title: A comparison of reproductive outcomes following hysteroscopic management versus dilatation and curettage of retained products of conception.
abstract: OBJECTIVE
  To compare the reproductive outcome of women who underwent blind dilatation and curettage (D&C) with those who underwent hysteroscopic resection of pathologically confirmed retained products of conception (RPOC).
  
  
  METHODS
  Medical records of women who underwent either D&C or hysteroscopic resection of RPOC at Assaf Harofeh Medical Center, Israel, between 2000 and 2010 were retrospectively reviewed.
  
  
  RESULTS
  A total of 177 women with pathologically confirmed RPOC underwent either D&C (n=94, 53.1%) or hysteroscopy (n=83, 46.9%). Mean time to conception was significantly shorter after hysteroscopy than after D&C (7.4±7 vs 12.9±16.8 months, P=0.037). Rate of occurrence of a newly diagnosed infertility problem was significantly higher following D&C than hysteroscopy (23 [24.5%] vs 10 [12.0%]; P=0.034). Etiology of the new problem was mechanical, including tubal occlusion and intrauterine adhesions. Logistic regression comparing both methods revealed that hysteroscopic resection was associated with a significant reduction in the occurrence of a new infertility problem compared with D&C (OR 0.42; 95% CI, 0.18-0.96, P=0.04).
  
  
  CONCLUSIONS
  Hysteroscopic removal of RPOC is associated with a shorter mean time to further conception and a lower rate of occurrence of newly diagnosed infertility problems than D&C.
authors.affiliation: Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel. Electronic address: idorit@netvision.net.il.
authors.forename: Ido
authors.initials: I
authors.lastname: Ben-Ami
authors.affiliation: Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Melcer
authors.affiliation: Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Noam
authors.initials: N
authors.lastname: Smorgick
authors.affiliation: Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Schneider
authors.affiliation: Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Moty
authors.initials: M
authors.lastname: Pansky
authors.affiliation: Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
authors.forename: Reuvit
authors.initials: R
authors.lastname: Halperin
mesh_terms: D000328:Adult; D004107:Dilatation and Curettage / Q000706:statistics & numerical data*; D005260:Female; D005298:Fertility; D005333:Fetus / Q000601:surgery*; D006801:Humans; D015907:Hysteroscopy / Q000706:statistics & numerical data*; D011247:Pregnancy / Q000706:statistics & numerical data*; D011248:Pregnancy Complications / Q000601:surgery*; D012189:Retrospective Studies; D055815:Young Adult
keywords: Curettage; Hysteroscopy; Infertility; Residual trophoblastic tissue; Retained products of conception