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Improved Hysteroscopic Resection of Endometrial Polyps Using 6-Fr Micro-Scissors and Forceps
Published on: August 2, 2024
Office hysteroscopy and adenomyosis
Carlos Roger Molinas1, Rudi Campo
1Centre for Gynaecological Endoscopy (Cendogyn), Centro Médico La Costa, Asunción, Paraguay. roger.molinas@lifeleuven.be
Best Practice & Research. Clinical Obstetrics & Gynaecology
|March 24, 2006
Summary
Office hysteroscopy, combined with transvaginal sonography (TVS), offers a powerful, non-invasive method for diagnosing adenomyosis and other uterine abnormalities before treatment.
Area of Science:
- Gynecology
- Diagnostic Imaging
- Pathology
Background:
- Adenomyosis, characterized by endometrial tissue in the myometrium, was traditionally diagnosed post-hysterectomy.
- Advancements in non-invasive imaging like transvaginal sonography (TVS) and hysteroscopy enable in-office diagnosis.
Purpose of the Study:
- To evaluate hysteroscopy as a first-line diagnostic tool for adenomyosis and other intrauterine anomalies.
- To highlight the role of office-based hysteroscopy in managing abnormal uterine bleeding and infertility.
Main Methods:
- Office hysteroscopy using mini-hysteroscopes and saline distension.
- Procedure preceded by physical exam and TVS, followed by a second TVS for contrast sonography.
- Direct visualization of the uterine cavity and potential for endometrial/myometrial biopsies.
Main Results:
- Hysteroscopy allows direct visualization of the uterine cavity.
- While not pathognomonic, findings like irregular endometrium, defects, altered vascularization, and cystic lesions may indicate adenomyosis.
- The combination of TVS and fluid hysteroscopy serves as a potent screening tool.
Conclusions:
- Office hysteroscopy is a valuable first-line diagnostic tool for intrauterine abnormalities.
- The integrated approach of TVS, fluid hysteroscopy, and contrast sonography effectively screens for endometrial and myometrial issues associated with adenomyosis.
