Cesarean Section, Dysmenorrhea
Conditions
Keywords
Cesarean Scar, Scar Mobility, Dysmenorrhea, Menstrual Pain, Visual Analog Scale, Adheremeter, Pressure Pain Threshold, Post-Cesarean Women
Brief summary
The aim of this observational cross-sectional study is to investigate the association between cesarean scar mobility and menstrual pain severity in women following cesarean section. The study will enroll women aged 20 to 35 years with a history of cesarean delivery who experience menstrual pain. Baseline assessments will be performed to evaluate cesarean scar mobility, menstrual pain severity, pressure pain threshold, and related clinical characteristics. The findings will help clarify whether reduced cesarean scar mobility is associated with greater menstrual pain severity and may provide evidence supporting the clinical assessment of cesarean scars in women with post-cesarean menstrual pain.
Detailed description
Cesarean section is one of the most frequently performed surgical procedures worldwide. Although generally safe, postoperative scar formation and fascial adhesions may result in long-term alterations in tissue mobility and biomechanics. These changes have been suggested to contribute to persistent symptoms, including menstrual pain, chronic pelvic pain, abdominal tenderness, and functional impairment. Despite increasing interest in cesarean scar assessment, the relationship between scar mobility and menstrual pain severity has not been sufficiently investigated. Restricted scar mobility may influence the mechanical behavior of the abdominal wall and surrounding fascial structures, potentially contributing to altered force transmission, increased tissue sensitivity, and pain during menstruation. Understanding this relationship may improve the clinical evaluation of women presenting with post-cesarean menstrual pain and assist in identifying patients who may benefit from targeted rehabilitation interventions. This observational cross-sectional study aims to investigate the association between cesarean scar mobility and menstrual pain severity in women following cesarean section. Baseline measurements will be obtained to assess cesarean scar mobility, menstrual pain severity, pressure pain threshold, and selected demographic and obstetric characteristics. Correlation and regression analyses will be performed to determine whether cesarean scar mobility is associated with menstrual pain severity and whether it independently predicts menstrual pain after controlling for potential confounding variables. The findings of this study are expected to improve understanding of the clinical significance of cesarean scar mobility in women with menstrual pain and provide evidence to support comprehensive scar assessment as part of women's health physical therapy practice.
Interventions
None listed
Sponsors
Cairo University
Study design
Observational model
COHORT
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
* Females aged 20-35 years. * History of at least one cesarean section. * Regular menstrual cycles. * Presence of menstrual pain during the previous three menstrual cycles. * Body mass index (BMI) between 18.5 and 29.9 kg/m². * Willingness to participate and provide written informed consent.
Exclusion criteria
* Current pregnancy. * History of pelvic or abdominal surgery other than cesarean section. * Endometriosis or adenomyosis. * Uterine fibroids associated with pelvic pain. * Pelvic inflammatory disease. * Congenital uterine anomalies. * Neurological disorders affecting pain perception. * Current use of hormonal therapy or medications affecting pain perception. * Active skin infection or open wound over the cesarean scar. * Malignancy. * Inability to complete study assessments.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Menstrual Pain Severity | Baseline | Menstrual pain severity will be assessed using the 10-cm Visual Analog Scale (VAS), where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate greater menstrual pain severity. |
| Cesarean Scar Mobility | Baseline | Cesarean scar mobility will be assessed using the Adheremeter. Higher scores indicate |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pressure Pain Threshold | Baseline | Pressure pain threshold will be measured using a pressure algometer. Higher values indicate a higher pressure pain threshold. |
| WaLIDD Score | Baseline | The severity of dysmenorrhea will also be evaluated using the Working ability, Location, Intensity, Days of pain, and Dysmenorrhea (WaLIDD) Score as a secondary clinical measure. The total score ranges from 0 to 12, with higher scores indicating more severe dysmenorrhea. |
Countries
Egypt
Outcome results
None listed