Journal of Education, Health and Sport (Jul 2023)

Restoration of reproductive function in women with uterine septum and reproductive disorders using different types of metroplasty techniques and different types of electric

  • O. Yevseyeva

DOI
https://doi.org/10.12775/JEHS.2023.42.01.014
Journal volume & issue
Vol. 42, no. 1

Abstract

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The purpose: to compare the effectiveness of restoring reproductive function in women with uterine septum and reproductive disorders with various metroplasty techniques using monopolar and bipolar surgical energy. Material and methods. 153 patients with a uterine septum (group US) and reproductive disorders were under prospective observation, of which 75 patients (group M) underwent metroplasty using a monopolar hysteroresectoscope, 78 patients (group B) underwent a bipolar hysteroresectoscope. In groups M and B, 2 groups were allocated: group MD - 39 women who underwent hysteroscopic monopolar dissection of the uterine septum; group MR - 36 women who underwent hysteroscopic monopolar resection of the uterine septum; BD group - 37 women who underwent hysteroscopic bipolar dissection of the uterine septum; group BR - 41 women who underwent hysteroscopic bipolar resection of the uterine septum. The observation of operated women was carried out for 2 years after metroplasty. Results. When using various types of electrical surgical energy and various techniques for performing metroplasty in women with reproductive disorders against the background of the uterine septum, when using bipolar removal of the septum, the overall frequency of pregnancy termination by childbirth and term delivery was the highest and exceeded similar indicators: with monopolar incision 2.20 times (OR 13.30 [3.95–44.72], p 0.05) and 1.37 times (OR 3.44 [1.06-11.20], p 0.05). The total number of births in women with initial miscarriage after bipolar incision was 2.17 times higher than that after unipolar incision (78.95% vs. 36.36%; OR 4.50 [1.13-17.99], p < 0.04), with bipolar resection was 2.34 times greater than that with monopolar incision (85.00% versus 36.36%; OR 6.80 [1.54–30.08], p < 0.02). Conclusion. The technique of choice when performing hysteroresectoscopic metroplasty in women with uterine septum and reproductive disorders is bipolar removal of the septum, which leads to a probable increase in the termination of pregnancy by urgent delivery and live births both in the general group and in the group of patients with initial infertility.

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