Hysteroscopic metroplasty with resectoscope or microscissors for the correction of septate uterus
- PMID: 8480265
Hysteroscopic metroplasty with resectoscope or microscissors for the correction of septate uterus
Abstract
During 1990, we performed hysteroscopic incision of uterine septum in 23 women with repeated abortion. The patients were allocated randomly to metroplasty with resectoscope (12 patients in group 1) or microscissors (11 patients in group 2) to compare surgical feasibility and anatomic results with these instruments. The uterine cavity was distended by instillation of sorbitol and mannitol solution under manometric control. Two patients in group 1 and three in group 2 had a complete septum. In group 1, the mean operating time, plus or minus standard deviation (S.D.), was 22 +/- 6 minutes compared with 17 +/- 5 minutes in group 2 (p = 0.06). The mean amount of distension medium used, plus or minus S.D., was 890 +/- 153 milliliters in group 1 versus 671 +/- 170 milliliters in group 2 (p = 0.003). One woman in group 1 with complete uterine septum had a uterine perforation that was managed conservatively. Postoperative morbidity for the entire series was negligible. At follow-up ultrasonography and hysteroscopy performed two months postoperatively, a residual fundal notch > or = 1 centimeter deep was detected and corrected in four patients in group 1 and two in group 2. Our findings indicate that, in terms of operating time and efficacy, the resectoscope and microscissors are equally valid instruments to correct a septate uterus, with a feasibility rate of 100 percent.
Similar articles
-
Small-diameter hysteroscopy with Versapoint versus resectoscopy with a unipolar knife for the treatment of septate uterus: a prospective randomized study.J Minim Invasive Gynecol. 2007 Sep-Oct;14(5):622-7. doi: 10.1016/j.jmig.2007.04.010. J Minim Invasive Gynecol. 2007. PMID: 17848325 Clinical Trial.
-
Argon laser versus microscissors for hysteroscopic incision of uterine septa.Am J Obstet Gynecol. 1991 Jan;164(1 Pt 1):87-90. doi: 10.1016/0002-9378(91)90632-2. Am J Obstet Gynecol. 1991. PMID: 1986632 Clinical Trial.
-
The diagnosis and reproductive outcome after surgical treatment of the complete septate uterus, duplicated cervix and vaginal septum.Am J Obstet Gynecol. 2004 Jun;190(6):1669-75; discussion 1675-8. doi: 10.1016/j.ajog.2004.02.046. Am J Obstet Gynecol. 2004. PMID: 15284765
-
Late complications of operative hysteroscopy: predicting patients at risk of uterine rupture during subsequent pregnancy.Eur J Obstet Gynecol Reprod Biol. 2005 Jun 1;120(2):134-8. doi: 10.1016/j.ejogrb.2004.10.010. Eur J Obstet Gynecol Reprod Biol. 2005. PMID: 15925040 Review.
-
Hysteroscopic unification of a complete obstructing uterine septum: case report and review of the literature.Fertil Steril. 2008 Nov;90(5):2016.e17-20. doi: 10.1016/j.fertnstert.2008.01.045. Epub 2008 Mar 6. Fertil Steril. 2008. PMID: 18328484 Review.
Cited by
-
[Hysteroscopic surgery].Arch Gynecol Obstet. 1995;257(1-4):21-9. doi: 10.1007/BF02264782. Arch Gynecol Obstet. 1995. PMID: 8579399 Review. German. No abstract available.
-
Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities.Cochrane Database Syst Rev. 2018 Dec 5;12(12):CD009461. doi: 10.1002/14651858.CD009461.pub4. Cochrane Database Syst Rev. 2018. PMID: 30521679 Free PMC article.
-
Transcervical incision of septa: 447 cases.Surg Endosc. 2009 Sep;23(9):2078-84. doi: 10.1007/s00464-008-0209-1. Epub 2008 Dec 5. Surg Endosc. 2009. PMID: 19057950
-
Assisted reproductive technology outcomes in women with congenital uterine anomalies: a systematic review.Arch Gynecol Obstet. 2024 Nov;310(5):2315-2332. doi: 10.1007/s00404-024-07666-0. Epub 2024 Sep 4. Arch Gynecol Obstet. 2024. PMID: 39227392 Review.
-
Intraoperative Three-Dimensional Transvaginal Ultrasound for Hysteroscopic Metroplasty: a Controlled Study.Reprod Sci. 2023 Nov;30(11):3372-3378. doi: 10.1007/s43032-023-01277-x. Epub 2023 Jun 6. Reprod Sci. 2023. PMID: 37280475 Free PMC article.