Share This Article:

Effects of operative hysteroscopy with anti-adhesive solution in the patients who have abnormal uterine bleeding or intrauterine lesions

Abstract Full-Text HTML Download Download as PDF (Size:58KB) PP. 327-330
DOI: 10.4236/ojog.2013.33060    2,807 Downloads   4,278 Views   Citations

ABSTRACT

Objective: The purpose of this study was to evaluate the efficacy, safety, and benefits of hysteroscopic surgery in the treatment of dysfunctional uterine bleeding (DUB) or intrauterine lesions causing uterine bleeding. Methods: This study prospectively enrolled 100 patients who underwent operative hysteroscopy in tertiary referral university center because of uterine bleeding due to endometrial polyps or uterine submucosal leiomyomas diagnosed by transvaginal ultrasonogram. Indications for the operative hysteroscopies included abnormal uterine bleeding (AUB), ultrasound findings indicative of intrauterine lesions, and DUB. After operative hysteroscopic management, we inserted anti-adhesive solution, sodium hyaluronate and carboxymethyl cellulose into the uterine cavity. Results: Operative hysteroscopy was a successful procedure in 100 of 100 cases (100%) but it needed to be repeated in three cases with large uterine submucosal leiomyoma and after two endometrial polypectomy. Mean duration of the procedure was 23.2 minutes (range 5 - 67) and postoperative hospital stay was 7 hours (range 3 - 48). Most common indication was DUB (39%), submucosal leiomyoma was 21%, and endometrial polyp was 17%. There were five cases with postoperative uterine bleeding and none with fluid overload syndrome. During postoperative follow-up (3 - 28 months) the majority of patients (90/100, 90%) were free of symptoms. Conclusion: Hysteroscopic procedure is an effective and safe method for the management of benign intracavitary pathology or the treatment of dysfunctional uterine bleeding. Although sodium hyaluronate and carboxymethyl cellulose seems to be effective in the prevention of adhesion in uterine cavity, further study will be needed to prove the effectiveness of anti-adhesive solution.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Kim, T. , Lee, H. , Chung, S. and Park, J. (2013) Effects of operative hysteroscopy with anti-adhesive solution in the patients who have abnormal uterine bleeding or intrauterine lesions. Open Journal of Obstetrics and Gynecology, 3, 327-330. doi: 10.4236/ojog.2013.33060.

References

[1] Lethaby, A., Shepperd, S., Cooke, I. and Farquhar, C. (1999) Endometrial resection and ablation versus hysterectomy for heavy menstrual bleeding. Cochrane Database of Systemic Review, 2, Article ID: CD000329.
[2] Weber, A. and Munro, M. (1998) Endometrial ablation versus hysterectomy: STOP-DUB. Medscape Women’s Health, 3, 3.
[3] Loffer, F.D. (1990) Removal of large symptomatic intrauterine growths by the hysteroscopic resectoscope. Obstetrics and Gynecology, 76, 836. doi:10.1097/00006250-199011000-00023
[4] Wamsteker, K., Emanuel, M.H. and De Kruif, J. (1993) Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: Results regarding the degree of intramural extension. Obstetrics and Gynecology, 82, 736.
[5] Hidlebaugh, D. (1996) A comparison of clinical outcomes and cost of office versus hospital hysteroscopy. The Journal of the American Association of Gynecologic Laparoscopists, 4, 39-45. doi:10.1016/S1074-3804(96)80107-1
[6] Hulka, J.F., Peterson, H.A., Phillips, J.M. and Surrey, M.W. (1995) Operative hysteroscopy: American Association of Gynecologic Laparoscopists’ 1993 membership survey. The Journal of the American Association of Gynecologic Laparoscopists, 2, 131-132. doi:10.1016/S1074-3804(05)80004-0
[7] Cayuela, E., Cos, R., Onbargi, L., Moreno, M., Mellado, F., Heredia, F., et al. (1996) Complications of operative hysteroscopy. Journal of the American Association of Gynecologic Laparoscopists, 3, S6. doi:10.1016/S1074-3804(96)80148-4
[8] Jansen, F.W., Vredevoogd, C.B., Van Ulzen, K., Hermans, J., Trimbos, J.B. and Trimbos-Kemper, T.C. (2000) Complications of hysteroscopy: A prospective, multicenter study. Obstetrics and Gynecology, 96, 266-270. doi:10.1016/S0029-7844(00)00865-6
[9] Propst, A.M., Liberman, R.F., Harlow, B.L. and Ginsburg, E.S. (2000) Complications of hysteroscopic surgery: Predicting patients at risk. Obstetrics and Gynecology, 96, 517-520. doi:10.1016/S0029-7844(00)00958-3
[10] Clark, T.J., Khan, K.S. and Gupta, J.K. (2002) Current practice for the treatment of benign intrauterine polyps: A national questionnaire survey of consultant gynaecologists in UK. European Journal of Obstetrics and Gynecology and Reproductive Biology, 103, 65-67. doi:10.1016/S0301-2115(02)00011-8
[11] Preutthipan, S. and Herabutya, Y. (2005) Hysteroscopic polypectomy in 240 premenopausal and postmenopausal women. Fertility and Sterility, 83, 705-709. doi:10.1016/j.fertnstert.2004.08.031
[12] Emanuel, M.H., Wamsteker, K., Hart, A.A., Metz, G. and Lammes, F.B. (1999) Long-term results of hysteroscopic myomectomy for abnormal uterine bleeding. Obstetrics and Gynecology, 93, 743-748. doi:10.1016/S0029-7844(98)00558-4
[13] Hart, R., Molnár, B.G. and Magos, A. (1999) Long term follow up of hysteroscopic myomectomy assessed by survival analysis. BJOG: An International Journal of Obstetrics and Gynaecology, 106, 700-705. doi:10.1111/j.1471-0528.1999.tb08370.x
[14] O’Connor, H., Broadbent, J., Magos, A.L. and McPherson, K. (1997) Medical Research Council randomised trial of endometrial resection versus hysterectomy in management of menorrhagia. Lancet, 349, 897. doi:10.1016/S0140-6736(96)07285-6
[15] O’Connor, H. and Magos, A. (1996) Endometrial resection for the treatment of menorrhagia. New England Journal of Medicine, 335, 151-156. doi:10.1056/NEJM199607183350302
[16] Cooper, K.G., Parkin, D.E., Garratt, A.M. and Grant, A.M. (1999) Two-year follow up of women randomised to medical management or transcervical resection of the endometrium for heavy menstrual loss: Clinical and quality of life outcomes. BJOG: An International Journal of Obstetrics and Gynaecology, 106, 258-265. doi:10.1111/j.1471-0528.1999.tb08240.x
[17] Tsapanos, V.S., Stathopoulou, L.P., Papathanassopoulou, V.S. and Tzingounis, V.A. (2002) The role of SeprafilmTM bioresorbable membrane in the prevention and therapy of endometrial synechiae. Journal of Biomedical Materials Research, 63, 10-14. doi:10.1002/jbm.10040

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.