Advanced operative office hysteroscopy without anaesthesia: analysis of 501 cases treated with a 5 Fr. bipolar electrode

Bettocchi, Stefano; Ceci, Oronzo; Venere, R Di; Pansini, M.V.; Pellegrino, A.; Marello, Fiorino; Nappi, Luigi

doi:10.1093/humrep/17.9.2435

Cited by 208 publications

(118 citation statements)

References 7 publications

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“…EPs are frequently described as benign lesions; however, a 0.3-4.8% risk of malignant progression has been reported (2,5,(17)(18)(19)(20). In the present patient cohort, the rate of malignant and premalignant lesions in excised EPs was 8.2%.…”

Section: Discussionmentioning

confidence: 49%

Thickness of preperitoneal fat as a predictor of malignancy in overweight and obese women with endometrial polyps

et al. 2016

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Abstract. The aim of the present study was to determine the association between the thickness of preperitoneal fat (PFT), utilized as an indicator of visceral fat deposition, and the risk of premalignant and malignant changes of endometrial polyps (EPs) in overweight and obese women. Overweight and obese women who had undergone diagnostic outpatient hysteroscopy and subsequent endometrial polypectomy between January 2010 and May 2013 were analyzed. Each patient underwent a transabdominal ultrasound for the purpose of measuring the thickness of preperitoneal fat. A total of 146 overweight or obese women were analyzed. The overall incidence of malignant or premalignant lesions was 8.2%. Notably, 5 patients (3.4%) received a histopathological diagnosis of complex hyperplasia with atypia, while polyps harboring carcinoma were diagnosed in 7 cases (4.8%). A significantly increased PFT was observed in women exhibiting preneoplastic and neoplastic lesions, compared with women with benign EPs (mean ± SD, 23.2±3.7 vs. 15.9±8.3; P<0.01). Patient age of >60 years was significantly associated with malignant progression of EPs, while body mass index, menopausal status, arterial hypertension, diabetes, abnormal uterine bleeding, hormone replacement therapy and tamoxifen treatment demonstrated no significant association with the development of preneoplastic and neoplastic lesions of the endometrium. In a multivariate analysis, only PFT maintained a significant correlation with the diagnosis of preneoplastic and neoplastic lesions on EPs (odds ratio, 1.14; 95% confidence interval, 1.04-1.26). Ultrasound evaluation of PFT in overweight and obese women may be useful for the identification of a particularly high-risk subgroup of women. Therefore, regardless of symptoms or additional clinical variables, these particularly high-risk women require appropriate counseling and prompt surgical removal of EPs.

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Section: Discussionmentioning

confidence: 49%

Thickness of preperitoneal fat as a predictor of malignancy in overweight and obese women with endometrial polyps

et al. 2016

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“…Some authors use 5 Fr bipolar electrodes without anesthesia, resecting polyps up to 4.5 cm in their offices. No relapses were observed in the follow-up of these patients [17].…”

Section: Discussionmentioning

confidence: 67%

Outcomes of endometrial-polyp treatment with hysteroscopy in operating room

et al. 2007

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To assess the results of using a resectoscope in the hysteroscopic resection of endometrial polyps that were previously diagnosed by office hysteroscopy and to demonstrate the necessity of extraction for histological study. A prospective long-term follow-up study (level of evidence II-2). University Hospital. 303 women presenting a hysteroscopic image of an endometrial polyp. Interventions: Office hysteroscopy, hysteroscopic resection of polyps by means of a resectoscope and an anatomopathological study of the polyps. Statistical analysis was performed. 303 diagnosed endometrial polyp formations were resected by means of hysteroscopy during surgery. In all cases, biopsies of the uterine cavity or of the polyp were negative. Resection of the polyps with hysteroscopy in the operating room using a resectoscope proved to be a safe technique. The anatomopathological study of the polyps showed hyperplasia with atypias in 10 cases (3.3%) and endometrial cancer in 9 women (3.0%). Our study data suggest that endometrial polyps should be resected because they may harbor malignant or premalignant lesions. Hysteroscopic surgery is recommended for its simplicity and scant complications.

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“…The myomectomy technique is the direct mobilization of the fibroid [5], uses no energy of any kind, allows the use of smaller diameter material, and causes less discomfort for the patient. It is also possible to use bipolar energy with small diameter instrument, allowing office hysteroscopic myomectomy to be performed with less discomfort and securely [12].…”

Section: Discussionmentioning

confidence: 99%