Application value of modified hysteroscopic adhesiolysis in the treatment of thin endometrium

Objective To explore the effective therapeutic methods for thin endometrium (TE) and recovery of reproductive function of uterine.

Methods Menstrual days, the Pictorial Blood Loss Assessment Chart (PBAC) score for menstrual volume, and ultrasound indicators before and after modified hysteroscopic adhesiolysis in 48 patients with TE were retrospectively analyzed.

Results The average postoperative menstrual period of 48 patients was (5.60±1.40) days, which was significantly longer than (4.30±1.20) days before operation (P < 0.05); the postoperative PBAC score for menstrual volume was (55.60±6.20) points, which was significantly higher than (21.40±5.60) points before operation (P < 0.05); there were no significant differences in the mean resistance index (RI) and pulse index (PI) of bilateral uterine arteries before and after surgery (P>0.05); the postoperative endometrial thickness and the endometrial volume were (9.10±1.10) mm and (4.68±0.81) cm³, which were significantly higher than (4.30±1.20) mm and (3.21±0.31) cm³ before operation (P < 0.05); the postoperative RI value and PI value of the endometrium were (0.51±0.13) and (0.77±0.26), which were significantly lower than (0.59±0.07) and (0.91±0.18) before operation (P < 0.05). The pregnancy rate of 48 patients was 60.4%. The volume and thickness of the endometrium were positively significantly correlated with pregnancy (P < 0.05), while the RI and PI values of the endometrium were negatively significantly correlated with pregnancy (P < 0.05).

Conclusion Changing electric current cutting to "cold needle" physical and mechanical separation of scar adhesions can effectively repair scar adhesions in the uterine cavity, facilitate postoperative reconstruction of endometrial blood flow, improve uterine receptivity of TE patients, and restore uterine reproductive function.