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Hysteroscopic Incisio- nal Metroplasty  
Kužel D., Tóth D., Fučíková Z., Cibula D., Hrušková H., Jurovich P., Živný J. 

Gynekologicko-porodnická klinika 1. LF UK a VFN v Praze, přednosta prof. MUDr. J. Živný, DrSc
 


Summary:

       Malformations of the Müllerian duct or- gans cause fertility problems in around of 1% of all women. The women more often suffered from infertility than sterility. Hysteroscopic incisional metroplasty is preferable due to minimal invasivity and favourable pregnancy outcomes. Material and methods: 49 patients (32 infertile and 8 sterile) were subjected to hysteroscopic incisional metro- plasty in the years 1996–1998. Procedures were perfor- med under general anaesthesia using the scissor „cold“ surgery. Postoperativelly were followed-up 24 patients (19 infertile and 5 sterile) they wanted to have baby. Results: From 24 patients in follow-up study followed up on 19 (79 %) women term delivery, 18 (95 %) infertile and 1 (20 %) sterile. Average duration of pregnancy was 39 weeks (37–41), average weight of the newborns was 3240 g (2620–4110), 15 (79 %) deliveries were terminated spon- taneously and 4 (21 %) with cesarian section. We did not meet any complications during pregnancy or labor. Conclusion: Hysteroscopic incisional metroplasty is gene- rally preferable due to minimal invasivity and favourable pregnancy outcomes. We prefere scissors „cold“ surgery due to better check out of the hysteroscopic procedure. We neither prepare endometrium preoperativelly nor admi- nistrate estrogens or IUD postoperativelly in prevention of postoperative intrauterine adhesions. There are only exceptionally mentioned complications in connection with hysteroscopic incisional metroplasty. Hysteroscopic incisional metroplasty is minimally inva- sive, laparoscopically assisted procedure, possible to per-.

        Key words: hysteroscopy, septum, sterility, infertility
       

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