Page 21 - World Journal of Laparoscopic Surgery

World Journal of Laparoscopic Surgery, May-August 2009;2(2):26-29
Okohue JE et al

A 3 Years Review of Hysteroscopy in a Private

Hospital in Nigeria

1,2 1,2 1 1,2 1,2 3
Okohue JE, Onuh SO, Akaba GO, Shaibu I, Wada I, Ikimalo JI
1 Nordica Fertility Center @ Nisa Premier Hospital, Jabi Abuja, Nigeria
2 Port Harcourt Fertility Center, Port Harcourt, Rivers State, Nigeria
3 Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Rivers State, Nigeria
Correspondence: Jude Okohue, Port Harcourt Fertility Center @ Prime Medical Consultants 4 Prime Close Rumuogba, Port
Harcourt, Rivers State, Nigeria, E-mail: judosca@yahoo.com

Abstract It can be used for both diagnostic and operative purposes
Background: Hysteroscopy is a valuable tool in the evaluation and and remains a valuable tool in the evaluation and treatment of
treatment of infertility and many other gynecological procedures. Its infertility, recurrent pregnancy loss and abnormal and
use has relegated blind procedures for the investigation and treatment postmenopausal uterine bleeding. It is also useful when saline
of endometrial pathologies and in some instances obviates the need infusion sonography findings are equivocal. 1
for open surgeries. Unfortunately the equipment is only available in a Different distention media are available for both diagnostic
few private hospitals in Nigeria.
and operative hysteroscopy. Among these are high viscosity
Objectives: To describe our experience with hysteroscopy in a private dextran 70 and low viscosity fluids such as hypotonic,
hospital setting in Nigeria.
electrolyte free and isotonic, electrolyte containing solutions
Material and methods: Retrospective reviews of all cases of such as glycine 1.5% and normal saline respectively. A flexible
hysteroscopy done between January 2003 and December 2005 at
Nisa Premier Hospital (Nordica Fertility Centre), a dedicated fertility hysteroscope which is used as an outpatient procedure
center in Abuja, Nigeria was carried out. Relevant information was commonly uses carbon dioxide as a distention medium.
extracted from the patients’ case notes and theater records. The Although carbon dioxide is not used in the presence of uterine
hysteroscopic procedures were carried out during the proliferative bleeding mainly because of the high-risk of embolism, many
phase of the patients’ menstrual cycle. All but nine patients had gynecologist still prefer it for its optimal clarity and patient
paracervical block with xylocaine in addition to intravenous pentazocine comfort during insufflations for diagnostic hysteroscopy. 2
and promethazine for pain relieve. Normal saline was used as distention Complications following hysteroscopy could be procedure
medium.
1
related, media related or postoperative. The most common
Results: A total of 87 hysteroscopies were carried out during the 3
period under review. Eighty-five patients (97.7%) presented with procedure related complication is uterine perforation. Cervical
infertility. Forty four patients (48.3%) had single pathology while 23 injuries could also occur. Media related complications include
(26.4%) had multiple pathologies. The commonest pathology was anaphylactic shock, noncardiogenic pulmonary edema; common
intrauterine adhesions (64.2%). There were 3 cases (3.5%) of retained with high viscosity fluids and gas embolism with carbon dioxide.
fetal bones within the endometrial cavity. Sixty-four (73.6%) patients Postoperative ascending infections, hematometria and
underwent hysteroscopic surgical procedures. The commonest pregnancy following endometrial ablation could also occur. 1
surgical procedure performed was intrauterine adhesiolysis (67.2%),
followed by polypectomy (35.9%). One complication occurred during
the study period (anesthetic). OBJECTIVES
Conclusion: Hysteroscopy is a valuable tool in the assessment of the To describe our experience with hysteroscopy in a private
uterine cavity. The equipments and skills are however presently lacking hospital setting in Nigeria.
in Nigeria.
Keywords: Hysteroscopy, infertility, adhesiolysis.
MATERIAL AND METHODS
Retrospective reviews of all cases of hysteroscopy done
INTRODUCTION
between January 2003 and December 2005 at Nisa Premier
Hysteroscopy involves the passage of a small diameter Hospital (Nordica Fertility Center), a dedicated fertility center
telescope either flexible or rigid, through the cervix to directly in Abuja, Nigeria was carried out. Relevant information was
inspect the uterine cavity. extracted from the patients’ case notes and theater records.

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