• Mario Franchini
  • Paolo Casadio
  • Pasquale Florio
  • Giampietro Gubbini


Isthmocele is usually asymptomatic or relates to postmenstrual spotting and dark red or brown discharge, pelvic pain, or infertility. Isthmoplasty should be offered to women with symptoms or if it is causing infertility. Hysteroscopic isthmoplasty appears to be the most popular and less invasive treatment. However, in the absence of randomized trials, the efficacy of different surgical approaches remains to be evaluated.


Isthmocele Cesarean scar defect Hysteroscopic resection 



Disclosure statement: The author Giampietro Gubbini is the inventor of “Gubbini system,” hence no royalties.

The authors Mario Franchini, Paolo Casadio, and Pasquale Florio have nothing to disclose.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Mario Franchini
    • 1
  • Paolo Casadio
    • 2
  • Pasquale Florio
    • 3
  • Giampietro Gubbini
    • 4
  1. 1.Regional Health Agency of TuscanyFlorenceItaly
  2. 2.S. Orsola-Malpighi, University of BolognaBolognaItaly
  3. 3.U.O.C. Gynecology and Obstetrics San JacopoPistoia, FlorenceItaly
  4. 4.Madre Fortunata Toniolo HospitalBolognaItaly

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