Prevalence of intrauterine adhesions after hysteroscopic myomectomy by integrated Bigatti Shaver (IBS)

Abstract

Background: Myomectomy is the best procedure for treatment of uterine fibroids. However, post-myomectomy adhesions represent a major problem. The introduction of hysteroscopic myomectomy thought to reduce these adhesions. However, the incidence is not determined after different shavers. Aim of the work: To assess the prevalence of adhesions in women undergoing IBS-myomectomy for uterine fibroids. Patients and methods: The study included 70 women indicated for IBS myomectomy. Eligible females were submitted to full history taking, clinical examination and routine laboratory investigations. In addition, all patients underwent transvaginal ultrasonography. Fibroid grade was defined and hysteroscopic myomectomy. Then office hysteroscopy was done after 3 months of the procedure, and any pathology especially intrauterine adhesions was reported. Patients were classified into two groups; with adhesions and without adhesions. Results: The incidence of adhesions was 5.7%. The development of adhesion was usually associated with multiple myomas present in posterior position who need long resection time and usually the resection is incomplete. The adhesions were usually mild [75%] and there was no complications were reported after hysteroscopic myomectomy. Conclusion: The incidence of intrauterine adhesion after the hysteroscopic myomectomy by IBS is low