Hysteroscopy complications

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OBJECTIVE: To evaluate the use of dilute carboprost tromethamine injection at the endometrium/myoma junction during hysteroscopy to facilitate myoma expulsion and removal in a single procedure. DESIGN: Case Series. SETTING: Single high-volume academic medical center. PARTICIPANTS: Seven patients aged 32-51 years old with FIGO type 2 uterine myomas and symptoms of abnormal uterine bleeding or infertility undergoing hysteroscopic resection with a morcellation device from November 2022 - July 2023...

BACKGROUND: Intramural ectopic pregnancy is a rare form of ectopic pregnancy that occurs within the myometrium. It is challenging to diagnose it early because of its nonspecific clinical presentation, and there is no consensus or guideline on the optimal management among gynecologists. CASE PRESENTATION: We report a case of a 34-year-old woman who developed fundal intramural ectopic pregnancy after a previous caesarean section with B-Lynch suture. The B-Lynch suture was performed at 38 weeks of gestation for postpartum hemorrhage caused by refractory uterine atony about 8 years ago...

A uterine scar defect, or isthmocele, is one of the known complications of cesarean delivery. It can cause obstetric as well as gynecological problems. Diagnosis can be suspected based on complaints such as abnormal uterine bleeding, pelvic pain, dysmenorrhea, and subfertility. It can be investigated by transvaginal ultrasound and MRI hysteroscopy. A hysteroscopy gives a confirmatory diagnosis. Isthmoplasty may be offered to avoid future obstetric complications and treat symptoms. In the present case report, a patient with prolonged postmenstrual dark-colored spotting underwent isthmocele repair by a procedure that could be unique, which is transvaginal isthmocele repair with temporary occlusion of uterine vessels...

The journey of addressing fertility challenges, especially in the context of fallopian tubal issues, has witnessed remarkable advancements. This comprehensive review delves into microsurgery for fallopian tubal re-canalization within the era of in vitro fertilization (IVF). The review begins by providing the historical backdrop, tracing the evolution of this surgical technique, and highlighting the transformative impact of microsurgical methods and instrumentation on its precision and outcomes. Microsurgery for fallopian tubal re-canalization is characterized by a range of patient-specific considerations, diagnostic modalities, and factors influencing the choice between re-canalization and IVF...

Surgical site infections (SSIs) refer to infections in the incision, organ, or postoperative space. As common healthcare-associated infections, SSIs correlate with prolonged hospital stay, additional procedures, ICU stay, and higher mortality rates. Around 8-10% of gynecologic surgery patients may experience infectious complications, influenced by microbial contamination, surgical nature, and patient factors. The goal of this narrative review is to compare and merge recommendations from globally published guidelines concerning the utilization of antibiotics in the perioperative phase...

We present a case of subfertility due to isthmocele and cesarean scar endometriosis with a successful pregnancy following laparoscopic repair. This case report is of a 35-year-old female (para 1, living 1) who presented to the gynecological outpatient department with complaints of lower abdominal pain, irregular vaginal bleeding for three months, and subfertility. She was suspected to have isthmocele and endometriosis at the site of the cesarean scar with seroma formation. She underwent a hysteroscopy and laparoscopic excision of the cyst at the site of the cesarean scar with the repair of the cesarean scar defect...

BACKGROUND: Traditionally, curettage is the most widely performed surgical intervention used to remove retained products of conception. However, hysteroscopic removal is increasingly performed as an alternative due to the potentially lower risk of intrauterine adhesions and higher rates of complete removal. Until recently, studies comparing curettage with hysteroscopic removal regarding reproductive and obstetric outcomes were limited, and data conflicting. OBJECTIVE: To study reproductive and obstetric outcomes in women wishing to conceive after removal of retained products of conception by hysteroscopy or ultrasound-guided electric vacuum aspiration...

We report the case of a woman with laminaria retention up to six years, followed by spontaneous pregnancy after the removal by hysteroscope of the intrauterine retained laminaria. A 26-year-old woman (G1P0) visited our hospital with complaints of prolonged menstrual bleeding, dyspareunia, and infertility. She had a history of dilatation and evacuation (D&E) at nine weeks of gestation six years earlier. A transvaginal ultrasound showed an artifact, and hysteroscopy revealed a long foreign body, which was suspected to be a laminaria retained after the prior abortion...

PURPOSE: The primary aim was to analyze the current practices on the use of operative hysteroscopy for preserving fertility in patients diagnosed with endometrial cancer and premalignancies. Our secondary objectives included investigating medical therapy and analyzing reported pregnancy-related outcomes subsequent to fertility preservation procedures. METHODS: We performed a semi-systematic literature review on PubMed, employing pertinent terms related to hysteroscopy, fertility preservation, and endometrial cancer and premalignancies...

BACKGROUND: Laparoscopic surgery has reduced morbidity and mortality rates, shorter postoperative recovery periods and lower complication rates than open surgery. It is routine practice in high-income countries and is becoming increasingly common in countries with limited resources. However, introducing laparoscopic surgery in low-and-middle-income countries (LMIC) can be expensive and requires resources, equipment, and trainers. AIM: To report the challenges and benefits of introducing laparoscopic surgery in LMIC as well as to identify solutions to these challenges for countries with limited finances and resources...

OBJECTIVE: The most common indications for Levonorgestrel intrauterine device (LNG-IUD) are contraception and management of abnormal uterine bleeding (AUB). This study was conducted with the aim of exploring the differences in the clinical profile and outcome of women using LNG-IUD for contraception and AUB. MATERIALS AND METHODS: This was a retrospective comparative cross-sectional study of women who underwent LNG-IUD (52 mg) between 2012 and 2017. Their electronic health records were reviewed until the last documented follow-up or until December 2021...

BACKGROUND: Cesarean scar pregnancy (CSP) is a long-term complication of cesarean section characterized by the localization of a subsequent gestational sac within the scar area or niche developed as a result of a previous cesarean section. Its incidence has increased substantially because of the high global cesarean section rate in recent decades. Several surgical and drug treatments exist for this condition; however, there is currently no optimal treatment. This study compared the effectiveness of direct hysteroscopic removal of the gestational tissue and hysteroscopy combined with vacuum suction for the treatment of CSP...

RATIONALE: Uterine perforation is a serious complication of intrauterine contraceptive device (IUD) placement. However, as complete uterine perforation and extrauterine migration may remain asymptomatic, thorough localization of the IUD is important prior to reinsertion. PATIENT CONCERNS: A 33-year-old patient who has had 4 IUD insertions, wherein the location of the first IUD (inserted 14 years ago) was not identified prior to reinsertion and replacement of the subsequent three...

Angular pregnancy, a rare condition, marked by implantation positioned medially to the uterotubal junction within the lateral angle of the endometrial cavity poses a risk of severe complications, such as uterine rupture, placental retention, postpartum hemorrhage, and even necessitating hysterectomy, all of which can be fatal. Distinguishing angular pregnancy from other emergent conditions, particularly interstitial and cornual pregnancies, is crucial due to similar presentations and difference in embryo viability, risk, and management...

Objective: Infertility is a complex condition that depends on numerous mechanisms regarding its occurrence and evolution. It does not appear as a single pathology, and therefore the diagnosis and management involve both the identification of etiological causes and other possible systemic interactions. Infertility is defined as a succession of unsuccessful attempts of unprotected intercourse within a couple for 12 months, during the reproductive life. Among the many causes related to infertility, uterine pathology has an important place and hysteroscopy is outstanding in diagnosing and treating various pathologies in this category...

Background: Hysteroscopy currently represents the gold standard for the diagnosis and treatment of intrauterine pathologies. Recent technological progress has enabled the integration of diagnostic and operative time, leading to the "see and treat" approach. Diode laser technology is emerging as one of the most innovative and intriguing techniques in this context. Methods: A comprehensive search of the literature was carried out on the main databases. Only original studies reporting the treatment of intrauterine pathologies using diode laser were deemed eligible for inclusion in this systematic review (PROSPERO ID: CRD42023485452)...

INTRODUCTION AND IMPORTANCE: International Federation of Gynecology and Obstetrics (FIGO) and WHO report the incidence of postpartum haemorrhage (PPH) reaches 1-10% and contributes to an increase in postpartum maternal mortality with uterine atony as the most common cause. B-Lynch method is a suturing technique to overcome PPH. Although this method has proven useful as an emergency life-saving measure, the post-procedure complications are still able to occur. PRESENTATION OF CASE: The patient was not menstruating for 14 months after giving birth through caesarean section with B-Lynch due to PPH...

OBJECTIVE: The primary objective of this clinical practice guideline is to provide gynaecologists with an algorithm and evidence to guide the diagnosis and management of endometrial polyps. TARGET POPULATION: All patients with symptomatic or asymptomatic endometrial polyps. OPTIONS: Options for management of endometrial polyps include expectant, medical, and surgical management. These will depend on symptoms, risks for malignancy, and patient choice...

OBJECTIVE: To evaluate the indications, benefits, and risks of hysteroscopy in the management of patients with infertility and provide guidance to gynaecologists who manage common conditions in these patients. TARGET POPULATION: Patients with infertility (inability to conceive after 12 months of unprotected intercourse) undergoing investigation and treatment. BENEFITS, HARMS, AND COSTS: Hysteroscopic surgery can be used to diagnose the etiology of infertility and improve fertility treatment outcomes...