Article Sidebar

Download
PDF

Main Article Content

Abstract

ABSTRACT
Background: Hysteroscopy is an essential tool to make intrauterine assessment in infertile patients. Diagnosis and appropriate correction of intrauterine anomalies are considered essential in order to increase chances of conception. Our objective was to determine the frequency and pattern of intra uterine anomalies identified among women attending hysteroscopy at the Gynaecological Endoscopic Surgery and Human Reproduction Teaching Hospital Paul et Chantal Biya – Yaoundé (GESHRTH). Methods and results. This was a cross sectional retrospective study of 96 women attending diagnostic or operative hysteroscopy at the GESHRTH between January 2020 and December 2021.The mean age was 38.7 ±7.6 years. Fifty-nine (61.5%) of the patients were nulliparous. Primary and secondary infertility were found respectively in fifty-two patients (54.2%) and forty-four patients (45.4%). Eleven patients (11.5%) were post-menopausal. Concerning previous surgery, 29 patients (30.2%) have had a myomectomy, 28 patients (29.1%) curettage, 16 patients (16.6%) laparoscopy, eight (8.3%) hysteroscopy and one (1%) caesarean section. In all, 92 patients (95.8%) had abnormal intra uterine findings consisting of endometrial polyps (43.7%), sub-mucosal fibroids (42.7%), uterine cavity adhesions (20.8%), endometrial atrophy (4.1%), foetal bone (2%), uterine septum (1%) and non-absorbable suture thread (1%). Conclusion: Abnormal uterine findings were identified in 95.8% of patients attending hysteroscopy at GESHRTH. Most frequent findings were polyps in 43.7%, sub-mucosal fibroids in 42.7% and synechiae in 20.8%. The overall per operatory complication rate was 6.2%.
RÉSUMÉ
Introduction. Le recours à l’hystéroscopie constitue une étape indispensable au bilan cavitaire des patientes infertiles. Le diagnostic et la prise en charge adéquate des lésions intra cavitaires permettent d’améliorer les chances de conception. L’objectif de cette étude était de déterminer la fréquence et les caractéristiques des anomalies intra cavitaires chez les patientes opérées d’une hystéroscopie au Centre Hospitalier de Recherche et d’Application en Chirurgie Endoscopique et Reproduction Humaine Paul et Chantal Biya – Yaoundé (CHRACERH). Méthodes et résultats. Nous avons mené une étude descriptive transversale de Janvier 2020 à Décembre 2021 et recruté 96 patientes. L’âge moyen était de 38,7 ±7,6 ans. Soixante-neuf patientes (61,5%) étaient nullipares. Cinquante-deux (54,2%) et quarante-quatre (45,5%) présentaient une infertilité primaire et secondaire respectivement. Onze patientes (11,5%) étaient ménopausées. Concernant les antécédents chirurgicaux, nous avons identifié une myomectomie chez 29 patientes (30,2%), un curetage utérin chez 28 (29,1%), une cœlioscopie chez 16 (16,6%), une hystéroscopie chez huit (8,3%) et une césarienne chez une (1%). Au total, 92 (95,8%) des patientes avaient des anomalies cavitaires objectivées. Il s’agissait de polypes endométriaux (43,7%), fibromes sous-muqueux (42,7%), synéchies utérines (20,8%), atrophie de l’endomètre (4,1%), métaplasie osseuse (2%), cloison utérine (1%) et corps étranger à type de fil de suture non résorbable (1%). Conclusion. Les anomalies intra-cavitaires étaient retrouvées chez 95,8% des patientes réalisant une hystéroscopie au CHRACERH. Les anomalies les plus représentées étaient les polypes endométriaux (43,7%), les fibromes sous-muqueux (42,7%) et les synéchies utérines (20,8%). Le taux global de complications opératoires était de 6,2%.

Keywords

Hysteroscopy, Fibroid, Polyp, Cameroon

Article Details

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to Cite
Serge Robert Nyada, Pascale Mpono E, Ngono A Vanina, Junie Annick Metogo Ntsama, Yves Kasia Onana, Etienne Belinga, Claude Noa Ndoua, Sandrine Mendibi, André N Dipanda, & Jean Marie Kasia. (2022). Frequency and Pattern of Intrauterine Hysteroscopic Lesions among Women Coming for IVF in the City of Yaoundé. HEALTH SCIENCES AND DISEASE, 24(1). https://doi.org/10.5281/hsd.v24i1.4137
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Koskas M, Mergui JL, Yazbeck C, Uzan S, Nizard J. Office hysteroscopy for infertility: a series of 557 consecutive cases. Hindawi Publishing Corp. Obstetrics and Gynecology International. 2010; doi:10.1155/2010/168096.
  2. Gupta N, Gupta A. Complications during hysteroscopy for gynaecological procedures: prevention is better than cure! Korean J Anesthesiol 2020; 73(1): 79-80.
  3. Fatemi HM, Kasius JC, Timmermans A, Van Disseldorp J, Fauser BC, Devroey P. Prevalence of unsuspected uterine cavity abnormalities diagnosed by office hysteroscopy prior to in vitro fertilization. Human Reproduction. 2010 25(8) 1959-1965. doi:10.1093/humrep/deq150
  4. Duggal BS, Sharma R K, Tarneja P, Rath SK, Wadhwa RD. Fertility enhancing hysteroscopic surgery: our experience. MJAFI 2003; 59:29-31
  5. Noa Ndoua CC, Ayissi Nga GG, Metogo J, Belinga E, Kasia Onana YB, Mendibi S. Hysteroscopic features of endocavitary lesions at CHRACERH Cameroon. Health Sci. Dis. 2018; 19(4) 61-65.
  6. Ray-Offor E, Nyengidiki TK. Diagnostic yield and therapeutic outcome of hysteroscopy in women with infertility in a referral clinical setting: a Port Harcourt, Nigeria experience. Pan African Medical Journal. 2021; 38(155). 10.11604/pamj.2021.38.155.27101
  7. Al-Husban N, Abu Rokbeh R. Operative hysteroscopy platform at a university teaching hospital: a retrospective study. Journal of international medical research. 2019, 47(10) 5028-5036. DOI: 10.1177/0300060519864494
  8. Mettler L, Wendland EM, Patel P, Caballero R, Schollmeyer T. Hysteroscopy: An analysis of 2-years’experience. Journal of the Society of Laparoendoscopic Surgeons (2002)6:195-197.
  9. Abayomi BA, Ajayi VD, Ifeoluwa OO, Bamgboye MA. Pathological findings from laparoscopy and hysteroscopy procedural assessments of the pelvic environment and the uterine cavity among infertile black women in a sub-sahara african country – Nigeria. EC Gynaecology. 2019; 8(9) 800-813.
  10. Abayomi BA, Oluwafunmilola B, Ajayi VD, Ifeoluwa OO, Aikhuele H, Bamgboye MA. Detection of intrauterine lesions by hysteroscopy among women with fertility challenges in an In-Vitro Fertilization Center in Lagos, Nigeria. Critical care Obstetrics and Gynecology.2015; 1(8); https://doi.org/10.4172/ipccog.1000008.
  11. Kodaman PH, Arici A. Intra-uterine adhesions and fertility outcome: how to optimize success? Curr Opin Obstet Gynecol. 2007; 19(3): 207-214.
  12. Taylor E, Gomel V. The uterus and fertility. Fertil Steril. 2008; 89(1): 1-16.
  13. Pritts EA, Parker WH, Olive DL. Fibroids and infertility: an updated systematic review of the evidence. Ferti Steril. 2009; 91(4): 1215-1223.
  14. Pritts EA. Fibroids and infertility: a systematic review of the evidence. Obstet Gynecol Surv. 2001; 56(8): 483-491.

Most read articles by the same author(s)