The role of hysteroscopy in diagnosis of menstrual disorders

Mahmud, Ayesha; Smith, Paul; Clark, Justin

doi:10.1016/j.bpobgyn.2015.03.023

Cited by 27 publications

(3 citation statements)

References 31 publications

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“…Traditionally operative resecoscopy or hysteroscopy was performed using monopolar or bipolar currents for resection of pathological tissue, but various risks were associated with this procedure such as fluid overload system, uterine perforation, and cervical trauma. Although these risks were directly dependent on the experience of the surgeon, the resection time and removal of tissue were related to the size of endometrial lesions and thus it becomes a complex and tedious process [4,5].…”

Section: Introductionmentioning

confidence: 99%

A Review on the Use of Hysteroscopy Tissue Removal System in Gynaecology

2021

Gynecol Obstet Open Acc

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Intrauterine pathologies have become the common cause of gynaecological visits. These pathologies, if not treated can increase the rates of infertility and the risk of endometrial cancer. Surgical resection of intrauterine pathologies including polyps, fibroids, and intracavitary lesions using resectoscopes or hysteroscopy has become the mainstay of treatment, but the removal of large lesions poses a significant challenge to the surgeon. Also, the accumulation of fibroid pieces, fluid overloads, and the need for additional surgeries make these procedures more complex and tiresome. Numerous innovations in endoscopic gynaecology technology have resulted in the availability of Hysteroscopy tissue removal systems or hysteroscopy morcellators. This minimally invasive procedure has proved to be an efficient and safe alternative to conventional hysteroscopy resection. The objective of this review was to explore the clinical evidence available for the use of Hysteroscopy tissue removal systems and determine their efficacy and safety in gynaecological practice. The structure, procedural details, and characteristics of commonly used hysteroscopy tissue removal systems were thoroughly studies. Clinical performance, safety, and efficacy of these systems in comparison to other techniques were also evaluated in several uterine abnormalities. After reviewing the published literature, we concluded that the hysteroscopy tissue removal systems were more effective and safe to treat a wide range of intrauterine pathologies. The minimal fluid deficit, simultaneous cutting, and suction of tissue fragments, reduced operating time and minimum need for additional procedures with hysteroscopy tissue removal systems make it an excellent and viable option for treating a wide spectrum of uterine abnormalities in both office and operative settings.

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Section: Introductionmentioning

confidence: 99%

A Review on the Use of Hysteroscopy Tissue Removal System in Gynaecology

2021

Gynecol Obstet Open Acc

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“…4 Therefore, it is widely accepted as a first-line diagnostic approach for women suffering from abnormal uterine bleeding (AUB). 5 Diagnostic hysteroscopy (HSC) offers direct visualization of the endocervix and the endometrial cavity providing the option of direct optical-guided biopsies 6,7 Over the years, the establishment of office hysteroscopy via vaginoscopic approach replaced old-fashioned methods such as, dilatation and curettage (D&C) achieving higher diagnostic accuracy in detecting endometrial pathologies. 3,8,9 Hysteroscopy is better tolerated by women in an outpatient setting, when is performed with the technique of vaginoscopic approach.…”

Section: Introductionmentioning

confidence: 99%

Comparative retrospective study on transvaginal sonography versus office hysteroscopy in the diagnosis of endometrial pathology among different subgroups

Tsonis

Gkrozou

Dimitriou

et al. 2020

J of Obstet and Gynaecol

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Background Transvaginal sonography (TVS) and office hysteroscopy are considered essential diagnostic tool for the gynecologic everyday practice. Through the years equipment developments in both techniques along with cumulative experience gained by the gynecologists result in a disunity among clinicians in choosing optimal diagnostic approach with regards to endometrial pathology. Aim To evaluate the diagnostic accuracy of TVS versus office hysteroscopy (OHSC) in detecting endometrial pathology. Results were compared to available scientific evidence available among similar published studies. Methods Comparative Retrospective study performed at the Endoscopic Unit, Department of Gynecology, University Hospital of Ioannina, Greece. A total of 2675 cases were collected for this study from January 1997 until August 2019. All cases recruited underwent a TVS followed by office hysteroscopy (OHSC) for various indications according to the local protocol. Endometrial samples from all cases were obtained and histology confirmed the diagnosis. Sonographic and hysteroscopic results were correlated with histologic reports to assess the diagnostic accuracy of both techniques. Results In a total of 2675 cases recruited for this study, 23.2% were postmenopausal while the majority (76.7%) was of reproductive age. The commonest indication for hysteroscopy was abnormal uterine bleeding (AUB) accounting for 29.7% of the cases. Overall, TVS demonstrated diagnostic accuracy of 84.7%% in detecting endometrial pathology, compared to 97.3% of OHSC. Sensitivity, specificity, positive prognostic value (PPV) and negative prognostic value (NPV) of TVS detecting endometrial pathology were 84.0, 86.8, 95.3 and 63.0%, respectively. The corresponding values for hysteroscopy were 98.9, 95.1, 98.4 and 93.9%, respectively. Diagnostic value of both techniques was estimated in 6 (six) additional subgroups: total sample with AUB, women of reproductive age, women of reproductive age with AUB, women of reproductive age with infertility issues, postmenopausal women and postmenopausal women suffering from postmenopausal bleeding (PMB). All values were calculated with regards to histologic findings as gold standard technique. All results were correlated with scientific evidence collected from the international literature. Conclusion Office hysteroscopy is a more reliable tool in detecting endometrial pathologies compared to TVS regardless of reproductive status or clinical presentation. TVS is likely to orientate and guide specialists on what to expect prior to an hysteroscopic intervention.

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“…TV-USS remains the most acceptable and validated first-line investigation. The increasing use of saline infusion ultrasonography (SIS) and selected hysteroscopy will improve sensitivity and specificity for diagnosis of polyps and SM fibroids [37,44]. The optimal mode of imaging for suspected adenomyosis has yet to be established [45].…”

Section: Assessment Of the Patient Presenting With Aub And Fibroidsmentioning

confidence: 99%

Abnormal uterine bleeding

Cheong¹,

Cameron²,

Critchley³

2019

British Medical Bulletin

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Abnormal uterine bleeding (AUB) is a common and debilitating condition with high direct and indirect costs. AUB frequently coexists with fibroids, but the relationship between the two remains incompletely understood and in many women the identification of fibroids may be incidental to a menstrual bleeding complaint. A structured approach for establishing the cause using the F ed eration International de Gyn ecologie et d'Obst etrique (FIGO) PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy (and hyperplasia), Coagulopathy, Ovulatory disorders, Endometrial, Iatrogenic and Not otherwise classified) classification system will facilitate accurate diagnosis and inform treatment options. Office hysteroscopy and increasing sophisticated imaging will assist provision of robust evidence for the underlying cause. Increased availability of medical options has expanded the choice for women and many will no longer need to recourse to potentially complicated surgery. Treatment must remain individualised and encompass the impact of pressure symptoms, desire for retention of fertility and contraceptive needs, as well as address the management of AUB in order to achieve improved quality of life.

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The role of hysteroscopy in diagnosis of menstrual disorders

Cited by 27 publications

References 31 publications

A Review on the Use of Hysteroscopy Tissue Removal System in Gynaecology

A Review on the Use of Hysteroscopy Tissue Removal System in Gynaecology

Comparative retrospective study on transvaginal sonography versus office hysteroscopy in the diagnosis of endometrial pathology among different subgroups

Abnormal uterine bleeding

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