INTRODUCTION:
Cesarean scar defect is an intrauterine pathology following C-sections with varying etiologies and as well variable clinical features. Major clinical presentations discussed in this study are abnormal uterine bleeding AUB and chronic pelvic pain. Among variable methods of treating isthmocele, hysteroscopy will be the target of the study and moreover, comparison between the resectoscope (26 Fr) and mini-operative hysteroscope (16 Fr.)

Aim of work
To assess the effect of hysteroscopic correction of caesarean niche in terms of AUB and chronic pelvic pain and also compare between both the resectoscope and the mini-operative hysterocope.


Subjects and Methods:
A prospective randomized observational study conducted from June 2021 till November 2022. The study included 240 patients complaining of AUB and/or chronic pelvic pain related to CSD excluding any other factors. Patients were divided into two groups, group 1 included 120 patients who underwent niche correction by resectoscope and group 2 included 120 patients who underwent niche correction by mini-operative hysteroscope. The two groups were compared as regards change between pre and postoperative bleeding and pain, which was the primary outcome. They were compared to each other as well in terms of whole operation time, amount of fluid used and rate of complications/incidents and that was the secondary outcome.