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Detection of Transient Postoperative Changes in the Endometrial Cavity by 3-Dimensional Ultrasonography After Hysteroscopic Correction of Various Uterine Anomalies

Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia USA.

Address correspondence to Silvina M. Bocca, MD, PhD, the Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, 601 Colley Ave, Norfolk, VA 23507 USA. E-mail: boccas{at}evms.edu

Objective. The purpose of this series was to prospectively evaluate early postoperative intrauterine changes by 3-dimensional ultrasonography (3DUS) in patients undergoing hysteroscopic correction of various uterine anomalies. Methods. Thirty consecutive patients with a diagnosis of an anomaly of the uterine cavity who underwent hysteroscopic correction were studied. Patients had transvaginal 3DUS to display the midcoronal view of the uterus immediately before and 1 and 2 months after hysteroscopy. The presence of postoperative changes and the pregnancy outcomes (either spontaneous or after assisted reproduction) in the subsequent 6 months after hysteroscopy were recorded. Results. Postoperative changes 1 month after hysteroscopy were detected by 3DUS in 20% (6/30) of these patients. The changes detected consisted of intrauterine cystic loculations in 3 patients and endometrial irregularities/possible mucus accumulations in the other 3. These loculations and irregularities were sometimes larger and more complex in nature than the original lesions and always coincided with the resection site. These changes resolved spontaneously after the second postoperative month and did not interfere with embryo implantation or cause pregnancy loss in patients attempting to conceive during the study period. Conclusions. Patients who underwent hysteroscopic correction of various anomalies of the uterine cavity had immediate postoperative findings when imaged by 3DUS that were transient and of no clinical relevance. These transient and self-resolving ultrasonographic changes did not affect the patients’ reproductive capacity.

Key Words: artifacts • hysteroscopy • 3-dimensional ultrasonography • uterine anomalies

Abbreviations: 3DUS, 3-dimensional ultrasonography • 2DUS, 2-dimensional ultrasonography