Document Detail


Uterine synechiae after bipolar hysteroscopic resection of submucosal myomas in patients with infertility.
MedLine Citation:
PMID:  18937941     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the rate of uterine synechiae after bipolar hysteroscopic myomectomy in patients suffering from infertility. DESIGN: Retrospective case series study. SETTING: University obstetrics gynecologic and assisted reproduction center. PATIENT(S): A group of 53 patients with primary (n = 30) and secondary (n = 23) infertility. INTERVENTION(S): Patients underwent bipolar hysteroscopic resection of myomas between 2001 and 2006, and an outpatient hysteroscopy was performed 2 months after the fibroid resection. MAIN OUTCOME MEASURE(S): The formation of uterine synechiae and pregnancy rates were collected from the patients' clinical notes. RESULT(S): The submucosal myomas were intracavitary class 0 (n = 12), intramural class 1 (n = 19), and intramural class 2 (n = 22). The mean age of the women was 35.0 +/- 4.8 years. The mean myoma size was 25 +/- 11 mm. Postoperative office hysteroscopies revealed synechiae in four (7.5%) of 53 patients. Sixteen (32.7%) of the 49 patients not lost to follow-up conceived, and 12 (24.5%) of them delivered at term. Myoma size >or=3.5 cm and age <35 years were associated with a significantly higher pregnancy rate in univariate and multivariate analysis. CONCLUSION(S): The incidence of uterine synechiae after bipolar hysteroscopic resection of fibroids was 7.5%. This appears to be lower than that reported in previous studies using monopolar energy. Bipolar hysteroscopic myomectomy may be a better option for infertile women.
Authors:
Cyril Touboul; Hervé Fernandez; Xavier Deffieux; Richard Berry; René Frydman; Amélie Gervaise
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-10-19
Journal Detail:
Title:  Fertility and sterility     Volume:  92     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-02     Completed Date:  2009-11-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1690-3     Citation Subset:  IM    
Affiliation:
University of Paris-Sud, Clamart, France.
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MeSH Terms
Descriptor/Qualifier:
Abortion, Spontaneous / epidemiology,  etiology
Adult
Age Factors
Female
Humans
Hysteroscopy / adverse effects*,  methods
Infertility, Female / epidemiology*,  etiology
Mucous Membrane / pathology,  surgery
Myoma / complications,  surgery*
Postoperative Complications / epidemiology
Pregnancy
Pregnancy Rate
Retrospective Studies
Tissue Adhesions / complications,  epidemiology,  etiology
Uterine Diseases / complications,  epidemiology*,  etiology
Uterine Neoplasms / complications,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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