Intrauterine adhesions on second-look hysteroscopy after myomectomy with endometrial cavity breach: incidence and risk factors in a population in Kinshasa

Abstract

Intrauterine adhesions are defined as abnormal attachment of the uterine cavity walls and are one of the main causes of infertility worldwide. Myomectomy can cause endometrial cavity breach and lead to postoperative intrauterine adhesions. The aim of this retrospective study was to determine the incidence and risk factors of intrauterine adhesions after myomectomy with endometrial cavity breach, including all patients that underwent myomectomy with endometrial cavity breach and second-look hysteroscopy, from January 2020 to December 2024. The incidence of intrauterine adhesions was 12.7%. History of abortion (p=0.015; aOR=6.9) and involvement of both uterine walls (p=0.000; aOR=27.3) emerged as risk factors. In conclusion, history of abortion or involvement of both the anterior and posterior uterine walls in patients undergoing myomectomy are risk factors for intra-uterine adhesions. Attention should then be paid to absolutely prevent this condition when dealing with these patients.