Outpatient diagnostic hysteroscopy

Article Abstract:

Hysteroscopy is a method of visually inspecting the inside of the uterus by inserting a small tube and magnifying lens through the vagina and cervix. Hysteroscopy is useful in diagnosing or removing a small sample of tissue for analysis (biopsy). Most investigations of abnormal bleeding use dilation and curettage (D and C), a method which involves dilating the cervix to allow the passage of instruments to scrap the lining of the uterus. However, because no visualization is possible with D and C, the samples are removed blindly and important lesions may be missed. Furthermore, complications such as urinary tract infections, fever, and uterine perforation may occur. Hysteroscopy inspection can provide more complete and accurate results. The procedure is performed under regional anesthesia and may be uncomfortable for patients. Subjective complaints of 160 women undergoing diagnostic hysteroscopy with regional anesthesia (para-cervical spinal block) are reported. The most common reason for the procedure was bleeding after menopause. The uterus was well-visualized in 152 patients. In eight patients the procedure was abandoned because of pain (two patients), difficult negotiation (four patients), or an obscured view (two patients). No abnormalities were detected in 72 women, atrophied lining of the uterus was discovered in 35 women, fibroid polyps were detected in 17 patients, endometrial polyps were found in 12 women, 10 subjects had a suspected cancer (that was confirmed in six), and uterine abnormalities were detected in five women. Most of the women said the pain associated with hysteroscopy was tolerable, and was similar to that experienced during menstruation. The pain was reported to be intolerable by five patients (3 percent), all of whom were very anxious during the procedure. There were no procedure-related complications. Outpatient hysteroscopy is a well-tolerated diagnostic method for assessing uterine disease. The use of this outpatient procedure can also reduce high inpatient hospital expenses. (Consumer Summary produced by Reliance Medical Information, Inc.)

---

Hysteroscopy for the investigation of abnormal uterine bleeding

Article Abstract:

Hysteroscopy is a method of visually inspecting the inside of the uterus by inserting a small tube, affixed with a magnifying lens, through the vagina and cervix. Hysteroscopy can be used to make a diagnosis or remove a small sample of tissue for analysis (biopsy). Traditionally, abnormal uterine bleeding is investigated by uterine dilation and curettage (D and C), a method which involves dilating the cervix to allow the passage of instruments to scrape the uterine lining to obtain tissue samples. However, these samples are removed blindly, and important lesions may be missed. Hysteroscopic devices require very little dilation and can be performed without anesthesia, although most practitioners premedicate. Since the hysteroscope visualizes the uterine lining directly, any tissue appearing abnormal can be biopsied. Therefore, if the results of a hysteroscopic evaluation are negative, it is unlikely that there is uterine disease. The procedure is best performed after menstruation so that blood does not obscure the view and the uterine lining is thin. Some studies have found that diagnoses made by hysteroscopy are more accurate. Women who are pregnant should not have hysteroscopies except in cases of miscarriage associated with abnormal bleeding. Women with active pelvic infections are not recommended for the procedure because of the possibility of spreading the infection. There are very few hysteroscopic-related complications. A few cases of uterine perforation and air embolism (formation of an air pocket that can dislodge and travel through the blood stream) have been reported in association with this procedure. Hysteroscopy can be risky when combined with laser surgery. Overall, outpatient hysteroscopy is a cost effective, diagnostically accurate, and well-tolerated procedure for assessing uterine diseases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Usage, Diagnosis, Medical examination, editorial

---

Patient selection for hysteroscopic endometrial resection

Article Abstract:

New techniques are available for treating women with excessive menstrual bleeding, which involve the use of lasers or radiofrequency thermal energy to remove portions of the endometrium (the membrane that forms the inner lining of the uterus). Surgical procedures may also be used to remove a portion of the endometrium (endometrial resection). In the past, many hysterectomies have been performed as a treatment for excessive menstrual bleeding. However, complete hysterectomy is not necessary if the only goal is to reduce menstrual bleeding. To identify the percentage of women who would be candidates for endometrial resection rather than hysterectomy, the medical case reports of 375 women who had hysterectomies were reviewed. Of the 375 hysterectomies, 186 were performed to reduce menstrual bleeding. Of these 186 cases, 108 patients would have met the criteria for endometrial resection instead of hysterectomy. Seventy-eight cases would have been unsuitable for endometrial resection because of tumors, endometriosis (the abnormal presence of endometrial tissue in areas other than the uterus), cysts, pain, or prolapse (a dropping of the uterus caused by lack of muscle tone as a result of old age or child birth). These results indicate that 58 percent of the women with excessive menstrual bleeding could have been treated by endometrial resection instead of hysterectomy. Although the procedure involved in performing a hysterectomy is associated with low mortality, endometrial resection is a less traumatic procedure and has many advantages for the patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Surgery, Endometrium, Hysterectomy

Similar abstracts:

• Abstracts: The prognostic significance of peritoneal cytology for stage I endometrial cancer. DNA content as a prognostic factor in endometrial carcinoma
• Abstracts: Malignant disease as temporomandibular joint dysfunction: review of the literature and report of case. Facial pain treated by temporomandibular joint arthroscopy and styloidectomy: report of case
• Abstracts: Control of immediate postoperative pain with topical bupivacaine hydrochloride for laparoscopic Falope ring tubal ligation
• Abstracts: Visual function in patients undergoing long-term total parenteral nutrition
• Abstracts: Drugs for treatment of fungal infections Systemic antifungal drugs. Itraconazole

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.