Efficacy of hysteroscopic cervical resection for cervical stenosis

Yu Hung Lin, Jiann-Loung Hwang, Lee Wen Huang, Kok Min Seow, Hen Ju Chen, Chii Ruey Tzeng

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Study Objective: Cervical stenosis can be an impediment to embryo transfer (ET) and intrauterine insemination (IUI). We propose a technique of hysteroscopic cervical resection to overcome cervical stenosis. Design: Prospective clinical study (Canadian Task Force classification III). Setting: Private general hospital. Patients: Forty-three infertile women in whom trial ET or IUI had failed with 3 available catheters. Interventions: The procedure was performed with a hysteroscope under ultrasound guidance. Starting from the external os, the loop electrode gradually resected protrusions and cervical tissue until the hysteroscope could enter the uterine cavity. Repeat trial ET/IUI was performed 1 month later. The women who became pregnant underwent sonographic measurement of the cervical length and dilatation in the second and third trimesters. Measurements and Main Results: Excluding 13 patients in whom the sound could pass through the cervical canal after anesthesia, 30 patients were included for analysis. The procedure failed in 1 patient (3.3%). The mean operation time was 18.0 (±7.4) minutes. Repeat trial ET/IUI was successful in all patients. There were 5 twin pregnancies and 9 singleton pregnancies after IUI or ET. From the 5 women with twin pregnancies; 2 underwent premature delivery at 34 weeks; and 3 underwent elective cesarean delivery at 35, 36, and 37 weeks, respectively. From the 9 women with singleton pregnancies, 1 underwent cesarean section at 36 weeks because of preeclampsia, and the other 8 delivered at term. Conclusion: Hysteroscopic cervical resection is a safe and effective treatment for cervical stenosis.

Original languageEnglish
Pages (from-to)836-841
Number of pages6
JournalJournal of Minimally Invasive Gynecology
Volume20
Issue number6
DOIs
Publication statusPublished - 2013

Fingerprint

Insemination
Embryo Transfer
Pathologic Constriction
Hysteroscopes
Twin Pregnancy
First Labor Stage
Pregnancy
Private Hospitals
Third Pregnancy Trimester
Second Pregnancy Trimester
Advisory Committees
Pre-Eclampsia
General Hospitals
Cesarean Section
Electrodes
Catheters
Anesthesia
Prospective Studies

Keywords

  • Cervical stenosis
  • Hysteroscope

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Efficacy of hysteroscopic cervical resection for cervical stenosis. / Lin, Yu Hung; Hwang, Jiann-Loung; Huang, Lee Wen; Seow, Kok Min; Chen, Hen Ju; Tzeng, Chii Ruey.

In: Journal of Minimally Invasive Gynecology, Vol. 20, No. 6, 2013, p. 836-841.

Research output: Contribution to journalArticle

Lin, Yu Hung ; Hwang, Jiann-Loung ; Huang, Lee Wen ; Seow, Kok Min ; Chen, Hen Ju ; Tzeng, Chii Ruey. / Efficacy of hysteroscopic cervical resection for cervical stenosis. In: Journal of Minimally Invasive Gynecology. 2013 ; Vol. 20, No. 6. pp. 836-841.
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abstract = "Study Objective: Cervical stenosis can be an impediment to embryo transfer (ET) and intrauterine insemination (IUI). We propose a technique of hysteroscopic cervical resection to overcome cervical stenosis. Design: Prospective clinical study (Canadian Task Force classification III). Setting: Private general hospital. Patients: Forty-three infertile women in whom trial ET or IUI had failed with 3 available catheters. Interventions: The procedure was performed with a hysteroscope under ultrasound guidance. Starting from the external os, the loop electrode gradually resected protrusions and cervical tissue until the hysteroscope could enter the uterine cavity. Repeat trial ET/IUI was performed 1 month later. The women who became pregnant underwent sonographic measurement of the cervical length and dilatation in the second and third trimesters. Measurements and Main Results: Excluding 13 patients in whom the sound could pass through the cervical canal after anesthesia, 30 patients were included for analysis. The procedure failed in 1 patient (3.3{\%}). The mean operation time was 18.0 (±7.4) minutes. Repeat trial ET/IUI was successful in all patients. There were 5 twin pregnancies and 9 singleton pregnancies after IUI or ET. From the 5 women with twin pregnancies; 2 underwent premature delivery at 34 weeks; and 3 underwent elective cesarean delivery at 35, 36, and 37 weeks, respectively. From the 9 women with singleton pregnancies, 1 underwent cesarean section at 36 weeks because of preeclampsia, and the other 8 delivered at term. Conclusion: Hysteroscopic cervical resection is a safe and effective treatment for cervical stenosis.",
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