After cesarean section, menstruation is endless, the doctor said that the cause of the disease is “cesarean section”?

Ms. Qing, 31, delivered a healthy and lovely daughter by cesarean section two years ago, but after giving birth to the baby, her menstruation recovered. Although her menstrual cycle was normal, 27-30 days, her menstrual period was extended from 5-7 days to 8-9 days, and her menstrual volume was more than before. < p > < p > in gynecological treatment, I learned that Ms. Qing had been in good health and denied any other history of surgery and trauma. She had three pregnancies and had a painless induced abortion 1, 4 and 5 years ago. < p > < p > physical examination: her height: 1.63M, weight: 52kg, BMI: 19.57. She had no acne, no hirsutism, and no abnormality was found in other physical examinations. Pelvic ultrasound: posterior uterus, size 5.9 × 5.7 × 4.3cm, endometrial thickness about 0.9CM, echo uniformity, uterine muscle layer echo uniform, the size of 0.6 × 0.4cm strong echo can be seen in the scar of the lower segment of anterior wall, accompanied by sound shadow, and regular uterine contour. There was no obvious tumor in bilateral adnexal area and no obvious effusion in pelvic cavity. < p > < p > the reason why Ms. Qing’s menstrual period was prolonged was due to the “cesarean section” she had done. B-ultrasound showed calcification in the scar of cesarean section, but at the same time, the recovery of scar was poor, or there was a small diverticulum, which was not found by B-ultrasound. < / P > < p > “doctor Fu, when it comes to cesarean section, I regret it after cesarean section, but I could have tried to give birth to my own baby, but I was afraid of pain and insisted on surgery. Now that it’s true, what else can you do to improve my menstruation Asked Ms. Qing. < / P > < p > the treatment is also very simple. I told Ms. Qing that she could take the compound oral contraceptive periodically to regulate her menstruation, eliminate the drug contraindications, take it orally for 3-6 months, and then stop taking the pill for 3 months to observe whether her menstruation has improved. If her menstruation still can continue to take oral contraceptives, it also has the purpose of contraception. The scar diverticulum of cesarean section is that the uterine incision healed badly after cesarean section, and the muscle layer of uterine scar became thin, forming a depression or cavity connected with the uterine cavity. < / P > < p > may be related to cesarean section related factors, infection factors, general state and other factors. < p > < p > in diverticulum women, 33.6% of them will have symptoms of menstrual bleeding, and the average time of symptoms is 6 months after cesarean section. At the same time, statistical analysis shows that diverticulum is significantly related to menstruation, and the symptoms are related to the size of diverticulum but not to the shape of diverticulum. Transvaginal three-dimensional ultrasound is the most convenient and commonly used examination method. The typical manifestation is that after cesarean section, the serosa layer of the uterine incision is continuous, but the muscular layer is discontinuous and the thickness is reduced. There are one or several wedge-shaped or cystic liquid dark areas. < p > < p > for patients with abnormal uterine bleeding symptoms, no fertility requirements, and refuse to accept surgery, oral short acting contraceptives can be considered. Oral short acting contraceptives, 3 menstrual cycles. The principle of operation is to remove or cauterize the abnormal mucosal tissue and dilated and proliferated blood vessels in the diverticulum, so as to improve the symptoms. For those who need fertility, the tissue of uterine incision should be thickened at the same time. The specific operation methods can be hysteroscopy, laparoscopy, vaginal or open surgery. < p > < p > about surgery, Shanlan concluded in related articles that the surgical treatment of diverticulum aims to avoid the retention of menstrual blood in the defect area and eliminate the bleeding after menstruation. Hysteroscopic surgery is a treatment to improve symptoms, while laparoscopic or vaginal surgery is considered to be a repair defect treatment. At present, it is generally accepted that when the thickness of residual muscular layer in diverticulum is greater than 3 mm, hysteroscopic approach is an appropriate and safe choice. However, if the muscular thickness of the diverticulum is less than 3 mm, laparoscopic surgery is more suitable because of the risk of uterine perforation. HEALTHY LIFE