Role of hysteroscopy in evaluating chronic pelvic pain

Sardo, Attilio Di Spiezio; Guida, Maurizio; Bettocchi, Stefano; Nappi, Luigi; Sorrentino, Francesco; Bifulco, Giuseppe; Nappi, Carmine

doi:10.1016/j.fertnstert.2007.07.1351

Cited by 10 publications

(3 citation statements)

References 55 publications

(70 reference statements)

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“…However, in women with giant cystic adenomyoma, there may be several confounding factors that do not allow for a conclusive correct diagnosis. In our case, we used office hysteroscopy, as it is safe and easy to perform, without significant discomfort for the patient; it is a well‐recognized useful tool in diagnosing uterine malformations and, it allows for the direct visualization of the intrauterine morphology. At hysteroscopy, a cystic adenomyoma should be differentiated from cystic degeneration of a myoma and from congenital cysts of the uterus, which are divided into Müllerian duct cysts (usually located on the midline) and Wolffian duct cysts (generally situated in the lateral uterine wall).…”

Section: Discussionmentioning

confidence: 99%

Rare case of giant cystic adenomyoma mimicking a uterine malformation, diagnosed and treated by hysteroscopy

Pontrelli

Bounous

Scarperi

et al. 2015

J of Obstet and Gynaecol

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We describe a case of giant cystic uterine adenomyoma that was diagnosed and treated by hysteroscopy. In a 27-year-old woman with menometrorrhagia, severe dysmenorrhea, and chronic pelvic pain, pelvic ultrasonography revealed an enlarged uterine cavity filled with homogeneous low echogenic fluid content. A large cornual hematometra of 8.0 cm in diameter in a bicornuate uterus was suspected, and this hypothesis was also supported by magnetic resonance imaging findings. On the contrary, hysteroscopy revealed a bilocular huge cystic lesion of the posterior uterine wall that was removed by means of monopolar loop resection. The operative finding and the histopathologic examination confirmed the diagnosis of cystic adenomyoma of the uterus. Hysteroscopy may represent a valid tool for diagnosis and minimally invasive treatment of cystic adenomyoma, including those of large volume. Its use is helpful in differential diagnosis between cystic adenomyoma and uterine malformations as a possible cause of pelvic pain.

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Section: Discussionmentioning

confidence: 99%

Rare case of giant cystic adenomyoma mimicking a uterine malformation, diagnosed and treated by hysteroscopy

Pontrelli

Bounous

Scarperi

et al. 2015

J of Obstet and Gynaecol

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“…Hysteroscopy offers the advantage of direct visualization of the uterine cavity while giving the option of collecting histological biopsy samples under visual control [ 22 , 23 ].…”

Section: Diagnosismentioning

confidence: 99%

The Role of Hysteroscopy in the Diagnosis and Treatment of Adenomyosis

Sardo

Calagna

Santangelo

et al. 2017

BioMed Research International

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Uterine adenomyosis is a common gynecologic disorder in women of reproductive age, characterized by the presence of ectopic endometrial glands and stroma within the myometrium. Dysmenorrhea, abnormal uterine bleeding, chronic pelvic pain, and deep dyspareunia are common symptoms of this pathological condition. However, adenomyosis is often an incidental finding in specimens obtained from hysterectomy or uterine biopsies. The recent evolution of diagnostic imaging techniques, such as transvaginal sonography, hysterosalpingography, and magnetic resonance imaging, has contributed to improving accuracy in the identification of this pathology. Hysteroscopy offers the advantage of direct visualization of the uterine cavity while giving the option of collecting histological biopsy samples under visual control. Hysteroscopy is not a first-line treatment approach for adenomyosis and it represents a viable option only in selected cases of focal or diffuse “superficial” forms. During office hysteroscopy, it is possible to enucleate superficial focal adenomyomas or to evacuate cystic haemorrhagic lesions of less than 1.5 cm in diameter. Instead, resectoscopic treatment is indicated in cases of superficial adenomyotic nodules > 1.5 cm in size and for diffuse superficial adenomyosis. Finally, endometrial ablation may be performed with the additional removal of the underlying myometrium.

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“…The main findings in the hysteroscopy exam, cervical stenosis, findings suggestive of adenomyosis and endometrial polyps, are directly correlated with chronic pelvic pain. 4,6,10 Cervical stenosis is a problem that causes CPP6 and it has a strong association with endometriosis and/or pelvic inflammatory disease (which occurs approximately in 15% of the premenopausal American women). The retrograde menstrual flow through the fallopian tubes occurs in greater quantities when cervical stenosis is present.…”

Section: 7mentioning

confidence: 99%

Evaluation of hysteroscopy as a complementary exam in the investigation of chronic pelvic pain.

et al. 2013

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Introduction: Chronic pelvic pain (CPP) is a difficult condition to identify and many disorders are correlated. This study investigates the role of hysteroscopy as a complementary exam in the diagnosis of CPP. Methods: One hundred ninety-one medical records of women with indication to perform a hysteroscopy and presented CPP were reviewed. Results: The analysis showed abnormalities in 99 patients. Of these, more than 70% presented conditions that could cause CPP. Cervical stenosis and findings suggestive of adenomyosis were the most frequent ocurrences. Conclusions: Hysteroscopy is useful to detect pathological conditions of the cervix and uterine cavity that may coexist with chronic pelvic pain.

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Role of hysteroscopy in evaluating chronic pelvic pain

Cited by 10 publications

References 55 publications

Rare case of giant cystic adenomyoma mimicking a uterine malformation, diagnosed and treated by hysteroscopy

Rare case of giant cystic adenomyoma mimicking a uterine malformation, diagnosed and treated by hysteroscopy

The Role of Hysteroscopy in the Diagnosis and Treatment of Adenomyosis

Evaluation of hysteroscopy as a complementary exam in the investigation of chronic pelvic pain.

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