Laparoscopic metroplasty in bicornuate and didelphic uteri

Objective To determine the feasibility of laparoscopic metroplasty in the treatment of bicornuate and didelphic uteri. Design Case report. Setting University and private hospitals. Patient(s) Four women with a diagnosis of double uterine cavity (two bicornuate and two didelphic uteri) with a history of two recurrent spontaneous abortions at less than 5 months of pregnancy. Intervention(s) Laparoscopic metroplasty with diagnostic hysteroscopy was performed for the unification of the uterus. Second-look laparoscopy and hysteroscopy was performed about 3 months later. Main Outcome Measure(s) Evaluation of the uterine compliance to high intrauterine pressure and presence of adhesions in the pelvic and uterine cavities. Result(s) In all four patients, laparoscopic metroplasty resulted in a unified uterus with a good cavity and tolerance to high intrauterine pressure. Minimal pelvic adhesions were noted in the two patients at the second surgery. Conclusion(s) This new technique of laparoscopic metroplasty is an acceptable alternative for abdominal metroplasty, with minimal adhesion formation.