Failed diagnostic hysteroscopy: Analysis of 62 cases

Genovese, Fortunato; D’Urso, Gisella; Guardo, Federica Di; Insalaco, Giulio; Tuscano, Attilio; Ciotta, L; Carbonaro, Antonio; Leanza, Vito; Palumbo, Marco

doi:10.1016/j.ejogrb.2019.10.031

Cited by 16 publications

(15 citation statements)

References 25 publications

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“…Outpatient hysteroscopy success in the literature varies between 44% and 99.5% 3,10,21 . In this study, the procedure was successfully completed in 98% of patients.…”

Section: Discussionmentioning

confidence: 70%

“…Cervical stenosis, severe synechiae, and excessively retroflexed uterus were the major causes of pain intolerability that prevented us to continue the procedure. Similarly, in a study of 62 failed hysteroscopic procedures, 90% of patients had a distinctly anteflexed or retroflexed uterus or cervical stenosis 10 …”

Section: Discussionmentioning

confidence: 90%

“…However, even in the presence of such optimal conditions, outpatient hysteroscopy remains a painful procedure, and at least one‐third of patients experience moderate to severe pain 1,9 . In addition, more than half of the patients who experience unsuccessful hysteroscopy due to pain do not accept a repeated procedure 10 . Therefore, all factors associated with the pain and failure of the hysteroscopy should be carefully evaluated, and patients who are unable to tolerate the procedure without anesthesia should be determined in advance.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic office hysteroscopy; why is it still painful procedure despite the surgical experience and mini‐hysteroscope?

Güraslan

Şentürk

Doğan

et al. 2022

J of Obstet and Gynaecol

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Aim To evaluate the effect of cervical canal features on pain during outpatient hysteroscopy performed by experienced surgeons using mini‐hysteroscope. Methods A prospective observational study was conducted on 303 women undergoing diagnostic hysteroscopy without anesthesia. Pain intensity was evaluated using the visual analog scale (VAS) when the cervical canal was passed. The patients were divided into two groups according to the VAS score: painless or mild pain (VAS <4) and moderate or severe pain (VAS ≥ 4). The relationship between cervical canal characteristics (length, version, and flexion positions, history of cervical intervention, stenosis, synechiae), obstetric and gynecological history, preoperative anxiety level, procedure duration, and pain intensity was examined. Results Moderate pain (4 ≤ VAS < 7) was observed in 38% of patients (n = 117) and 14 patients (5%) experienced severe pain (VAS ≥ 7). In multivariate analysis, nulliparity (p = 0.01; OR, 4.6; 95% CI, 1.7–13.2), postmenopausal state (p = 0.02; OR, 2.2; 95% CI, 1.2–4.3), excessive flexion of the cervix and retroverted uterus (p <0.001; OR, 4.1; 95% CI, 2.0–8.5) were identified as risk factors for a painful procedure. Diagnostic hysteroscopy was successful in 98% of the patients. The pain was the primary cause of the failed hysteroscopy. Conclusion In addition to nulliparity and postmenopausal status, unfavorable features of the cervical canal, such as the excessive flexion position of the cervix and uterine retroversion are significant causes of pain during outpatient hysteroscopy.

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“…Outpatient hysteroscopy success in the literature varies between 44% and 99.5% 3,10,21 . In this study, the procedure was successfully completed in 98% of patients.…”

Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic office hysteroscopy; why is it still painful procedure despite the surgical experience and mini‐hysteroscope?

Güraslan

Şentürk

Doğan

et al. 2022

J of Obstet and Gynaecol

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show abstract

“…Moreover, it represents a highly effective therapeutic approach to treat various conditions [20] and it can be useful to assess their eventual recurrence [21]. However, discomfort due to anatomical impediments may represent a cause of office hysteroscopy failure, requiring the necessity for anesthesia and operating theater [22]; a fact that increases both risks and costs. Furthermore, it should be performed by a gynecologist with enough facilities and expertise [23].…”

Section: Introductionmentioning

confidence: 99%

“…In the last 20 years, several studies have proposed the use of SIS, as a less invasive alternative to HS [22,23]. Indeed, it is an affective "add-on" to TVS which involves the use of slow instillation of sterile saline solution into the endometrial cavity through a 5-French catheter under continuous TVS guidance, providing both a contrast medium and an expanding agent [24].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of sonohysterography and hysteroscopy for evaluation of endometrial lesions in tamoxifen treated patients: a systematic review

2022

EJGO

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Objective: This review aims to evaluate the incidence of endometrial lesions in tamoxifen-treated breast cancer patients identified by hysteroscopy (HS) and sonohysterography (SIS) and the diagnostic accuracy of the two methods to detect them. Methods: A systematic review of the literature concerning the role of HS and SIS for evaluation of the endometrium in tamoxifen-treated breast cancer patients was performed. We searched MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, Web of Science, SCOPUS, congress abstracts, and Grey literature (Google Scholar; British Library). The search terms used were "hysteroscopy", "hysterosonography", "sonohysterography" combined with "tamoxifen"; 89 citations were identified and selected in the initial screening. Results: 28 studies were included in the systematic review. There were 61 citations excluded because they were review articles (n = 9) or case report (n = 5) and non-English articles (n = 8), and had too little information in the full text (n = 39). Similar accuracy between SIS and HS in detection of endometrial tamoxifen-related lesions was found. Conclusions: SIS may represent a minimally invasive, simple, safe, well-tolerated and cost-effective alternative to HS, associated with few contraindications and no potential complications.

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Patients’ Use of Virtual Reality Technology for Pain Reduction during Outpatient Hysteroscopy: A Meta-analysis of Randomized Controlled Trials

Vitagliano,

Dellino,

Favilli

et al. 2023

Journal of Minimally Invasive Gynecology

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Failed diagnostic hysteroscopy: Analysis of 62 cases

Cited by 16 publications

References 25 publications

Diagnostic office hysteroscopy; why is it still painful procedure despite the surgical experience and mini‐hysteroscope?

Diagnostic office hysteroscopy; why is it still painful procedure despite the surgical experience and mini‐hysteroscope?

Efficacy of sonohysterography and hysteroscopy for evaluation of endometrial lesions in tamoxifen treated patients: a systematic review

Patients’ Use of Virtual Reality Technology for Pain Reduction during Outpatient Hysteroscopy: A Meta-analysis of Randomized Controlled Trials

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