Balloon fluoroscopy as treatment for intrauterine adhesions: a novel approach.
OBJECTIVE
To report a unique fluoroscopically guided approach to treat severe intrauterine adhesions and cervical stenosis using balloon hysteroplasty.


METHODS
Case report.


METHODS
Military-based fertility center.


METHODS
A 33-year-old woman undergoing assisted reproductive technology whose uterus could not be cannulated because of the development of intrauterine synechiae and cervical stenosis after a post-IUI infection that was further complicated by a prominent lower uterine segment-filling defect in the location of a prior cesarean delivery scar.


METHODS
Fluoroscopic cannulation and balloon uterine dilation.


METHODS
Resolution of synechiae by hysterosalpingogram and successful uterine cannulation.


RESULTS
A postprocedure hysterosalpingogram demonstrated a normalized uterine cavity with the exception of a persistent prominent lower uterine segment-filling defect from a prior cesarean delivery. A frozen ET cycle was performed successfully.


CONCLUSIONS
Hysteroplasty, using standard interventional radiographic techniques, may provide an alternative treatment modality for patients with intrauterine adhesions and lower uterine defects from prior cesarean deliveries in select cases. While treating intrauterine adhesions improves pregnancy outcome, the effect of lower uterine segment-filling defects from cesarean deliveries on pregnancy outcome in assisted reproductive technology cycles warrants further investigation.
Chason
Rebecca J
RJ
National Naval Medical Center, Bethesda, Maryland, 20889-5600 , USA. rebecca.chason@amedd.army.mil
Levens
Eric D
ED
Yauger
Belinda J
BJ
Payson
Mark D
MD
Cho
Kenneth
K
Larsen
Frederick W
FW
D000328:Adult; D002404:Catheterization; D002585:Cesarean Section / Q000009:adverse effects; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005471:Fluoroscopy; D006175:Gynatresia / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007047:Hysterosalpingography; D015641:Radiography, Interventional; D000267:Tissue Adhesions; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*
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