HYSTEROSCOPIC METROPLASTY WITH RESECTOSCOPE OR MICROSCISSORS FOR THE CORRECTION OF SEPTATE UTERUS

During 1990, we performed hysteroscopic incision of uterine septum in 23 women with repeated abortion. The patients were allocated randomly to metroplasty with resectoscope (12 patients in group 1) or microscis sors (11 patients in group 2) to compare surgical feasibility and anat omic results with these instruments. The uterine cavity was distended by instillation of sorbitol and mannitol solution under manometric con trol. Two patients in group 1 and three in group 2 had a complete sept um. In group 1, the mean operating time, plus or minus standard deviat ion (S.D.), was 22 +/- 6 minutes compared with 17 +/- 5 minutes in gro up 2 (p=0.06). The mean amount of distension medium used, plus or minu s S.D., was 890 +/- 153 milliliters in group 1 versus 671 +/- 170 mill iliters in group 2 (p=0.003). One woman in group 1 with complete uteri ne septum had a uterine perforation that was managed conservatively. P ostoperative morbidity for the entire series was negligible. At follow -up ultrasonography and hysteroscopy performed two months postoperativ ely, a residual fundal notch greater-than-or-equal-to 1 centimeter dee p was detected and corrected in four patients in group 1 and two in gr oup 2. Our findings indicate that, in terms of operating time and effi cacy, the resectoscope and microscissors are equally valid instruments to correct a septate uterus, with a feasibility rate of 100 percent.