Search results for "hysteroscopy"
showing 10 items of 47 documents
Small-diameter hysteroscopy with Versapoint versus resectoscopy with a unipolar knife for the treatment of septate uterus: A prospective randomized s…
2007
Abstract Study objective To compare 2 procedures for metroplasty: resectoscopy with monopolar knife versus small-diameter hysteroscopy fitted with a Versapoint device. Design Prospective randomized study (Canadian Task Force classification I). Setting Endoscopic gynecology units at tertiary care university hospitals. Patients One hundred-sixty patients with septate uterus and a history of recurrent abortion or primary infertility undergoing hysteroscopic metroplasty from 2001 to 2005. Interventions Hysteroscopic resection of the uterine septum performed with either a 26F resectoscope with unipolar knife (80 women, group A) or a 5-mm diameter hysteroscope with Versapoint device (80 women, gr…
A randomized comparison of endometrial laser intrauterine thermotherapy and hysteroscopic endometrial resection.
2003
Objective To investigate the difference of long-term amenorrhea rate in patients with menorrhagia treated by endometrial laser intrauterine thermal therapy (ELITT), a new nonhysteroscopic endometrial ablation procedure, versus transcervical hysteroscopic endometrial resection (TCRE). Design Randomized clinical study. Healthy volunteers in an academic research environment. Setting Academic teaching hospital. Patient(s) Premenopausal women with abnormal uterine bleeding. Intervention(s) Fifty-eight patients were treated with the ELITT procedure and 58 patients with TCRE; both groups were treated with GnRH agonists before the procedure. Main outcome measure(s) Bleeding status and patient satis…
Hysteroscopic Isthmoplasty: Step-by-Step Technique
2018
Study Objective To demonstrate our technique for surgical hysteroscopy performed with a standard-size resectoscope or miniresectoscope in 3 cases of isthmocele. Design Step-by-step demonstration of the technique using slides, pictures, and video (educative video) (Canadian Task Force classification III). Setting Isthmocele is a characteristic semidiverticular anomaly of the anterior isthmic wall of the uterus, located at the site of a previous cesarean delivery scar. The etiopathogenesis of isthmocele remains poorly understood, although several hypotheses have been proposed. Factors that may possibly play a role in niche development include a very low incision through cervical tissue, inade…
Resectoscope versus small diameter hysteroscopy for endometrial polypectomy in patients with "unfavorable" cervix
2017
BACKGROUND: The aim of this study was to compare resectoscopic and small-diameter hysteroscopic techniques for endometrial polypectomy in patients with "unfavorable" cervix.METHODS: Eighty women with a single 2-4 cm sized endometrial polyp, with unfavorable cervical anatomical conditions were enrolled in the study. Forty patients were treated with a 26F resectoscope requiring cervical dilatation (group A), forty patients were treated with a 5-mm hysteroscope requiring vaginoscopic approach (group B). Operative time, fluid absorption, complications, instrument failure, postoperative pain, overnight stay were analyzed. Operative visualization, operative difficulty and overall surgeon's satisf…
Laparoscopic Sentinel Lymph Node Detection After Hysteroscopic Injection of Technetium-99 in Patients With Endometrial Cancer
2015
Background and Objectives Endometrial cancer (EC) has an increasing incidence worldwide. Despite the unequivocal prognostic importance of nodal status, systematic lymphadenectomy is associated to elevated morbidity. Sentinel lymph node (SLN) biopsy is designed to avoid extensive nodal dissection and provide crucial oncologic information. The goal of this prospective study was to determine the feasibility, safety, and accuracy of laparoscopic SLN biopsy in EC obtained through hysteroscopic injection of technetium-99 (Tc-99). Methods From January 2008 to December 2012, a total of 42 women with EC were included in the study. We injected 20 mBq of Tc-99 hysteroscopically underneath the tumor mi…
Hysteroscopic removal of a gauze inadvertently retained in uterus for two years following caesarean section
2021
Despite the worldwide accomplishment of manual counting procedures of surgical textiles and instruments, cases of retained (forgotten) surgical items (RSIs) still occur. Gauzes are the most frequently RSIs, accounting for 90% of the cases because they are widely used. Approximately half of the cases occur in the context of general surgery procedures, fol- lowed by gynaecological – obstetrics surgery. The time inter- val between initial surgery, diagnosis and removal of the gauze is clinically relevant, as the morbidity and mortality are reduced if the foreign body is removed immediately after the offending operation. We report on a successful hysteroscopic identification and removal of a ga…
The Role of Hysteroscopy in the Diagnosis and Treatment of Adenomyosis
2017
Uterine adenomyosis is a common gynecologic disorder in women of reproductive age, characterized by the presence of ectopic endometrial glands and stroma within the myometrium. Dysmenorrhea, abnormal uterine bleeding, chronic pelvic pain, and deep dyspareunia are common symptoms of this pathological condition. However, adenomyosis is often an incidental finding in specimens obtained from hysterectomy or uterine biopsies. The recent evolution of diagnostic imaging techniques, such as transvaginal sonography, hysterosalpingography, and magnetic resonance imaging, has contributed to improving accuracy in the identification of this pathology. Hysteroscopy offers the advantage of direct visualiz…
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…