{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T21:00:24Z","timestamp":1764277224848,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T00:00:00Z","timestamp":1700524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare and evaluate the efficacy of the levonorgestrel\u2010releasing intrauterine system (LNG\u2010IUD) and resectoscopy remodeling procedure for intermenstrual bleeding associated with previous cesarean delivery scar defect (PCDS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective comparative study was conducted on patients with PCDS receiving LNG\u2010IUD (levonorgestrel 20\u2009\u03bcg\/24\u2009h, <jats:italic>N<\/jats:italic>\u2009=\u200933) or resectoscopy remodeling (<jats:italic>N<\/jats:italic>\u2009=\u200927). Treatment outcomes were compared over 1, 6, and 12\u2009months. Outcomes in patients with a retroverted or large uterus size, defect size, and local vascularization also were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 12\u2009months post\u2010treatment, there were no significant differences between groups in efficacy rate; however, the reduction of intermenstrual bleeding days was higher in the LNG\u2010IUD group than in the resectoscopy group (13.6 vs. 8.5\u2009days, <jats:italic>p<\/jats:italic>\u2009=\u20090.015). Within the first year, both groups experienced a reduction in bleeding days, but the decrease was greater in the LNG\u2010IUD group. Individuals exhibiting increased local vascularization at the defect site experienced more favorable outcomes in the LNG\u2010IUD group than the resectoscopy group (<jats:italic>p<\/jats:italic>\u2009=\u20090.016), and who responded poorly tended to have a significantly larger uterus in the LNG\u2010IUD group (<jats:italic>p<\/jats:italic>\u2009=\u20090.019). No significant differences were observed in treatment outcomes for patients with a retroverted uterus or large defect in either group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings support that the LNG\u2010IUD is as effective as resectoscopy in reducing intermenstrual bleeding days associated with PCDS and can be safely applied to patients without recent fertility aspirations. Patients with increased local vascularization observed during hysteroscopy may benefit more from LNG\u2010IUD intervention than resectoscopy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.15840","type":"journal-article","created":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T23:48:36Z","timestamp":1700783316000},"page":"253-261","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluating resectoscopy and the levonorgestrel intrauterine system for intermenstrual bleeding associated with cesarean scar defects: A retrospective study of treatment outcomes"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-2128-9309","authenticated-orcid":false,"given":"Szu\u2010Yu","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7437-7893","authenticated-orcid":false,"given":"Ying\u2010Yi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching\u2010Chang","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung 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