Diagnosis and treatment of intrauterine adhesions by microhysteroscopy.

In this report of 69 patients, a new type of hysteroscope was used to evaluate the extent and character of intrauterine adhesions, to perform lysis of them, and to monitor the effects of therapy. Additionally, prospective studies with regard to pathogenesis and endometrial regeneration can be achieved in vivo. In 59 patients the procedures were performed in an office setting using a CO2 hysteroscopic technique without the need for local anesthesia or cervical dilatation. Of 30 infertile patients, 38% subsequently had uncomplicated deliveries. The severe forms of this disease still remain very difficult to treat effectively. When the adhesions were severe or the procedure painful, the operation was scheduled under general anesthesia (ten cases). A sequential hysteroscopy with good patient acceptance affords additional opportunity for removing residual adhesions and intrauterine devices, and serves as a basis for ending treatment with steroids.