Office hysteroscopic early lysis of intrauterine adhesion after transcervical resection of multiple apposing submucous myomas

Objective: To analyze the prevalence of intrauterine adhesion (IUA) formation in women undergoing transcervical resection (TCR) for submucous myomas. Design: Retrospective cohort study. Setting: Tertiary university hospital. Patient(s): One hundred fifty-three women undergoing TCR for submucous myomas were retrospectively analyzed. Among them, 132 women had a solitary myoma (group 1), 5 had two submucous myomas not in apposition to each other and who received postoperative intrauterine device (IUD) placement (group 2), 9 had two or more apposing submucous myomas and received IUD placement (group 3), and 7 had two or more apposing submucous myomas and who underwent subsequent office hysteroscopic early lysis of IUA (group 4). Intervention(s): Placement of an IUD for 1 month (groups 2 and 3) or office hysteroscopy for early lysis of IUA within 2 weeks after hysteroscopic myomectomy (group 4). Main Outcome Measure(s): Diagnostic office hysteroscopy was done 1-3 months after hysteroscopic myomectomy to evaluate whether there was permanent formation of IUA. Result(s): Two (1.5%) of 132 women in group 1 had IUA. For women receiving IUD placement; none of the 5 women in group 2 and 7 (78%) of 9 women in group 3 had IUA. For women undergoing office hysteroscopic early lysis of adhesion bands (group 4), none of 7 women had IUA. Conclusion(s): Intrauterine adhesion is a common complication after TCR for apposing submucous myomas, but not for a solitary myoma. Office hysteroscopy within 2 weeks after TCR is an easy and effective procedure in separating the newly formed IUA.