Because of the growing number of CS deliveries worldwide, complications such as prolonged menstruation, irregular menstrual bleeding, and secondary infertility have become major concerns, and treatment for these complications has received increased attention. The relation between cesearian scar defect and abnormal bleeding is gradually revealed.
Currently, there are two main therapeutic treatments: hormone therapy and surgical diverticulum correction. According to studies, hormone treatments generally fail to treat CSD-related menstrual bleeding abnormalities or cyclic pain. Vaginal repair, laparoscopy, and hysteroscopy are all surgical methods for diverticulum repair.
Surgical hysteroscopy corrects the anatomical defect by resection of the niche's margins, preventing the collection of menstrual blood. Furthermore, cauterizing the pouch of the isthmocele decreases in situ blood production and inflammatory factor release, resulting in scar retraction of the pouch.

AIM:
The aim of the work was to compare between the effectiveness of two different techniques of hysteroscopic ablation of cesarean scar defect and hormonal treatment to improve abnormal uterine bleeding and pelvic pain localized in the suprapubic area associated with isthmocele.