Diagnosis and Treatment of Uterine Septum
We assessed the efficacy of different methods of diagnosing and correcting uterine septa in 80 women. Hysterosalpingography revealed a uterine malformation, but failed to specify its character, and ultrasound scan was performed to screen the malformations. In 74 women hysteroscopy combined with laparoscopy was performed to define the malformation, and estimate the volume of uterine cavity and extent of septum. Preoperatively the patients received danazol or decapeptyl depot; a few cases were performed in the early follicular phase. Forty-six uterine septa were managed by laparoscopic-controlled resectoscopy. The distending medium was polyglukin or 2.7% sorbitol and 0.54% mannitol. Operating time ranged from 10 to 60 minutes (average 30 min). There was no significant blood loss. Postoperative hospital stay was 1 to 3 days. Twenty-five patients underwent hysteroscopy with curettage 2 to 4 months later, and filmy synechiae were found in four (16%). Histology and electron microscopic examination of endometrial tissue revealed its complete restoration. Of 29 women followed for 3 to 17 months, 12 (41.4%) conceived and 9 had a full-term infant. In this series, resectoscopy was atraumatic, operating time was short, blood loss was insignificant, and hospital stay was brief.
Adamian
LV
Department of Operative Gynecology, Scientific Center for Obstetrics, Gynecology, and Perinatology, Oparin Str. 4, 117815 Moscow, Russia.
Kulakov
VI
Kiselev
SI
Zurabiana
ZR
Khashukoeva
AZ
Sorour
EA