The importance of operative hysteroscopy in treating pathologies of the uterine cavity in infertile patients

Abstract

According to the definition of the World Health Organization (WHO), infertility is the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year. One of the causes of sterility is inborn and acquired uterine anomalies. The best visualization of the inside of the uterus is achieved hysterscopically. Hysteroscopy is a minimally invasive surgical procedure and has the greatest significance in the diagnosis and treatment of congenital anomalies of the uterus. It is possible to eliminate and correct most of the congenital anomalies of the uterus, and it also enables the removal of other pathological changes in the cavity of the uterus. The incidence of congenital uterine anomalies in general population is 0.1-3.5%. Infertile patients have a higher incidence of these anomalies which range from 3-6%, and 5-10% in habitual abortions. The study included 200 infertile patients up to 40 years of age, with performed surgical hysteroscopy due to diagnosed changes in the uterine cavity. The patients were operated at the Department of infertility of the Obstetrics and Gynecology Clinic "Narodni Front" in Belgrade, in 2013. and 2014. The following pathological changes of the uterine cavity, were hysteroscopically removed: submucosal fibroids type 0 and type I. The aim of this paper was to evaluate the success of operative hysteroscopy in the treatment of pathological changes of the uterine cavity in infertile patients, based on the number of relapses in the first six months upon surgery. Relapses occurred in 0.5% of patients during a six-month postoperative course. Complications during hysteroscopic operations were intraoperative and postoperative. There were 1.5% of overall complications in the participants.