The role of abdominal metroplasty in the era of operative hysteroscopy.

The current retrospective study was undertaken at a tertiary care academic reproductive medical center to evaluate the role of abdominal metroplasty (Jones or Strassman techniques) in patients with bicornuate uteri, T-shaped uteri and septate uteri when associated with other pelvic lesions not amenable to the transcervical approach. Fifteen patients with double uterus (13 septate and two bicornuate) and three with T-shaped uterine cavities after diethylstilbestrol exposure underwent abdominal metroplasty (Jones or Strassman techniques) for the repair of the uterus during the period August 1983 through August 1991. Patients with septate uteri had other pelvic lesions as well. Thirteen of 16 patients attempting pregnancy conceived and delivered postoperatively. The fetal wastage rate decreased from 87.9 percent before metroplasty to 9.1 percent after metroplasty. Abdominal metroplasty (Jones or Strassman techniques) continues to yield gratifying results in patients with bicornuate, T-shaped and septate uteri. When patients have additional pelvic lesions not amenable to the transcervical approach alone, it may be appropriate to use conventional abdominal metroplasty. For the bicornuate condition, this remains the only approach.