A pilot study comparing hysteroscopic adhesiolysis by conventional resectoscope versus mini-resectoscope

الملخص EN

Objectives: To compare the feasibility and efficacy of the mini-resectoscope with the conventional resectoscope in terms of the operative, menstrual, and reproductive outcome in hysteroscopic adhesiolysis in infertile women.

Methods: We conducted a parallel prospective randomized study at All India Institute of Medical Sciences, New Delhi.

A total of 60 patients underwent hysteroscopic adhesiolysis using either conventional resectoscope (n = 30) or mini-resectoscope (n = 30).

The primary outcome measures were pregnancy-related indicators.

Secondary outcome measures were the operative parameters (cervical dilatation time, operation time, postoperative pain scores, fluid deficit, and preoperative and postoperative sodium levels), second-look hysteroscopy findings, and improvement in the menstrual pattern after surgery.

Results: Cervical dilatation time and pain score 30 minutes after the procedure were significantly lower in the mini-resectoscope group.

Out of the total 21 cases with hypomenorrhea, 12 cases (57.1%) started having normal menstrual flow postsurgery.

All amenorrheic patients resumed menstruation after surgery.

However, nine cases continued to have hypomenorrhea.

Over long-term followup, 16 patients out of 60 had conceived (seven in the conventional resectoscope group and nine in the mini-resectoscope group).

There were three ongoing pregnancies, three abortions, one ectopic pregnancy, and nine term pregnancies.

The difference between the two groups was not statistically significant.

Conclusions: The use of mini-resectoscope for hysteroscopic adhesiolysis is associated with reduced operative morbidity.

Use of the mini-resectoscope is an effective and safe alternative to the conventional system.