Search results for " Hysteroscopy"

Operative Hysteroscopy Ten Years' Experience

1994

Cold loops applied to bipolar resectoscope: A safe "one-step" myomectomy for treatment of submucosal myomas with intramural development

2015

AIM: To assess the safety and efficacy of cold loop myomectomy applied to bipolar resectoscope to perform "one-step" myomectomy of submucosal myomas with intramural involvement. METHODS: Seventy-two patients with at least one symptomatic G1 or G2 myoma (Wamsteker's classification) underwent cold loop myomectomy from January 2011 to January 2013. All surgical procedures were performed using a 26Fr resectoscope and bipolar energy source. At one month after the procedure, all patients underwent an office hysteroscopy check-up. A subgroup of seven infertile patients underwent an office hysteroscopy every two-weeks to evaluate recovery time of the myometrial fovea. RESULTS: Resectoscopic myomect…

Hysteroscopic Evaluation of Endometrial Changes in Breast Cancer Women with or without Hormone Therapies: Results from a Large Multicenter Cohort Stu…

2020

ABSTRACT Study Objective The primary aim of our study was to investigate the incidence of endometrial pathologies, especially endometrial cancer, in women with breast cancer treated with tamoxifen (TAM), aromatase inhibitors (AIs), or receiving no treatment (NT). The secondary aim was to identify, in this cohort, ultrasonographic findings that represent robust indications for hysteroscopy and endometrial biopsy, to avoid unnecessary second-level diagnostic procedures. Design Multicenter retrospective cohort study (Clinical Trial ID: NCT03898947). Setting Data were collected from different Italian centers: Regina Elena National Cancer Institute of Rome, Arbor Vitae Centre of Rome, Gaetano Ma…

Office hysteroscopic treatment of a vanishing external uterine orifice in a postmenopausal woman with an obstetrical history of 44 abortions

2015

Abstract Cervical stenosis, defined as cervical scarring of variable degree, represents a significant anatomical impediment to hysteroscopic procedures. Acquired cervical stenoses are more common than congenital forms and they are mainly associated with aging, estrogen–progesteron drugs, cervical trauma or carcinoma. The overcoming of cervical stenosis at office hysteroscopy is challenging and it often fails requiring the scheduling of the patient for an in-patient treatment under general anesthesia. We report the office hysteroscopy treatment of a vanishing external uterine orifice in a postmenopausal woman with an ultrasonographic report of a heterogeneous and thick endometrium suggestive…

Endometrial biopsy: Indications, techniques and recommendations. An evidence-based guideline for clinical practice

2023

This practice guideline provides updated evidence for the gynecologist who performs endometrial biopsy (EB) in gynecologic clinical practice. An international committee of gynecology experts developed the recommendations according to AGREE Reporting Guideline. An adequate tissue sampling is mandatory when performing an EB. Blind methods should not be first choice in patients with suspected endometrial malignancy. Hysteroscopy is the targeted-biopsy method with highest diagnostic accuracy and cost-effectiveness. Blind suction techniques are not reliable for the diagnosis of endometrial polyps. In low resources settings, and in absence of the capacity to perform office hysteroscopy, blind tec…

Chronic Endometritis

2016

Chronic endometritis is a persistent inflammation of the inner lining of the uterine cavity. Several studies have demonstrated that it is a condition frequently associated with repeated unexplained implantation failure at in vitro fertilization, recurrent miscarriage, as well as poor obstetric outcomes such as preterm labor. The aim of this paper is to provide information about diagnosis and treatment of this condition to improve reproductive outcome. In fact, significantly higher rate of successful pregnancies was achieved in those patients in whom antibiotic treatment was able to normalize both hysteroscopic and histologic endometrial pattern compared with women who were not treated or wi…

Does Hysteroscopic Dissection of Partial Uterine Septum Represent a Risk Factor for Placental Abnormalities in Subsequent Pregnancy Compared with Con…

2022

Background: Hysteroscopic septum dissection (HSD) is thought to improve fertility and pregnancy outcomes. However, the available literature suggests that uterine surgery can cause placental abnormalities in subsequent pregnancies. Methods: A case–control study was performed at the University Medical Center of Ljubljana, Department of Human Reproduction, from 1 January 2016 to 31 December 2018. The primary outcome was the association between HSD and the occurrence of placental abnormalities. We included women who underwent HSD due to infertility. Age-matched women who underwent hysteroscopic surgery for other issues were considered as controls. In addition, we divided the groups according to…

Chronic Endometritis in Infertile Women: Impact of Untreated Disease, Plasma Cell Count and Antibiotic Therapy on IVF Outcome—A Systematic Review and…

2022

This systematic review and meta-analysis aims to evaluate the impact of chronic endometritis (CE) and its therapy on in vitro fertilization (IVF) outcome. Additionally, we aim to investigate whether various degrees of CE severity may exert a different effect on IVF outcome. Ongoing-pregnancy rate/live-birth-rate (OPR/LBR), clinical-pregnancy rate (CPR), and miscarriage rate (MR) were calculated. A total number of 4145 patients (from ten studies) were included. Women with CE had lower OPR/LBR (OR 1.97, p = 0.02) and CPR (OR 2.28, p = 0.002) compared to those without CE. CE cure increased OPR/LBR (OR 5.33, p < 0.0001) and CPR (OR 3.64, p = 0.0001). IVF outcome was comparable between women …

Training in Diagnostic Hysteroscopy: The "Arbor Vitae" Method

2023

Background and Objectives: Diagnostic hysteroscopy is the gold standard in the diagnosis of intrauterine pathology and is becoming an essential tool in the daily practice of gynecology. Training programs for physicians are necessary to ensure adequate preparation and learning curve before approaching patients. The aim of this study was to describe the “Arbor Vitae” method for training in diagnostic hysteroscopy and to test its impact on the knowledge and skills of trainees using a customized questionnaire. Materials and Methods: A three-day hysteroscopy workshop combining theory and practical “hands on “sessions with dry and wet labs has been described. The aim of the course is to teach ind…

Feasibility and Acceptability of Office-Based Polypectomy With a 16F Mini-Resectoscope: A Multicenter Clinical Study

2016

Abstract Study Objective To investigate the feasibility and acceptability of office hysteroscopic polypectomy using a novel continuous-flow operative 16F mini-resectoscope. Design Multicenter prospective case series (Canadian Task Force classification III). Setting “SS Antonio e Biagio” Hospital, Alessandria, and University “Federico II” of Naples. Patients One hundred eighty-two patients with endometrial polyps. Interventions Hysteroscopic polypectomy performed with 16F mini-resectoscope in an office setting, without analgesia and/or anesthesia. Measurements and Main Results Polypectomy was successfully performed in 175 patients in a single surgical step (96.15%), with only 1 patient (.54%…