Hysteroscopic Surgery of Complex Cervical Adhesions after Cold Knife Conization in Postmenopausal Women:A Report of Two Cases
LUO Yi-yang
ZHOU Qiao-yun
XIAO Yu
HUANG Xiao-wu
XIA En-lan
Abstract：Complex cervical adhesions following cold knife conization in postmenopausal women present a significant clinical challenge for gynecological procedures.The clinical data of two such cases were analyzed.In Case 1,the patient presented with endometrial thickening and abdominal distension,while Case 2 involved a uterine cavity mass with fluid accumulation.Cervical adhesiolysis was performed using ultrasound-guided direct puncture combined with methylene blue staining(Case 1),and blunt dissection with mosquito curved forceps(Case 2),followed by gradual cervical dilation using Hegar dilators and a combined cold knife-electrosurgery technique.Successful adhesiolysis and resection of endometrial lesion were achieved in both cases.The mean operative duration was 40 minutes,with an estimated blood loss of 5 mL.No complications(e.g.,uterine perforation or adjacent organ injury)occurred.Ultrasound-guided direct puncture with methylene blue staining or blunt dissection with mosquito curved forceps may overcome surgical limitations in postmenopausal women with post-conization cervical adhesions,offering a safe,minimally invasive,and effective approach for complex cases.
Keywords：Uterine cervical diseasesHysteroscopyPostmenopauseUltrasound-guided direct punctureBlunt dissectionCervical adhesions
Publication Date：2025-08-15
Online Publishing Date：2025-09-23(First online date of this platform, not the publication date of the document)
Pages：3( 474-476 )