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Hysteroscopic adhesiolysis: efficacy and safety.
Arch Gynecol Obstet. 2016 08; 294(2):411-6.AG

Abstract

OBJECTIVE

To evaluate the efficacy and safety of hysteroscopic adhesiolysis in patients with intrauterine adhesions (IUAs).

SETTING

Minia Maternity University Hospital, Egypt.

DESIGN

Prospective cohort study.

PATIENTS

This study included 61 patients presented with infertility (primary or secondary) or recurrent pregnancy losses caused by IUAs.

INTERVENTION(S)

The adhesions were divided by semi-rigid scissors introduced under direct vision through hysteroscopy. Three months later, second-look hysteroscopy was performed.

PRIMARY OUTCOME PARAMETERS

Primary outcome parameters were reproductive parameters (pregnancy rate, duration of pregnancies, life births rate, time lag between the intervention and diagnosis of pregnancy).

SECONDARY OUTCOME PARAMETERS

Secondary outcome parameters were the changes in post-operative menstrual pattern, number and duration of intervention and type of intra- and post-operative complications.

RESULT(S)

Pregnancy rate changed from 18 to 65.5 %, while live birth rate improved from 14.7 to 36 %. The mean time until the first conception was 10.2 months (range 2-60 months) after the operation. There was significant negative correlation between the degree of IUAs and the improvement in reproductive performance. Hysteroscopic adhesiolysis significantly improved menstrual pattern in 60.7 % of patients complaining of hypomenorrhea or amenorrhea. (p = 0.0017). The average operative time was 29 ± 10.2 (10-52) min and the hospital stay was 12.5 ± 2.1 (9-24) h. Uterine perforation occurred on 3 (4.9 %), and cervical laceration occurred in one case (1.6 %).

CONCLUSION(S)

Hysteroscopic adhesiolysis of IUAs is safe and effective in terms of reproductive outcome. The outcome is significantly affected by degree of intrauterine adhesions rather than the main complaint before the procedure.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Faculty of Medicine, Minia Maternity University Hospital, Minia University, Cournish El-Nile Street, Minia, Egypt. asasanad@hotmail.com.Department of Obstetrics and Gynecology, Faculty of Medicine, Minia Maternity University Hospital, Minia University, Cournish El-Nile Street, Minia, Egypt.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27129970

Citation

Sanad, Ahmad Sameer, and Mahmoud Elmorsi Aboulfotouh. "Hysteroscopic Adhesiolysis: Efficacy and Safety." Archives of Gynecology and Obstetrics, vol. 294, no. 2, 2016, pp. 411-6.
Sanad AS, Aboulfotouh ME. Hysteroscopic adhesiolysis: efficacy and safety. Arch Gynecol Obstet. 2016;294(2):411-6.
Sanad, A. S., & Aboulfotouh, M. E. (2016). Hysteroscopic adhesiolysis: efficacy and safety. Archives of Gynecology and Obstetrics, 294(2), 411-6. https://doi.org/10.1007/s00404-016-4107-9
Sanad AS, Aboulfotouh ME. Hysteroscopic Adhesiolysis: Efficacy and Safety. Arch Gynecol Obstet. 2016;294(2):411-6. PubMed PMID: 27129970.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hysteroscopic adhesiolysis: efficacy and safety. AU - Sanad,Ahmad Sameer, AU - Aboulfotouh,Mahmoud Elmorsi, Y1 - 2016/04/29/ PY - 2015/11/27/received PY - 2016/04/22/accepted PY - 2016/5/1/entrez PY - 2016/5/1/pubmed PY - 2017/8/10/medline KW - Hysteroscopic adhesiolysis KW - Intrauterine adhesions KW - Reproductive outcome SP - 411 EP - 6 JF - Archives of gynecology and obstetrics JO - Arch Gynecol Obstet VL - 294 IS - 2 N2 - OBJECTIVE: To evaluate the efficacy and safety of hysteroscopic adhesiolysis in patients with intrauterine adhesions (IUAs). SETTING: Minia Maternity University Hospital, Egypt. DESIGN: Prospective cohort study. PATIENTS: This study included 61 patients presented with infertility (primary or secondary) or recurrent pregnancy losses caused by IUAs. INTERVENTION(S): The adhesions were divided by semi-rigid scissors introduced under direct vision through hysteroscopy. Three months later, second-look hysteroscopy was performed. PRIMARY OUTCOME PARAMETERS: Primary outcome parameters were reproductive parameters (pregnancy rate, duration of pregnancies, life births rate, time lag between the intervention and diagnosis of pregnancy). SECONDARY OUTCOME PARAMETERS: Secondary outcome parameters were the changes in post-operative menstrual pattern, number and duration of intervention and type of intra- and post-operative complications. RESULT(S): Pregnancy rate changed from 18 to 65.5 %, while live birth rate improved from 14.7 to 36 %. The mean time until the first conception was 10.2 months (range 2-60 months) after the operation. There was significant negative correlation between the degree of IUAs and the improvement in reproductive performance. Hysteroscopic adhesiolysis significantly improved menstrual pattern in 60.7 % of patients complaining of hypomenorrhea or amenorrhea. (p = 0.0017). The average operative time was 29 ± 10.2 (10-52) min and the hospital stay was 12.5 ± 2.1 (9-24) h. Uterine perforation occurred on 3 (4.9 %), and cervical laceration occurred in one case (1.6 %). CONCLUSION(S): Hysteroscopic adhesiolysis of IUAs is safe and effective in terms of reproductive outcome. The outcome is significantly affected by degree of intrauterine adhesions rather than the main complaint before the procedure. SN - 1432-0711 UR - https://www.unboundmedicine.com/medline/citation/27129970/Hysteroscopic_adhesiolysis:_efficacy_and_safety_ L2 - https://dx.doi.org/10.1007/s00404-016-4107-9 DB - PRIME DP - Unbound Medicine ER -