Office hysteroscopic early lysis of intrauterine adhesion after transcervical resection of multiple apposing submucous myomas.
OBJECTIVE
To analyze the prevalence of intrauterine adhesion (IUA) formation in women undergoing transcervical resection (TCR) for submucous myomas.


METHODS
Retrospective cohort study.


METHODS
Tertiary university hospital.


METHODS
One hundred fifty-three women undergoing TCR for submucous myomas were retrospectively analyzed. Among them, 132 women had a solitary myoma (group 1), 5 had two submucous myomas not in apposition to each other and who received postoperative intrauterine device (IUD) placement (group 2), 9 had two or more apposing submucous myomas and received IUD placement (group 3), and 7 had two or more apposing submucous myomas and who underwent subsequent office hysteroscopic early lysis of IUA (group 4).


METHODS
Placement of an IUD for 1 month (groups 2 and 3) or office hysteroscopy for early lysis of IUA within 2 weeks after hysteroscopic myomectomy (group 4).


METHODS
Diagnostic office hysteroscopy was done 1-3 months after hysteroscopic myomectomy to evaluate whether there was permanent formation of IUA.


RESULTS
Two (1.5%) of 132 women in group 1 had IUA. For women receiving IUD placement; none of the 5 women in group 2 and 7 (78%) of 9 women in group 3 had IUA. For women undergoing office hysteroscopic early lysis of adhesion bands (group 4), none of 7 women had IUA.


CONCLUSIONS
Intrauterine adhesion is a common complication after TCR for apposing submucous myomas, but not for a solitary myoma. Office hysteroscopy within 2 weeks after TCR is an easy and effective procedure in separating the newly formed IUA.
Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Jehn-Hsiahn
JH
Yang
Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Mei-Jou
MJ
Chen
Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Ming-Yih
MY
Wu
Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Kuang-Han
KH
Chao
Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Hong-Nerng
HN
Ho
Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: yangys@ntu.edu.tw.
Yu-Shih
YS
Yang
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007434:Intrauterine Devices; D007889:Leiomyoma / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D010049:Ovarian Diseases / Q000209:etiology* / Q000601:surgery*; D011183:Postoperative Complications; D015995:Prevalence; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000209:etiology / Q000601:surgery; D014594:Uterine Neoplasms / Q000601:surgery*