Septums and synechiae: Approaches to surgical correction

Clinical Obstetrics and Gynecology

Volumn 49, Issue 4, 2006, Pages 767-788

  Fedele, Luigi ^a   Bianchi, Stefano ^a   Frontino, Giada ^a  

^a UNIVERSITY OF MILAN   (Italy)

Author keywords

Asherman syndrome; Intrauterine adhesions; Metroplasty; M llerian fusion defects; Septate uterus; Uterine adhesions; Uterine septum; Uterine synechiae

Indexed keywords

CONJUGATED ESTROGEN; DANAZOL; ESTROGEN; GESTAGEN; GONADORELIN AGONIST; ORAL CONTRACEPTIVE AGENT; STEROID;

ANATOMY; CELL PROLIFERATION; CLINICAL TRIAL; CURETTAGE; DIAGNOSTIC ACCURACY; DIAGNOSTIC IMAGING; DISEASE CLASSIFICATION; DISEASE SEVERITY; ECHOGRAPHY; ENDOMETRIUM; ESTROGEN THERAPY; FEMALE FERTILITY; GOLD STANDARD; GYNECOLOGIC SURGERY; HEMOSTASIS; HUMAN; HYSTERORRHAPHY; HYSTEROSALPINGOGRAPHY; HYSTEROSCOPY; INCIDENCE; INTRAUTERINE CONTRACEPTIVE DEVICE; LAPAROTOMY; MEDICAL INSTRUMENTATION; MENSTRUATION; MISSED ABORTION; MORBIDITY; MUELLERIAN DUCT; NEODYMIUM LASER; NUCLEAR MAGNETIC RESONANCE IMAGING; OUTCOME ASSESSMENT; PEROPERATIVE COMPLICATION; POSTOPERATIVE CARE; PREGNANCY DISORDER; PREMATURE LABOR; RECURRENT ABORTION; REPRODUCTION; REVIEW; SURGEON; SURGICAL TECHNIQUE; TRANSVAGINAL ECHOGRAPHY; TREATMENT INDICATION; UTERUS BLEEDING; UTERUS CAVITY; UTERUS DIDELPHYS; UTERUS MALFORMATION; UTERUS SEPTUM; UTERUS SURGERY; UTERUS SYNECHIA;

ADHESIONS; CURETTAGE; ENDOMETRIUM; FEMALE; HUMANS; HYSTEROSCOPY; INFERTILITY, FEMALE; TREATMENT OUTCOME; UTERINE DISEASES; UTERUS;

EID: 33750615129     PISSN: 00099201     EISSN: None     Source Type: Journal    
DOI: 10.1097/01.grf.0000211948.36465.a6     Document Type: Review

References (103)

1. Homer HA, Li TC, Cooke ID. The septate uterus: a review of management and reproductive outcome. Fertil Steril. 2000;73:1-14.
2. Grimbizis GF, Camus M, Tarlatzis BC, et al. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2001;7:161-174.
3. Raga F, Bauset C, Remohi J, et al. Reproductive impact of congenital Mullerian anomalies. Hum Reprod. 1997;12:2277-2281.
4. Ashton D, Amin HK, Richart RM, et al. The incidence of asymptomatic uterine anomalies in women undergoing transcervical tubal sterilization. Obstet Gynecol. 1988;72:28-30.
5. Fedele L, Bianchi S. Hysteroscopic metroplasty for septate uterus. Obstet Gynecol Clin North Am. 1995;22:473-489.
6. Fayez JA. Comparison between abdominal and hysteroscopic metroplasty. Obstet Gynecol. 1986;68:399-403.
7. Dabirashrafi H, Bahadori M, Mohammad K, et al. Septate uterus: new idea on the histologic features of the septum in this abnormal uterus. Am J Obstet Gynecol. 1995;172:105-107.
8. Anonymous. The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, mullerian anomalies and intrauterine adhesions. Fertil Steril. 1988;49:944-955.
9. Buttram VC Jr, Gibbons WE. Mullerian anomalies: a proposed classification. An analysis of 144 cases. Fertil Steril. 1979;32:40-46.
10. Rock JA, Thompson JD, Rock JA, eds. Surgery for Anomalies of the Mullerian Ducts. Philadelphia: Lippincott-Raven; 1997.
11. Acien P. Reproductive performance of women with uterine malformations. Hum Reprod. 1993;8:122-126.
12. Grimbizis G, Camus M, Clasen K, et al. Hysteroscopic septum resection in patients with recurrent abortions or infertility. Hum Reprod. 1998;13:1188-1193.
13. Fedele L, Bianchi S, Marchini M, et al. Ultrastructural aspects of endometrium in infertile women with septate uterus. Fertil Steril. 1996;65:750-752.
14. Rock JA, Jones HW Jr. The clinical management of the double uterus. Fertil Steril. 1977;28:798-806.
15. Musich JR, Behrman SJ. Obstetric outcome before and after metroplasty in women with uterine anomalies. Obstet Gynecol. 1978;52:63-66.
16. Buttram VC Jr. Mullerian anomalies and their management. Fertil Steril. 1983;40:159-163.
17. Rock JA, Schlaff WD. The obstetric consequences of uterovaginal anomalies. Fertil Steril. 1985;43:681-692.
18. March CM, Israel R. Hysteroscopic management of recurrent abortion caused by septate uterus. Am J Obstet Gynecol. 1987;156:834-842.
19. Heinonen PK, Saarikoski S, Pystynen P. Reproductive performance of women with uterine anomalies. An evaluation of 182 cases. Acta Obstet Gynecol Scand. 1982;61:157-162.
20. Heinonen PK. Complete septate uterus with longitudinal vaginal septum. Fertil Steril. 2006;85:700-705.
21. Acien P. Incidence of Mullerian defects in fertile and infertile women. Hum Reprod. 1997;12:1372-1376.
22. Candiani GB, Fedele L, Zamberletti D, et al. Endometrial patterns in malformed uteri. Acta Eur Fertil. 1983;14:311-318.
23. Fedele L, Dorta M, Brioschi D, et al. Pregnancies in septate uteri: outcome in relation to site of uterine implantation as determined by sonography. AJR Am J Roentgenol. 1989;152:781-784.
24. Salim R, Regan L, Woelfer B, et al. A comparative study of the morphology of congenital uterine anomalies in women with and without a history of recurrent first trimester miscarriage. Hum Reprod. 2003;18:162-166.
25. Fedele L, Ferrazzi E, Dorta M, et al. Ultrasonography in the differential diagnosis of "double" uteri. Fertil Steril. 1988;50:361-364.
26. Fedele L, Dorta M, Brioschi D, et al. Re-examination of the anatomic indications for hysteroscopic metroplasty. Eur J Obstet Gynecol Reprod Biol. 1991;39:127-131.
27. Pellerito JS, McCarthy SM, Doyle MB, et al. Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography. Radiology. 1992;183:795-800.
28. de Crespigny L, Kuhn R, McGinnes D. Saline infusion sonohysterosalpingography, an underutilized technique. Aust N Z J Obstet Gynaecol. 1997;37:206-209.
29. Doyle MB. Magnetic resonance imaging in mullerian fusion defects. J Reprod Med. 1992;37:33-38.
30. Fedele L, Dorta M, Brioschi D, et al. Magnetic resonance evaluation of double uteri. Obstet Gynecol. 1989;74:844-847.
31. Raga F, Bonilla-Musoles F, Blanes J, et al. Congenital Mullerian anomalies: diagnostic accuracy of three-dimensional ultrasound. Fertil Steril. 1996;65:523-528.
32. Ayida G, Kennedy S, Barlow D, et al. Contrast sonography for uterine cavity assessment: a comparison of conventional two-dimensional with three-dimensional transvaginal ultrasound; a pilot study. Fertil Steril. 1996;66:848-850.
33. Jurkovic D, Gruboeck K, Tailor A, et al. Ultrasound screening for congenital uterine anomalies. Br J Obstet Gynaecol. 1997;104:1320-1321.
34. Marcus S, al-Shawaf T, Brinsden P. The obstetric outcome of in vitro fertilization and embryo transfer in women with congenital uterine malformation. Am J Obstet Gynecol. 1996;175:858-859.
35. Fedele L, Arcaini L, Parazzini F, et al. Reproductive prognosis after hysteroscopic metroplasty in 102 women: life-table analysis. Fertil Steril. 1993;59:768-772.
36. Cararach M, Penella J, Ubeda A, et al. Hysteroscopic incision of the septate uterus: scissors versus resectoscope. Hum Reprod. 1994;9:87-89.
37. Fedele L, Bianchi S, Bocciolone L, et al. Relief of dysmenorrhea associated with septate uteri after abdominal or hysteroscopic metroplasty. Acta Obstet Gynecol Scand. 1994;73:56-58.
38. Chervenak FA, Neuwirth RS. Hysteroscopic resection of the uterine septum. Am J Obstet Gynecol. 1981;141:351-353.
39. Daly DC, Walters CA, Soto-Albors CE, et al. Hysteroscopic metroplasty: surgical technique and obstetric outcome. Fertil Steril. 1983;39:623-628.
40. Daly DC, Maier D, Soto-Albors C. Hysteroscopic metroplasty: six years' experience. Obstet Gynecol. 1989;73:201-205.
41. DeCherney A, Polan ML. Hysteroscopic management of intrauterine lesions and intractable uterine bleeding. Obstet Gynecol. 1983;61:392-397.
42. Israel R, March CM. Hysteroscopic incision of the septate uterus. Am J Obstet Gynecol. 1984;149:66-73.
43. Jones HWJ, Jones GE. Double uterus as an etiological factor in repeated abortion: indications for surgical repair. Am J Obstet Gynecol. 1953;65:325-339.
44. Tompkins P. Comments on the bicornuate uterus and twinning. Surg Clin North Am. 1962;42:1049-1062.
45. Fedele L, Bianchi S, Gruft L, et al. Danazol versus a gonadotropin-releasing hormone agonist as preoperative preparation for hysteroscopic metroplasty. Fertil Steril. 1996;65:186-188.
46. Choe JK, Baggish MS. Hysteroscopic treatment of septate uterus with Neodymium-YAG laser. Fertil Steril. 1992;57:81-84.
47. Nisolle M, Donnez J. Endoscopic treatment of uterine malformations. Gynaecol Endosc. 1996;5:155-160.
48. Gimpelson RJ, Sammarco MJ, Stovall TG, et al, eds. Operative Hysteroscopy-myomas, Septums, and Synechiae. Baltimore: Williams and Wilkins; 1996:6174.
49. Baggish MS, Daniell JF. Catastrophic injury secondary to the use of coaxial gas-cooled fibers and artificial sapphire tips for intrauterine surgery: a report of five cases. Lasers Surg Med. 1989;9:581-584.
50. Fedele L, Bianchi S. Hysteroscopic metroplasty for septate uterus. Obstet Gynecol Clin North Am. 1995;22:473-489.
51. Fedele L, Bianchi S, Marchini M, et al. Residual uterine septum of less than 1 cm after hysteroscopic metroplasty does not impair reproductive outcome. Hum Reprod. 1996;11:727-729.
52. Kormanyos Z, Molnar BG, Pal A. Removal of a residual portion of a uterine septum in women of advanced reproductive age: obstetric outcome. Hum Reprod. 2006;21:1047-1051.
53. Rock JA, Roberts CP, Hesla JS. Hysteroscopic metroplasty of the Class Va uterus with preservation of the cervical septum. Fertil Steril. 1999;72:942-945.
54. Donnez J, Nisolle M. Endoscopic laser treatment of uterine malformations. Hum Reprod. 1997;12:1381-1387.
55. Parsanezhad ME, Alborzi S, Zarei A, et al. Hysteroscopic metroplasty of the complete uterine septum, duplicate cervix, and vaginal septum. Fertil Steril. 2006;85:1473-1477.
56. Lin BL, Iwata Y, Miyamoto N, et al. Three-contrasts method: an ultrasound technique for monitoring transcervical operations. Am J Obstet Gynecol. 1987;156:469-472.
57. Querleu D, Brasme TL, Parmentier D. Ultrasound-guided transcervical metroplasty. Fertil Steril 1990;54:995-998.
58. Lobaugh ML, Bammel BM, Duke D, et al. Uterine rupture during pregnancy in a patient with a history of hysteroscopic metroplasty. Obstet Gynecol. 1994;83:838-840.
59. Perino A, Cittadini E, Hamou J, et al. Hysteroscopic treatment of uterine septa. Acta Eur Fertil. 1985;16:331-335.
60. Angell NF, Tan Domingo J, Siddiqi N. Uterine rupture at term after uncomplicated hysteroscopic metroplasty. Obstet Gynecol. 2002;100:1098-1099.
61. Kerimis P, Zolti M, Sinwany G, et al. Uterine rupture after hysteroscopic resection of uterine septum. Fertil Steril. 2002;77:618-620.
62. Golan A, Raziel A, Pansky M, et al. Manual removal of the placenta - its role in intrauterine adhesion formation. Int J Fertil Menopausal Stud. 1996;41:450-451.
63. Valle RF, Sciarra JJ. Hysteroscopic treatment of the septate uterus. Obstet Gynecol. 1986;67:253-257.
64. DeCherney AH, Russell JB, Graebe RA, et al. Resectoscopic management of mullerian fusion defects. Fertil Steril. 1986;45:726-728.
65. Vercellini P, Fedele L, Arcaini L, et al. Value of intrauterine device insertion and estrogen administration after hysteroscopic metroplasty. J Reprod Med. 1989;34:447-450.
66. Dabirashrafi H, Mohammad K, Moghadami-Tabrizi N, et al. Is estrogen necessary after hysteroscopic incision of the uterine septum? J Am Assoc Gynecol Laparosc. 1996;3:623-625.
67. Candiani GB, Vercellini P, Fedele L, et al. Repair of the uterine cavity after hysteroscopic septal incision. Fertil Steril. 1990;54:991-994.
68. Fedele L, Marchini M, Baglioni A, et al. Endometrial reconstruction after hysteroscopic incisional metroplasty. Obstet Gynecol. 1989;73:492-495.
69. Perino A, Mencaglia L, Hamou J, et al. Hysteroscopy for metroplasty of uterine septa: report of 24 cases. Fertil Steril. 1987;48:321-323.
70. Pabuccu R, Atay V, Orhon E, et al. Hysteroscopic treatment of intrauterine adhesions is safe and effective in the restoration of normal menstruation and fertility. Fertil Steril. 1997;68:1141-1143.
71. Valle RF. Hysteroscopic treatment of partial and complete uterine septum. Int J Fertil Menopausal Stud. 1996;41:310-315.
72. Asherman JG. Amenorrhea traumatica. J Obstet Gynaecol Br Emp. 1948;55.
73. Dmowski WP, Greenblatt RB. Asherman's syndrome and risk of placenta accreta. Obstet Gynecol. 1969;34:288-299.
74. Al-Inany H. Intrauterine adhesions. An update. Acta Obstet Gynecol Scand. 2001;80:986-993.
75. Fedele L, Bianchi S, Dorta M, et al. Intrauterine adhesions: detection with transvaginal US. Radiology. 1996;199:757-759.
76. Soares SR, Barbosa dos Reis MM, Camargos AF. Diagnostic accuracy of sonohysterography, transvaginal sonography, and hysterosalpingography in patients with uterine cavity diseases. Fertil Steril. 2000;73:406-411.
77. Schenker JG, Margalioth EJ. Intrauterine adhesions: an updated appraisal. Fertil Steril. 1982;37:593-610.
78. Nasr AL, Al-Inany HG, Thabet SM, et al. A clinicohysteroscopic scoring system of intrauterine adhesions. Gynecol Obstet Invest. 2000;50:178-181.
79. Yaffe H, Ron M, Polishuk WZ. Amenorrhea, hypomenorrhea, and uterine fibrosis. Am J Obstet Gynecol. 1978;130:599-601.
80. March CM. Intrauterine adhesions. Obstet Gynecol Clin North Am. 1995;22:491-505.
81. Friedler S, Margalioth EJ, Kafka I, et al. Incidence of post-abortion intra-uterine adhesions evaluated by hysteroscopy - a prospective study. Hum Reprod. 1993;8:442-444.
82. Polishuk WZ, Siew FP, Gordon R, et al. Vascular changes in traumatic amenorrhea and hypomenorrhea. Int J Fertil. 1977;22:189-192.
83. Munro MG. Gynecologic endoscopy. In: Berek J, Adashi E, Hillard P, eds. Novak's Gynecology. New York: Lippincott Williams & Williams; 1996: 677-725.
84. Salle B, Gaucherand P, de Saint Hilaire P, et al. Transvaginal sonohysterographic evaluation of intrauterine adhesions. J Clin Ultrasound. 1999;27:131-134.
85. Bacelar AC, Wilcock D, Powell M, et al. The value of MRI in the assessment of traumatic intra-uterine adhesions (Asherman's syndrome). Clin Radiol. 1995;50:80-83.
86. Troiano RN, McCarthy SM. Mullerian duct anomalies: imaging and clinical issues. Radiology. 2004;233:19-34.
87. March CM, Israel R, March AD. Hysteroscopic management of intrauterine adhesions. Am J Obstet Gynecol. 1978;130:653-657.
88. Valle RF, Sciarra JJ. Intrauterine adhesions: hysteroscopic diagnosis, classification, treatment, and reproductive outcome. Am J Obstet Gynecol. 1988;158:1459-1470.
89. Donnez J, Nisolle M. Hysteroscopic lysis of intrauterine adhesions (Asherman syndrome). In: Donnez J, ed. Atlas of Laser Operative Laparoscopy and Hysteroscopy. New York: Press-Parthenon Publishers; 1995:305-322.
90. Wamsteker K, DeBlok SJ. Diagnostic hysteroscopy: technique and documentation. In: Sutton C, Diamond M, eds. Endoscopic Surgery for Gynaecologists. London: Saunders; 1995:263-276.
91. Tsapanos VS, Stathopoulou LP, Papathanassopoulou VS, et al. The role of seprafilm bioresorbable membrane in the prevention and therapy of endometrial synechiae. J Biomed Mater Res. 2002;63:10-14.
92. Valle RF. Lysis of intrauterine adhesions (Asherman syndrome). In: Sutton C, Diamond M, eds. Endoscopic Surgery for Gynaecologists. London: Saunders; 1995:338-344.
93. Goldenberg M, Sivan E, Sharabi Z, et al. Reproductive outcome following hysteroscopic management of intrauterine septum and adhesions. Hum Reprod. 1995;10:2663-2665.
94. Capella-Allouc S, Morsad F, Rongieres-Bertrand C, et al. Hysteroscopic treatment of severe Asherman's syndrome and subsequent fertility. Hum Reprod. 1999;14:1230-1233.
95. McComb PF, Wagner BL. Simplified therapy for Asherman's syndrome. Fertil Steril. 1997;68:1047-1050.
96. Chen FP, Soong YK, Hui YL. Successful treatment of severe uterine synechiae with transcervical resectoscopy combined with laminaria tent. Hum Reprod. 1997;12:943-947.
97. Protopapas A, Shushan A, Magos A. Myometrial scoring: a new technique for the management of severe Asherman's syndrome. Fertil Steril. 1998;69:860-864.
98. Barbot J. Traitement chirurgical et endoscopique des synecnies uterines. In: Anonymous, ed. Techniques Chir, Urologie-Gynecologie. Paris: Editions Techniques; 1994:41-70.
99. Tiras MB, Oktem M, Noyan V. Laparoscopic intracorporeal ultrasound guidance during hysteroscopic adhesiolysis. Eur J Obstet Gynecol Reprod Biol. 2003;108:80-84.
100. Baggish MS. Operative hysteroscopy. In: Anonymous, eds. Te Linde's Operative Gynecology. New York: Lippincott Raven; 1997:415-442.
101. Orhue AA, Aziken ME, Igbefoh JO. A comparison of two adjunctive treatments for intrauterine adhesions following lysis. Int J Gynaecol Obstet. 2003;82:49-56.
102. Acunzo G, Guida M, Pellicano M, et al. Effectiveness of auto-cross-linked hyaluronic acid gel in the prevention of intrauterine adhesions after hysteroscopic adhesiolysis: a prospective, randomized, controlled study. Hum Reprod. 2003;18:1918-1921.
103. Reddy S, Rock JA. Surgical management of complete obliteration of the endometrial cavity. Fertil Steril. 1997;67:172-174.