Ambulatory hysteroscopy: evidence-based guide to diagnosis and therapy

Bakour, Shagaf H.; Jones, Siân; O’Donovan, Peter

doi:10.1016/j.bpobgyn.2006.06.004

Cited by 68 publications

(50 citation statements)

References 37 publications

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“…Bladder emptying is not a routine unless it interferes with bimanual uterine assessment. The smaller the scope size the less likely dilatation required, 3-5 mm scope is recommended [13].…”

Section: Discussionmentioning

confidence: 99%

National inpatient diagnostic hysteroscopy survey

Tawfeek

Scott

2009

Gynecol Surg

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This survey was undertaken to determine the common practise patterns of how hysteroscopy is carried out in the UK. We believe this will help to develop a consensus and set national guidelines in accordance with the way we undertake this procedure. In addition; we aim to assess the operators understanding of hysteroscope optics related to this procedure. The study was conducted in a teaching hospital in the southwest of England, UK. Postal questionnaires were sent within the first week of June 2007 to 1,000 consultant gynaecologists in the UK. The surveyed gynaecologists were selected from the Royal college of Obstetricians and Gynaecologists (RCOG) register of Fellows and Members. The questionnaire included questions regarding common preoperative preparation, operative techniques, post-operative management, and follow-up. Four hundred seventy-five (47.5%) responses were returned. Four hundred forty (44%) consultant gynaecologists completed the survey and 35 (3.5%) incomplete questionnaires were returned by consultants who currently do not undertake hysteroscopy. It appears that there is some consensus in with the way we undertake this procedure. However, the results showed a wide variation in the understanding of the hysteroscopes angled optics and how this relates to surgical technique for inpatient hysteroscopy. It seems that setting up a national guideline is feasible. However, there was a clear lack of understanding of the optics used during a hysteroscopic procedure between gynaecologists. Optics-related surgical techniques should be included into training programmes. Professional societies are able to develop a general consensus for this procedure. We are pleased that the practical skills courses run by the RCOG include clear training in this area.

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“…Bladder emptying is not a routine unless it interferes with bimanual uterine assessment. The smaller the scope size the less likely dilatation required, 3-5 mm scope is recommended [13].…”

Section: Discussionmentioning

confidence: 99%

National inpatient diagnostic hysteroscopy survey

Tawfeek

Scott

2009

Gynecol Surg

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“…1 Hysteroscopy is the current gold standard for evaluating intrauterine pathology including submucous myomas, endometrial polyps, endometrial hyperplasia and endometrial cancer. 2 Though major role of outpatient hysteroscopy in abnormal uterine bleeding is diagnostic there is a scope for simple operative procedures such as targeted endometrial biopsy, polypectomy compared with random sampling where small intrauterine lesions can be easily missed. Thus accurate diagnosis of abnormal uterine bleeding helps in choosing appropriate treatment there by avoiding unnecessary major surgical interventions.…”

Section: Introductionmentioning

confidence: 99%

Hysteroscopic evaluation in infertility and abnormal uterine bleeding

Kaur¹,

Bhatia

Kaur

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: Hysteroscopy an endoscopic procedure for visualization of uterine cavity may be extensively used in both primary and secondary infertility and abnormal uterine bleeding for evaluating intrauterine pathology. The objectives of this study were to visualize and identity intrauterine pathology in both primary and secondary infertility and abnormal uterine bleeding (AUB) by hysteroscopic evaluation and to perform hysteroscopic guided therapeutic procedures like endometrial currettage, polypectomy, adhesiolysis.Methods: Hysteroscopic evaluation of uterine cavity for any intrauterine pathology in AUB and Infertility. Adhesiolysis, polypectomy, endometrial biopsy misplaced copper T removal were carried out under hysteroscopic vision.Results: Intrauterine synechia in 20.51%, Submucous fibroid in 5.13%, bicornuate uterus, endometrial hyperplasia and endometrial polyp were seen in 2.56% patient each were detected in infertility group while 81.95% cases with AUB had abnormal intrauterine pathology commonest being endometrial hyperplasia in 33.33% followed by endometrial polyps in 23.81% cases, submucous fibroid and misplaced copper T in 9.52% each and intrauterine synechia in 4.76% patient. Endometrial biopsy and polypectomy was done in 23.80% each with AUB, misplaced copper T removal in 9.52% and adhesiolysis in 4.76% patient with AUB.Conclusions: Hysteroscopy remains gold standard for evaluating intrauterine lesions in abnormal uterine bleeding and infertility. A safe, simple minimally invasive procedure not only diagnostic but therapeutic modality for adhesiolysis, endometrial biopsy/curettage, polypectomy, misplaced copper T removal under direct vision with minimal complication within reach of every Gynaecologist thereby reducing burden of major surgical intervention.

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“…Advances in instrumentation, namely miniaturisation, improved optics and digital imaging, have made direct endoscopic visualisation of the uterus a simple and acceptable outpatient investigation. [25][26][27][28] These tests described in Table 2 provide different albeit overlapping information, and diagnostic accuracy varies according to the particular pathology under scrutiny. NICE guidance from 2007 recognised that '.…”

Section: Current Diagnostic Pathways For Heavy Menstrual Bleedingmentioning

confidence: 99%