Department of Obstetrics and Gynecology, Hurley Medical Center, Michigan State University College of Human Medicine, Flint Campus, Flint, Michigan.
Department of Obstetrics and Gynecology, Hurley Medical Center, Michigan State University College of Human Medicine, Flint Campus, Flint, Michigan.
J Minim Invasive Gynecol. 2018 Jan;25(1):133-138. doi: 10.1016/j.jmig.2017.06.031. Epub 2017 Aug 26.
To determine the incidence of postoperative ascending infection without antibiotics with the use of a pediatric Foley catheter (PFC) after operative hysteroscopy for intrauterine pathology.
Retrospective case series (Canadian Task Force classification III).
University-affiliated outpatient medical center.
Patients who underwent operative hysteroscopy for uterine septum, arcuate uterine anomaly, or multiple submucosal myomas between 1992 and 2015.
In all patients, a PFC was placed in the endometrial cavity at the conclusion of operative hysteroscopy and left in place for 7 days to reduce intrauterine adhesion formation.
A total of 1010 patients who underwent operative hysteroscopy for uterine septum (n = 479), arcuate uterine anomaly (n = 483), or multiple submucosal myomas (n = 48) were studied. All patients presented with infertility, recurrent pregnancy loss, or excessive uterine bleeding (in patients with submucous myomas). In all patients, a PFC was placed at the conclusion of the procedure and left in place for 7 days. An 8Fr PFC was used after hysteroscopic division of uterine septum or arcuate uterine anomaly, and a 10Fr PFC was used after hysteroscopic myomectomy. Patients with a history of pelvic inflammatory disease were excluded. Following PFC placement, patients were prescribed estrogen for 6 weeks and progestogen for the last 10 days of the estrogen course. No prophylactic antibiotic therapy was provided. All patients were discharged to home on the same day. Postoperative pain was well controlled with oral pain medication in 98.5% of the patients. There were no reported postoperative infections, and all patients had an uneventful recovery.
In 1010 consecutive operative hysteroscopies followed by temporary (7-day) PFC placement, no clinically significant uterine infection was observed.
在因子宫内疾病而行宫腔镜手术的患者中，研究在术后不使用抗生素而仅使用小儿 Foley 导管（PFC）是否会导致上行性感染。
回顾性病例系列（加拿大任务组分类 III 级）。
大学附属门诊医疗中心。
1992 年至 2015 年间因子宫纵隔、弓形子宫畸形或多发性黏膜下肌瘤而行宫腔镜手术的患者。
所有患者在宫腔镜手术后将 PFC 置于子宫内膜腔中，并保留 7 天以减少宫腔粘连形成。
共有 1010 名因子宫纵隔（n=479）、弓形子宫畸形（n=483）或多发性黏膜下肌瘤（n=48）而行宫腔镜手术的患者接受了研究。所有患者均因不孕、复发性流产或子宫出血过多（黏膜下肌瘤患者）就诊。所有患者在手术结束时均放置 PFC 并保留 7 天。在宫腔镜下分割子宫纵隔或弓形子宫畸形后使用 8Fr PFC，在宫腔镜下肌瘤切除术后使用 10Fr PFC。排除有盆腔炎病史的患者。PFC 放置后，患者接受 6 周雌激素治疗和雌激素疗程最后 10 天孕激素治疗。未给予预防性抗生素治疗。所有患者均在同一天出院回家。98.5%的患者术后疼痛通过口服止痛药得到良好控制。无报告术后感染，所有患者均恢复顺利。
在 1010 例连续行宫腔镜手术并临时（7 天）放置 PFC 的患者中，未观察到明显的子宫感染。
