Office hysteroscopic metroplasty with diode laser for septate uterus: a multicenter cohort study

Manchado, Berta Esteban; López-Yarto, Maite; Fernández-Parra, J.; Rodríguez-Oliver, A.J.; González-Paredes, A.; Laganà, Antonio Simone; Garzon, Simone; Haimovich, Sergio

doi:10.1080/13645706.2020.1837181

Cited by 20 publications

(17 citation statements)

References 29 publications

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“…In addition, recently Haimovich et al con rmed our preliminary results on hysteroscopic metroplasty with a diode laser. Tissue vaporization and coagulation with low power diode laser energy allow for the quick elimination of the uterine septum without affecting the underlying myometrium [21]. The septum should be considered as a solid foreign body in the uterine cavity, surrounded by healthy myometrium, this was con rmed in the most recent literature [22].…”

Section: Discussionmentioning

confidence: 97%

The use of hysteroscopic metroplasty with diode laser to increase endometrial volume in women with septate uterus: preliminary results

et al. 2021

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Background Septate uterus is a common Mullerian ducts anomaly. The aim of our pilot study was the evaluation of diode laser hysteroscopic metroplasty efficacy to increase endometrial volume in women with septate uterus. Results We prospectively enrolled 10 consecutive patients with septate uterus undergoing office hysteroscopic metroplasty with diode laser between February and November 2019. Endometrial volume was evaluated before and 3 months after surgery using 3D transvaginal ultrasound. The surgical procedure was uncomplicated in all patients, the endometrial volume increased at 3 months follow-up (the median increase was 1.9 cm3 (range 1.7–2.1), and there was a complete removal of septum with no intrauterine synechiae at follow-up hysteroscopy. Conclusions Office hysteroscopic metroplasty with diode laser is a safe procedure and has preliminary showed to increase endometrial volume. The increase in endometrial volume by 3D-TV US could be used as a prognostic factor for the reproductive outcomes.

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Section: Discussionmentioning

confidence: 97%

The use of hysteroscopic metroplasty with diode laser to increase endometrial volume in women with septate uterus: preliminary results

et al. 2021

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“…Some reports have shown that hysteroscopic septal division can reduce the risk of miscarriage and improve live birth rates [6,[68][69][70], but surgical management for incidentally diagnosed septum and fusion or unification defects is controversial and unproven [71]. Various hysteroscopic instruments, including microscissors, forceps, operating loop, electrosurgical needle, and laser energy, have been proposed for surgical correction [72]. Gradually, several methods are being introduced to help the proliferation of endometrial tissue, reduce adhesion formation and minimize intraoperative or postoperative complications [73].…”

Section: Discussionmentioning

confidence: 99%

Reproductive, Obstetric and Neonatal Outcomes in Women with Congenital Uterine Anomalies: A Systematic Review and Meta-Analysis

Kim¹,

Kim²,

Kim³

2021

JCM

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Congenital uterine anomalies (CUA) may influence reproductive performance, resulting in adverse pregnancy associated complications. This study aimed to assess the association of CUA subtypes with reproductive, obstetric, and perinatal outcomes. We performed a systematic search of the MEDLINE, EMBASE, and Cochrane libraries for studies comparing pregnancy outcomes between women with CUA and those with a normal uterus. The random effects model was used to estimate the odds ratios (ORs) with a 95% confidence interval (CI). Women with CUA had a lower rate of live births (OR 0.47; 95% CI 0.33–0.69), and a higher rate of first trimester miscarriage (OR, 1.79; 95% CI, 1.34–2.4), second trimester miscarriage (OR 2.92; 95% CI 1.35–6.32), preterm birth (OR 2.98; 95% CI 2.43–3.65), malpresentation (OR 9.1; 95% CI 5.88–14.08), cesarean section (OR 2.87; 95% CI 1.56–5.26), and placental abruption (OR 3.12; 95% CI 1.58–6.18). Women with canalization defects appear to have the poorest reproductive performance during early pregnancy. However, unification defects were associated with obstetric and neonatal outcomes throughout the course of pregnancy. It may be beneficial for clinicians to advise on potential complications that may be increased depending on the type and severity of CUA.

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“…These include visually-directed endometrial sampling, lysis of intrauterine or cervical adhesions, and removal of numerous pathologies, such as endometrial and endocervical polyps, small leiomyomas, retained products of conception and intrauterine devices. 17–19…”

Section: Indications For Office Hysteroscopymentioning

confidence: 99%

Implementation of Office Hysteroscopy for the Evaluation and Treatment of Intrauterine Pathology

Orlando

Bradley

2022

Obstetrics &Amp; Gynecology

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Hysteroscopy provides a minimally invasive strategy to evaluate intrauterine pathology and manage conditions such as abnormal uterine bleeding, infertility, intrauterine adhesions, mu ¨llerian anomalies, and intrauterine foreign bodies. Increasing access to hysteroscopy procedures in the office has the potential to improve patient care by minimizing financial and logistical barriers, aiding in streamlined diagnosis and treatment planning, and potentially averting unnecessary operative procedures and anesthesia. Office hysteroscopy refers to procedures performed in outpatient settings where pain management involves no medications, oral nonsedating medications, local anesthetic agents, or oral or inhaled conscious sedation. We present best practices for the implementation of hysteroscopy in an office setting. These include appropriate patient selection, optimal procedural timing, cervical preparation for patients at highest risk of cervical stenosis or pain with dilation, individualized pain-management strategies, use of distension media, and video monitoring to engage patients in the procedure. We describe miniaturized equipment for use in the office setting and "no-touch" vaginoscopic approaches to limit patient discomfort. With appropriate training and experience, office hysteroscopy presents a simple and cost-effective modality for optimizing gynecologic care for our patients.

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Office hysteroscopic metroplasty with diode laser for septate uterus: a multicenter cohort study

Cited by 20 publications

References 29 publications

The use of hysteroscopic metroplasty with diode laser to increase endometrial volume in women with septate uterus: preliminary results

The use of hysteroscopic metroplasty with diode laser to increase endometrial volume in women with septate uterus: preliminary results

Reproductive, Obstetric and Neonatal Outcomes in Women with Congenital Uterine Anomalies: A Systematic Review and Meta-Analysis

Implementation of Office Hysteroscopy for the Evaluation and Treatment of Intrauterine Pathology

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