Hysteroscopic septal resection using unipolar resectoscope versus bipolar resectoscope: Prospective, randomized study

Area of Science:

• Gynecology
• Minimally Invasive Surgery
• Reproductive Medicine

Background:

• Hysteroscopic septal resection is a common procedure to correct uterine septum.
• Both unipolar and bipolar resectoscopes are used, with differing safety profiles.
• Understanding the comparative outcomes is crucial for surgical decision-making.

Purpose of the Study:

• To compare the operational efficiency and reproductive success of hysteroscopic septal resection using unipolar versus bipolar resectoscopes.
• To evaluate intraoperative parameters, fluid balance, and postoperative complications.
• To assess the incidence of hyponatremia and subsequent reproductive outcomes.

Main Methods:

• A prospective randomized study involving 70 women undergoing hysteroscopic septal resection.
• Comparison of operative time, fluid deficit, and serum sodium levels between unipolar and bipolar resectoscope groups.
• Second-look hysteroscopy at 6 weeks and recording of all subsequent pregnancies.

Main Results:

• No significant differences were observed in operative parameters or second-look hysteroscopy findings between the groups.
• Six patients in the unipolar group developed postoperative hyponatremia, versus none in the bipolar group (P=0.025).
• Reproductive outcomes were comparable between the unipolar and bipolar resectoscope groups.

Conclusions:

• Bipolar resectoscopy significantly reduces the risk of postoperative hyponatremia compared to unipolar resectoscopy.
• Bipolar resectoscopy is a safe and effective alternative for hysteroscopic septal resection.
• The choice of resectoscope does not impact the reproductive outcome.