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Introduction: intrauterine pathologies were traditionally evaluated by blind dilatation and curettage along with hysterosalpingography. Hysteroscopy is a veritable tool for evaluation of uterine cavity pathologies with an increasing availability in Nigeria. The study aims to report the diagnostic yield and therapeutic outcome of hysteroscopy in women with infertility from a Nigerian metropolis., Methods: a retrospective cross-sectional study of consecutive cases of infertile women referred for hysteroscopy to an ambulatory care endoscopy facility in Port Harcourt, Nigeria. The variables collated included age, parity, past gynaecological history, indication, hysteroscopy findings and interventions. Statistical analysis was performed using SPSS version 25., Results: included in study were 75 patients undergoing a total of 124 hysteroscopic procedures. The age range of patients was 25 to 56 years (mean 40.7 ± 5.9 years). A positive diagnostic yield of 93.3% with non-visualization of intracavitary uterine pathology in 5 patients was recorded. The most common pathologies were submucous myoma-25(31.3%), endometrial polyps- 18(22.5%) and intrauterine adhesions-18(22.5%). There was no statistical difference between the mean age of patients with or without polyp, myoma and intrauterine adhesions (P = 0.185, P = 0.510 and P = 0.619 respectively) but a non-linear relationship between age and polyp detection (Eta2 = 0.024). Operative hysteroscopies were all performed on out- patient basis but staged in 30(40.0%) patients., Conclusion: benign uterine growths and intrauterine adhesions are frequent causes of uterine factor infertility. A high successful completion rate of hysteroscopic interventions was achieved., Competing Interests: The authors declare no competing interests., (Copyright: Emeka Ray-Offor et al.)

The effect of endometrial thickness on in vitro fertilization (IVF) outcome is still a subject of debate. It is unclear why a thin endometrium reduces IVF success rates. Our objective was to analyze the hysteroscopic findings in women scheduled for IVF who had an endometrial thickness less than 7 mm. Relevant data of patients scheduled for IVF cycles and found to have an endometrial thickness (ET) of <7 mm on transvaginal ultrasound scan (TVS) between April 1, 2010 and March 31, 2017, at a private fertility and minimal access surgery unit in the Niger-Delta region of Nigeria, were retrieved and documented. A total of 41 patients had ET <7 mm during the study period. These patients accounted for 2.8% of the 1487 IVF cycles performed during the same period. All 41 patients had office hysteroscopies performed, constituting 4.1% of the 1,002 hysteroscopies performed during the study period. The age range of the patients was 23 - 50 years with a mean of 39.9 ± 6.9 years, and the duration of infertility ranged from 3 to 13 years with a mean of 7.2 ± 2.5 years. Most of the patients (32, 78.1%) had secondary infertility. Sixteen patients (39.0%) had intrauterine adhesions. A thin endometrium, though infrequent during IVF treatment cycles, might be associated with undiagnosed intrauterine adhesions.

In developing countries, reports on adhesion intestinal obstruction in children are scanty. We report 30 children managed for adhesion intestinal obstruction during a 16-year period. The age range was 10 weeks-14 years (median 9 years). There were 24 boys and 6 girls. Postoperative adhesion was the cause in 13 (43%) patients, inflammatory in 11 (37%), and in 5 (17%) no cause could be identified. In one patient, adhesion followed missed ileal perforation from blunt abdominal trauma. Duration of symptoms was 1-21 days (median 4 days). Only four of the 13 patients with postoperative adhesion obstruction were managed conservatively initially, but this failed in all; one was found to have an intestinal perforation at laparotomy. The remaining nine had immediate laparotomy owing to presence of features of strangulation at presentation; two required intestinal resection for gangrene. All other patients had laparotomy soon after resuscitation. The resection rate for gangrene was 13% and 3% required closure of perforations. Postoperatively six (20%) patients developed eight infective complications. There was recurrence in three of 27 (11%) surviving patients within 3 months. Mortality was three (10%). The presentation of adhesion intestinal obstruction in children in northern Nigeria is late and morbidity and mortality are high. Early presentation should improve the outcome.

From July 1973 to December 1980, 6942 patients were admitted to the Gynaecology unit of the University of Benin Teaching Hospital, Benin City, Nigeria. Fifty-nine patients presented with gynatresia (vaginal atresia and stenosis), an incidence of 8.5 1000. The most common causes of this condition were caustic vaginitis, secondary to local herb pessary insertion, and circumcision. The resulting vaginal adhesions were effectively treated surgically by simple adhesiolysis . There was a low incidence of congenital gynatresia . As the large proportion of cases of acquired gynatresia were preventable, improvement in health education should further reduce incidence of this condition in our community.

One hundred and three patients with intestinal gangrene were managed in Ile-Ife, Nigeria over a 10-year period. The overall mortality in the series was 25.2%. Strangulated hernias were responsible for 65 cases (63%), intussusception 20.4%, adhesions 11.7% and volvulus 2.9%. Avoidable deaths resulted from anastomotic breakdown and inadequate preoperative fluid therapy. Primary intestinal resection and end-to-end anastomosis of large bowel involved in gangrene gave very good results. It was found to be quite safe and economical, and avoided the inconveniences and complications of a colostomy.