Factors associated with operative hysteroscopy outcome in patients with uterine adhesions or submucosal myomas.
OBJECTIVE
To determine the factors associated with hysteroscopic surgery long-term outcome in patients with intrauterine adhesions or submucosal myomas.


METHODS
Factors thought to be associated with outcome were retrospectively evaluated from the records of 591 patients who were followed up for at least 5years after undergoing hysteroscopic adhesiolysis (n=203) or myomectomy (n=388).


RESULTS
The major factors affecting outcome were degree of adhesion (OR, 1.91; P=0.03) in the former group and parity (OR, 0.55; P=0.005) and depth of intramural penetration of the myoma (OR, 30.74; P<0.001) in the latter. Severe intrauterine adhesion, low parity, and deep intramural penetration of submucosal myoma had an associated increase risk of poor outcome. The overall complication rate was 1.35% and, respectively, 12.8% and 9.3% of the patients who underwent hysteroscopic adhesiolysis or myomectomy needed a second intervention.


CONCLUSIONS
Hysteroscopic surgery is a safe and effective procedure. Degree of adhesion or parity and depth of intramural penetration of myomas are the major factors affecting outcome in patients with these lesions.
Chang
Cherry Yin-Yi
CY
Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan. changyinyi@hotmail.com
Chang
Yung-Tsang
YT
Chien
Shu-Chin
SC
Yu
Shyr-Shen
SS
Hung
Yao-Ching
YC
Lin
Wu-Chou
WC
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011183:Postoperative Complications / Q000473:pathology; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000601:surgery*; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*; D055815:Young Adult