Lap Uterolysis - Part 2

Video case: increasing cesarean section increases chance of adhesions of anterior wall of the uterus in midline with lower anterior abdominal wall. Using ultrasound dissector the adhesions are separated. The final separation of the uterus from abdominal wall should be performed by starting dissection from back to front after finding out limits of bladder. Post operative adhesion following cesarean sections are expressed in the range of 24-75% (published data). One should be careful about inadvertent bladder injury. There is expected myometrial loss. Sutures are taken to approximate the superficial myometrial defect. Patients present to us having pelvic pain and infertility, and on clinical examination and TVS this type of uterine adhesion is diagnosed.