Diagnostic Hysteroscopy

2020 ◽  
pp. 89-101
Author(s):  
Sergio Haimovich
Keyword(s):  
Diagnostic Hysteroscopy

scholarly journals Hysteroscopy as a standard procedure for assessing endometrial lesions among postmenopausal women

2007 ◽  
Vol 125 (6) ◽  
pp. 338-342 ◽  
Author(s):  
Camila Toffoli Ribeiro ◽  
Júlio César Rosa-e-Silva ◽  
Marcos Felipe Silva-de-Sá ◽  
Ana Carolina Japur de Sá Rosa-e-Silva ◽  
Omero Benedicto Poli Neto ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Standard Procedure ◽  
University Hospital ◽  
Histopathological Analysis ◽  
Benign Lesions ◽  
Predictive Values ◽  
Asymptomatic Patients ◽  
Cavity Design ◽  
Diagnostic Hysteroscopy ◽  
Sensitivity Specificity

CONTEXT AND OBJECTIVES: Endometrial cancer is the most prevalent type of malignant neoplasia of the genital tract. The objective of this study was to calculate the sensitivity, specificity, accuracy and positive and negative predictive values for diagnostic hysteroscopy, in comparison with histopathological tests, for all lesions of the endometrial cavity. DESIGN AND SETTING: Retrospective descriptive study at the public tertiary-level university hospital of Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. METHODS: Diagnostic hysteroscopy was indicated in the following instances: endometrial thickness > 4 mm in asymptomatic patients; postmenopausal bleeding; and irregular endometrium or endometrium difficult to assess from ultrasound, with or without vaginal bleeding. Ultrasound evaluations were carried out no more than three months prior to hysteroscopy. RESULTS: There were 510 patients, with a mean age of 61.1 ± 2.0 years and mean time elapsed since the menopause of 12.7 ± 2.5 years. Endometrial biopsies were performed on 293 patients (57.5%). Histopathological analysis showed that 18 patients presented endometrial carcinoma or typical or atypical hyperplasia, and none of them presented endometrial thickness of less than 8 mm. No significant differences were found between the median thicknesses of the various benign lesions (p > 0.05). In our data, the sensitivity, specificity, accuracy and positive and negative predictive values for cancer or hyperplasia were 94.4%, 97.0%, 96.8%, 68% and 99.6%, respectively. CONCLUSIONS: Our results suggest that hysteroscopy is valuable as a diagnostic tool for malignant/hyperplastic and benign lesions, except for submucous myomas, for which the sensitivity was only 52.6%.

scholarly journals Evaluation of pain in outpatient diagnostic hysteroscopy with gas

2010 ◽  
Vol 8 (1) ◽  
pp. 24-28
Author(s):  
Daniela Barreto Fraguglia Quental Diniz ◽  
Daniella de Batista Depes ◽  
Ana Maria Gomes dos Santos ◽  
Simone Denise David ◽  
Salete Yatabe ◽  
...  
Keyword(s):  
Social Sciences ◽  
Carbon Dioxide ◽  
Vaginal Delivery ◽  
Carbon Dioxide Gas ◽  
Verbal Scale ◽  
Experienced Pain ◽  
The Social ◽  
Before And After ◽  
Study Power ◽  
Diagnostic Hysteroscopy

ABSTRACT Objective: To evaluate the intensity of pain reported by patients undergoing outpatient diagnostic hysteroscopy. Methods: Exam performed with a 5-mm lens hysteroscope, vaginal speculum, tenaculum and uterine distention with carbon dioxide gas. Before and after the examination, patients were interviewed to define, in a verbal scale from 0 to 10, pain values that they expected to feel and that they experienced after the end, and also if they would repeat it if indicated. Data were analyzed using Statistical Package for the Social Sciences 15.0, statistic significance was defined as p < 0.05 with a study power of 95%. Results: Fifty-eight patients were included with mean age of 50.9 years, with 32.8% at postmenopause and 6.9% nulliparous. Among those with previous deliveries, mean parity was 2.21 and at least one vaginal delivery had occurred in 63.8%. Only 24.1% of patients knew how the exam would be done, 62.1% needed an endometrial sample and the result was considered satisfactory in 89.7%. The means of expected and experienced pain were similar (6.0 versus 6.1), and 91.4% of women would repeat the hysteroscopy if necessary. The only factor associated with less pain after the exam was previous vaginal delivery, with a decrease of pain score from 7.1 to 5.5 (p = 0.03). Mean pain was significantly lower in those who agreed to repeat the exam (5.8 versus 9.4; p = 0.003). Conclusions: Outpatient diagnostic hysteroscopy with gas can be associated with moderate but tolerable discomfort and satisfactory results.

scholarly journals Endometrial osseous metaplasia: Presentation of two rare cases related with infertility, and their hysteroscopic approaching

10.3823/2505 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
José Martínez-Más ◽  
Paloma Gómez-Leal ◽  
Juan Pedro Martínez-Cendán ◽  
Andrés Bueno-Crespo ◽  
Sebastián Ortiz-Reina ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Transvaginal Ultrasound ◽  
Intrauterine Device ◽  
Ultrasound Image ◽  
University Hospital ◽  
Osseous Metaplasia ◽  
Ultrasound Scan ◽  
Hospital Patients ◽  
Bone Fragments ◽  
Diagnostic Hysteroscopy

Objective: To present two cases of patients diagnosed of endometrial osseous metaplasia related with infertility and their hysteroscopic approaching. Design: Case report. Setting: Two clinical cases diagnosed and treated at Institutional University Hospital. Patients: Two premenopasual women diagnosed and treated in our Center. Interventions: Transvaginal ultrasound scan, diagnostic hysteroscopy and hysteroscopic removal of bone fragments. Main Outcome Measures: Ultrasound scan during further clinical follow up. Results: Both patients underwent a diagnostic hysteroscopy, and removal of all the bone fragments with total resolution of their pathology. Conclusions: Endometrial osseous metaplasia is a rare pathology that should be suspected in patients with a history of secondary infertility, several miscarriages and curettages, that present with an ultrasound image compatible with an intrauterine device. Hysteroscopic approach is the best diagnostic and therapeutic option.   Key words: Endometrial osseous metaplasia, bony intrauterine tissue, miscarriage, infertility, hysteroscopy, unadverted intrauterine device.

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