Objective

To identify the prevalence of and risk factors for chronic endometritis (CE) in patients with intrauterine disorders and the therapeutic efficacy of hysteroscopic surgery in the treatment of CE without antibiotic therapy.

Design

Prospective cohort study.

Setting

Hospital specializing in reproductive medicine.

Patient(s)

The study population consisted of 350 women with infertility, of whom 337 were recruited, who underwent hysteroscopic surgery between November 2018 and June 2021. Eighty-nine consecutive patients without intrauterine disorders were also recruited as controls.

Intervention(s)

Endometrial samples were collected during the surgery for CD138 immunostaining for the diagnosis of CE. In women diagnosed with CE, endometrial biopsy was performed without antibiotic use in the subsequent menstrual cycle.

Main Outcome Measure(s)

Prevalence of and risk factors for CE in intrauterine disorders and therapeutic effects of hysteroscopic surgery on CE.

Result(s)

The prevalence of CE with ≥5 CD138-positive cells in women with no intrauterine disorder and with endometrial polyps, myomas, intrauterine adhesions (IUAs), and septate uterus was 15.7%, 85.7%, 69.0%, 78.9%, and 46.2%, respectively. A multivariate analysis revealed that CE was diagnosed significantly more often in the endometrial polyp (odds ratio, 27.69; 95% confidence interval, 15.01–51.08) and IUA groups (odds ratio, 8.85; 95% confidence interval, 3.26–24.05). The rate of recovery from CE with surgery in women with endometrial polyps, myomas, IUA, and septate uterus was 89.7%, 100%, 92.8%, and 83.3%, respectively.

Conclusion(s)

Endometrial polyp and IUA were risk factors for CE. Most CE cases with intrauterine disorders were cured with hysteroscopic surgery without antibiotic therapy, regardless of the type of intrauterine abnormalities.

中文翻译：

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宫腔镜手术后宫内疾病患者慢性子宫内膜炎的患病率及危险因素

客观的

确定宫内疾病患者慢性子宫内膜炎 (CE) 的患病率和危险因素，以及宫腔镜手术在没有抗生素治疗的情况下治疗 CE 的疗效。

设计

前瞻性队列研究。

环境

生殖医学专科医院。

病人）

研究人群包括 350 名不孕症女性，其中 337 名被招募，她们在 2018 年 11 月至 2021 年 6 月期间接受了宫腔镜手术。同时招募了 89 名没有宫内疾病的连续患者作为对照。

干预措施

在手术期间收集子宫内膜样本进行 CD138 免疫染色以诊断 CE。在诊断为 CE 的女性中，在随后的月经周期中未使用抗生素的情况下进行了子宫内膜活检。

主要观察指标）

宫内疾病中 CE 的患病率和危险因素以及宫腔镜手术对 CE 的治疗效果。

结果）

在无子宫内膜息肉、肌瘤、宫腔粘连 (IUA) 和纵隔子宫的女性中，≥5 个 CD138 阳性细胞的 CE 患病率分别为 15.7%、85.7%、69.0%、78.9% 和 46.2%，分别。多变量分析显示，在子宫内膜息肉（比值比，27.69；95% 置信区间，15.01-51.08）和 IUA 组（比值比，8.85；95% 置信区间，3.26-24.05）中，CE 的诊断率明显更高。患有子宫内膜息肉、肌瘤、IUA 和纵隔子宫的女性通过手术从 CE 中恢复的比例分别为 89.7%、100%、92.8% 和 83.3%。

结论

子宫内膜息肉和 IUA 是 CE 的危险因素。大多数宫内异常的 CE 病例通过宫腔镜手术治愈，无需抗生素治疗，无论宫内异常的类型如何。