What is Isthmocele? Isthmocele Treatment

Isthmocoele is a pouch-like or indented structure that forms along the suture line in the lower part of the uterus (womb) after a cesarean delivery. In the medical literature, it is also referred to as a “cesarean scar defect.” Over time, this condition may lead to the accumulation of fluid inside the uterus, menstrual irregularities, chronic groin pain, and even secondary infertility. Op. Dr. Serpil Kırım, who provides medical services in Istanbul, prioritizes not only structural healing but also the support of the patient’s hormonal balance and overall health by adopting a holistic medical approach in the diagnosis and treatment of isthmocoele.

Why Does Isthmocoele Occur?

Isthmocoele develops when the uterine muscles do not close properly during a cesarean section or when tissue loss occurs during the healing process. This condition is generally associated with the following factors:

• Multiple cesarean deliveries
• Inappropriate incision technique
• Infections and wound-healing problems
• Poor tissue quality
• Loss of elasticity at the suture line

While the presence of isthmocoele may be asymptomatic in some patients, it can cause significant discomfort in others.

What Are the Symptoms of Isthmocoele?

• Prolonged menstrual bleeding (especially in the form of spotting)
• Brown discharge after menstruation
• Pain during sexual intercourse
• Chronic, dull pain in the lower abdomen
• A feeling of bloating due to fluid accumulation in the uterus
• Difficulty becoming pregnant naturally or prior to IVF treatment

Since these symptoms may be confused with other gynecological conditions, a detailed examination and imaging are required.

How Is Isthmocoele Diagnosed?

The diagnosis of isthmocoele is usually made through transvaginal ultrasonography, hysterosalpingography (HSG), or hysteroscopy. In addition, MRI imaging methods can be used to evaluate the depth of the tissue and the size of the scar defect in detail.

Op. Dr. Serpil Kırım does not rely solely on imaging techniques but also conducts a holistic evaluation by considering factors such as hormonal balance, the condition of the uterine lining, and immune system status together.

How Is Isthmocoele Treated?

Both surgical and non-surgical methods are available in the treatment of isthmocoele. However, if the defect is severe, surgical intervention is generally preferred. Treatment options include:

1. Hysteroscopic Surgery

• The scar area is corrected by entering the uterus via the vaginal route
• Excess tissue is removed and the uterine wall is smoothed
• It is usually a day procedure with a short recovery period

2. Laparoscopic Surgery

• The defect is repaired with the aid of a camera through small incisions made in the abdomen
• Preferred in larger isthmocoele cases
• Coexisting conditions such as endometriosis can be treated simultaneously

3. Holistic Support Methods

In Serpil Kırım’s practice, surgical intervention is accompanied by a holistic treatment protocol:

• Ozone therapies to enhance tissue healing
• Hormone-balancing support programs
• Vitamin and mineral supplements (especially B12, vitamin D, zinc)
• Pelvic floor muscle strengthening programs
• Herbal supports aimed at strengthening the immune system

This approach both increases surgical success and enhances long-term patient satisfaction.

Postoperative Process After Isthmocoele Surgery

• Mild pain and spotting may occur in the first few days after surgery
• The patient usually returns to normal daily life within 3–5 days
• A follow-up examination is performed after 3 weeks
• Within 6 weeks, return to sexual activity and pregnancy planning can be evaluated

Isthmocoele Treatment Costs – 2026 (Istanbul)

The table below contains average price ranges prepared for informational purposes only. Prices may vary depending on the surgical technique to be applied, the scope of the intervention, and the holistic support planned specifically for the patient.

These prices are average values and may vary depending on the physician, clinic, and hospital where the procedure is performed. Please contact our clinic for exact pricing information.

You may also be interested in the article Hymen repair surgery prices in Istanbul.

Holistic Medical Approach with Serpil Kırım

Op. Dr. Serpil Kırım not only offers surgical solutions but also evaluates the patient’s immune system, hormonal imbalances, tissue regeneration capacity, and overall quality of life together. In this way, the goal is not only to repair the scar on the uterine wall but also to increase the chances of pregnancy and permanently resolve menstrual problems.

Expert Opinion and Appointment

Isthmocoele is an intrauterine condition that is often overlooked but can have serious consequences. Op. Dr. Serpil Kırım, who provides services in Istanbul with modern technology and a holistic perspective, offers patient-centered and comprehensive solutions in the treatment of isthmocoele. Accurate diagnosis and effective treatment require detailed evaluation and personalized planning. For more information and to schedule an appointment, please contact our clinic.