Factors associated with operative hysteroscopy outcome in patients with uterine adhesions or submucosal myomas

Objective: To determine the factors associated with hysteroscopic surgery long-term outcome in patients with intrauterine adhesions or submucosal myomas. Methods: Factors thought to be associated with outcome were retrospectively evaluated from the records of 591 patients who were followed up for at least 5 years after undergoing hysteroscopic adhesiolysis (n=203) or myomectomy (n=388). Results: The major factors affecting outcome were degree of adhesion (OR, 1.91; P=0.03) in the former group and parity (OR, 0.55; P=0.005) and depth of intramural penetration of the myoma (OR, 30.74; P<0.001) in the latter. Severe intrauterine adhesion, low parity, and deep intramural penetration of submucosal myoma had an associated increase risk of poor outcome. The overall complication rate was 1.35% and, respectively, 12.8% and 9.3% of the patients who underwent hysteroscopic adhesiolysis or myomectomy needed a second intervention. Conclusion: Hysteroscopic surgery is a safe and effective procedure. Degree of adhesion or parity and depth of intramural penetration of myomas are the major factors affecting outcome in patients with these lesions. (C) 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All tights reserved.