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Concept: Hysteroscopy


To compare the efficacy of intrauterine balloon, intrauterine contraceptive device and hyaluronic acid gel in the prevention of the adhesion reformation after hysteroscopic adhesiolysis for Asherman’s syndrome.

Concepts: Birth control, Uterus, Intrauterine device, Abortion, Endometrium, Asherman's syndrome, Hysteroscopy, Hyalobarrier


Abstract Objectives: In the context of common adhesion prevention in laparotomic, laparoscopic and hysteroscopic surgery this article details the effects of a cross-linked sodium hyaluronate anti-adhesion barrier gel. The observed adhesion score is expressed in the following three measurements: Severity, extent and incidents of adhesions. Material and methods: From a total of 85 patients treated by laparoscopy and hysteroscopy, a second look endoscopic procedure could be performed in 35 cases. Results: Our preliminary, short evaluation of 35 patients submitted to a second look laparoscopy or hysteroscopy revealed the beneficial effect of the applied HYAcorp endo gel, showing only a minimal amount of adhesions at the second look observation. Conclusion: Cross-linked sodium hyaluronate is highly effective in the prevention of adhesions at laparoscopic and hysteroscopic surgery.

Concepts: Effect, Surgery, Effectiveness, Gynecology, Laparoscopic surgery, Laparoscopy, Endoscopy, Hysteroscopy


This is a retrospective cohort study conducted in a national training centre for hysteroscopy between January 2012 and December 2014 to compare the clinical outcome of two doses of oestradiol valerate (4 mg and 10 mg daily) in the prevention of recurrence of adhesions after hysteroscopic adhesiolysis. A total of 176 women who suffered from Asherman syndrome with moderate to severe intrauterine adhesions were included: 91 subjects received a 10 mg daily dose of oestradiol and 85 subjects received a 4 mg daily dose of oestradiol in the postoperative period. Second look hysteroscopy was performed 4-6 weeks after the initial surgery. There was no difference in age and preoperative American Fertility Society (AFS) adhesion score between the two groups. The proportion of women in whom menstruation had returned to normal in the 10 mg group (49/91 = 53.8%) was significantly (p < 0.05) higher than that of subjects in the 4 mg group (35/85 = 41.2%). However, there was no difference in AFS scores at second look hysteroscopy between the two groups or in the conception rate and miscarriage rate between the two groups. The findings do not support the use of high-dose postoperative oestrogen therapy following hysteroscopic adhesiolysis.

Concepts: Cohort study, Pregnancy, Uterus, Menstrual cycle, Miscarriage, Endometrium, Asherman's syndrome, Hysteroscopy


A uterine intracavital adhesion was detected by non-invasive virtual hysteroscopy and removed by conventional operative hysteroscopy, enabling subsequent embryo implantation.

Concepts: Pregnancy, Embryo, Fetus, Uterus, Obstetrics, Endometrium, Implantation, Hysteroscopy


Asherman syndrome is a debatable topic in gynaecological field and there is no clear consensus about management and treatment. It is characterized by variable scarring inside the uterine cavity and it is also cause of menstrual disturbances, infertility and placental abnormalities. The advent of hysteroscopy has revolutionized its diagnosis and management and is therefore considered the most valuable tool in diagnosis and management. The aim of this review is to explore the most recent evidence related to this condition with regards to aetiology, diagnosis management and follow up strategies.

Concepts: Pregnancy, Uterus, The Canon of Medicine, Gynecology, Endometrium, Asherman's syndrome, Hysteroscopy, Hypomenorrhea


Laparotomic myomectomy is often the only realistic solution for symptomatic women with multiple or large myomas who wish to retain their fertility. The aim of this study was to document the rate of uterine synechiae and their associated risk factors after laparotomic myomectomy. This prospective observational study took place in a teaching hospital from May 2009 to June 2014. It included all women aged 18-45 years who had laparotomic myomectomies (without diagnostic hysteroscopy at the time of surgery) for myomas and a postoperative diagnostic office hysteroscopy 6-8 weeks later. The study included 98 women with a laparotomic myomectomy and a postoperative hysteroscopic follow-up. Women with a laparotomic myomectomy for a subserosal myoma were excluded. The intrauterine adhesion rate after laparotomic myomectomy was 25.51% (25/98); 44% (11/25) of them were complex intrauterine adhesions. Opening the uterine cavity was a major risk factor for these complex adhesions, with an OR of 6.42 (95% CI 1.27 to 32.52). Office hysteroscopy could be carried out after surgery in such cases.

Concepts: Pregnancy, Uterus, Hospital, Observational study, Asherman's syndrome, Uterine fibroids, Hysteroscopy, Internal orifice of the uterus



The objective of this study was to investigate the incidence of unexpected uterine malignancy (UUM) diagnosed after hysteroscopic surgery for presumed submucosal leiomyomas or endometrial polyps.

Concepts: Uterus, Hysteroscopy, Myometrium


The objective was to compare results of two groups of population (novices and experts) on a virtual reality simulator of hysteroscopy resection for different metrics and for a multimetric score to assess its construct validity.

Concepts: Psychometrics, Construct validity, Simulated reality, Virtual reality, Hysteroscopy


Intracavitary uterine fibroids and fibroids that distort the uterine cavity are associated with excessive vaginal bleeding and infertility. While intracavitary fibroids smaller than 4 cm are usually treated safely by operative hysteroscopy, larger fibroids may require multiple surgeries or more extensive surgery with possible damage to the integrity of the uterine wall. Magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a noninvasive approach for treating uterine fibroids, mainly the intramural type. We present the outcome of MRgFUS treatment for intracavitary fibroids (FIGO class 1) in cases that could not be treated by hysteroscopy due to either fibroid size or patient refusal. (Canadian Task Force II-1).

Concepts: Uterus, Hospital, Surgery, Surgical instrument, Gynecology, Hysterectomy, Uterine fibroids, Hysteroscopy