Preoperatory treatment with Triptorelin LA in hysteroscopic metroplastic

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Minimally Invasive Procedures

Background:

• Septate uterus is a significant intracavitary pathology linked to infertility and preterm labor.
• Hysteroscopic metroplasty is the primary surgical intervention for septate uterus.
• The introduction of the resectoscope revolutionized gynecological endoscopy and surgical techniques.

Purpose of the Study:

• To evaluate the efficacy of gonadotropin-releasing hormone agonist (GnRHa) therapy prior to hysteroscopic metroplasty.
• To determine if preoperative GnRHa therapy impacts surgical outcomes, including operative time, blood loss, and fluid usage.
• To assess the influence of GnRHa therapy on different types of uterine septa (partial vs. complete).

Main Methods:

• Review of hysteroscopic metroplasty procedures.
• Analysis of surgical outcomes in patients receiving preoperative GnRHa therapy versus those who did not.
• Comparison of results based on the extent of the uterine septum (partial, inferior third, or more extensive).

Main Results:

• Preoperative GnRHa therapy demonstrated advantages in surgical results, reduced surgery time, and decreased intraoperative bleeding.
• The amount of fluid used for uterine cavity distention was also reduced with GnRHa therapy.
• While preoperative treatment did not significantly improve outcomes for partial septa, it provided better conditions for hysteroscopic metroplasty in cases of complete septa reaching the inferior third or beyond.

Conclusions:

• GnRHa therapy before hysteroscopic metroplasty offers benefits for complete uterine septa, improving surgical conditions and outcomes.
• The utility of preoperative GnRHa therapy is limited in cases of partial uterine septa.
• Hysteroscopic metroplasty remains a key procedure for managing septate uterus, with potential adjunctive benefits from GnRHa therapy in specific cases.