Office hysteroscopic metroplasty: Three “diagnostic criteria” to differentiate between septate and bicornuate uteri

Bettocchi, Stefano; Ceci, Oronzo; Nappi, Luigi; Pontrelli, Giovanni; Pinto, L.; Vicino, Mario

doi:10.1016/j.jmig.2006.11.010

Cited by 49 publications

(30 citation statements)

References 29 publications

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“…All of the procedures were performed by the same hysteroscopist, who stopped resection once healthy myometrium was reached; this was known by the occurrence of minimal bleeding and/or pain perception by the patient. 23 In the current study, the operative time and fluid deficit were less in group B (bipolar twizzle) than in group A (miniscissor), but the difference did not reach the level of statistic significance. No major complications (e.g., fluid overloads, uterine perforations, hemorrhaging, or vasovagal episodes) were recorded in either group.…”

Section: Discussioncontrasting

confidence: 66%

“…In the current study, follow-up HSG performed 3 months later, showed complete resections with no residual problems in all cases in both groups. However, this particular scheduling for HSG 3 months postoperatively was arranged in accordance with the postoperative follow-up timing cited in previous articles, 23,25 which included information about following patients undergoing metroplasty. This does not constitute evidence that such scheduling is the best time to perform the HSGs, based on what is known about uterine healing following metroplasty, which heals uniformly within 4 weeks.…”

Section: Discussionmentioning

confidence: 99%

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Mini-Scissor Versus Bipolar Twizzle in Ambulatory Hysteroscopic Metroplasty: A Prospective Randomized Study

KamelMostafa

El-Tawab

El-AshkarOsama

et al. 2014

Journal of Gynecologic Surgery

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Objective: The goal of this study was to compare mechanical (cold scissor) and electrosurgical metroplasty (bipolar twizzle) in terms of feasibility and pain scoring during ambulatory-based hysteroscopic metroplasty for short, narrow-based uterine septae. Materials and Methods: Forty women, with recurrent abortions or infertility, with short narrow-based septae < 2 cm diagnosed by transvaginal ultrasound and hysterosalpingogram (HSG) were included in the study. The patients were randomized into two groups of 20 patients each. In group A, metroplasty was performed with a cold mini-scissor (mechanical resection). In group B, metroplasty was performed with a bipolar twizzle (electrosurgical resection). None of the patients were given anesthesia or analgesia. Metroplasty was scheduled in the early proliferative phase of each patient's menstrual cycle, without pharmacologic preparation. The VersascopeÒ hysteroscopy system was used. Through the expanding plastic collapsible channel, insertion of a 7-Fr semirigid mechanical instrument (the mini-scissor) or a 5-Fr bipolar electrode (the twizzle) was performed, allowing ambulatory metroplasty to be performed. All patients had postoperative HSGs 3 months later, after exclusion of pregnancy, to evaluate objectively the complete resection of their septae. Results: No significant difference was found between both groups in terms of operative time and fluid deficit (12.68 -2.08 versus 12.08 -2.62) and (519 -118.59 versus 480 -106.01), respectively. Pain scores were significantly higher in the bipolar twizzle group than in the mini-scissor group. The pain scores had (4.01 -0.68 versus 6.98 -1.28) a p significance of < 0.05. Conclusions: Ambulatory-based hysteroscopic metroplasty, using either a mini-scissor or bipolar twizzle, is a safe and effective procedure. Electrosurgical electrodes induce significantly higher pain scores than mechanical cold instruments, necessitating careful instrument selection when treating patients in whom more pain is anticipated (e.g., previous cesarean section, chronic pelvic pain, or anxious or menopausal women). If an electrosurgical electrode is the only available device, a preoperative analgesic is recommended, especially for such patients. ( J GYNECOL SURG 30:147)

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Section: Discussioncontrasting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Mini-Scissor Versus Bipolar Twizzle in Ambulatory Hysteroscopic Metroplasty: A Prospective Randomized Study

KamelMostafa

El-Tawab

El-AshkarOsama

et al. 2014

Journal of Gynecologic Surgery

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“…Although its diagnostic accuracy in the management of congenital anomalies is not yet fully elucidated, it seems to be an extremely useful tool, especially in cases of obstructive or nonobstructive vaginal and/or cervical aplasia or dysplasia (8,11,24,25,(70)(71)(72)(73)(74)(75)(76)(77). All these improvements, together with advances in the field of endoscopy (e.g., office hysteroscopy, hydrolaparoscopy, better imaging in laparoscopy), greatly increase our efficacy for an accurate, clear, and detailed estimation of the anatomy of the female genital system (78)(79)(80)(81).…”

Section: Clear and Accurate Definitionsmentioning

confidence: 99%

“…Laparoscopy and hysteroscopy markedly increase our therapeutic options (6,77,78,98,(114)(115)(116)(117)(118)(119)(120)(121). Furthermore, many new therapeutic options have been proposed for the restoration of vaginal and/or cervical aplasia/dysplasia in the presence or not of a functional uterus (18, 26, 32, 82, 100-104, 106, 113, 122-131).…”

Section: Correlation With Treatmentmentioning

confidence: 99%

Congenital malformations of the female genital tract: the need for a new classification system

Grimbizis

Campo

2010

Fertility and Sterility

104

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“…Moreover, office hysteroscopy may play a primary role in the resolution of many causes of CPP, such as M€ ullerian anomalies (28,62), intrauterine bone structures (34,35,40,(42)(43)(44)(45), endocervical ossification (46), and intrauterine abnormalities (51,52,62).…”

Section: Discussionmentioning

confidence: 99%

Role of hysteroscopy in evaluating chronic pelvic pain

Sardo

Guida

Bettocchi

et al. 2008

Fertility and Sterility

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Office hysteroscopic metroplasty: Three “diagnostic criteria” to differentiate between septate and bicornuate uteri

Cited by 49 publications

References 29 publications

Mini-Scissor Versus Bipolar Twizzle in Ambulatory Hysteroscopic Metroplasty: A Prospective Randomized Study

Mini-Scissor Versus Bipolar Twizzle in Ambulatory Hysteroscopic Metroplasty: A Prospective Randomized Study

Congenital malformations of the female genital tract: the need for a new classification system

Role of hysteroscopy in evaluating chronic pelvic pain

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