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document
Small-diameter hysteroscopy with Versapoint versus resectoscopy with a unipolar knife for the treatment of septate uterus : a prospective randomized study . STUDY OBJECTIVE To compare 2 procedures for metroplasty : resectoscopy with monopolar knife versus small-diameter hysteroscopy fitted with a Versapoint device . DESIGN Prospective randomized study ( Canadian Task Force classification I ) . SETTING Endoscopic gynecology units at tertiary care university hospitals . PATIENTS One hundred-sixty patients with septate uterus and a history of recurrent abortion or primary infertility undergoing hysteroscopic metroplasty from 2001 to 2005 . INTERVENTIONS Hysteroscopic resection of the uterine septum performed with either a 26F resectoscope with unipolar knife ( 80 women , group A ) or a 5-mm diameter hysteroscope with Versapoint device ( 80 women , group B ) . All patients were managed expectantly , with follow-up lasting 1 year . MEASUREMENTS AND MAIN RESULTS Operative parameters ( operative time , fluid absorption , complications , need for second intervention ) and reproductive outcome parameters ( pregnancy , abortion , term and preterm delivery , modality of delivery , cervical cerclage ) were measured . Operative time and fluid absorption were significantly greater in group A than in group B ( 23.4 +/- 5.7 vs 16.9 +/- 4.7 minutes and 486.4 +/- 170.0 vs 222.1 +/- 104.9 mL , respectively ) . The cumulative complication rate was significantly lower in group B than in group A . No difference in any of the reproductive parameters was observed between the 2 groups : pregnancy and delivery rates were 70 % and 81.6 % in group A vs 76.9 % and 84 % in group B . Nine women ( 18.4 % ) from group B and 8 women ( 16 % ) from group B experienced spontaneous abortions . Most patients ( 54/82 ) delivered by cesarean section without differences according to the hysteroscopic technique used for metroplasty ( 65 % in group A vs 67.7 % in group B ) or to the gestational age ( 65.1 % of term and 68.7 % of preterm deliveries ) . CONCLUSIONS Small-diameter hysteroscopy with bipolar electrode for the incision of uterine septum is as effective as resectoscopy with unipolar electrode regarding reproductive outcome and is associated with shorter operating time and lower complication rate .
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Intervention_Physical
Small-diameter hysteroscopy with Versapoint
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Intervention_Physical
resectoscopy with a unipolar knife
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Intervention_Physical
resectoscopy with monopolar knife
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Intervention_Physical
small-diameter hysteroscopy fitted with a Versapoint device
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Intervention_Physical
Hysteroscopic
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Intervention_Physical
26F resectoscope with unipolar knife
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Intervention_Physical
5-mm diameter hysteroscope with Versapoint device
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Intervention_Physical
hysteroscopy
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Intervention_Physical
resectoscopy
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Outcome_Other
operative time
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Outcome_Physical
fluid absorption
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Outcome_Adverse-effects
complications
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Outcome_Physical
need for second intervention
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Outcome_Physical
pregnancy
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Outcome_Physical
abortion
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Outcome_Physical
term and preterm delivery , modality of delivery , cervical cerclage
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Outcome_Other
Operative time
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Outcome_Physical
fluid absorption
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Outcome_Adverse-effects
cumulative complication rate
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Outcome_Other
reproductive parameters
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Outcome_Physical
pregnancy and delivery rates
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Outcome_Physical
spontaneous abortions
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Outcome_Physical
cesarean section without differences
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Outcome_Other
operating time
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Outcome_Adverse-effects
complication rate
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Participant_Condition
septate uterus
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Participant_Sample-size
One hundred-sixty
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Participant_Condition
septate uterus
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Participant_Condition
infertility