Assessment of uterine cavity after hystroscopic removal of sub- mucous fibroids by morcellation

摘要

Study Objective: sub- mucous fibroid can be removed hystroscopically by different techniques , hystoscopic shaver represent one of the most recent treatment of intra cavitary fibroids, althought its usage is simple and has a good result for removal of fibroid, it may be complicated by formation of intra uterine adhesions. Study Objective: to determine the incidence and types of uterine syechia following hystroscopic myomectomy by morcellation. Design: prospective observational study. Patients and methods : Setting: Al- Azhar University hospital (New Damietta) during the period from August 2016 to March 2018. Patients: fifty women who had hystroscopic myomectomy by intra uterine Bigatti shaver (IBS).for different reasons (abnormal uterine bleeding, infertility, recurrent pregnancy loss). Interventions: office hysteroscopy after 2 months from hystroscopic myomectomy by Bigatti shaver. Measurements and Main Results: Evaluation of uterine cavity especially formation of adhesions is observed. The incidence of adhesions was 8%. The development of adhesion was usually associated with multiple myomas present in posterior position who need long resection time and usually the resection is incomplete. The adhesions were usually mild (75%) and there was no complications were reported after hysteroscopic myomectomy. Conclusion: the IBS proves to be an effective and safe new instrument for the removal of submucous fibroids, however such procedure may be followed by formation of intra uterine adhesions however most adhesions are filmy and its incidence is less than conventional hystroscopic methods as reviewed in literature.