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Anshika Lekhi et al 10.5005/jp-journals-10033-1279
CaSe RepORt

Hysteroscopy in Uterine Anomalies: An Edge

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1 Anshika Lekhi, Rahul Manchanda, Sravani Chithra, Nidhi Jain
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ABSTRACT and other adverse fetal outcomes. The prevalence
2-7
Hysteroscopy is the inspection of the uterine cavity by rates of uterine anomalies have varied between 0.06 and
endoscopy with access through the cervix. It allows for the 38%. 8-15 This wide variation is likely to be linked to the
diagnosis of intrauterine pathology and serves as a method assessment of different patient populations and the use
for surgical intervention at the same time. Congenital uterine of different diagnostic techniques with variable, and
anomalies result from abnormal formation, fusion, or resorption
of the Müllerian ducts during fetal life. These anomalies yet to be determined, test accuracy as well as reliance
have been associated with an increased rate of miscarriage, on nonstandardized classification systems. The endo-
preterm delivery, and other adverse fetal outcomes. In the past scopic technique for the management of uterine septa
whenever a patient presented with Müllerian fusion defect that was first proposed by Edstrom and Fernstrom in 1970.
was thought to be the cause of recurrent pregnancy loss, a In the past whenever a patient presented with Müllerian
laparotomy was performed. They required lengthy anesthesia.
Also the postoperative complications were more besides the fusion defect that was thought to be the cause of recur-
trauma of a laparotomy scar. With the use of endoscopy all rent pregnancy loss, a Jones, Strassman, or Tompkins
these problems have vanished. The diagnosis and management procedure would be performed by laparotomy. They
for uterine anomalies has become much easier and less required lengthy anesthesia and also the postoperative
cumbersome with the use of hysteroscopy. We report a case complications were more. With the use of endoscopy all
series (six cases) of uterine anomalies and their hysteroscopic
management. It includes one case of hypoplastic gonads, these problems have vanished. The diagnosis and man-
one of rudimentary horn, two of bicornuate uterus, one of agement for uterine anomalies has become much easier
complete septum, and one of complex anomaly. With this, and less cumbersome with the use of hysteroscopy. This
the authors would like to emphasize on the revolutionary role review has assessed the ease and accuracy of hystero-
of hysteroscopy in the diagnosis and management of uterine scopic diagnosis of uterine anomalies.
anomalies and would review the literature regarding the same.
Keywords: Hysteroscopy, Infertility, Müllerian duct, Uterine CASE REPORTS
anomalies.
The authors report a series of six cases of uterine
How to cite this article: Lekhi A, Manchanda R, Chithra S,
Jain N. Hysteroscopy in Uterine Anomalies: An Edge. World J anomalies.
Lap Surg 2016;9(2):86-91. 1. This 18-year-old was suffering from primary amenor-
Source of support: Nil rhea. She came to us with chief complaints of not hav-
ing started with menses and poorly developed breasts.
Conflict of interest: None
There was no history to suggest any insidious/ongo-
ing disease process/radiation exposure. Tuberculosis
INTRODUCTION and thyroid illness were ruled out. Her ultrasound
and magnetic resonance imaging (MRI) showed
Hysteroscopy is the inspection of the uterine cavity by
endoscopy with access through the cervix. It allows for smaller ovaries and a hypoplastic uterus (33 mm)
the diagnosis of intrauterine pathology and serves as with the endometrium not being well defined. Her
a method for surgical intervention at the same time. chromosomal analysis was normal and on exami-
Congenital uterine anomalies result from abnormal nation breasts were a little less developed, but rest
formation, fusion, or resorption of the Müllerian ducts of the secondary sexual characters were within the
range of development. Hormonal profile was within
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during fetal life. These anomalies have been associated
with an increased rate of miscarriage, preterm delivery, normal but on the lower side. She was taken up for
a hysteroscopy and laparoscopy for further manage-
ment. Hysteroscopy showed a very small cavity with
1,3,4 Fellow, Consultant endometrium being in proliferative phase and thin
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1-4 Department of Gynae Endoscopy, Manchanda’s (Fig. 1A). On laparoscopy ovaries were a tad smaller
Endoscopy Centre, New Delhi, Delhi, India and the uterus too appeared smaller. Hysteroscopic
Corresponding Author: Anshika Lekhi, Fellow, Department cutting of septum with bilateral lateral wall metro-
of Gynae Endoscopy, Manchanda’s Endoscopy Centre plasty was done (Fig. 1B). She was put on high doses
New Delhi, India, Phone: +918860241148, e-mail: of sequential estrogen and progesterone therapy and
dranshikalekhi@gmail.com was asked to follow-up. She did very well and got her

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