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- Title
New Efficient Method for Hysteroscopic Isthmoplasty: Four Simple Steps Lead to a Significant Improvement in Bleeding Status.
- Authors
Huang, Chien-Chu; Chiu, Shao-Chih; Pan, Chih-Ming; Huang, Chun-Chung; Chang, Cherry Yin-Yi; Chao, Shih-Chi; Cho, Der-Yang; Lin, Wu-Chou
- Abstract
We demonstrate an effective reduction in postmenstrual spotting after our novel hysteroscopic isthmoplasty. This study included 66 patients with isthmocele-related postmenstrual spotting confirmed by sonography and diagnostic hysteroscopy between 2000 and 2017. Our new interventions included the following four steps: (1) make a resection gradient of the distal edge of the isthmocele from the ape of the isthmocele down to the cervical outer orifice; (2) resect the distal and proximal niches of the isthmocele; (3) electrocauterize the distal and proximal sides (not only the niche bottom) of the small cave on the scar side of the isthmocele; (4) manage the isthmocele until it is largely connected to the cavity. In our results, all patients underwent extensive hysteroscopic repair of newly hysteroscopic isthmoplasty without any intra- or postoperative complications. After final hysteroscopic repair modification, prolonged menstrual spotting was significantly decreased in 98.2% (53/54) of the patients, and the total number of bleeding days per menstrual cycle significantly decreased from a mean of 15.38 ± 3.3 days to 6.4 ± 1.9 days postoperatively (p < 0.001). Our four-step hysteroscopic technique successfully resolved prolonged menstrual spotting in over 90% of the patients, exceeding the resolution rates of 60–85% achieved with other hysteroscopic techniques used to treat symptomatic isthmocele. No patients experience recurrence after long-term follow up. Four simple steps led to a significant improvement in bleeding status.
- Subjects
DIAGNOSTIC ultrasonic imaging; HYSTEROSCOPY; MENSTRUAL cycle; HEMORRHAGE; PATIENTS' attitudes; SURGICAL complications; MASTOIDECTOMY
- Publication
Journal of Clinical Medicine, 2022, Vol 11, Issue 21, p6541
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm11216541