Revision hysteroscopy is a procedure in which the abnormal, deformed or malformed uterine cavity is restored to its normal anatomical form and physiological function through hysteroscopic operations such as cutting, separation and cautery. A significant proportion of female infertility patients are caused by uterine cavity abnormalities. In this paper, we analyzed the clinical data and follow-up results of infertility patients treated with revision hysteroscopy in our hospital in the past 6 years, with the aim of elaborating the role of revision surgery in infertility treatment. 1. Materials and methods 1.1 Source: 256 patients diagnosed with infertility due to uterine factors in our hospital from October 1998 to October 2004 were excluded from other infertility factors by hysteroscopy and other examinations. These patients underwent revision hysteroscopy according to the specific etiology. Among them, 234 cases with complete follow-up data were selected for the study, with a follow-up rate of 91.4%. 1.2 Case grouping: The cases were divided into three groups according to the etiology and the type of surgery performed. Uterine septum group (65 cases), uterine adhesions group (100 cases), and submucosal myoma group (69 cases). The ages of the three groups were 23-34 years (29.05±3.59 years), 25-39 years (29.15±3.46 years), and 26-42 years (30.10±3.21 years), respectively. There were 25 cases of complete septum, 40 cases of incomplete septum, and 3 cases of complete septum combined with other genital tract anomalies in the uterine septum group. There were 11 patients with primary infertility, 23 with secondary infertility, and 31 with infertility in this group, one of whom had a history of four spontaneous abortions. Septal resection (TCRS) was performed in all cases. In the group of uterine adhesions, 39 cases had mild to moderate adhesions and 61 cases had severe adhesions, all of which underwent adhesion separation (TCRA). There were 28 cases of primary infertility, 58 cases of secondary infertility and 14 cases of infertility. In the submucosal myoma group, 22 cases with myoma diameter ≤2.5 cm, 36 cases with 2.5-5.0 cm and 11 cases with ≥5.0 cm underwent myomectomy (TCRM). There were 34 cases of primary infertility, 20 cases of secondary infertility and 15 cases of infertility. 1.3 Surgical equipment: Japanese OLYMPUS 24 fiberoptic hysteroscope with 4.5 mm outer sheath and 180° bend at the front end was used for hysteroscopy; German WOLF continuous irrigation type with 9 mm outer sheath was used for hysteroscopy; monopolar electricity was used for surgical energy, and the cutting ring was a vertical cutting ring and needle electrode. The irrigation fluid was selected as 5% mannitol. 1.4 Surgical methods : Continuous epidural anesthesia was used in all cases. Different types of surgery were used according to different etiologies as follows: TCRS For incomplete septum, retrograde excision was performed by pushing the cutting ring or needle electrode upward from the lower edge of the septum and cutting to the root so that its base was flush with the uterine fundus on both sides, exposing the opening of the fallopian tubes on both sides; for complete septum, the septum was first entered on one side and a small incision was made at 0.5-1 cm above the intrauterine orifice, and then the above retrograde excision was performed. The septum is incised at the thinnest point without trimming. The uterine cavity is opened using dilatation pressure and an intrauterine device is placed after surgery for 3 months of hormonal therapy. For TCRA, retrograde excision is performed directly for visible reticular structures and adhesions, while for severe adhesions that are completely closed, excision is performed at the most obvious point of scarring, with ultrasound monitoring if necessary. After surgery, an intrauterine device was placed and hormonal therapy was performed for 3 months. TCRM can be resected in a parallelepipedal fashion. Smaller ones can be cut directly at the tip or root of the tumor and then clamped out; larger ones can be cut into strips to reduce the size of the tumor, and the base should be cut flush with the uterine wall, and some larger tumors should be suspended to allow further protrusion of the tumor into the uterine cavity, and so on until the cut is clean. 1.5 Clinical outcomes Satisfactory: TCRS: regular menses, no decrease in menstrual flow, no abdominal pain and other discomforts after surgery; TCRA: normal or significantly increased menses after surgery; TCRM: less than preoperative or normal menses after surgery, no abdominal pain and other discomforts. Unsatisfactory: all types of postoperative procedures failed to meet the above requirements or symptoms worsened requiring further treatment. 1.6 Follow-up All three groups of cases were followed up after surgery by outpatient follow-up, telephone and letter, and the follow-up date was up to April 2005. Follow-up indicators included menstrual status, number of postoperative pregnancies. The time between the first pregnancy and surgery, and pregnancy outcome. 1.7 Data processing SPSS10.0 statistical software was used for analysis. 2. Results 2.1 Surgery All surgeries went smoothly, and the operative time and bleeding volume in the three groups of TCRS, TCRA, and TCRM are shown in Table 1, and there was no significant difference in the operative time among the three groups by comparison (P > 0.05).