Kaminski Pawel, Gajewska Malgorzata, Wielgos Miroslaw, Szymusik Iwona, Ziolkowska Kinga, Bartkowiak Robert
1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland.
Neuro Endocrinol Lett. 2006 Dec;27(6):813-7.
The aim of the study was to analyze the use of endoscopic procedures in the group of infertile patients.
The study material consisted of 636 patients, aged 20-41. They all had endoscopic procedures performed (laparoscopy and/or hysteroscopy) due to infertility, and were qualified for the procedure after a gynecological examination and ultrasound scan. The study group was divided into subgroups of primary and secondary sterility and endoscopic procedures were then analyzed.
A total of 724 endoscopic procedures were performed on 636 patients. Eighty eight women had both hysteroscopy and laparoscopy performed, 476 had only laparoscopy, while 72--only hysteroscopy. Women diagnosed due to primary sterility more often had no visible abnormalities in the pelvic region (30%) and patent oviducts than those with secondary sterility. The remaining 70% more often had ovaries typical for polycystic ovarian syndrome and endometriosis. However, periadnexal adhesions and tubal impotency were more common in the group of secondary sterility. As to hysteroscopy, women with primary sterility more often had congenital uterine malformations, while submucosal myomas and intrauterine adhesions were less common in that group. All the surgical procedures performed during laparoscopies were analyzed. Tubal patency assessment and ovarian drilling were significantly more often performed in the subgroup of primary sterility. All intrauterine pathologies were treated during hysteroscopy.
Laparoscopy and hysteroscopy play an important role as both diagnostic and therapeutic tools in the infertility treatment centers.
本研究旨在分析不育患者群体中内镜手术的应用情况。
研究材料包括636例年龄在20至41岁之间的患者。他们均因不育接受了内镜手术（腹腔镜检查和/或宫腔镜检查），并且在经过妇科检查和超声扫描后符合手术条件。研究组被分为原发性不育和继发性不育亚组，然后对内镜手术进行分析。
对636例患者共进行了724例内镜手术。88名女性同时接受了宫腔镜检查和腹腔镜检查，476名仅接受了腹腔镜检查，而72名仅接受了宫腔镜检查。因原发性不育而被诊断的女性在盆腔区域无明显异常（30%）且输卵管通畅的情况比继发性不育的女性更为常见。其余70%的患者更常出现多囊卵巢综合征和子宫内膜异位症典型的卵巢情况。然而，继发性不育组中附件周围粘连和输卵管功能不全更为常见。至于宫腔镜检查，原发性不育的女性更常出现先天性子宫畸形，而该组中黏膜下肌瘤和宫腔粘连则较少见。对腹腔镜检查期间进行的所有外科手术进行了分析。原发性不育亚组中输卵管通畅性评估和卵巢打孔的操作明显更为频繁。宫腔镜检查期间对所有宫腔病变进行了治疗。
腹腔镜检查和宫腔镜检查在不育治疗中心作为诊断和治疗工具均发挥着重要作用。
