Hysteroscopic resection of retained products of conception after temporal laparoscopic uterine artery ligation

AbstractObjectiveTo describe hysteroscopic resection of retained products of conception (RPOC) after temporal laparoscopic uterine artery ligation for prevention of massive bleeding.Materials and methodsThis retrospective study was based in a community medical care hospital. Eight patients with RPOC underwent hysteroscopic resection of RPOC. Before the procedure, we performed temporal laparoscopic uterine artery ligation for prevention of massive bleeding.ResultsPatients' clinical backgrounds, intervals between the abortion or delivery and the operation, serum human chorionic gonadotropin (hCG) level at diagnosis, surgical times, and blood loss levels during surgery were recorded. The mean patient age was 28.2 ± 4.7 years. The mean interval between the abortions or deliveries and the surgeries was 43.2 ± 20.2 days. Three patients underwent spontaneous abortions, three patients underwent artificial abortions, and two patients had vaginal deliveries. The mean serum hCG level at the initial diagnosis was 168.7 ± 310 IU/L. Rich blood flow in the RPOCs was revealed by two-dimensional Doppler ultrasound examinations. Temporal uterine artery ligation was performed in all patients. The mean surgical time was 123.6±19.4 minutes, and the blood loss was minimal in all eight cases. Neither blood transfusion nor conversion to laparotomy was required. The histologic evaluation revealed trophoblastic cells in all cases.ConclusionHysteroscopic resection of RPOC after temporal laparoscopic uterine artery ligation is an effective and safe procedure for controlling bleeding