FOLLOW UP OF OUTCOMES OF HYSTEROSCOPIC MYOMECTOMY, SEPTUM RESECTION AND DISSECTION OF INTRAUTERINE SYNECHIAE RETROSPECTIVE ANALYSIS OF OUTCOMES OF HYSTEROSCOPIC SURGERY

Abstract

Office hysteroscopy examination is established in diagnosis of cases with infertility, recurrent pregnancy loss, amenorrhea and abnormal uterine bleeding by providing information about intracavitary lesions that cannot be obtained by hysterography or ultrasonography and important in treating uterine lesions which in the past require invasive surgical procedures. In our retrospective study we could follow up 190 from 551 patients who had operative hysteroscopy at (Early Cancer Detection Unit) at Ain Shams Maternity Hospital of Ain Shams University from the year 1996 to the year 2007, (25 hysteroscopic myomectomy, 35 hysteroscopic septum resection and 130 hysteroscopic adhesiolysis). We could follow up 34% of the patients and most of the followed up patients were through telephone calls. The highest percentage of followed up patients (41%) are educated at secondary schedule level. The highest mean age was encountered among fibroid patients (35 years) and the least mean age among patients with septum (29 years). The most used contraceptive technique among those using contraception was the IUDs. The longest mean duration of illness was for fibroid patients (11.4 months) while the shortest duration of illness was among septum patients (6.7 months). Infertility was the most reported complaint among all studied patients 67% and particularly higher among patients who had hysteroscopic adhesiolysis 75%, while menorrhagia was the most reported complaint among patients who had hysteroscopic myomectomy 43% and abortion was the most reported complaint among patients who had hysteroscopic septum resection 43%. Conventional technique was the most used method among patients who had hysteroscopic septum resection 55%, while vaginoscopic technique was higher among patients who had hysteroscopic adhesiolysis 53%. Equal distribution of conventional and vaginoscopic techniques were done to fibroid patients. The highest percentage of patients that needed general anesthesia with the maneuver was patients who had hysteroscopic myomectomy (96%), while general anesthesia was least needed among patients who had hysteroscopic adhesiolysis (62%).