[Uterine synechias treated exclusively hysteroscopically - about 127 cases]

ABSTRACT

This retrospective study of 127 patients with uterine synechias treated exclusively hysteroscopically included 84 [66.25%] low fertility patients, 36[28.5%] with menstrual disorders and 7 [4%] with no other symptoms. About ninety three patients [73.8%] had a past history of trauma on a gravid uterus. Operative hysteroscopy was performed in all cases, including sections with scissors in 8 cases [13.3%] between 1995 and 1996, and electrosection between 1997 and 2003. A single endoscopic procedure was efficient in 70% of cases and second procedure were required in 6 cases [7.5% of the patients]. No complications due to infection, bleeding or metabolic disorders occurred, but perforations were seen in 2 patients [2.5%] both with complexe synechia. Good anatomic results were achieved after 1 hysteroscopic procedure [70%]. Clinical results were less satisfactory, particularly in cases with low fertility in which another pathology was often associated [31.42%]. We obtained good results in 78.57% of the patients with amenorrhea. However, 49 pregnancies were achieved including 12 normal deliveries