Role of Hysteroscopy in the Diagnosis of Incomplete Uterine Septum and Significant Arcuate Uterine Anomaly

Background: Infertility is one of the most important and underappreciated reproductive health problems in developing countries. The aim of the present study was to evaluate the role of hysterolaparoscopy in infertility.Methods: It was observational prospective study. In this study, 50 patients in the age group of 20-40 years who are anxious to conceive formed the study group. All women were subjected to a detailed history taking followed by clinical examination.Results: Out of 50 cases studied, 30 (60%) were of primary infertility while, 20 (40%) were of secondary infertility. Laparoscopic findings were as follows, 28% had polycystic ovaries, 20% had endometriosis, 18% had tubal factors, 18% had adhesions, and 8% had fibroids while 4% had PID. Hysteroscopic findings were uterine septum in 16%, T shaped cavity in 14%, shaggy-hyperplastic endometrium in 10% while adhesions and polyps in 8% and 4% respectively. 16 women (32%) conceived after the procedure during the study period.Conclusions: It is concluded that while investigating the causes of female infertility combined simultaneous diagnostic laparoscopy and hysteroscopy with operative interventions wherever indicated should be performed in all infertile patients before treatment, especially in women with age more than 30 years.

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Hysterolaparoscopy in the evaluation and management of female infertility

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174423 ◽

2017 ◽

Vol 6 (10) ◽

pp. 4454

Author(s):

Ramalingappa C. Antaratani ◽

Harsha B.

Keyword(s):

Retrospective Study ◽

Therapeutic Modality ◽

Pelvic Endometriosis ◽

Polycystic Ovaries ◽

Medical Sciences ◽

Septate Uterus ◽

Infertile Women ◽

Uterine Anomaly ◽

Case Files

Background: To study the role of hysterolaparoscopy in the evaluation and management of female infertility.Methods: A retrospective study of the 677 case files of all the patients who underwent diagnostic hysterolaparoscopy for infertility between January 2011 to December 2016 at Karnataka Institute of Medical Sciences, Hubli and Sushruta Multispeciality hospital, Hubli. These infertile women were confirmed to have normal ovulatory cycles, hormonal assays and seminogram report. Dye studies as well as inspection for abnormal pelvic and intrauterine pathology and necessary therapeutic interven-tions were done during the procedure. Abnormal pelvic and intrauterine pathology by hysterolaparoscopy were categorized.Results: Out of 677 cases, 74% patients had primary, 26% patients had secondary infertility. As a whole pelvic pathology was confirmed in 59.5% and intrauterine pathology in 22.3% patients by hysteroscopy. The most common laparoscopic abnormality detected was Polycystic ovaries (27.1%), followed by pelvic adhesions (18.7%). Tubal block comprised 8.1% whereas distorted uterus by fibroid in 6.2% and pelvic endometriosis in 8.7%. In hysteroscopy, the incidence of uterine anomaly was 54 (7.9%). Septate uterus is the most common with a mean incidence of approximately 37 (67.8%).Conclusions: Diagnostic hysterolaparoscopy is an effective diagnostic and therapeutic modality for certain significant and correctable abnormalities in pelvis, tubes and uterus which are missed by other imaging modalities.

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Hysteroscopy in the Evaluation of Recurrent First Trimesteric Miscarriages

QJM ◽

10.1093/qjmed/hcaa056.017 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A I Abdelmageed ◽

M M Alsherbiny ◽

A M Abdelhamed ◽

W Y Alsaleem

Keyword(s):

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Treatment Strategies ◽

Uterine Cavity ◽

First Trimester ◽

Maternity Hospital ◽

Uterine Septum ◽

Study Population ◽

Diagnostic Hysteroscopy

Abstract Background Recurrent pregnancy loss (RPL) is one of the most frustrating and difficult areas in reproductive medicine because the etiology is often unknown and there are few evidence-based diagnostic and treatment strategies. Studies on the etiology, evaluation, and management of RPL are often flawed, uterine factors (acquired and congenital)are responsible for 10 to 50 %of recurrent pregnancy loss,hysteroscopy is the gold standard for evaluation of the eendometrial cavity. Aim of the work to evaluate the role of hysteroscopy in the diagnosis of possible uteri.ne congenital and acquired causes of recurrent first trimesteric miscarriages. Patients and methods This prospective cohort study was conducted on 164 patients with recurrent (3 or more), first trimester miscarriage planned to undergo office (diagnostic) hysteroscopy to assess the uterine cavity, who attend Ain Shams University maternity Hospital Early Cancer detection Unit during period from July 2018 to December 2018. Results the largest proportion 53% of our study population had abnormal hysteroscopic findings, and the uterine septum had the highest prevalence among women with recurrent first trimesteric miscarriages. Conclusion In women with recurrent pregnancy loss, hysteroscopy is a useful diagnostic tool in the diagnosis of possible uterine causes of recurrent miscarriages. Uterine septum is the most common congenital uterine abnormality found in patients with recurrent first trimesteric miscarriages.

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