OBJECTIVE: To investigate the effectiveness and safety of office hysteroscopic metroplasty by diode laser for the treatment of septate uteri.STUDY DESIGN: We performed a prospective cohort study including 41 nulliparous women diagnosed with septate uterus and a history of primary infertility or recurrent miscarriage. All patients underwent hysteroscopic metroplasty for the treatment of the uterine septum, which was performed in-office setting using a 4.3mm continuous-flow hysteroscope and a 15-watt diode laser at 1470nm. Surgical and reproductive outcomes after 2 years of follow-up are reported.RESULTS: The procedure was well tolerated by 93% of patients. No surgical complications were reported. Thirty women out of 38 (78.9%) became pregnant: 17 (56.7%) pregnancies were spontaneously conceived, and 13 (43.3%) were obtained with assisted reproductive techniques. Twenty-four (80%) of the 30 pregnant women had a live birth, with a cumulative live birth of 63.2% among the 38 women (95% CI: 45.9-78.2%). There were no cases of post-partum hemorrhage or uterine rupture among 14 (58.3%) women who had vaginal deliveries.CONCLUSION: Office hysteroscopic metroplasty for septate uterus using diode laser appears to be a feasible and safe alternative to other available techniques and has sufficient efficacy in terms of reproductive outcomes to be considered for further investigations.

Office hysteroscopic metroplasty with diode laser for septate uterus: a multicenter cohort study

Simone Garzon
;
2022-01-01

Abstract

OBJECTIVE: To investigate the effectiveness and safety of office hysteroscopic metroplasty by diode laser for the treatment of septate uteri.STUDY DESIGN: We performed a prospective cohort study including 41 nulliparous women diagnosed with septate uterus and a history of primary infertility or recurrent miscarriage. All patients underwent hysteroscopic metroplasty for the treatment of the uterine septum, which was performed in-office setting using a 4.3mm continuous-flow hysteroscope and a 15-watt diode laser at 1470nm. Surgical and reproductive outcomes after 2 years of follow-up are reported.RESULTS: The procedure was well tolerated by 93% of patients. No surgical complications were reported. Thirty women out of 38 (78.9%) became pregnant: 17 (56.7%) pregnancies were spontaneously conceived, and 13 (43.3%) were obtained with assisted reproductive techniques. Twenty-four (80%) of the 30 pregnant women had a live birth, with a cumulative live birth of 63.2% among the 38 women (95% CI: 45.9-78.2%). There were no cases of post-partum hemorrhage or uterine rupture among 14 (58.3%) women who had vaginal deliveries.CONCLUSION: Office hysteroscopic metroplasty for septate uterus using diode laser appears to be a feasible and safe alternative to other available techniques and has sufficient efficacy in terms of reproductive outcomes to be considered for further investigations.
2022
Hysteroscopy
diode laser
metroplasty
reproductive outcomes
uterine septum
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1028272
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