Reproductive outcomes after Versapoint hysteroscopic metroplasty

Objective: To determine the feasibility, safety and the outcomes of hysteroscopic metroplasty with bipolar Versapoint electrode. Design: Prospective, observational study. Setting: Endoscopy Unit, Suzan Moubark Maternity and Pediatric University Hospital. Patient(s): Twenty-six patients with different degree of uterine septa and poor reproductive outcomes (spontaneous abortion, habitual abortion, preterm labor and unexplained primary infertility). Intervention(s): Versapoint hysteroscopic division of the uterine septum. Main outcome measure(s): Prospective evaluation of the reproductive outcomes during 24months follow up. Result(s): There was significant changes in the results after metroplasty, as 23 (88.46%) patients became pregnant, of them 3/23 (13.04%) had habitual abortion, 2 patients (4.34%) ended in preterm labor, 14/23 (60.86%) had reached to term delivery with a total pregnancy loss of 5/23 (21.73%) and pregnancy complications occurred in 5/23 (21.73%), these results represent a statistically significant difference (P⩽0.05). The mean gestational age, the mean neonatal weight at delivery, early neonatal condition judged by apgar scores both in 1 and 5min after delivery were significantly improved after hysteroscopic metroplasty (P<0.05). There were no intraoperative or postoperative complications, and complete removal of the septum was achieved in 21 patients (80.67%), a residual septum was found in 5 woman (19.23%), and a 2nd intervention was done in only 2 patients (7.69%) with a residual septum >1cm using office hysteroscopy. Conclusion(s): Hysteroscopic metroplasty using the Versapoint is a successful alternative to the resectoscope technique; it has the same effectiveness and broad safety profile with its simplicity, minimal postoperative squeal, and improved reproductive outcome, this approach should be recommended for metroplasty