O Abuzeid1, M Ibrahim2, S Joseph2, J Herbert3, M Abuzeid2,3,4. 1. Fellow, Division of Maternal Fetal-Medicine, Department of Obstetrics and Gynecology, Stony Brook University, Long Island, New York, USA. 2. IVF Michigan Rochester Hills and Flint PC, Rochester Hills, Michigan, USA. 3. Department of Obstetrics and Gynecology, Hurley Medical Center, Michigan State University, College of Human Medicine, Flint, Michigan, USA. 4. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hurley Medical Center, Michigan State University, College of Human Medicine, Flint, Michigan, USA.
Abstract
BACKGROUND: To determine the safety and efficacy of hysteroscopic resection of uterine leiomyoma embedded at the base of a uterine septum. METHODS: This case series included 11 patients with infertility or recurrent pregnancy loss who were found to have a uterine septum (one septate and 10 sub-septate) and a uterine leiomyoma embedded at the base of the uterine septum. All patients underwent a hysteroscopic division of the uterine septum and hysteroscopic resection of the uterine leiomyoma. Safety was determined by any intra-operative complications, and any immediate or late postoperative complications. Efficacy was determined based on the findings on a postoperative trans-vaginal 3D ultrasound (TV 3D US) with a saline infusion sonohysterogram (SIH) and reproductive outcomes. RESULTS: There were no reported intra-operative complications, or immediate or late postoperative complications. Eleven patients underwent TV 3D US with SIH; findings were normal in 8 (72.7%); 3 patients underwent a second operative hysteroscopy and subsequent TV 3D US with SIH were also normal. The analysis of reproductive outcomes was limited to patients who were < 40 years (9 patients). Seven patients conceived (77.8%), six delivered (66.7%) and one miscarried (14.3%). CONCLUSIONS: Hysteroscopic myomectomy of a leiomyoma, which is embedded at the base of a uterine septum, can be safely performed at the same session of hysteroscopic division of the uterine anomaly. Improvement in reproductive outcomes is to be expected after such procedures.
BACKGROUND: To determine the safety and efficacy of hysteroscopic resection of uterine leiomyoma embedded at the base of a uterine septum. METHODS: This case series included 11 patients with infertility or recurrent pregnancy loss who were found to have a uterine septum (one septate and 10 sub-septate) and a uterine leiomyoma embedded at the base of the uterine septum. All patients underwent a hysteroscopic division of the uterine septum and hysteroscopic resection of the uterine leiomyoma. Safety was determined by any intra-operative complications, and any immediate or late postoperative complications. Efficacy was determined based on the findings on a postoperative trans-vaginal 3D ultrasound (TV 3D US) with a saline infusion sonohysterogram (SIH) and reproductive outcomes. RESULTS: There were no reported intra-operative complications, or immediate or late postoperative complications. Eleven patients underwent TV 3D US with SIH; findings were normal in 8 (72.7%); 3 patients underwent a second operative hysteroscopy and subsequent TV 3D US with SIH were also normal. The analysis of reproductive outcomes was limited to patients who were < 40 years (9 patients). Seven patients conceived (77.8%), six delivered (66.7%) and one miscarried (14.3%). CONCLUSIONS: Hysteroscopic myomectomy of a leiomyoma, which is embedded at the base of a uterine septum, can be safely performed at the same session of hysteroscopic division of the uterine anomaly. Improvement in reproductive outcomes is to be expected after such procedures.
Authors: Donna Day Baird; David B Dunson; Michael C Hill; Deborah Cousins; Joel M Schectman Journal: Am J Obstet Gynecol Date: 2003-01 Impact factor: 8.661
Authors: Grigoris F Grimbizis; Stephan Gordts; Attilio Di Spiezio Sardo; Sara Brucker; Carlo De Angelis; Marco Gergolet; Tin-Chiu Li; Vasilios Tanos; Hans Brölmann; Luca Gianaroli; Rudi Campo Journal: Hum Reprod Date: 2013-06-14 Impact factor: 6.918