Reproductive outcomes after hysteroscopic septoplasty and comparison of different surgical techniques: A retrospective cohort study

Deniz Şimşek; Çağrı Güven; Çağdaş Şahin; Ali Akdemir; Ahmet Mete Ergenoğlu; Ahmet Özgür Yeniel; Fatih Şendağ

doi:10.19161/etd.416612

TR EN

Histeroskopik septoplasti sonrası gebelik sonuçları ve farklı cerrahi tekniklerin karşılaştırılması: Retrospektif kohort çalışma

Öz

Amaç: Uterin septum kadınların büyük bir kısmını, özellikle tekrarlayan düşüğü olan hastaları etkilemektedir. Histeroskopik septoplasti tedavi için yararlı ve minimal invaziv bir tekniktir. Histeroskopi sonrası gebelik oranları değişik çalışmalarda değişkenlik göstermektedir. Çalışmamızda histeroskopik septoplasti sonrası gebelik sonuçları ve farklı histeroskopik tekniklerin yararlı etkilerini karşılaştırmayı amaçladık.

Gereç ve Yöntem: Ege Üniversitesinde 2007-2013 tarihleri arasında histeroskopik septoplasti gerçekleştirilen hastalar retrospektif olarak tarandı. Hastaların gebelik sonuçları üniversite bilgi sistemi ve telefon görüşmeleri ile takip edildi. Canlı doğum oranları ve düşükler değerlendirilmeye alındı. Farklı cerrahi teknikler (rezektoskop, soğuk makas) canlı doğum oranları baz alınarak karşılaştırıldı.

Bulgular: Yüz yirmi iki hasta çalışmaya dahil edildi. Doksan dört gebelik %77 oran ile gerçekleşti. Yetmiş dokuz canlı doğum ve 15 düşük saptandı. Altmış dört (%54) kadın en az bir canlı doğum gerçekleştirmişti. Histeroskopik septoplasti; 72 (%59) hastada rezektoskop, 50 (%41) hastada 5 mm histeroskop ve soğuk makas kullanılarak gerçekleştirildi. Rezektoskop ile işlem gören hastalardan 42’sinde (%58) ve soğuk makas ile gerçekleştirilen hastalardan 24’ünde (%48) canlı doğum gerçekleşti. Cerrahi tekniklere göre canlı doğum oranları karşılaştırıldığında istatistiksel anlamlı fark saptanmadı.

Sonuç: Histeroskopik septoplasti; uterin septum tedavisinde güvenli, yararlı ve minimal invaziv bir yöntemdir. Rezektoskop ve soğuk makas kullanımına göre canlı doğum oranları arasında istatistiksel anlamlı fark saptanmamıştır. Uterin septuma sahip infertil hastalara histeroskopi seçeneği düşük komplikasyon oranları ve yüksek gebelik sonuçları ile önerilebilir.

Anahtar Kelimeler

Uterin septum,histeroskopik septoplasti,rezektoskop,histeroskopi,soğuk makas.

Reproductive outcomes after hysteroscopic septoplasty and comparison of different surgical techniques: A retrospective cohort study

Abstract

Aim: Uterine septum affects a large proportion of women, especially patients with recurrent abortion. Hysteroscopic septoplasty is a novel and minimally invasive method for its treatment. Pregnancy rates after hysteroscopy vary in different studies. We aimed to evaluate pregnancy outcomes after hysteroscopic septoplasty and to compare the beneficial effects of different hysteroscopic techniques.

Materials and Methods: Patients undergoing hysteroscopic septoplasty between 2007 and 2013 in Ege University were retrospectively reviewed. Patients’ pregnancy outcomes were followed-up by using the university’s registry system and telephone interviews. Live birth rates and miscarriages were determined. Different surgical techniques (resectoscope, cold scissors) were compared regarding live birth ratios.

Results: One hundred twenty two patients were included in this study. Ninety-four pregnancies occurred with an overall pregnancy rate of 77%. Seventy nine live births and 15 abortions had occurred. Sixty-six women (54%) gave at least one live birth. Hysteroscopic septoplasty was performed in 72 (59%) and 50 (41%) patients using resectoscope and cold scissors with 5mm hysteroscope, respectively. Fourty two (58%) of patients undergoing septoplasty by resectoscope and 24 patients (48%) of patients undergoing septoplasty by cold scissors group had a live birth. There was no statistically significant difference among the pregnancy outcomes of the two surgical techniques.

Conclusion: Hysteroscopic septoplasty is a safe, effective and minimally invasive method for uterine septum treatment. There is no significant difference in the live birth rates according to whether the resectoscope or cold scissors were used. Infertile patients with uterine septum should be offered the option of hysteroscopy which is feasible with low complication rates and high pregnancy rates.

Keywords

Septate uterus,hysteroscopic septoplasty,resectoscope,hysteroscopy,cold scissor.

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Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Deniz Şimşek ^*
0000-0002-0975-9457
Türkiye

Çağrı Güven
0000-0002-1559-0600
Türkiye

Çağdaş Şahin
0000-0001-7346-3987
Türkiye

Ali Akdemir
0000-0001-8723-5889
Türkiye

Ahmet Mete Ergenoğlu
0000-0003-2775-7911
Türkiye

Ahmet Özgür Yeniel
0000-0002-5604-047X
Türkiye

Fatih Şendağ
0000-0001-9200-7469
Türkiye

Publication Date

September 14, 2018

Submission Date

May 20, 2017

Acceptance Date

June 16, 2017

Published in Issue

Year 2018 Volume: 57 Number: 3

DOI

https://doi.org/10.19161/etd.416612

IZ

https://izlik.org/JA73CU58UM

Cite

RIS / Bibtex

Vancouver

1.Deniz Şimşek, Çağrı Güven, Çağdaş Şahin, Ali Akdemir, Ahmet Mete Ergenoğlu, Ahmet Özgür Yeniel, Fatih Şendağ. Reproductive outcomes after hysteroscopic septoplasty and comparison of different surgical techniques: A retrospective cohort study. EJM. 2018 Sep. 1;57(3):125-30. doi:10.19161/etd.416612