How is a uterine diverticulum formed?

Apr 18, 2023 Source: Cainiu Health

Dr. Lv Aiming

Introduction

Uterine diverticulum may result from improper approximation of the uterine body margin to the cervical margin during surgery, or from an inappropriate suturing technique that compromises blood circulation in the uterine tissue. Additionally, if sterilization during surgery is inadequate or personal hygiene is neglected postoperatively, leading to wound infection, a uterine diverticulum may also develop.

Generally, uterine diverticulum is a common complication following cesarean section, usually associated with factors such as uneven wound suturing after surgery, incorrect suturing techniques, and infection. A detailed analysis is as follows:

1. Uneven postoperative wound suturing

The incision from cesarean section is primarily located at the lower segment of the uterus. If the surgeon fails to properly align the edges of the uterine body and cervix during suturing, it may lead to the formation of a uterine diverticulum.

2. Incorrect suturing technique

The main suturing methods used in cesarean sections are interrupted suturing and continuous suturing. The choice between these methods should be based on the individual patient's condition. An inappropriate suturing technique during surgery may impair normal blood circulation in uterine tissues, hinder wound healing, and consequently result in uterine diverticulum formation.

3. Infection

Inadequate sterilization of surgical instruments during cesarean section or poor hygiene practices after surgery may lead to wound infection, which can interfere with normal wound healing and contribute to the development of uterine diverticulum.

Uterine diverticulum may cause vaginal bleeding, prolonged menstrual spotting, and even female infertility. Even if pregnancy occurs, there is a higher risk of placenta previa. Therefore, once diagnosed, patients should promptly seek medical treatment at a hospital, where surgical repair and reconstruction of the uterine scar diverticulum (such as diverticulectomy and uterine plastic surgery) should be performed.

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Video of the surgical procedure for uterine diverticulum

In general, the surgical approach for uterine diverticulum varies depending on the chosen procedure, leading to certain differences in the operation process. Clinically, hysteroscopic electroresection is commonly used. This procedure features minimal invasiveness and rapid recovery, but it still carries some risk of injury. To avoid harm to the body, surgery should be performed under the guidance of a qualified physician.

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Menstrual spotting caused by diverticulum

Menstrual spotting caused by uterine diverticulum can be treated through general management, medication, or surgical intervention. The specific analysis is as follows: Uterine diverticulum is a condition in the uterus characterized by a fissure or cleft within the uterine wall. This fissure tends to accumulate blood, potentially leading to prolonged menstrual bleeding in women. In severe cases, it may also cause postcoital bleeding.

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Will an untreated uterine diverticulum lead to cancer?

Uterine diverticulum, if left untreated, usually does not lead to cancer. However, it may cause prolonged vaginal bleeding that does not resolve easily. Without treatment, excessive blood loss can result in anemia, leading to symptoms such as physical weakness, fatigue, poor appetite, infertility, dysmenorrhea, lower back pain, and abdominal pain. It is considered a benign condition and typically does not develop into cancer, but timely treatment is necessary to prevent the progression of these symptoms.

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What surgery is performed for uterine diverticulum?

Uterine diverticulum is usually treated with hysteroscopic electroresection, a procedure in which an electric resecting loop is inserted into the uterine cavity to remove the tissue of the uterine diverticulum. Uterine artery embolization involves inserting a catheter via an endovascular approach to block the arteries supplying the diverticular area, causing it to atrophy and disappear. Uterine balloon tamponade involves inserting a balloon through the cervical os, inflating it within the uterine cavity to push the diverticulum outward, allowing surgical excision.