Surgical repair of a cesarean scar defect using a vaginal approach.

Objective To discuss the signs and symptoms of a cesarean section (C-section) scar defect, and to describe the techniques to repair the defect using a vaginal approach. Design A video review of a 32-year-old woman with abnormal bleeding and a C-section scar defect managed surgically by vaginal repair. The patient provided consent for video recording and publication. This surgical report, with no identifying patient data, was exempt from the institutional review board approval. Setting Tertiary care facility. Patient(s) A 32-year-old gravida 2, para 2 woman was seen with prolonged menses, and an 11 × 9 × 5-mm C-section scar defect was seen on transvaginal ultrasound. Intervention(s) The patient opted for the repair of the C-section scar defect using a vaginal approach. Main Outcome Measure(s) Postoperative course. Result(s) The patient had resolution of her prolonged menses, and transvaginal ultrasound showed improvement of her C-section scar defect. Conclusion(s) The vaginal approach is an efficacious way to repair a C-section scar defect, particularly when the defect occurs low at the level of the cervix.