Sublingual Misoprostol Versus No Cervical Priming Before Hysteroscopic Resection of Symptomatic Uterine Niches

Inclusion Criteria: * ≥1 previous cesarean section * Post cesarean section uterine niche confirmed by saline infusion sonohysterography (niche depth ≥2 mm) * Residual myometrial thickness ≥2.5 mm as confirmed by saline infusion sonohysterography * Regular cycles * Abnormal uterine bleeding for ≥3 consecutive cycles * Post menstrual spotting or brownish discharge ≥2 days * Total monthly bleeding duration \>7 days Exclusion Criteria: * Irregular cycles * Amenorrhea * Abnormal cervical cytology * Acute or chronic cervicitis * Pelvic inflammatory disease * Endometrial polyps * Uterine fibroids * Contraindications to spinal or general anesthesia * Refusal to participate