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Role of endometrial suppression on the frequency of intrauterine adhesions after resectoscopic surgery.
J Am Assoc Gynecol Laparosc. 2000 Aug; 7(3):351-4.JA

Abstract

STUDY OBJECTIVES

To evaluate long-term effects of operative hysteroscopy on the development of intrauterine adhesions (IUA), and to determine whether hypoestrogenism has a modulatory role in preventing IUA.

DESIGN

Prospective, randomized study (Canadian Task Force classification I).

SETTING

Tertiary-care teaching hospital.

PATIENTS

Ninety-five women requiring resectoscopic surgery. Intervention. Hysteroscopic surgery using the resectoscope and 1.5% glycine for uterine distention.

MEASUREMENTS AND MAIN RESULTS

Indications for hysteroscopy were polyps (28 patients), solitary myoma (32), multiple myomata (20), and uterine septa (15). Patients in each group were randomized to endometrial suppression with danazol or placebo. Second-look office hysteroscopy with CO2 for uterine distention was performed after the first menses after surgery to assess the frequency, extent, and severity of IUA. The likelihood and severity of IUA depended on the pathology treated at initial surgery. Of women treated for polyps and uterine septa, in only one with septa (placebo group) developed IUA. Mild IUA formation was present in 10 patients (31.3%) with solitary fibroids and 9 (45.5%) with multiple myomata. The frequency was similar in placebo- and danazol-treated groups with both solitary and multiple myomas (50% and 44.4% vs 50% and 55.6%). All IUA were lysed during second-look surgery, except in one woman with multiple myomata who required repeat resectoscopy.

CONCLUSION

Intrauterine adhesions are the major long-term complication of operative hysteroscopy, with frequency dependent on the pathology initially treated. Second-look office hysteroscopy is a cost-effective method of diagnosing and lysing IUA after resectoscopy.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Akdeniz University Medical School, Antalya, Turkey.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

10924629

Citation

Taskin, O, et al. "Role of Endometrial Suppression On the Frequency of Intrauterine Adhesions After Resectoscopic Surgery." The Journal of the American Association of Gynecologic Laparoscopists, vol. 7, no. 3, 2000, pp. 351-4.
Taskin O, Sadik S, Onoglu A, et al. Role of endometrial suppression on the frequency of intrauterine adhesions after resectoscopic surgery. J Am Assoc Gynecol Laparosc. 2000;7(3):351-4.
Taskin, O., Sadik, S., Onoglu, A., Gokdeniz, R., Erturan, E., Burak, F., & Wheeler, J. M. (2000). Role of endometrial suppression on the frequency of intrauterine adhesions after resectoscopic surgery. The Journal of the American Association of Gynecologic Laparoscopists, 7(3), 351-4.
Taskin O, et al. Role of Endometrial Suppression On the Frequency of Intrauterine Adhesions After Resectoscopic Surgery. J Am Assoc Gynecol Laparosc. 2000;7(3):351-4. PubMed PMID: 10924629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of endometrial suppression on the frequency of intrauterine adhesions after resectoscopic surgery. AU - Taskin,O, AU - Sadik,S, AU - Onoglu,A, AU - Gokdeniz,R, AU - Erturan,E, AU - Burak,F, AU - Wheeler,J M, PY - 2000/8/5/pubmed PY - 2000/10/21/medline PY - 2000/8/5/entrez SP - 351 EP - 4 JF - The Journal of the American Association of Gynecologic Laparoscopists JO - J Am Assoc Gynecol Laparosc VL - 7 IS - 3 N2 - STUDY OBJECTIVES: To evaluate long-term effects of operative hysteroscopy on the development of intrauterine adhesions (IUA), and to determine whether hypoestrogenism has a modulatory role in preventing IUA. DESIGN: Prospective, randomized study (Canadian Task Force classification I). SETTING: Tertiary-care teaching hospital. PATIENTS: Ninety-five women requiring resectoscopic surgery. Intervention. Hysteroscopic surgery using the resectoscope and 1.5% glycine for uterine distention. MEASUREMENTS AND MAIN RESULTS: Indications for hysteroscopy were polyps (28 patients), solitary myoma (32), multiple myomata (20), and uterine septa (15). Patients in each group were randomized to endometrial suppression with danazol or placebo. Second-look office hysteroscopy with CO2 for uterine distention was performed after the first menses after surgery to assess the frequency, extent, and severity of IUA. The likelihood and severity of IUA depended on the pathology treated at initial surgery. Of women treated for polyps and uterine septa, in only one with septa (placebo group) developed IUA. Mild IUA formation was present in 10 patients (31.3%) with solitary fibroids and 9 (45.5%) with multiple myomata. The frequency was similar in placebo- and danazol-treated groups with both solitary and multiple myomas (50% and 44.4% vs 50% and 55.6%). All IUA were lysed during second-look surgery, except in one woman with multiple myomata who required repeat resectoscopy. CONCLUSION: Intrauterine adhesions are the major long-term complication of operative hysteroscopy, with frequency dependent on the pathology initially treated. Second-look office hysteroscopy is a cost-effective method of diagnosing and lysing IUA after resectoscopy. SN - 1074-3804 UR - https://www.unboundmedicine.com/medline/citation/10924629/Role_of_endometrial_suppression_on_the_frequency_of_intrauterine_adhesions_after_resectoscopic_surgery_ DB - PRIME DP - Unbound Medicine ER -