[Intrauterine synechiae after use of monopolar resectoscope].

BACKGROUND

Uterine synechiae are defined as abnormal adhesions and fibrosis within the uterine cavity due to direct trauma or injury to the basal membrane of the endometrium.

OBJECTIVE

To identify, by routine hysteroscopy, how many patients who were treated because of intrauterine pathology developed uterine synechiae within the first six months after treatment with monopolar resectoscope.

MATERIAL AND METHOD: A descriptive, open, observational, retrospective and cross-sectional study was performed at Hysteroscopy Unit, Gynecology Service of General Hospital Manuel Gea Gonzalez, Mexico City. From January 1, 2008 to December 31, 2011, we took, from the record books of the operating rooms, the file number of those patients who were treated with monopolar resectoscopy, and subsequently underwent routine hysteroscopy within the first six months.

RESULTS

69 records were included in the study. The main diagnoses were: endometrial polyp in 48% (n=33), submucosal myoma in 45% (n=3 1); 48% (n=33) polypectomy and 45% (n=31) myomectomy. Within the first six months after the main procedure, patients underwent a routine hysteroscopy, which revealed the development of intrauterine synechiae in 5.8% (n=4) of the patients. Of the patients who underwent myomectomy, 5.8% (n=4) developed uterine synechiae; while those patients who underwent polypectomy, synechiaes were not found. Minimal synechiaes were found in 4.3% (n=3) of patients, moderate synechiaes were found in 1.4% (n=1) of patients, and severe synechiaes were found in none patient.

CONCLUSION

Uterine synechiaes were found in 5.8% of patients with intrauterine pathology and treated with monopolar resectoscopy. Minimal to moderate synechia occur more commonly after myomectomy.