Clinical and Morphological Evaluation of the Effectiveness of Ambulatory Hysteroscopic Metroplasty in Case of Intrauterine Septum

Abstract

Aim: Clinical and morphological evaluation of the effectiveness of the hysteroscopic metroplasty using the pulsed diode laser in case of the intrauterine septum. Design: Retrospective comparative study. Materials and methods. A comparative analysis of the effectiveness of the metroplasty, specific features of the course of the surgery, postoperative period, status of the endometrium and reproductive function was performed in 39 women (1st group) who underwent the surgery with the use of the pulsed diode laser and 19 patients (2nd group) who underwent bipolar electrosurgery. Results. When using the proposed method of metroplasty, the dissection of the intrauterine septum was statistically significantly more often optimal (82.05%) (p < 0.001). The morphological structure of the endometrium after metroplasty in patients of the 1st group significantly more often corresponded to the phase of the menstrual cycle (86.36%; p = 0.044) and was less often changed due to manifestations of perivascular fibrosis (12 (54.55%) of 22; p = 0.037). In most women of the 1st group, pregnancy ended in timely delivery — 15 (71.43%) out of 21 (p = 0.013). Conclusion. The proposed method of metroplasty is an effective and safe method of dissection of the intrauterine septum, which has a positive effect on reproductive function. Keywords: intrauterine septum, hysteroscopic metroplasty, reproductive function.