Review of Findings on Hysteroscopy Procedure done on Women who Come to Fertility Unit at SPHMMC: A Three Years Retrospective Review

Abstract

Abstract Back Ground Hysteroscopy is being used for diagnostic and operative intervention for endometrial polyps; sub mucous and pedunculated Myomas, intrauterine adhesions, and uterine septa. It is also useful for the diagnosis of congenital anomalies and evaluating endocervical anatomy. Complete infertility workup should include an evaluation of the uterine cavity and nowadays hysteroscopy is considered the gold standard for evaluating the uterine cavity. The objective of this study is therefore to review findings of diagnostic & therapeutic hysteroscopy done at Fertility unit of SPHMMC from June 2018 to June 2021. Methodology-This is a three years retrospective analysis of cases of patients for whom diagnostic and operative hysterescopic procedure done at fertility center of SPHMMC.Descriptive statistics was used to characterize the dependant and independent variables and qualitative date was presented as number, frequency and percentage and comparison between groups was estimated by Chi-square. Result- A total of 328 patients records were analyzed with the mean age being 31.9 (31.9±5.1) and about 81.4 % of the study participants were nulliparous. The commonest indication for hysterescopic procedure was primary infertility in 48.5% cases followed by secondary amenorrhea in 18%, secondary Infertility 17.4% and AUB in 8.8%. Regarding finding of hysterescopic evaluation, 6% did not have any abnormality (normal) and the commonest hysteroscopic finding was intracavitary adhesion in 48.1% of cases followed by endometrial poly 22.5% and sub mucus myoma in 9.1%. Adhesiolysis was the commonest operative hysterescopic procedure performed in 54.1% of the cases followed by polypectomy in 27.6% and fibroid removal in 10% of the cases. 2.4% of the patients had complication during the hysterescopic procedure and uterine perforation was the commonest complication encountered in 1.8% of the patients and hemorrhage and fluid overload were the other complications that occurred. Conclusion Hysteroscopy is the best diagnostic and therapeutic modality for intrauterine pathologies. The commonest indication for hysterescopic evaluation was primary infertility followed by secondary amenorrhea, secondary Infertility and AUB. Intracavitary adhesion was the commonest hysteroscopic finding followed by endometrial polyp and sub mucus myoma. Adhesiolysis and Uterine perforation were the commonest hysteroscopic therapeutic intervention and commonest complication emanating from the procedure among patients respectively. Persistent efforts and trainings are key to overcome the long learning curve for expected skill and expand the service.