Hysteroscopic management of uterine synechiae: a series of 102 observations.
This retrospective study concerns 102 cases of intra-uterine adhesions treated by exclusive hysteroscopic approach. Fifty-two patients (51%) presented with reproductive problems, 44 patients (43%) with menstrual problems and 6 were asymptomatic. Seventy-eight patients (76.5%) had an antecedent endometrial trauma on a gravid uterus. One hundred and forty-eight operative hysteroscopies were performed to treat 102 patients; 70 patients were treated in one endoscopic session (68.6%), 23 in two sessions (22.6%), 4 in three sessions (3.9%) and 5 in four sessions (4.9%). We report no infectious, hemorragic or metabolic complication but 6 perforations (5.8%). The mean follow-up is 24.4 months (from 6 to 46 months). Ten patients did not keep contact during follow-up. A good anatomical result was obtained in 88 patients (86.2%) after one or two hysteroscopic sessions. A good result on menstrual problems was obtained in 75% of the cases, especially in amenorrhea (90.5% success rate). The reproductive outcome is more disappointing. We obtained 34 pregnancies in 28 patients (10 abortions, 24 live born children). Twenty-two patients achieved no pregnancy (44%), but 13 of these patients presented with additional infertility factors.
Roge
P
P
Sérvice de Gynécologie-Obstétrique B, Hôpital de La Conception, Marseille, France.
D'Ercole
C
C
Cravello
L
L
Boubli
L
L
Blanc
B
B
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000601:surgery; D014591:Uterine Diseases / Q000601:surgery*