Hysteroscopic findings after laparoscopic and open myomectomy with or without uterine cavity breach: historical cohort study

Abstract

Introduction

The aim of this study was to evaluate hysteroscopic findings after laparoscopic and laparotomic myomectomy with a focus on the presence of postoperative intrauterine adhesions in groups of patients with and without perioperative uterine cavity breach (UCB).

Material and methods

This is a historical cohort study. Our database was searched to identify patients with UCB during myomectomy and matched the same number of patients after myomectomy without UCB to create a control group. All relevant data were retrieved from our medical records. In both groups, the results of follow-up hysteroscopy were analyzed.

Results

Low prevalence of intrauterine adhesions after myomectomy was observed in only 3.5% of the 170 patients in our samples. No significant difference in the occurrence of synechiae between the patients with and without UCB was found (2 vs. 4, RR 0.5, 95% CI 0.1–2.7, p = .341), nor was the difference in other hysteroscopic findings. Follow-up hysteroscopy was performed with slender optics and expandable casing system without need of any anesthesia in 87.1% of cases.

Conclusions

According to our findings, the prevalence of post-myomectomy intrauterine adhesions after myomectomy is low. Our study did not demonstrate that UCB during myomectomy is a risk factor for the formation of intrauterine synechiae.

Keywords:

• Fertility
• hysteroscopy
• intrauterine adhesions
• leiomyoma
• myomectomy

Acknowledgments

The authors wish to thank Mrs. Alena Dohnalova, Dr. Marian Rybar Ph.D. and Dr. Martin Hynek, Ph.D. for statistical consultations and analysis of the results.

Declaration of interest

No author has any potential conflicts of interest.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The study was financially supported by the Charles University in Prague [UNCE 204065] and Všeobecná Fakultní Nemocnice v Praze (General University Hospital in Prague) [00064165].