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Obstetrics & Gynecology 1983;61:392-397
© 1983 by The American College of Obstetricians and Gynecologists
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HYSTEROSCOPIC MANAGEMENT OF INTRAUTERINE LESIONS AND INTRACTABLE UTERINE BLEEDING

Alan DeCherney, MD and Mary Lake Polan, MD, PhD

From the Division of Reproductive Endocrinology and the Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut

Müllerian fusion defects, submucous myomas, and intractable uterine bleeding have been managed traditionally by major surgical intervention. However, the cystoscope-resectoscope provides the operative versatility allowing transvaginal surgical management of these situations. Forty women underwent hysteroscopy and treatment with the cystoscoperesectoscope at the Yale-New Haven Hospital. Those patients treated for septate müllerian defects also underwent concomitant laparoscopy. Therapeutic surgical use of the cystoscope-resectoscope resulted in no immediate or longterm complications. Of 11 patients with uterine anomalies treated in this fashion, 9 carried to term without difficulty. Fourteen women with space-occupying intrauterine lesions were treated and resumed normal cyclical menses for a minimum of 1 year. In all 11 patients with intractable uterine bleeding hemorrhage was controlled immediately and 6 women remained amenorrheic for a sustained period. The use of the cystoscope-resectoscope for the management of these entities provides several advantages: 1) A transcervical approach obviates the necessity for abdominal surgery, and 2) the instrument is rapidly and easily accessible to the practicing gynecologist.




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