Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-28T09:29:19.382Z Has data issue: false hasContentIssue false

Chapter 43 - Basic Hysteroscopy

from Section 10 - Operative Gynaecology

Published online by Cambridge University Press:  24 November 2021

By
Attilio Di Spiezio Sardo ,
Fabrizia Santangelo ,
Maria Chiara De Angelis ,
Stephan Gordts ,
Helena Van Kerrebroeck  and
Rudi Campo
Edited by
Tahir Mahmood ,
Charles Savona-Ventura ,
Ioannis Messinis  and
Sambit Mukhopadhyay
Tahir Mahmood
Affiliation:
Victoria Hospital, Kirkcaldy
Charles Savona-Ventura
Affiliation:
University of Malta, Malta
Ioannis Messinis
Affiliation:
University of Thessaly, Greece
Sambit Mukhopadhyay
Affiliation:
Norfolk & Norwich University Hospital, UK
Get access

Summary

Modern gynaecology has witnessed a rapid evolution and a widespread application of endoscopic techniques over the past 20 years, particularly those seen in hysteroscopy. This has been made possible mainly due to technological developments relating to instrumentation and equipment, along with continuous improvements related to surgical techniques. The advances in technology and techniques, have made hysteroscopy less painful, less invasive and an outpatient procedure . Together with transvaginal ultrasound it provides the gold standard for diagnosis of uterine pathology.

Hysteroscopy enlarges the diagnostic capacity by minor surgical operative procedures like removal of IUD, biopsy or removal of polyps and minor synechiolysis.

This chapter provides a description of basic hysteroscopic procedures including simple operative procedures like second- and third-generation endometrial ablation and grade 0 to grade 1 myomectomy for small myomas.

Keywords

uterushysteroscopyendometrial cavitysynechiaepolypsendometrial biopsyvaginoscopy
Type
Chapter
Information
The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
Gynaecology
 , pp. 376 - 384
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Doraiswami, S, Johnson, T, Rao, S, et al. Study of endometrial pathology in abnormal uterine bleeding. J Obstet Gynaecol India 2011;61:426–30.CrossRefGoogle ScholarPubMed
Kubista, E, Remenyi, IM. Leitlinien Zur Prävention, Früherkennung und Behandlungdes Des Mammakarzinoms der Arbeitsgemeinschaft Gynakologische Onkologie (AGO). Speculum d Zeitschr Gynakol Geburts. 2006;24:33e40 [In German, English abstract].Google Scholar
Obeidat, B, Mohtaseb, A, Matalka, I. The diagnosis of endometrial hyperplasia on curettage: how reliable is it? Arch Gynecol Obstet 2009;279:489–92.Google Scholar
Karageyim Karsidag, AY, Buyukbayrak, EE, Kars, B, Unal, O, Turan, MC. Trans-vaginal sonography, sonohysterography, and hysteroscopy for investigation of focal intrauterine lesions in women with recurrent postmenopausal bleeding after dilatation & curettage. Arch Gynecol Obstet 2010;281:637–43.CrossRefGoogle Scholar
Chen, YL, Cheng, WF, Lin, MC, et al. Concurrent endometrial carcinoma in patients with a curettage diagnosis of endometrial hyperplasia. J Formos Med Assoc 2009;108:502–507.CrossRefGoogle ScholarPubMed
Thiel, FC, Renner, SP, Ackermann, S, et al. Comparison of pretreatment assessment of intrauterine tumor spread in endometrial carcinoma using ultrasonography, hysteroscopy, and fractional curettage. Gynecol Surg 2008;5:15–19.Google Scholar
Naderi, T, Asharaf-ganjooei, T, Bahrampoor, A, Mehrimahani, I. Comparison of the diagnostic accuracy of pipelle biopsy, dilatation and curettage and hysterectomy in detection of endometrial lesions. J Kerman Univ Med Sci 2006;13:159–163.Google Scholar
Humber, N. The occasional D & C. Can J Rural Med 2009;14:115–118.Google ScholarPubMed
Bettocchi, S, Ceci, O, Vicino, M, et al. Diagnostic inadequacy of dilatation and curettage. Fertil Steril 2001;75:803–805.CrossRefGoogle ScholarPubMed
Goldstein, SR. Modern evaluation of the endometrium. Obstet Gynecol 2010;116:168–176.CrossRefGoogle ScholarPubMed
Bettocchi, S, Ceci, O, Spinelli, ML, et al. Office hysteroscopy. Ref Gynecol Obstet 2010;12:1e9.Google Scholar
Bettocchi, S, Selvaggi, L. A vaginoscopic approach to reduce the pain of office hysteroscopy. J Am Assoc Gynecol Laparosc 1997;4:255–258.CrossRefGoogle ScholarPubMed
Committee on Practice Bulletins – Gynaecology. Practice bulletin no.136: management of abnormal uterine bleeding associated with ovulatory dysfunction. Obstet Gynecol 2013;122:176–185.Google Scholar
Marsh, F, Kremer, C, Duffy, S. Delivering an effective outpatient service in gynaecology: a randomized controlled trial analysing the cost of outpatient versus day-case hysteroscopy. BJOG 2004;111:243–248.Google Scholar
El-Toukhy, T, Campo, R, Khalaf, Y, et al. Hysteroscopy in recurrent in-vitro fertilisation failure (TROPHY): a multicentre, randomised controlled trial. Lancet 2016;387:2614–21.Google Scholar
Campo, R, Molinas, CR, Rombauts, L, et al. Prospective multicentre randomized controlled trial to evaluate factors influencing the success rate of office diagnostic hysteroscopy. Hum Reprod 2005;20:258–263.Google Scholar
Di Spiezio Sardo, A, Calagna, Di Carlo, C. Tips and tricks in office hysteroscopy. J Minim Invasive Gynecol 2015;4:3–7.CrossRefGoogle Scholar
Nappi, C., Di Spiezio Sardo, A. State of the Art Hysteroscopic Approaches to Pathologies of the Genital Tract. Tuttlingen: Endo-Press, 2016.Google Scholar
Salazar, CA, Isaacson, KB. Office operative hysteroscopy: an update. J Minim Invasive Gynecol 2018;25:199–208.Google Scholar
Bedner, R, Rzepka-Gorska, I. Hysteroscopy with directed biopsy versus dilatation and curettage for the diagnosis of endometrial hyperplasia and cancer in perimenopausal women. Eur J Gynaecol Oncol 2007;28:400–402.Google Scholar
Bettocchi, S, DiVenere, R, Pansini, N, et al. Endometrial biopsies using small diameter hysteroscopes and 5 Fr instruments: how can we obtain enough material for correct histologic diagnosis? J Am Assoc Gynecol Laparosc 2002;9:290–292.Google Scholar
Siegler, AM, Kemmann, E. Location and removal of misplaced or embedded intrauterine devices by hysteroscopy. J Reprod Med 1976;16:139–144.Google ScholarPubMed
Bettocchi, S, Ceci, O, Nappi, L, et al. Operative office hysteroscopy without anesthesia: analysis of 4863 cases performed with mechanical instruments. J Am Assoc Gynecol Laparosc 2004;11:59–61.Google Scholar
Garuti, G, Centinaio, G, Luerti, M. Outpatient hysteroscopic polypectomy in postmenopausal women: a comparison between mechanical and electrosurgical resection. J Minim Invasive Gynecol 2008;15:595–560.Google Scholar
Smith, PP, Middleton, LJ, Connor, M, Clark, TJ. Hysteroscopic morcellation compared with electrical resection of endometrial polyps: a randomized controlled trial. Obstet Gynecol 2014;123:745–751.CrossRefGoogle ScholarPubMed
Noventa, M, Ancona, E, Quaranta, M, et al. Intrauterine morcellator devices: the icon of hysteroscopic future or merely a marketing image? A systematic review regarding safety, efficacy, advantages, and contraindications. Reprod Sci 2015;22:1289–1296.CrossRefGoogle ScholarPubMed
Dealberti, D, Riboni, F, Cosma, S, et al. Feasibility and acceptability of office-based polypectomy with a 16 F Mini-resectoscope: a multicenter clinical study. J Minim Invasive Gynecol 2016;23:418–424.CrossRefGoogle Scholar
Guida, M, Di Spiezio-Sardo, A, Acunzo G, S, et al. Vaginoscopic versus traditional office hysteroscopy: a randomized controlled study. Hum Reprod 2006;21:3253–3257.Google Scholar
Wamsteker, K, Emanuel, MH, de Kruif, JH. Transcervical hysteroscopic resection of submucous fibroids for abnormal uterine bleeding: results regarding the degree of intramural extension. Obstet Gynecol 1993;82:736–740.Google ScholarPubMed
Salim, R, Lee, C, Davies, A, et al. A comparative study of three-dimensional saline infusion sonohysterography and diagnostic hysteroscopy for the classification of submucous fibroids. Hum Reprod 2005;20:253–257.CrossRefGoogle ScholarPubMed
Di Spiezio Sardo, A, Mazzon, I, Bramante, S, et al. Hysteroscopic myomectomy: a comprehensive review of surgical techniques. Hum Reprod Update 2008;14:101–119.Google Scholar
McGurgan, P, O’Donovan, P. Second-generation endometrial ablation: an overview. Best Pract Res Clin Obstet Gynaecol 2007;21:931–945.Google Scholar
Angioni, S, Pontis, A, Nappi, L, et al. Endometrial ablation: first vs. second generation techniques. Minerva Ginecol 2016;68:143–153.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×