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Hager M, Ott J. The Role of Hysteroscopy in the Assessment of Fallopian Tubal Patency: A Comprehensive Review and Meta-analysis. Geburtshilfe Frauenheilkd 2024; 84:619-628. [PMID: 38993802 PMCID: PMC11233202 DOI: 10.1055/a-2304-5018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 05/09/2024] [Indexed: 07/13/2024] Open
Abstract
Hysteroscopy has been recognized as a reliable method for the evaluation of female infertility for several years. The outpatient setting is particularly convenient, as patients do not require general anesthesia and do not have to stay overnight. In recent years, more and more articles have dealt with the role of diagnostic hysteroscopy in tubal evaluation. Twenty-four articles were included in this comprehensive review and 14 of them were also included in a meta-analysis. This review provides an overview of the different techniques of hysteroscopic tubal evaluation, with a focus on perioperative changes in cul-de-sac volume, the air bubble technique ("Parryscope" technique), the Flow technique and selective hysteroscopic pertubation with methylene blue dye (SHPMBD). In pooled analyses, SHPMBD achieved the highest sensitivity for tubal patency (91.7%, 95% confidence interval, CI: 88.8-94.0), whereas the air bubble technique revealed the highest specificity of all methods (98.4, 95% CI: 95.3-99.6). Furthermore, in a meta-analysis of all methods on the assessment of single tubes, an overall sensitivity of 87.1% and an overall specificity of 79.8% (95% CI: 76.4-82.9) could be shown. In conclusion, the techniques of hysteroscopic tubal evaluation are well-tolerated, clinically relevant, and reliable.
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Affiliation(s)
- Marlene Hager
- Clinical Division of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
| | - Johannes Ott
- Clinical Division of Gynecological Endocrinology and Reproductive Medicine, Medical University of Vienna, Vienna, Austria
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Çallıoğlu N, Kanza Gül D, Özer Aslan İ, Fendal Tunca A, Başlı Kasım K, Akay B, Uysal E, Ekin M. The effect of informing the patient about the procedure with video imaging before office hysteroscopy on pain. J Obstet Gynaecol Res 2023; 49:2387-2392. [PMID: 37462062 DOI: 10.1111/jog.15738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 06/27/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE To evaluate the effect of informing patients undergoing diagnostic office hysteroscopy via a video 24 h before the procedure and determine the changes in pain scores, channel transit time, the degree of difficulty of the procedure, and physiological parameters. DESIGN Single-blind randomized controlled trial. SETTING The study was conducted between September 1, 2021 and April 1, 2022 at the University of Health Sciences Bakirkoy Dr. Sadi Konuk Training and Research Hospital. PARTICIPANTS A total of 134 patients aged 18-65 years who needed diagnostic office hysteroscopy. INTERVENTIONS Participants were randomized into two groups, the standard information group (Group 1: controls), and the video information + standard information group (Group 2). After office hysteroscopy, a visual analog scale (VAS) and Likert scale were used to assess pain and the degree of difficulty of the procedure, respectively. Physiological parameters were evaluated before and after the procedure. MAIN OUTCOME MEASURE To determine the effect of video-based multimedia information administered 24 h before office hysteroscopy on post-procedure pain. RESULTS The mean VAS score of the group that watched the training video (3.02 ± 1.88) was significantly lower than the control group (4.72 ± 2.54) who did not watch the training video (p < 0.001). The mean cervical channel transit time in seconds (sec) during the procedure was found to be significantly higher in the control group (21.57 ± 15.10 s) than in the video-watching group (p = 0.011). There was no significant difference between the groups in terms of physiological parameters and the degree of ease of the procedure. CONCLUSION Our study has shown that informing patients in a pre-procedure video is an effective approach that shortens the duration of the channel transit time and reduces pain.
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Affiliation(s)
- Nihal Çallıoğlu
- Department of Obstetrics and Gynecology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Derya Kanza Gül
- Medipol University School of Medicine Health, Istanbul, Turkey
| | - İlke Özer Aslan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
| | - Aysun Fendal Tunca
- Department of Obstetrics and Gynecology, University of Health Sciences Istanbul, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Kardelen Başlı Kasım
- Department of Obstetrics and Gynecology, University of Health Sciences Istanbul, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Burcu Akay
- Department of Obstetrics and Gynecology, University of Health Sciences Istanbul, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Elif Uysal
- Department of Obstetrics and Gynecology, University of Health Sciences Istanbul, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Murat Ekin
- Department of Obstetrics and Gynecology, University of Health Sciences Istanbul, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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Baradwan S, Khalil M, Alshahrani MS, Albouq B, AlSghan R, Khadawardi K, Mohamed DF, Yousef DH, Kamal SHM, Abdel Halim HW, Elhawary MAA, Alkholy EA, Elsharkawy MRM, Abdelhakim AM, Abbas AM, Dahshan SA, Alshawadfy A, Soror GI. Warm saline effectiveness for pain relief in office hysteroscopy: A systematic review and meta‐analysis of randomized controlled trials. J Obstet Gynaecol Res 2022; 48:1523-1530. [DOI: 10.1111/jog.15272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/23/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Saeed Baradwan
- Department of Obstetrics and Gynecology King Faisal Specialist Hospital and Research Center Jeddah Saudi Arabia
| | - Mohamed Khalil
- Department of Obstetrics and Gynecology Faculty of Medicine, Kafrelsheikh University Kafr el‐Sheikh Egypt
| | - Majed S. Alshahrani
- Department of Obstetrics and Gynecology Faculty of Medicine, Najran University Najran Saudi Arabia
| | - Bayan Albouq
- Department of Obstetrics and Gynecology Prince Mohammed Bin Abdulaziz National Guard Hospital Madinah Saudi Arabia
| | - Rayan AlSghan
- Department of Obstetrics and Gynecology Maternity and Children Hospital AlKharj Saudi Arabia
| | - Khalid Khadawardi
- Department of Obstetrics and Gynecology Faculty of Medicine, Umm Al‐Qura University Makkah Saudi Arabia
| | - Doaa F. Mohamed
- Department of Obstetrics and Gynecology Faculty of Medicine for Girls, Al‐Azhar University Cairo Egypt
| | - Doaa H. Yousef
- Department of Obstetrics and Gynecology Faculty of Medicine for Girls, Al‐Azhar University Cairo Egypt
| | - Shaimaa H. M. Kamal
- Department of Obstetrics and Gynecology Faculty of Medicine for Girls, Al‐Azhar University Cairo Egypt
| | - Hala W. Abdel Halim
- Department of Obstetrics and Gynecology Faculty of Medicine for Girls, Al‐Azhar University Cairo Egypt
| | - Mona A. A. Elhawary
- Department of Obstetrics and Gynecology Faculty of Medicine for Girls, Al‐Azhar University Cairo Egypt
| | - Eman A. Alkholy
- Department of Obstetrics and Gynecology Faculty of Medicine for Girls, Al‐Azhar University Cairo Egypt
| | | | | | - Ahmed M. Abbas
- Department of Obstetrics and Gynecology Faculty of Medicine, Assiut University Assiut Egypt
| | - Shaimaa A. Dahshan
- Department of Anesthesia and Intensive care Faculty of Medicine, Suez Canal University Ismaïlia Egypt
| | - Abdelrhman Alshawadfy
- Department of Anesthesia and Intensive care Faculty of Medicine, Suez Canal University Ismaïlia Egypt
| | - Ghada I. Soror
- Department of Obstetrics and Gynecology Faculty of Medicine for Girls, Al‐Azhar University Cairo Egypt
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Ultra-minimally invasive surgery in gynecological patients: a review of the literature. Updates Surg 2022; 74:843-855. [PMID: 35366181 PMCID: PMC9213331 DOI: 10.1007/s13304-022-01248-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/21/2022] [Indexed: 01/18/2023]
Abstract
In the last decade, Ultra-minimally invasive surgery (UMIS) including both minilaparoscopic (MH) and percutaneous (PH) endoscopic surgery achieved widespread use around the world. Despite UMIS has been reported as safe and feasible surgical procedure, most of the available data are drawn from retrospective studies, with a limited number of cases and heterogeneous surgical procedures included in the analysis. This literature review aimed to analyze the most methodologically valid studies concerning major gynecological surgeries performed in UMIS. A literature review was performed double blind from January to April 2021. The keywords ‘minilaparoscopy’; ‘ultra minimally invasive surgery’; ‘3 mm’; ‘percutaneous’; and ‘Hysterectomy’ were selected in Pubmed, Medscape, Scopus, and Google scholar search engines. PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines were followed for the drafting of the systematic review. The systematic literature research provided 298 studies, of which 9 fell within the inclusion criteria. Two hundred ninety-six total patients were included, 148 for both PH and MH groups. Median age (48 years), BMI (24 kg/m2), OT (90 min), EBL (50 ml), time to discharge (1 day), self scar evaluation (10/10), and VAS (3/10) were reported. The most frequent intraoperative complication in both the PH and MH groups was surgical bleeding. The UMIS approaches were feasible and safe even for complex gynecological procedures. Operative times and complications were superimposable to the “classical” minimally invasive approaches reported in the literature. The reported results apply only to experienced surgeons.
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Vitale SG, Caruso S, Carugno J, Ciebiera M, Barra F, Ferrero S, Cianci A. Quality of life and sexuality of postmenopausal women with intrauterine pathologies: a recommended three-step multidisciplinary approach focusing on the role of hysteroscopy. MINIM INVASIV THER 2021; 30:317-325. [PMID: 34278934 DOI: 10.1080/13645706.2021.1910312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Intrauterine pathologies are common in postmenopausal women and clinicians must identify signs and symptoms accurately to provide the adequate diagnosis and treatment. The quality of life (QoL) and sexuality of women are important outcomes to be considered to provide adequate clinical management of the postmenopausal patient with gynecologic pathologies. The aim of this paper is to propose a simple and replicable three-step multidisciplinary approach to evaluate the psychological outcomes of postmenopausal women with intrauterine pathologies, focusing on the role of hysteroscopy. In particular, the article describes three evaluation steps of those psychological outcomes corresponding to three fundamental moments of the patient's diagnostic and therapeutic path: the initial symptoms, diagnosis, and treatment. In our viewpoint, the standard use of such a protocol might considerably improve the QoL of postmenopausal patients undergoing hysteroscopic procedures due to intrauterine pathologies.
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Affiliation(s)
- Salvatore Giovanni Vitale
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Salvatore Caruso
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Jose Carugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Michał Ciebiera
- Second Department of Obstetrics and Gynaecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino - IST, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (Dinogmi), University of Genoa, Genoa, Italy
| | - Simone Ferrero
- Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino - IST, Genoa, Italy.,Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (Dinogmi), University of Genoa, Genoa, Italy
| | - Antonio Cianci
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Vitale SG, Caruso S, Ciebiera M, Török P, Tesarik J, Vilos GA, Cholkeri-Singh A, Gulino FA, Kamath MS, Cianci A. Management of anxiety and pain perception in women undergoing office hysteroscopy: a systematic review. Arch Gynecol Obstet 2020; 301:885-894. [PMID: 32140807 DOI: 10.1007/s00404-020-05460-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/17/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE The aim of this review is to provide an overview of the literature about the perception and management of anxiety and pain in women undergoing an office hysteroscopic procedure. METHODS We performed a systematic literature search in Embase, PubMed/MEDLINE, Cochrane Library and Web of Science for original studies written in English (registered in PROSPERO 2019-CRD42019132341), using the terms 'hysteroscopy' AND 'pain' AND 'anxiety' published up to January 2019. Only original articles (randomized, observational and retrospective studies) about management of anxiety and pain related to the hysteroscopic procedure were considered eligible. RESULTS Our literature search produced 84 records. After exclusions, 11 studies including 2222 patients showed the following results: (a) pain experienced during hysteroscopy is negatively affected by preprocedural anxiety; (b) pharmacological interventions seem to be help in reducing pain during hysteroscopy; (c) waiting time before the procedure is a significant factor affecting patients' anxiety; (d) music during the procedure may be helpful in reducing anxiety. CONCLUSIONS The utilization of office hysteroscopy is hampered by varying levels of anxiety and pain perceived by women who are candidates for the procedure. For these reasons, it is essential to identify effective pharmacological and non-pharmacological strategies to alleviate these factors. We recommend further studies especially focusing on non-pharmacological interventions to facilitate the dissemination of good clinical practices among hysteroscopists.
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Affiliation(s)
- Salvatore Giovanni Vitale
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
| | - Salvatore Caruso
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Michal Ciebiera
- Second Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland
| | - Péter Török
- Faculty of Medicine, Institute of Obstetrics and Gynaecology, University of Debrecen, Debrecen, Hungary
| | | | - George Angelos Vilos
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Aarathi Cholkeri-Singh
- Department of Obstetrics and Gynecology, Advocate Lutheran General Hospital, Park Ridge, IL, USA
| | - Ferdinando Antonio Gulino
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | | | - Antonio Cianci
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Abbas AM, Elzargha AM, Ahmed AGM, Mohamed II, Altraigey A, Abdelbadee AY. Oral Diclofenac Potassium Versus Hyoscine-N-Butyl Bromide in Reducing Pain Perception during Office Hysteroscopy: ARandomized Double-blind Placebo-controlled Trial. J Minim Invasive Gynecol 2019; 26:709-716. [DOI: 10.1016/j.jmig.2018.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/29/2018] [Accepted: 08/01/2018] [Indexed: 10/28/2022]
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Fertility Preserved Hysteroscopic Approach for the Treatment of Stage Ia Endometrioid Carcinoma. Int J Gynecol Cancer 2018; 27:1919-1925. [PMID: 28885274 PMCID: PMC5671800 DOI: 10.1097/igc.0000000000001109] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE This study aims to explore the feasibility of a hysteroscopic procedure combined with progestin therapy in young patients with stage Ia endometrioid carcinoma (EC) to avoid sterilization. MATERIALS AND METHODS Eleven young women with stage Ia EC (International Federation of Gynecology and Obstetrics grade 1) who were treated with a hysteroscopic approach combined with progestin from July 2004 to June 2016 were retrospectively analyzed and followed up to monitor their general recovery and pregnancy outcome. RESULTS The patients' median age was 27.3 years (range, 25-39 years). Comorbidities consisted of primary infertility in 8 patients, polycystic ovary syndrome in 4, uterine fibroids in 2, and diabetes in 1. The results of immunohistochemical analysis were positive for all estrogen and progestin receptors. After treatment, 9 patients attained complete remission, and 2 patients achieved partial remission. The results of peritoneal cytology in 4 patients were negative. As of this writing, 6 of the 11 patients have given birth to 7 infants, and 1 patient had an ectopic pregnancy. Two patients ultimately underwent radical resection. The average follow-up time was 82.3 months (range, 15 to 152 months), and all patients remain disease-free. CONCLUSIONS Hysteroscopic surgery combined with progestin treatment for stage Ia EC in young patients to avoid sterilization was practical and may represent a new option for patients with stage Ia EC who wish to preserve their fertility.
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Optimal timing of misoprostol administration in nulliparous women undergoing office hysteroscopy: a randomized double-blind placebo-controlled study. Fertil Steril 2016; 106:196-201. [DOI: 10.1016/j.fertnstert.2016.03.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/10/2016] [Accepted: 03/10/2016] [Indexed: 11/22/2022]
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Paulo AAS, Solheiro MHR, Paulo COS, Afreixo VMA. What proportion of women refers moderate to severe pain during office hysteroscopy with a mini-hysteroscope? A systematic review and meta-analysis. Arch Gynecol Obstet 2015; 293:37-46. [DOI: 10.1007/s00404-015-3836-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 07/28/2015] [Indexed: 11/29/2022]
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Seyam EM, Hassan MM, Mohamed Sayed Gad MT, Mahmoud HS, Ibrahim MG. Pregnancy Outcome after Office Microhysteroscopy in Women with Unexplained Infertility. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2015; 9:168-75. [PMID: 26246874 PMCID: PMC4518484 DOI: 10.22074/ijfs.2015.4237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 02/16/2014] [Indexed: 11/04/2022]
Abstract
Background Hysteroscopy offers diagnostic accuracy and the ability to treat uterine
pathology. The current study aimed to review the findings and feasibility of the proposed
office-based diagnostic and operative microhysteroscopy in previously diagnosed wom-
en with unexplained infertility and to evaluate the post-microhysteroscopic pregnancy
outcome in a-year follow-up period. Materials and Methods This prospective controlled study was conducted between
2006 and 2013. Two hundreds women with unexplained infertility were randomized into
two groups: A. study group including 100 women recruited for office micohysteroscopic
session and B. control group including 100 without the proposed microhysteroscopic
intervention. A malleable fiberoptic 2-mm, 0 and 30 degrees angled hysteroscopy along
with an operative channel for grasping forceps, scissors, or coaxial bipolar electrode
were used for both diagnostic and operative indications. The findings, complications, and
patient tolerance were recorded. A-year follow-up of pregnancy outcome for both groups
was also performed. Results Seventy cases (70%) of patients had a normal uterine cavity. Twenty wom-
en (20%) had endometrial polyps. Other pathology included submucous myomas
in 3 cases (3%), intrauterine adhesions in 3 cases (3%), polypoid endometrium in
3 cases (3%), and bicornuate uterus in one case (1%). The pathological findings
were treated in all patients without complication. Also a-year follow-up of the to-
tal developing cumulative pregnancy rate (CPR) was evaluated in groups A and B
(control). Group A revealed the total CPR of 28.5%, among which 25% in women
without pathology, 40% in women with endometrial polyps, 23% in women with
adhesions, 33% in women with polypoid endometrium, and 21% in those with bi-
cornuate uterus. However, A-year follow-up of spontaneous pregnancy outcome in
group B showed a total CPR of 15%. Conclusion Women tolerance, safety, and feasibility of simultaneous operative correc-
tion make the proposed office microhysteroscopy an ideal and routine procedure in order
to diagnose and to treat missed intrauterine abnormalities, especially in cases with un-
explained infertility, with additional improvement of the pregnancy outcome after the
procedure.
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Affiliation(s)
- Emaduldin Mostafa Seyam
- Department of Obstetrics and Gynecology, College of Medicine, El Minya University, Minya, Egypt
| | - Momen Mohamed Hassan
- Department of Obstetrics and Gynecology, College of Medicine, El Minya University, Minya, Egypt
| | | | - Hazem Salah Mahmoud
- Department of Obstetrics and Gynecology, Al Fayoum General Hospital, Fayoum, Egypt
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Is pain better tolerated with mini-hysteroscopy than with conventional device? A systematic review and meta-analysis. Arch Gynecol Obstet 2015; 292:987-94. [DOI: 10.1007/s00404-015-3731-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 04/21/2015] [Indexed: 10/23/2022]
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Abstract
Introduction: Nowadays minimally invasive techniques are a leading factors in medicine. According to this trend, hysteroscopy has been used in gynecology more and more frequently. Office hysteroscopy gives opportunity for a faster examination with less costs and strain for the patient. Aim: The aim of this work was to get familiar with the novel method. The author examined the level of pain during hysteroscopy performed for different indications with different types of instruments. In addition, the novel method invented for evaluating tubal patency was compared to the gold standard laparoscopy in 70 tubes. Method: Office hysteroscopy was performed in 400 cases for indications according to the traditional method. All examinations were performed in University of Debrecen, Department of Obstetrics and Gynecology in an outpatient setting. A 2.7 mm diameter optic with diagnostic or operative sheet was used. Hysteroscopies were scheduled between the 4th and 11th cycle day. For recording pain level VAS was used in 70 cases. Comparison of hysteroscopic evaluation of tubal patency to the laparoscopic method was studies in 70 cases. Results: It was found that office hysteroscopy can be performed in an outpatient setting, without anesthesia. Pain level showed no difference among subgroups (nulliparous, non-nulliparous, postmenopausal, diagnostic, operative) (mean±SD, 3.5±1.01; p=0.34). For the evaluation of tubal patency, office hysteroscopy showed 92.06% accuracy when compared to laparoscopy. Conclusions: Office hysteroscopy has several advantages over traditional method. This procedure is fast, it has less strain for the patient. The novel method, rather than traditional hysteroscopy, should be used in the work-up of infertility as well. Orv. Hetil., 2014, 155(40), 1589–1597.
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Affiliation(s)
- Péter Török
- Debreceni Egyetem, Klinikai Központ, Általános Orvostudományi Kar Szülészeti és Nőgyógyászati Klinika Debrecen Nagyerdei krt. 98. 4032
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Evaluating the level of pain during office hysteroscopy according to menopausal status, parity, and size of instrument. Arch Gynecol Obstet 2012; 287:985-8. [DOI: 10.1007/s00404-012-2667-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 11/27/2012] [Indexed: 10/27/2022]
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Hysteroscopic findings in women with recurrent IVF failures and the effect of correction of hysteroscopic findings on subsequent pregnancy rates. Arch Gynecol Obstet 2012. [PMID: 23183783 DOI: 10.1007/s00404-012-2627-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Our aim is to evaluate the incidence of unrecognized uterine abnormalities in cases with recurrent IVF failure by screening office hysteroscopy (OH), and impacts of treatment of hysteroscopic findings on the success rate of IVF. MATERIALS AND METHODS The retrospective and descriptive study was conducted at assisted reproduction unit in a tertiary medical center. One hundred and fifty-seven patients with a history of recurrent IVF failures underwent hysteroscopy between May 2009 and March 2012. Hysteroscopy (diagnostic or operative, as appropriate) was performed to evaluate the endometrial cavity in patients with two or more IVF failures and Incidence of abnormal hysteroscopic findings and the clinical pregnancy rate (CPR) in subsequent IVF cycles were assessed. RESULTS In all, 44.9 % of the patients included in this study had abnormal hysteroscopic findings and 75 women (48.1 %) became pregnant following hysteroscopy. Of these pregnancies, 36 occurred in women with corrected endometrial pathology, the majority of which was identified as endometrial polyps. Implantation rate and clinical pregnancy rate were statistically significant increased after polipectomy. CONCLUSION Abnormal findings on hysteroscopy are significantly higher in patients with previous ART failure and hysteroscopy could be seen as a positive prognostic factor for achieving pregnancy in subsequent IVF procedure in women with a history of RIF.
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Habibaj J, Kosova H, Bilali S, Bilali V, Qama D. Comparison between transvaginal sonography after diagnostic hysteroscopy and laparoscopic chromopertubation for the assessment of tubal patency in infertile women. JOURNAL OF CLINICAL ULTRASOUND : JCU 2012; 40:68-73. [PMID: 21935964 DOI: 10.1002/jcu.20883] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Accepted: 08/16/2011] [Indexed: 05/31/2023]
Abstract
PURPOSE Diagnostic hysteroscopy has become a well-established modality for evaluating the uterine cavity, but provides no information regarding tubal patency. The aim of the present study was to investigate the diagnostic value of transvaginal sonography (TVS), performed directly after diagnostic hysteroscopy, for assessing tubal patency in infertile women, and to compare the findings with those obtained by means of laparoscopic chromopertubation. METHODS A total of 56 infertile patients were referred to our endoscopic unit for laparoscopic chromopertubation in the period from September 2008 to January 2010. Diagnostic hysteroscopy, followed by TVS, was carried out prior to laparoscopic chromopertubation. The collection of free fluid in the pouch of Douglas was accepted as evidence of tubal patency. The findings of TVS and laparoscopic chromopertubation were compared. The data were analyzed for the sensitivity, specificity, accuracy, positive-predictivevalue, and negative-predictive value of the combination of hysteroscopy and TVS in detecting unilateral or bilateral tubal patency. RESULTS The presence of fluid in the pouch of Douglas was observed in 37 of the 56 cases. In 36 of these cases, unilateral or bilateral tubal patency was confirmed by laparoscopic chromopertubation. In 17 of the remaining 19 cases (without fluid in the pouch of Douglas during ultrasound), bilateral tubal occlusion was confirmed by laparoscopic chromopertubation. Diagnostic hysteroscopy followed by TVS showed a high sensitivity and specificity for the assessment of tubal patency. CONCLUSIONS TVS performed directly after diagnostic hysteroscopy in infertile patients provides additional nformation regarding tubal patency.
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Affiliation(s)
- Julian Habibaj
- Obstetric and Gynecology University Hospital Queen Geraldine, Obstetric and Gynecology, Boulevard Zogu I, Tirana, Albania
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Bastos de Souza CA, Schmitz C, Genro VK, Martins A, Scheffel C, Oppermann ML, Cunha Filho JS. Histeroscopia ambulatorial em casos de abortamento consecutivo. Rev Assoc Med Bras (1992) 2011. [DOI: 10.1590/s0104-42302011000400013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Siristatidis C, Chrelias C, Kassanos D. Rudimentary-horn pregnancy: some points to review. Arch Gynecol Obstet 2010; 283:917-8. [PMID: 20830482 DOI: 10.1007/s00404-010-1658-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2010] [Accepted: 08/16/2010] [Indexed: 10/19/2022]
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