Descrição:
The cesarean section uterine scar defect also known as "uterine niche or isthmocele", is a complication that arises at the site of hysterotomy of the anterior uterine wall, whose cause seems to be multifactorial. This pathology is characterized by dysmenorrhea, post-menstrual bleeding and chronic pelvic pain, infertility may also occur. Therefore, early identification could facilitate rapid medical intervention to reduce the associated symptoms. Several diagnostic tests are currently available; however, ultrasonography is the most commonly available test in public health facilities. And, given the symptomatology, women can undergo treatment with a hormonal IUD, thus avoiding the risks inherent in any surgical intervention. Objectives: To determine the prevalence of isthmocele in non-pregnant women with at least one previous cesarean section and to evaluate the pattern of menstrual bleeding, dysmenorrhea and chronic pelvic pain in the occurrence of this defect compared to women without the defect. And, propose treatment with a hormonal intrauterine device (52mg) for the symptoms, as well as, assess difficulty and/or pain in inserting the device.