Authors: Tarek A Shokeir Muhammad Fawzy Muhammad Tatongy
Publish Date: 2007/10/16
Volume: 277, Issue: 5, Pages: 423-427
Abstract
To evaluate the rate and characteristics of postoperative intrauterine adhesions IUA that might be formed following hysteroscopic reproductive surgery from both a gross and a histologic perspective as determined by early and late followup diagnostic hysteroscopyRetrospective analysis of 61 women wishing a pregnancy and suffering from a significant intrauterine pathology affecting their reproductive outcome were reviewed All patients were treated hysteroscopically Subsequently they were randomly assigned to perform a followup diagnostic hysteroscopy at a variable intervals from their initial surgery Multiple hysteroscopicguided biopsies from IUA when present were obtained in several cases Twenty patients were in the early group and had followup hysteroscopy performed 2–4 weeks after the initial operation The late diagnostic group consisted of 41 patients with followup hysteroscopy at about 12 months 8–16 months The two groups were similar to composition Postoperatively none of the early diagnostic group underwent hysterosalpingography HSG whereas all of the late group performed HSG 4 months following the initial surgery which showed at least onethird of the cavity free of adhesions When adhesions were present no effort was made to lyse themAt followup hysteroscopy 25 of both groups had no significant adhesions Grade I adhesions thin filmy occurred in 60 of the early hysteroscopy patients and in only 12 of the late group P 005 Grade II adhesions were present in 10 of the early group and in up to 41 in the late group P 005 whereas Grade III adhesions were present in only 5 of the early hysteroscopy group but in 22 of the late one P 005 Correlation between hysteroscopic and histologic findings were good in most of cases in both groups Followup to determine the subsequent reproductive outcome revealed similar conception rates in both groupsThe IUA that might be formed immediately following hysteroscopic reproductive surgery are histologically different from those appearing a longer time after the original operation Routine early followup hysteroscopy can influence the prognosis resulting from the original surgery
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