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Management of septate uterus by flexible hysteroscopy and Nd:YAG laser
Author(s) -
Jourdain O,
Dabysing F,
Harle T,
Lajus C,
Roux D,
Dallay D
Publication year - 1998
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(98)00154-4
Subject(s) - medicine , hysteroscopy , septate , abortion , uterine cavity , pregnancy , retrospective cohort study , obstetrics , complication , infertility , surgery , uterine rupture , uterus , gynecology , paleontology , genetics , biology
Objective: To evaluate the efficiency of flexible Nd‐YAG laser hysteroscopic metroplasty. Methods: We present a retrospective study of 17 patients treated for septate uteri between 1990 and 1995. The indication of hysteroscopy was recurrent abortion in nine cases and eight with primary infertility with indication of IVF in another five cases. We did not prescribe any pretreatment. A flexible hysteroscope with a 100‐W Nd:YAG laser was used with glycine‐controlled flow. The septum was divided by the laser after exploration of the cavity. We proposed a control office hysteroscopy 2 months after surgery to prevent uterine adhesions. Results: There was no complication. Twelve patients conceived with 10 live births at term and two spontaneous abortions. Four are still infertile, two were lost from the study and two no longer desired pregnancy. Resectoscopic studies showed the same results. Conclusion: The advantages of this method are the excellent ergonomic properties of the fibroscope and the safety of the laser. We suggest that metroplasty does not improve the pregnancy rate but only the pregnancy outcome of these patients. However, for those with the indication of IVF the procedure seems useful in avoiding abortion.