The use of hysteroscopic metroplasty with diode laser to increase endometrial volume in women with septate uterus: preliminary results

Nappi, Luigi; Falagario, M; Angioni, Stefano; Feo, Vincenzo De; Bollino, Michele; Sorrentino, Felice

doi:10.1186/s10397-021-01093-8

Cited by 8 publications

(2 citation statements)

References 22 publications

(24 reference statements)

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“…Gradually, several methods are being introduced to help the proliferation of endometrial tissue, reduce adhesion formation and minimize intraoperative or postoperative complications [ 73 ]. Tissue vaporization and coagulation with low power diode laser energy can rapidly remove the uterine septum without damaging the underlying myometrium [ 74 , 75 ]. Still, there is a lack of large scale studies on which technique is better.…”

Section: Discussionmentioning

confidence: 99%

Reproductive, Obstetric and Neonatal Outcomes in Women with Congenital Uterine Anomalies: A Systematic Review and Meta-Analysis

Kim

2021

JCM

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Congenital uterine anomalies (CUA) may influence reproductive performance, resulting in adverse pregnancy associated complications. This study aimed to assess the association of CUA subtypes with reproductive, obstetric, and perinatal outcomes. We performed a systematic search of the MEDLINE, EMBASE, and Cochrane libraries for studies comparing pregnancy outcomes between women with CUA and those with a normal uterus. The random effects model was used to estimate the odds ratios (ORs) with a 95% confidence interval (CI). Women with CUA had a lower rate of live births (OR 0.47; 95% CI 0.33–0.69), and a higher rate of first trimester miscarriage (OR, 1.79; 95% CI 1.34–2.4), second trimester miscarriage (OR 2.92; 95% CI 1.35–6.32), preterm birth (OR 2.98; 95% CI 2.43–3.65), malpresentation (OR 9.1; 95% CI 5.88–14.08), cesarean section (OR 2.87; 95% CI 1.56–5.26), and placental abruption (OR 3.12; 95% CI 1.58–6.18). Women with canalization defects appear to have the poorest reproductive performance during early pregnancy. However, unification defects were associated with obstetric and neonatal outcomes throughout the course of pregnancy. It may be beneficial for clinicians to advise on potential complications that may be increased depending on the type and severity of CUA.

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Section: Discussionmentioning

confidence: 99%

Reproductive, Obstetric and Neonatal Outcomes in Women with Congenital Uterine Anomalies: A Systematic Review and Meta-Analysis

Kim

2021

JCM

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“…In addition, second- generation techniques have been used in hysteroscopy with good results. These new technological advances in the treatment of septate uterus have demonstrated sufficient efficacy in terms of reproductive outcomes ( 24 – 26 ).…”

Section: Discussionmentioning

confidence: 99%

Reproductive outcomes and risk factors of women with septate uterus after hysteroscopic metroplasty

et al. 2023

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BackgroundHysteroscopic metroplasty of the uterine septum has been the standard treatment strategy to improve reproductive outcomes, but there are still controversies about the appropriateness of metroplasty. In addition, there have been few studies of the factors related to reproductive outcomes of women after surgery. The study aimed to evaluate the reproductive outcomes and the associated risk factors that influence reproductive outcomes after hysteroscopic metroplasty of women with septate uterus and the desire to conceive.MethodsThis study was an observational study. Cases were screened by searching electronic patient files, and demographic factors were collected. We conducted telephone follow-ups to collect the postoperative reproductive outcomes. The primary outcome of this study was live birth, and secondary outcomes were ongoing pregnancy, clinical pregnancy, early miscarriage, and preterm birth. Demographic variables included patients’ age, body mass index (BMI), the type of septum, infertility and miscarriage history, and complications including intrauterine adhesions, endometrial polyps, endometriosis, and adenomyosis were collected to perform univariate and multivariate analyses to predict the risk factors of reproductive outcomes after surgery treatment.ResultsIn total, 348 women were evaluated and followed up. There were 95 cases (27.3%, 95/348) with combined infertility, 195 cases (56.0%, 195/348) with miscarriage history, and cases combined with intrauterine adhesions, endometrial polyps, endometriosis, and adenomyosis were 107 (30.7%, 107/348), 53 (15.2%, 53/348), 28 (8.0%, 28/348), and 5 (1.4%), respectively. Following surgery, the live birth rate and clinical pregnancy rate were significantly higher than prior to surgery (84.6% vs 3.7%, p= 0.000; and 78.2% vs 69.5%, p= 0.01, respectively), early miscarriage rate and preterm delivery rate were significantly lower (8.8% vs 80.6%, p= 0.000; and 7.0% vs 66.7%, p=0.000, respectively). After adjusting for body mass index, miscarriage history, and complications, multivariable logistic regression analysis revealed age ≥ 35 years and primary infertility as independent factors that affected postoperative clinical pregnancy (OR 4.025, 95% CI 2.063–7.851, p= 0.000; and OR 3.603, 95% CI 1.903–6.820, p= 0.000; respectively) and ongoing pregnancy (OR 3.420, 95% CI 1.812–6.455, p= 0.000; and OR 2.586, 95% CI 1.419–4.712, p= 0.002; respectively).ConclusionsHysteroscopic metroplasty could lead to improved reproductive outcomes of women with septate uterus. Both age and primary infertility were independent factors for postoperative reproductive outcomes.Trial registrationChi ECRCT20210343

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Pathophysiology of Female Reproduction and Clinical Management

Nappi

Sorrentino

Greco

et al. 2022

Practical Clinical Andrology

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The female genital system is made up of dynamic organs that change during the woman’s life cycle. Ovarian cycle consists of the growth and development of the ovarian follicle, its bursting, and transformation into the corpus luteum with relative production of estrogens and progesterone.The normal menstrual cycle is the result of the integration of the primary neuroendocrine complex (the hypothalamus–pituitary–ovarian axis) into a control system regulated by a series of peripheral mechanisms of feedback and nerve signals that result in the release of a single mature oocyte from a pool of hundreds of thousands of primordial oocytes. Alterations of these mechanisms can lead to pathological conditions and affect fertility of patients.

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The use of hysteroscopic metroplasty with diode laser to increase endometrial volume in women with septate uterus: preliminary results

Cited by 8 publications

References 22 publications

Reproductive, Obstetric and Neonatal Outcomes in Women with Congenital Uterine Anomalies: A Systematic Review and Meta-Analysis

Reproductive, Obstetric and Neonatal Outcomes in Women with Congenital Uterine Anomalies: A Systematic Review and Meta-Analysis

Reproductive outcomes and risk factors of women with septate uterus after hysteroscopic metroplasty

Pathophysiology of Female Reproduction and Clinical Management

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