Comparison of three biopsy forceps for hysteroscopic endometrial biopsy in postmenopausal patients (HYGREB‐1): A multicenter, single‐blind randomized clinical trial

Vitale, Salvatore Giovanni; Laganà, Antonio Simone; Caruso, Salvatore; Garzon, Simone; Vecchio, Giada Maria; Rosa, Valentina Lucia La; Casarin, Jvan; Ghezzi, Fabio

doi:10.1002/ijgo.13669

Cited by 42 publications

(23 citation statements)

References 33 publications

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“…The hysteroscopic removal of misplaced IUD, or fragments of it, was categorized as easy by the majority of gynecologists participating in this survey. Moreover, the minimal patient's discomfort and the high success rate of retrieval with in-office hysteroscopy without anesthesia reveals that is a feasible and effective approach for the retrieval of an IUD with not visible strings [19,23,24].…”

Section: Discussionmentioning

confidence: 99%

In-office hysteroscopic removal of retained or fragmented intrauterine device without anesthesia: a cross-sectional analysis of an international survey

et al. 2022

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To investigate about the opinions of gynecologists regarding the in-office hysteroscopic removal of retained or fragmented intrauterine device (IUD) without anesthesia. An online survey was made available to gynecologists who routinely performed in-office hysteroscopy. Five areas of interest were analyzed: average number of hysteroscopic procedures performed without anesthesia, availability on their local market of the different types of hormonal and non-hormonal IUDs, reasons for the hysteroscopic removal of the IUD, types of IUDs that were more commonly found retained or fragmented and, overall difficulty of the hysteroscopic removal. A total of 419 surgeons voluntarily responded the survey, of which 19 were excluded for not performing in-office hysteroscopy. The most commonly available IUD was the Levonorgestrel-based Mirena (Bayer Healthcare, Germany) or similar, (399/400, 99.7%), followed by Copper T (Paragard, CooperSurgical INC, United States) (397/400, 99.2%), Multiload (234/400, 58.5%) and Jaydess (Bayer Healthcare, Germany) (227/400, 56.7%). The intracavitary retention of the IUD with (44.5%, 178/400) and without (42.2%, 169/400) visible strings accounted as the most common reason for undergoing hysteroscopic IUD removal. Copper T IUD was the most common intracavitary retained (297/400, 74.2%) as well as fragmented device (236/400, 59.9%). The in-office hysteroscopic removal of the IUD was considered an easy procedure by almost all the operators (386/400, 96.5%). In-office hysteroscopy without anesthesia is seen as a feasible and easy approach to remove retained or fragmented IUDs inside the uterine cavity or cervical canal. While the Levonorgestrel-based IUD is the most commercialized, Copper T IUDs are the most commonly found retained or fragmented.

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Section: Discussionmentioning

confidence: 99%

In-office hysteroscopic removal of retained or fragmented intrauterine device without anesthesia: a cross-sectional analysis of an international survey

et al. 2022

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“…There is no RCT evaluating life birth rate after metroplasty or expectant management. Hysteroscopic metroplasty is performed during the follicular phase of the cycle, it can be performed in an ambulatory setting under conscious sedation, without cervical dilatation, as in our case report either with the use of bipolar electrosurgical system or monopolar hook [37,38]. The remodeling of uterine morphology can improve uterine compliance as well as vascularization and induce changes on endometrial receptivity.…”

Section: Discussionmentioning

confidence: 88%

Does metroplasty on dysmorphic uterus improve displaced and disrupted implantation window? A Case Report

Puente¹,

Vega²,

Alonso³

2023

It Journ Gyn Obs

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Background:Different studies have shown that dysmorphic uterus may be associated with reproductive failure and adverse reproductive outcomes. Euploid embryos may fail to implant if the uterine environment is not appropriate. Nevertheless, a causal relationship between dysmorphic uterus and impaired endometrial receptivity remains unproven. Case presentation:Therapeutic management of T-shaped uterus is challenging while some authors advice expectant management others find encouraging results after enlargement of uterine cavity by hysteroscopic metroplasty. Here we present a case of primary infertility in a 35 years-old woman, who presented a dysmorphic uterus on her fertility workup. She followed IVF cycle and had two failed embryo transfers besides personalized embryo transfer according to ERA test result and correction of mild dysbiosis according to EMMA test recommendations. She was offered hysteroscopic metroplasty and a sequential oestrogen-progestagen therapy for two months. The anatomical outcome was evaluated through second look hysteroscopy and 3D transvaginal ultrasound, and a new evaluation of endometrial receptivity was performed: her ERA test result before hysteroscopy was post-receptive and after the procedure showed receptive endometrium with 5 full days of progesterone administration, an optimal window of implantation, Alice test found no pathogens and no dysbiotic endometrial microenvironment. She had a spontaneous pregnancy afterwards. Conclusion:This is first report to describe the impact of hysteroscopic metroplasty for U1a dysmorphic uterus on endometrial receptivity. This could shed some light for further research in order to explain improvement on reproductive outcome found by different authors after hysteroscopic metroplasty for correction of T-shaped uterus.

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“…Among the gynecological diseases, 3/5 (60%) had a histological diagnosis of atypical endometrial hyperplasia obtained by hysteroscopic biopsy [11][12][13] and 2/5 (40%) had uterine fibromatosis.…”

Section: Resultsmentioning

confidence: 99%

Minimally invasive anesthesia for laparoscopic hysterectomy: a case series

Corte

Mercorio

Palumbo

et al. 2022

Arch Gynecol Obstet

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Purpose Regional anesthesia (RA) is considered as a “minimally invasive technique” to achieve anesthesia. To assess the feasibility and the perioperative outcomes of laparoscopic hysterectomy in regional anesthesia from the point of view of the surgeon, anesthesiologist and patient. Methods A retrospective search was performed to identify patients who underwent laparoscopic hysterectomy under RA from April 2020 to September 2021. Five patients affected by benign gynecological disease (atypical endometrial hyperplasia or uterine leiomyomas) were included. Results The postoperative pain, nausea, and vomiting (PONV) and the antiemetic/analgesic intake were evaluated. Postoperative surgical and anesthesiological variables were recorded. Duration of surgery was 84 ± 4.18 and no conversion to GA was required. According to VAS score, the postoperative pain during the whole observation time was less than 4 (median). A faster resumption of bowel motility (≤ 9 h) and patient’s mobilization (≤ 4 h) were observed as well as a low incidence of post-operative nausea and vomit. Early discharge and greater patient’s satisfaction were recorded. Intraoperatively pain score was assessed on Likert scale during all the stages of laparoscopy in RA, with only 2 patients complaining scarce pain (= 2) at pneumoperitoneum. Conclusion RA showed to have a great impact on surgical stress and to guarantee a quicker recovery without compromising surgical results. RA technique could be a viable option for patients undergoing laparoscopic hysterectomy.

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Comparison of three biopsy forceps for hysteroscopic endometrial biopsy in postmenopausal patients (HYGREB‐1): A multicenter, single‐blind randomized clinical trial

Cited by 42 publications

References 33 publications

In-office hysteroscopic removal of retained or fragmented intrauterine device without anesthesia: a cross-sectional analysis of an international survey

In-office hysteroscopic removal of retained or fragmented intrauterine device without anesthesia: a cross-sectional analysis of an international survey

Does metroplasty on dysmorphic uterus improve displaced and disrupted implantation window? A Case Report

Minimally invasive anesthesia for laparoscopic hysterectomy: a case series

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