Investigation of abnormal uterine bleeding in perimenopausal women by hysteroscopy and endometrial biopsy

Stamatellos, Ioannis; Stamatopoulos, P; Rousso, D.; Asimakopoulos, Efstratios; Stamatopoulos, Charalampos; Bontis, Ioannis

doi:10.1007/s10397-004-0076-2

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…Fourteen authors were contacted and asked for additional data, 3 responded whereas 11 did not respond and had to be excluded. In total, 54 studies were excluded because of various reasons as shown in Figure 1 2,16–68 . Finally 17 studies with 4208 procedures remained, and were included in our meta‐analysis 69–85 .…”

Section: Resultsmentioning

confidence: 99%

Diagnostic hysteroscopy in abnormal uterine bleeding: a systematic review and meta‐analysis

Dongen

Kroon

Jacobi

et al. 2007

BJOG

213

111

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Background This study was conducted to assess the accuracy and feasibility of diagnostic hysteroscopy in the evaluation of intrauterine abnormalities in women with abnormal uterine bleeding.Search strategy Electronic databases were searched from 1 January 1965 to 1 January 2006 without language selection. The medical subject heading (MeSH) and textwords for the following terms were used: hysteroscopy, diagnosis, histology, histopathology, hysterectomy, biopsy, sensitivity and specificity.Setting University Hospital.Selection criteria The inclusion criteria were report on accuracy of diagnostic hysteroscopy in women with abnormal uterine bleeding compared to histology collected with guided biopsy during hysteroscopy, operative hysteroscopy or hysterectomy.Data collection and analysis Electronic databases were searched for relevant studies and references were cross-checked. Validity was assessed and data were extracted independently by two authors. Heterogeneity was calculated and data were pooled. Subgroup analysis was performed according to validity criteria, study quality, menopausal state, time, setting and performance of the procedure. The pooled sensitivity, specificity, likelihood ratios, post-test probabilities and feasibility of diagnostic hysteroscopy on the prediction of uterine cavity abnormalities. Post-test probabilities were derived from the likelihood ratios and prevalence of intrauterine abnormalities among included studies. Feasibility included technical success rate and complication rate.Main results One population of homogeneous data could be identified, consisting of patients with postmenopausal bleeding. In this subgroup the positive and negative likelihood ratios were 7.9 (95% CI 4.79-13.10) and 0.04 (95% CI 0.02-0.09), raising the pretest probability from 0.61 to a post-test probability of 0.93 (95% CI 0.88-0.95) for positive results and reducing it to 0.06 (95% CI 0.03-0.13) for negative results. The pooled likelihood ratios of all studies included, calculated with the random effects model, were 6.5 (95% CI 4.1-10.4) and 0.08 (95% CI 0.07-0.10), changing the pre-test probability of 0.46 to post-test probabilities of 0.85 (95% CI 0.78-0.90) and 0.07 (0.06-0.08) for positive and negative results respectively. Subgroup analyses gave similar results. The overall success rate of diagnostic hysteroscopy was estimated at 96.9% (SD 5.2%, range 83-100%).Conclusions This systematic review and meta-analysis shows that diagnostic hysteroscopy is both accurate and feasible in the diagnosis of intrauterine abnormalities.

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Section: Resultsmentioning

confidence: 99%

Diagnostic hysteroscopy in abnormal uterine bleeding: a systematic review and meta‐analysis

Dongen

Kroon

Jacobi

et al. 2007

BJOG

213

111

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“…Hysteroscopy of reproductive tracts became commonly used in humane medicine as a method of diagnosing infertility, polyps, hyperplasia, neoplasm, endometriosis (Stamatellos et al, 2005;Makled et al, 2014). Also, this method of diagnostics is recommended as the prior investigation in cases of cow infertility (Šavc et al, 2011).…”

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confidence: 99%

Hysteroscopic Investigation of Dairy Cows Uterus With Subclinical Endometritis

Basarab

Stefanyk

2016

SMLNUVMB

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During the postpartum period among the dairy cattle there are cases of bacteriological infection of the uterus tissues. This process occurs in over 90% of the herd. If the animal wasn’t provided with early effective treatment, acute inflammation becomes a chronic disease. After analyzing published data, it was concluded that hysteroscopic studies are not described enough. For this study 5 (n = 5) cows of Ukrainian black and white breed, aged 4 to 6 years were selected, which had not shown estrus for over 25 days. Diagnosis was reached by hysteroscopy of uterus. Analysis of the data has proved that area size of bright red color of uterus with subclinical endometritis was – 57.6 ± 5.2%, whereas after the treatment with «Metrodek» it decreased by more than 7 times – 7.3 ± 1.6% (p < 0.001); area of exudate in the uterus with subclinical endmometritis was – 59.3 ± 6.5%, whereas after the treatment with «Metrodek» decreased about 11 times – 5.4 ± 1.1 % (p < 0,001).

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The role of hysteroscopy in the current management of the cervical polyps

Stamatellos

Stamatopoulos

Bontis

2007

Arch Gynecol Obstet

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The current management of patients with cervical polyps may include different approaches and protocols, such as a simply removal of the polyp in most cases at an office setting, surgical dilatation and curettage, electrosurgical excision or hysteroscopic polypectomy. Exploration of the cervical canal and uterine cavity by hysteroscopy determines the exact origin of the polyp pedicle (cervical or endometrial) and if there is any concurrent endometrial pathology. The majority of cervical polyps are asymptomatic, and their incidence is increasing with age. Symptomatic cervical polyps may cause intermenstrual bleeding, postcoital bleeding, heavy menses, postmenopausal bleeding and vaginal discharge. Cervical polyps may be detected by routine gynaecological examination, colposcopy, filling defects on hysterosalpingogram, gynaecological ultrasound (abdominal, transvaginal or sonohysterography) or endometrial biopsy. The location, number, and size of cervical polyps are best determined with diagnostic hysteroscopy. In the past, simple twisting or avulsion of the polyp or blind curettage was the standard surgical treatment of choice. However, this treatment often leaves residual polyp fragments in the cervical canal. Difficulty may also occur in differentiating endocervical from endometrial lesions. In addition, up to 25% of patients who have cervical polyp, have also a coexisting endometrial polyp, so there is a need for evaluation of the endometrial cavity. It is important to note the usefulness of hysteroscopy to manage a patient with a cervical polyp, especially when she presents abnormal uterine bleeding, in order to make an accurate diagnosis and offer appropriate treatment.

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Investigation of abnormal uterine bleeding in perimenopausal women by hysteroscopy and endometrial biopsy

Cited by 4 publications

References 22 publications

Diagnostic hysteroscopy in abnormal uterine bleeding: a systematic review and meta‐analysis

Diagnostic hysteroscopy in abnormal uterine bleeding: a systematic review and meta‐analysis

Hysteroscopic Investigation of Dairy Cows Uterus With Subclinical Endometritis

The role of hysteroscopy in the current management of the cervical polyps

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