Hysteroscopic treatment of congenital uterine malformations causing hemihematometra: a report of three cases.

To our knowledge, this is the first case report of hysteroscopic treatment of congenital uterine malformations with one-sided occlusion causing hemihematometra. This rare form of uterine anomaly should be considered when symptoms such as increasing pelvic pain start with menarche. A 9-mm resectoscope was used for dissecting the way into the occluded part of the uterine body. There the endometrium was ablated for prevention of recurrence of hemihematometra. By this endoscopic approach the disadvantages of laparotomy could be avoided in three adolescent patients.

[Hysteroscopic resection of submucous myoma]. / Die hysteroskopische Resektion submuköser Myome.

Between 1988 and 1991, 39 patients with intrauterine submucous fibroids were treated at the University of Düsseldorf, Department of Gynaecology and Obstetrics, by hysteroscopic resection. Myoma diameter ranged from 1 cm to 6 cm with a median of 2.6 cm. 29 patients had bleeding problems in form of meno-metrorrhagia; 14 patients suffered from infertility, 2 patients were treated by combined transabdominal-transcervical approach because of multiple myomata. One severe intraoperative complication occurred as an uterine perforation with injury to the small bowel. No other complication was seen. All patients with bleeding problems returned to normal menses after the operation. Four women became pregnant, one had an early abortion, one an ectopic pregnancy, two women delivered at term. Hysterectomy could be avoided in all cases.

[Pregnancy after combined microsurgical and hysteroscopic surgical procedure in a patient with uterus septus and vagina septa]. / Schwangerschaft nach kombiniert mikrochirurgischem und operativ-hysteroskopischem Vorgehen bei einer Patientin mit Uterus septus und Vagina septa.

Disturbances in the development of the Müllerian duct system may cause different forms of genital anomalies. We report on a patient with uterus septus and vagina septa, undiagnosed for years, and consequently successfully treated for infertility, who became pregnant immediately after combined microsurgical and operative-hysteroscopic treatment. The pregnancy proceeded without any complications. The patient delivered a healthy girl in the 41st week of gestation.

[Experience with hysteroscopy or ultrasound-controlled removal of an intrauterine spiral with no visible thread in early pregnancy]. / Erfahrungen mit der hysteroskopischen oder sonographisch gesteuerten Entfernung einer Intrauterinspirale ohne sichtbaren Faden in der Frühschwangerschaft.

In case of intrauterine pregnancy with an intrauterine device (IUD), it is recommended, to remove the device because of the risk of abortions or septic complications. If the thread of the IUD is not visible, which often occurs because of growth of the uterus in pregnancy, it is advisable, to perform extraction by hysteroscopy or ultrasonic guidance. We report on 13 cases with hysteroscopic or ultrasonic guided IUD extraction in early pregnancy. 11 resulted in healthy infants, two pregnancies are continuing without complications.