The influence of different methods of hysteroscopic metroplasty using a bipolar resectoscope on the restoration of reproductive function in women with a septate uterus

Yevseyeva O. A., Gladchuk I. Z., Rozhkovskaya N. M., Nosenko O. M. The influence of different methods of hysteroscopic metroplasty using a bipolar resectoscope on the restoration of reproductive function in women with a septate uterus. Journal of Education, Health and Sport. 2023;13(4):367-378. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2023.13.04.043

https://apcz.umk.pl/JEHS/article/view/44518

https://zenodo.org/record/8030070

The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of December 1, 2021. No. 32343.

Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences).

Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 1 grudnia 2021 r. Lp. 32343. Posiada Unikatowy Identyfikator Czasopisma: 201159.

Przypisane dyscypliny naukowe:Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu).

 © The Authors 2023;

This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland

Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium,

provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited.

The authors declare that there is no conflict of interests regarding the publication of this paper.

Received: 10.03.2023. Revised: 24.03.2023. Accepted: 28.04.2023.

THE INFLUENCE OF DIFFERENT METHODS OF HYSTEROSCOPIC METROPLASTY USING A BIPOLAR RESECTOSCOPE ON THE RESTORATION OF REPRODUCTIVE FUNCTION in women with a septate uterus

O. A. Yevseyeva, I. Z. Gladchuk, N. M. Rozhkovskaya, O. M. Nosenko

Odessa National Medical University

Yevseyeva Oksana Anatolyevna ORCID: 0000-0001-9457-0028

Gladchuk Igor Zinoviyevich ORCID: 0000-0003-2926-4125

Rozhkovskaya Natalya MikolayivnaORCID: 0000-0001-7860-3272I

Nosenko Olena Mikolayivna ORCID: 0000-0002-7089-2476

Abstract

Uterine septum is the most common congenital anomaly of the uterus, accounting for 35% of all diagnosed malformations. Data on the effectiveness of restoring reproductive function in women with a septate uterus after hysteroscopic metroplasty are contradictory, there are no data on the comparison of reproductive results after removal and dissection of the septum using a bipolar hysteroresectoscope. The purpose of the study was to assess the effectiveness of reproductive function recovery after dissection and removal of the uterine septum using a bipolar hysteroresectoscope. Material and methods. 78 patients of group B with uterine septum, reproductive failure, bipolar hysteroscopic metroplasty were under observation. Among the examined patients, 39 suffered from miscarriage and 39 suffered from infertility. 37 women of the BI group underwent hysteroscopic bipolar dissection of the uterine septum; 41 women of the BII group underwent hysteroscopic bipolar resection of the septum. Results and their discussion. Within 2 years after metroplasty, pregnancy occurred in 86.49% of women in the BI group and in 100% of women in the BII group (p>0.05); the specific weight of miscarriages was 9.38% and 0.00%, respectively (p>0.05); childbirth - 58.88% and 70.97% (p>0.05); premature births – 17.65% and 6.45% (p>0.05); term deliveries - 38.24% and 64.52% (p<0.04, SD 0.34 [0.12-0.93]). In women with initial infertility, pregnancy occurred in 61.54% of women in the BI group (n=13) within 2 years after the operation, in 69.23% in the BII group (n=13) (p>0.05); the specific weight of miscarriages was 25.00% and 22.22%, respectively (p>0.05); childbirth - 75.00% and 77.78% (p>0.05); premature births – 12.50% and 11.00% (p>0.05); term deliveries - 62.50% and 66.67% (p>0.05). Analysis of recovery of reproductive function 2 years after surgery in women with initial miscarriage showed that 90.48% of women in the BI group became pregnant, 94.44% in the BII group (p>0.05); the specific weight of miscarriages was 31.58% and 11.76%, respectively (p>0.05); childbirth - 68.42% and 88.24% (p>0.05); premature births – 26.32% and 5.88% (p>0.05); term deliveries - 42.11% and 82.35% (p<0.02, SD 0.16 [0.03-0.73]). Conclusions. The use of the technique of removal of the uterine septum during bipolar hysteroresectoscopy compared to the technique of its dissection in women with a septate uterus and reproductive failure leads to a probable increase in the termination of pregnancy by term delivery both in the general group and in the group of patients with initial miscarriage.

Key words: septate uterus; bipolar hysteroresectoscope; septum dissection; septum removal; reproductive failure; infertility; miscarriage; reproductive results.