Reproductive outcomes after Versapoint hysteroscopic metroplasty

Abstract

To determine the feasibility, safety and the outcomes of hysteroscopic metroplasty with bipolar Versapoint electrode. Prospective, observational study. Endoscopy Unit, Suzan Moubark Maternity and Pediatric University Hospital. Twenty-six patients with different degree of uterine septa and poor reproductive outcomes (spontaneous abortion, habitual abortion, preterm labor and unexplained primary infertility). Versapoint hysteroscopic division of the uterine septum. Prospective evaluation of the reproductive outcomes during 24months follow up. There was significant changes in the results after metroplasty, as 23 (88.46%) patients became pregnant, of them 3/23 (13.04%) had habitual abortion, 2 patients (4.34%) ended in preterm labor, 14/23 (60.86%) had reached to term delivery with a total pregnancy loss of 5/23 (21.73%) and pregnancy complications occurred in 5/23 (21.73%), these results represent a statistically significant difference (P⩽0.05). The mean gestational age, the mean neonatal weight at delivery, early neonatal condition judged by apgar scores both in 1 and 5min after delivery were significantly improved after hysteroscopic metroplasty (P<0.05). There were no intraoperative or postoperative complications, and complete removal of the septum was achieved in 21 patients (80.67%), a residual septum was found in 5 woman (19.23%), and a 2nd intervention was done in only 2 patients (7.69%) with a residual septum >1cm using office hysteroscopy. Hysteroscopic metroplasty using the Versapoint is a successful alternative to the resectoscope technique; it has the same effectiveness and broad safety profile with its simplicity, minimal postoperative squeal, and improved reproductive outcome, this approach should be recommended for metroplasty.