Effect of istmocele line on endometrial microbiota

Isthmocele is defined as a scar defect seen after caesarean section and its clinical effects are still debated. In our study, we aimed to determine whether the blood accumulated in the isthmus sac could be a source for pathogenic microorganisms that may cause inflammation in the endometrium. A total of 60 patients were included in our prospectively designed study. Patients aged between 18 and 45 years, with a body mass index below 35, without menstrual irregularities, pregnancy and smoking history were selected for the study. Thirty of these participants had an isthmocele defect, while the remaining 30 did not have an isthmocele defect. Patients with isthmocele defect had no symptoms of this pathology and were diagnosed by ultrasound during routine examination. At the end of menstruation, endometrial samples were taken from the patients who applied to our outpatient clinic with the complaint of vaginitis by femoflor test, which is a PCR test, and each patient was evaluated in terms of 13 different microorganisms. The mean age of the patients who participated in our study was 34.55 +/- 2.53 years. The body mass index of both groups was close to each other. Lactobacillus, Gardnerella, Candida, Ureoplasma, Mycoplasma and Human Papilloma Virus species were detected in the endometrial microbiota of the patients. Lactobacillus was the most dominant microorganism in the endometrial flora. There was no significant difference in the total number and diversity of microorganisms in the patient groups with and without isthmus defect. The number and diversity of microorganisms were not affected whether the depth of the isthmus was above or below 2 mm. It was determined that the blood accumulated in the isthmus sac did not constitute a source for pathogenic microorganisms in the endometrial microbiota. Larger scale prospective studies are needed to understand the effects of this pathology on the flora of the uro-genital system. Keywords: Isthmocele, endometrium, microbi