Transcervical incision of septa: 447 cases.

BACKGROUND

Although uterine septum does not cause infertility, it may lead to recurrent abortion, preterm delivery, and premature rupture of membrane in over 25% of patients. The aim of this study was to evaluate feasibility and clinical value of hysteroscopic bipolar electric vaporization technique (Versapoint Bipolar Electrosurgical System) used in transcervical incision of septa (TCIS) in an outpatient setting.

METHODS

Retrospectively, 447 cases of hysteroscopic TCIS were analyzed. Operative time, blood loss, consumption of uterus distension medium, and period of postoperative hospital stay were compared between outpatients and inpatients. Feasibility of outpatient TCIS using bipolar electric vaporization system under analgesia and without anesthesia was investigated. All hysteroscopic procedures were performed after review and approval by institutional ethical committee. Stata 8.0 software was used for statistical analysis, and t test and chi (2) test were used to evaluate association among numerical and categorical variables. p < 0.05 indicated statistically significant difference.

RESULTS

The study included 121 inpatients (27.1%) and 326 outpatients (72.9%). Three hundred sixty-two cases (80.98%) were under only pethidine analgesia and 420 cases (93.96%) under local infiltration anaesthesia or analgesia. Of 447 cases of TCIS, 433 (96.87%) were accomplished under intravenous, local infiltration anaesthesia or pethidine analgesia. In all TCIS, 421 cases (94.18%) were carried out with mechanical microscissors and bipolar electric vaporization incision. No significant difference was identified between inpatients and outpatients in terms of operative time, blood loss, or consumption of uterus distension medium (p > 0.05). However, period of postoperative hospital stay was significantly shorter in outpatient TCIS than in inpatient TCIS by an average of 24 h or more (p < 0.01).

CONCLUSIONS

Hysteroscopic bipolar electric vaporization TCIS could be carried out safely and efficaciously in an outpatient setting, by using smaller hysteroscope and bipolar electrodes.