medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2013, Number 07

<< Back Next >>

Ginecol Obstet Mex 2013; 81 (07)

Diagnostic Histeroscopies Indications and Results in Complexo Hospitalario Universitario De Ourense

Pato-Mosquera M, Vázquez-Rodríguez M, Pérez-Adán M, García-García MJ, Blanco-Pérez S

Language: Spanish
References: 15
Page: 382-388
PDF size: 551.66 Kb.


ABSTRACT

Background: Diagnostic hysteroscopy is an endoscopic technique that allows the evaluation of the endocervical canal and uterine cavity.
Objective: To evaluate indications, complications and referral to operative hysteroscopy. To analyze the correlation between sonographic display, hysteroscopy findings and histological diagnosis.
Materials and methods: Retrospective and descriptive study of 904 patients who underwent diagnostic hysteroscopy between January 1, 2008 and June 30, 2012.
Results: The most frequent indication was sonographic detection of endometrial polyps (75% were premenopausal and 71.2% postmenopausal). The complication rate associated with the test was 11.4%. The reduction experimented in operative hysteroscopies was from 31.2% in 2008 to 12.2% between January and June 2012. When a polyp or a myoma was detected by sonography, diagnostic hysteroscopy showed them in 64.4% y 62.5% of the cases, respectively. The correlation between hysteroscopic findings and histopathologic diagnosis was 77.7% for normal endometrium, 77.9% for polyps, 17.8% for hyperplasic appearance and 100% for carcinoma suspicion.
Conclusions: Diagnostic hysteroscopy is a safe technique that allows small interventions avoiding operative hysteroscopies. There is a good relation between hysteroscopic visual inspection and anatomopathologic diagnosis, but biopsy should be taken except if normal endometrium is visualized.


REFERENCES

  1. Bettocchi S, Nappi L, Oronzo C, Selvaggi L. What does diagnostic hysteroscopy mean today? The role of the new techniques. Curr Opin Obstet Gyencol 2003;15:303-308.

  2. Sánchez C, Brito M. Histeroscopia diagnóstica y terapéutica. Experiencia de 10 años. Rev Obstet Ginecol Venez 2006;66:251-258.

  3. Coloma F, Payá V, Diago V, Costa S, Valero V y López J. Dos mil histeroscopias diagnósticas ambulatorias: experiencia de ocho años. Prog Obstet Ginecol 1998;41:347-352.

  4. Nagele F, O´Connor H, Davies A, Badawy A, Mohamed H, Magos A. 2500 Outpatient diagnostic hysteroscopies. Obstet Gynecol 1996;88:87-92.

  5. Fernández-Parra J, Rodríguez-Oliver AJ, González- Paredes A. Histeroscopia en consulta: análisis de 5000 pacientes. Clin Invest Gin Obst 2012;39:10-13.

  6. Vilos GA, Abu-Rafea B. New developments in ambulatory hysteroscopic surgery. Best Pract Res Clin Obstet Gynaecol 2005;19:727-742.

  7. De Vries L, Dijkhuizen P, Mol B, Brölmann H, Moret E, Heintz P. Comparison of transvaginal sonography, saline infusion sonography and hysteroscopy in premenopausal women with abnormal uterine bleeding. J Clin Ultrasound 2000;28:217-223.

  8. Leone FPG, Timmerman D, Bourne T, Valentin L, Epstein E, Goldstein S.R. Terms, definitions and mea surements to describe the sonographic features of the endometrium and intrauterine lesions: a consensus opinion of the International Endometrial Tumor Analisys (IETA) group. Ultrasound Obstet Gynecol 2010; 35:103–112.

  9. Epstein E, Ramirez A, Skoog L, Valentin L. Transvaginal sonography, saline contrast sonohysterography and hysteroscopy for the investigation of women with postmenopausal bleeding and endometrium > 5 mm. Ultrasound Obstet Gynecol 2001;18:157-167.

  10. Timmermans A, Gerritse M, Opmeer BC, Jansen WF, Mol BWJ, Veersema S. Diagnostic accuracy of endometrial thickness to exclude polyps in women with postmenopausal bleeding. J Clin Ultrasound 2008;36:286-290.

  11. Timmermans A, Veersema S. Office hysteroscopy in women with postmenopausal bleeding: see and treat of endometrial polyps using a Duckbill polyp snare. Gynecol Surg 2004;1:189.

  12. Haller H, Matejcic N, Rukavina B, Krasevic M, Rupeic S, Mozetic D. Transvaginal sonography and hysteroscopy in women with postmenopausal bleeding. Int J Gynaecol Obstet 1996;54:155-159.

  13. Pérez-Medina T, Bajo J, Huertas MA, Rubio A. Predicting atypia inside endometrial polyps. J Ultrasound Med 2002;21:125-128.

  14. Di Spiezo A, Taylor A, Tsirkas P, Mastrogamvrakis G, Sharma M, Magos A. Hysteroscopy: a technique for all? Analysis of 5000 outpatien hysteroscopies. Fertil Steril 2008;89:438-443.

  15. Fernández-Parra J, Rodríguez Oliver AJ, López Gallego MF, Parrilla Fernández F, Montoya Ventoso F. Dolor durante la histeroscopia en consulta. Prog Obstet Ginecol 2005;48 suppl 2:397-452.




2020     |     www.medigraphic.com