The niche: a pocket left in the uterine wall
Extremely common, frequently symptomatic, and rarely mentioned.
Where the uterus was cut and stitched, the wall often does not heal flush. A pocket forms on the inner surface. Doctors call it a niche, or sometimes an isthmocele, a word that simply means a pocket.
In a systematic review of 87 studies, niche prevalence in unselected women examined with saline-infusion ultrasound ranged from 42% to 84%, depending on the definition and technique used. Niches are associated with gynecologic symptoms, particularly spotting for days after a period ends, with pelvic pain, and with poorer reproductive outcomes.
What this looks like in real lifeBrown spotting for five or six days after every period, starting after a cesarean, is one of the most common unrecognized consequences of the operation. Women are told it is normal. It often has a specific, findable cause.
Where this comes from:
324. Klein Meuleman SJM, Min N, Hehenkamp WJK, Post Uiterweer ED, Huirne JAF, de Leeuw RA. The definition, diagnosis, and symptoms of the uterine niche: a systematic review. Best Pract Res Clin Obstet Gynaecol. 2023;90:102390.
Covered in the essential classes
Continue
More from Next pregnancy
This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.