Journal Article

Total corporal synechiae due to tuberculosis carry a very poor prognosis following hysteroscopic synechialysis

Orhan Bukulmez, Hakan Yarali and Timur Gurgan

in Human Reproduction

Published on behalf of European Society of Human Reproduction and Embryology

Volume 14, issue 8, pages 1960-1961
Published in print August 1999 | ISSN: 0268-1161
Published online August 1999 | e-ISSN: 1460-2350 | DOI: http://dx.doi.org/10.1093/humrep/14.8.1960
Total corporal synechiae due to tuberculosis carry a very poor prognosis following hysteroscopic synechialysis

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Twelve consecutive patients with total corporal synechiae due to tuberculosis were reviewed in terms of intrauterine adhesion re-formation rate following hysteroscopic surgery. All patients presented with secondary amenorrhoea and infertility. The diagnosis was based on a `glove finger appearance' at hysterosalpingography and classical laparoscopic and tubal biopsy findings. Intrauterine synechiae re-formation was assessed by postoperative hysterosalpingograms performed 3–4 months after the procedure. The 12 patients underwent 15 attempts for hysteroscopic lysis of total corporal synechiae. Three perforations occurred and all were managed with laparoscopic extracorporal suturing. Ultimately, adequate uterine cavity was obtained in all cases. Total intracorporal synechiae recurred in all patients at control postoperative hysterosalpingograms. We conclude that total corporal synechiae caused by tuberculosis, unlike other causes, carry a poor prognosis following hysteroscopic lysis. Surrogacy may be the only option for fertility in such couples.

Keywords: hysteroscopic surgery; tuberculosis; uterine synechiae

Journal Article.  1319 words.  Illustrated.

Subjects: Reproductive Medicine

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