Study Design
Single center prospective cohort study with consecutive inclusion of patients and structured follow-up every three months during the first year after inclusion.
Population
Women aged between 20-45 years, diagnosed with a niche by MRI scan with postmenstrual spotting of at least two days who considered to undergo a hysteroscopic niche resection or to receive a LNG-IUD between April 2018 and April 2019 in the International Peace Maternity and Child Health Hospital affiliated to Shanghai Jiao Tong University School of Medicine, China were asked to participate in the study, consecutively. Exclusion criteria were fertility wish within 1year, irregular menstrual cycle before the last CS, the presence of an intrauterine device, coagulopathy, current exogenous hormone treatment, and other gynecological conditions that could cause prolonged bleeding such as leiomyoma, adenomyoma, endometrial hyperplasia, ovarian endometriosis and pregnancy. In the hysteroscopic niche resection group, additional exclusion criteria were contraindication for general anesthesia and a residual myometrial thickness of less than 2mm.