TITLE:
Effects of operative hysteroscopy with anti-adhesive solution in the patients who have abnormal uterine bleeding or intrauterine lesions
AUTHORS:
Tae-Hee Kim, Hae-Hyeog Lee, Soo-Ho Chung, Junsik Park
KEYWORDS:
Hysteroscopy; Uterine Hemorrhage; Menorrhagia
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.3 No.3,
May
8,
2013
ABSTRACT: Objective: The purpose of this study was to
evaluate the efficacy, safety, and benefits of hysteroscopic surgery in the
treatment of dysfunctional uterine bleeding (DUB) or intrauterine lesions
causing uterine bleeding. Methods: This study prospectively enrolled 100
patients who underwent operative hysteroscopy in tertiary referral university
center because of uterine bleeding due to endometrial polyps or uterine submucosal
leiomyomas diagnosed by transvaginal ultrasonogram. Indications for the
operative hysteroscopies included abnormal
uterine bleeding (AUB), ultrasound findings indicative of intrauterine
lesions, and DUB. After operative hysteroscopic management, we inserted
anti-adhesive solution, sodium hyaluronate and carboxymethyl cellulose into
the uterine cavity. Results: Operative hysteroscopy was a successful
procedure in 100 of 100 cases (100%) but it needed to be repeated in three
cases with large uterine submucosal leiomyoma and after two endometrial polypectomy.
Mean duration of the procedure was 23.2 minutes (range 5 - 67) and
postoperative hospital stay was 7 hours (range 3 - 48). Most common indication
was DUB (39%), submucosal leiomyoma was 21%, and endometrial polyp was 17%.
There were five cases with postoperative uterine bleeding and none with fluid
overload syndrome. During postoperative follow-up (3 - 28 months) the
majority of patients (90/100, 90%) were free of symptoms. Conclusion: Hysteroscopic
procedure is an effective and safe method for the management of benign intracavitary
pathology or the treatment of dysfunctional uterine bleeding. Although sodium
hyaluronate and carboxymethyl cellulose seems to be effective in the prevention
of adhesion in uterine cavity, further study will be needed to prove the
effectiveness of anti-adhesive solution.