anechoic areas associated with various gynecological symptoms. However, the prevalence
and clinical significance of niches remain debated.
Objectives: This study aimed to investigate the prevalence of niches in women with previous
CS, correlate their presence with clinical symptoms, and evaluate their impact on quality of
life.
Methods: A cross-sectional study was conducted on 100 women with previous CS.
Transvaginal ultrasound (TVUS) was used to identify and measure niches. Patients were
classified as symptomatic or asymptomatic based on their symptoms.
Results: Uterine niche was detected in 42% of patients, with TVUS identifying 80% and SIS
95% of the cases (p=0.02). Postmenstrual spotting was the most common symptom, reported
in 65% of patients with a niche. Infertility was observed in 20% of the affected group, and a
significant correlation was found between niche size and symptom severity (p