Abstract: Objective：To investigate the clinical effect of hysteroscopic surgery in the treatment of symptomatic cesarean scar defect. Methods：The clinical data were retrospectively analyzed for the 103 patients with symptomatic cesarean scar defect who underwent hysteroscopic surgery from January 2011 to November 2017 in Hysteroscopy Center, Fuxing Hospital Affiliated to Captial Medical University. The symptom improvement and pregnant outcomes were followed-up. Results：In total 103 patients, the average operation time was (11.0±3.3) min, the average days of hospital stay was (3.9±1.0) d, the average hospitalization cost was (6 217±556) yuan, and no complications occurred. The symptom improvement was followed-up after three months of surgery. The clinical symptoms of intermenstrual bleeding were significantly improved after hysteroscopic surgery with an improvement rate of 82.5% (85/103). Mean duration of bleeding prior and after the treatment were (13.83±3.41) d and (7.43±2.29) d respectively, and the differences were statistically significant (t=3.108, P=0.021). The pregnant outcomes were followed-up for 4-82 months after the initial surgery. For the 17 cases of secondary infertility patients, 14 cases got successful pregnancy. Conclusions：Hysteroscopic surgery can significantly improve postoperative symptoms of intermenstrual bleeding and pregnant outcome with symptomatic cesarean scar defect and is a safe, effective, and economical treatment.

Key words: Diverticulum, Cesarean section, Pregnancy, Intermenstrual bleeding