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

Minim Invasive Ther Allied Technol. 2022 Jun;31(5):789-796. doi: 10.1080/13645706.2021.1986542. Epub 2021 Oct 20.

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.

MeSH terms

  • Cohort Studies
  • Female
  • Humans
  • Hysteroscopy / adverse effects
  • Hysteroscopy / methods
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Leiomyoma* / surgery
  • Pregnancy
  • Tissue Adhesions / epidemiology
  • Tissue Adhesions / etiology
  • Tissue Adhesions / surgery
  • Uterine Diseases* / surgery
  • Uterine Myomectomy* / adverse effects
  • Uterine Myomectomy* / methods
  • Uterine Neoplasms* / surgery