided into postoperative pregnancy and nonpregnancy groups. A receiver operating characteristic curve was drawn, and the optimal cutoff value was calculated based on the area under the curve to predict pregnancy after hysteroscopic surgery., Measurements and main results:
No complications were observed in any cases. Among the 70 patients, 49 patients (70%) became pregnant after hysteroscopic surgery. There was no significant difference in patient characteristics between the pregnancy and nonpregnancy groups. In the receiver operating characteristic curve analysis for patients aged <38 years, the value of the area under the curve was 0.77 (sensitivity, 0.83; specificity, 0.78) when optimal cutoff of RMT was 2.2 mm. There was a significant difference in preoperative RMT between the pregnancy and nonpregnancy groups (3.3 mm and 1.7 mm, respectively) in patients aged <38 years., Conclusion:
For RMT ≥2.2 mm, hysteroscopic surgery was reasonable for secondary infertility owing to symptomatic CSD, particularly in patients aged <38 years., Journal Article},
 title = {Indication Criteria of Hysteroscopic Surgery for Secondary Infertility due to Symptomatic Cesarean Scar Defect Based on Clinical Outcomes : A Retrospective Cohort Study.},
 year = {2023}
}