Optimal waiting period for subsequent fertility treatment after various hysteroscopic surgeries

Capsule:
The duration of endometrial wound healing is different after various hysteroscopic surgeries. It can be clearly observed with postoperative monthly office hysteroscopic examinations.

Authors:
Jehn-Hsiahn Yang, M.D., Mei-Jou Chen, M.D., Ph.D., Chin-Der Chen, M.D., Shee-Uan Chen, M.D., Hong-Nerng Ho, M.D., Yu-Shih Yang, M.D., Ph.D.

Volume 99, Issue 7, Pages 2092-2096.e3, June 2013

Abstract:

Objective:
To investigate the endometrial wound healing duration after a hysteroscopic surgery.

Design:
Prospective study.

Setting:
Tertiary university hospital.

Patient(s):
One hundred sixty-three women who underwent hysteroscopic surgeries for endometrial polyp (n=37), submucous myoma (n=65), uterine septum (n=16), and intrauterine adhesion (IUA, n=45).

Intervention(s):
Postoperative office hysteroscopy was consecutively done till complete endometrial wound healing. If there was newly formed IUA occurring at the endometrial wounds, adhesiolysis was immediately done with the tip of the office hysteroscope.

Main Outcome Measure(s):
Office hysteroscopic inspection of endometrial wound healing, and the presence of newly formed IUA.

Result(s):
Thirty-two out of 37 women (86%) achieved a fully healed endometrium one month after polypectomy, higher than those after myomectomy (18%), septal incision (19%), and adhesiolysis (67%). Postoperative office hysteroscopy revealed that 88% and 76% of the women had new IUA formation after septal incision and adhesiolysis, more than those after myomectomy (40%) and polypectomy (0%). Women with postoperative new IUA formation were less likely to achieve endometrial wound healing within one month, as compared with those who had no new IUA formation (31% vs. 61%).

Conclusion(s):
The duration of endometrial wound healing is different after various hysteroscopic surgeries. Postoperative new IUA formation is an important factor influencing endometrial wound healing.

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