Abstract
BackgroundSeptate uterus is a common Mullerian ducts anomaly. The aim of our pilot study was the evaluation of diode laser hysteroscopic metroplasty efficacy to increase endometrial volume in women with septate uterus.ResultsWe prospectively enrolled 10 consecutive patients with septate uterus undergoing office hysteroscopic metroplasty with diode laser between February and November 2019. Endometrial volume was evaluated before and 3 months after surgery using 3D transvaginal ultrasound. The surgical procedure was uncomplicated in all patients, the endometrial volume increased at 3 months follow-up (the median increase was 1.9 cm3 (range 1.7–2.1), and there was a complete removal of septum with no intrauterine synechiae at follow-up hysteroscopy.ConclusionsOffice hysteroscopic metroplasty with diode laser is a safe procedure and has preliminary showed to increase endometrial volume. The increase in endometrial volume by 3D-TV US could be used as a prognostic factor for the reproductive outcomes.
Highlights
IntroductionBackground Septate uterus is a commonMullerian ducts anomaly. The aim of our study was the evaluation of the efficacy of hysteroscopic metroplasty with diode laser to increase endometrial volume in women with septate uterus
Background Septate uterus is a commonMullerian ducts anomaly
The surgical procedure was uncomplicated in all patients, the endometrial volume increased at 3 months follow up and there was a complete removal of septum with no intrauterine synechiae at follow up hysteroscopy
Summary
Background Septate uterus is a commonMullerian ducts anomaly. The aim of our study was the evaluation of the efficacy of hysteroscopic metroplasty with diode laser to increase endometrial volume in women with septate uterus. One third of anomalies is characterized by septate uterus, one third bicornuate uterus, 10% by arcuate uterus, a ten percent by didelphys and unicornuate uterus and less than five percent by uterine aplasia according to the American Fertility Society Classification [3]. Rotational measurement of volume has become possible thanks to the introduction of Virtual Organ Computer-aided Analysis (VOCALa), which is an extension of 3D-VIEWa software (Kretz Technik, Zipf, Austria). With this new imaging program, the dataset can be rotated around a fixed axis through a number of rotation steps determined by the observer. There are four rotation angles to choose from: 30°, 15°, 9°and 6°, and because the entire dataset is rotated about 180°, it results that we can observe respectively 6, 12, 20 and 30 planes
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