Metroplasty which is also called as uteroplasty or hysteroplasty is a plastic surgery or reconstructive surgery performed on the uterus. This technique of tactile cold scissor metroplasty is always safe, and effective backup procedure for hysteroscopic metroplasty. A study was conducted on a group In patients with septate uterus, hysteroscopic metroplasty is associated with a significant improvement in reproductive performance, concluded the authors of an observational retrospective study conducted in France.
Nowadays, metroplasty is the safest method of choice for the surgical correction of separate uterus, which is the most common congenital uterine anomaly. It has been determined that compared with the open, abdominal metroplasty which is performed before the advent of minimally invasive surgical techniques, hysteroscopic metroplasty is a simple, safe, and relatively a quick procedure. It is ranging from 20 to 60 minutes of procedure time, for achieving the normal uterine architecture in women diagnosed with separate uterus. A recent study conducted concludes approximately 40% of women with a separate uterus, will experience reproductive problem that manifest most commonly as infertility, obstetrical complications and higher chances of recurrent miscarriages.
Considering metroplasty’s empirical clinical value, the procedure and its indications are at a debatable level, as there is a lack of randomized trials giving us definitive evidence on the outcome of the procedure. For example, there are some patients with a separate uterus have had successful pregnancies without any treatment interventions identified. To assess the reproductive outcomes of patients after surgical correction of a class V or VI separate uterus, there was a study conducted and the evaluated data from 128 patients with a separate uterus who have issues of either primary infertility or recurrent miscarriages. Out of the 128 participants, 78 women (61%) became pregnant and 70 live births were recorded after performing hysteroscopic metroplasty.
Among the women who had primary infertility problem, more than 25 pregnancies recorded. In this more than half (13) of these pregnancies were the result of assisted reproductive technology. The rate of first live births in women with infertility was 53.1%. While among the women who have experienced recurrent miscarriages, performing hysteroscopic metroplasty procedure has resulted in a significantly improved miscarriage rates. However, the outcomes after surgery were largely dependent on the anatomical type of septum.
Based on outcomes, the study was concluded that hysteroscopic metroplasty is producing a secure improvement in reproductive performance in majority of patients with different diagnosed conditions of septate uterus. Other additional potential benefits of metroplasty that have been reported previously include the prevention of breech delivery and a reduction in the rate of caesarean deliveries among problematic patients. Our hospital’s success rate in Hysteroscopic Metroplasty stands at 65% and majority of the patients seen very low level of miscarriages.