Hysteroscopic dilation techniques in hysteroscopic adhesiolysis

Area of Science:

• Gynecology
• Minimally Invasive Surgery
• Reproductive Medicine

Background:

• Intrauterine adhesion (IUA) often results from intrauterine procedures, leading to endometrial trauma.
• Hysteroscopic adhesiolysis is key for IUA treatment but risks complications like uterine perforation.
• Traditional cervical dilation methods can cause endometrial injury, adhesion recurrence, and false passage formation.

Purpose of the Study:

• To evaluate hysteroscopic dilation techniques for internal os and lower uterine segment dilation in IUA patients.
• To improve the safety and effectiveness of cervical dilation during hysteroscopic adhesiolysis.
• To reduce complications associated with IUA treatment.

Main Methods:

• 282 patients with internal os or lower uterine segment adhesions underwent hysteroscopic dilation.
• Hysteroscopy with a 5Fr instrument channel and 4.9 mm outer sheath was used for dilation under direct vision.
• Surgical success rates and complication incidence were assessed.

Main Results:

• Hysteroscopic dilation techniques successfully achieved uterine entry in all cases without needing traditional dilators.
• No surgical complications such as cervix laceration, false passage, or uterine perforation occurred.
• Postoperative hysteroscopy showed no significant fibrotic stenosis in the dilated areas.

Conclusions:

• Hysteroscopic dilation techniques offer a safe, effective