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Hysteroscopy complications

Konrad Futyma, Krzysztof Gałczyński, Katarzyna Romanek, Aleksandra Filipczak, Tomasz Rechberger
The reported number of cesarean sections in Poland is approximately 30% and is associated with increasing number of early and late complications. The myometrial discontinuity at the site of previous cesarean section is known in the literature as "isthmocoele", "niche", "pouch" or cesarean scar defect. In most cases presence of isthmocoele has no clinical significance, but in some patients it may cause abnormal uterine bleeding, dysmenorrhea, dyspareunia, pelvic pain or be associated with secondary infertility...
2016: Ginekologia Polska
E Nguyen Ba, F Golfier, C Malhaire, L Louafi, S Alran
Tumors of trophoblast implantation site TTSI are rare gestational tumors. This case highlights the diagnostic difficulties and treatment of tumors of trophoblastic implantation site early. Patient of 28 years with no medical history, G1P1 who gave birth 11 months ago presented bleeding with an HCG level of 73IU that led to the diagnosis of early miscarriage. Treatment of miscarriage by hysteroscopy and curettage is complicated leading to the realization of an abdominopelvic CT and pelvic ultrasound that show an atypical uterine vascularity and an intracavitary heterogeneous mass...
September 28, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Ying Hua, Wenwen Zhang, Xiaoli Hu, Ansu Yang, Xueqiong Zhu
The effects of misoprostol use on cervical priming prior to hysteroscopy have been controversial. Therefore, a systematic literature review and meta-analysis of studies were conducted to assess the effect of misoprostol on cervical priming prior to hysteroscopy. All studies published before July 2014 with data related to the use of misoprostol for cervical priming compared with placebo or no medication prior to hysteroscopy, were identified. Twenty-five randomized controlled trials involving 2,203 females were systematically analyzed...
2016: Drug Design, Development and Therapy
Yanli Li, Liyan Gong, Xufeng Wu, Han Gao, Hongbing Zheng, Weishun Lan
OBJECTIVE: To compare the complication rates after uterine artery chemoembolization (UACE) followed by dilation and curettage (D&C) guided by different types of monitoring for treatment of cesarean scar pregnancy (CSP). METHODS: A randomized controlled trial was undertaken of women with CSP attending a hospital in Wuhan, China, between June 1, 2010, and June 30, 2014. Using sealed opaque envelopes containing random numbers, participants were randomly allocated to undergo D&C with hysteroscopy monitoring, ultrasonography monitoring, or no monitoring...
November 2016: International Journal of Gynaecology and Obstetrics
M Lemmers, M A C Verschoor, K Oude Rengerink, C Naaktgeboren, B C Opmeer, P M Bossuyt, J A F Huirne, C A H Janssen, C Radder, E R Klinkert, J Langenveld, R Catshoek, L Van der Voet, F Siemens, P Geomini, M H Van Hooff, J M Van der Ploeg, S F P J Coppus, W M Ankum, B W J Mol
STUDY QUESTION: Is curettage more effective than expectant management in case of an incomplete evacuation after misoprostol treatment for first trimester miscarriage? SUMMARY ANSWER: Curettage leads to a higher chance of complete evacuation but expectant management is successful in at least 76% of women with an incomplete evacuation of the uterus after misoprostol treatment for first trimester miscarriage. WHAT IS KNOWN ALREADY: In 5-50% of the women treated with misoprostol, there is a suspicion of incomplete evacuation of the uterus on sonography...
September 2, 2016: Human Reproduction
Shlomo B Cohen, Jerome Bouaziz, Ariella Jakobson-Setton, Motti Goldenberg, Eyal Schiff, Raoul Orvieto, Adrian Shulman
OBJECTIVE: Investigate a novel office hysteroscopic tubal catheterization therapeutic method for proximal tubal occlusion. STUDY DESIGN: Prospective cohort study in a tertiary referral center. We evaluated the procedure on a group of 27 patients that were referred to our unit for proximal tubal occlusion demonstrated by hysterosalpingography, 9 (33.3%) of them with primary infertility and 18 of them (66.6%) with secondary infertility. The intervention included the usage of the modified Novy cornual cannulation set which was inserted through a 5F working cannel during an office operative hysteroscopy, followed by fallopian tube irrigation with saline-air mixture under ultrasonographic imaging...
September 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Bijan W Salari, Bala Bhagavath, Michael Galloway, Austin Findley, Jerome L Yaklic, Steven R Lindheim
OBJECTIVE: To report a step-by-step technique to using a hysteroscopic morcellator to safely gain access into the intrauterine cavity in two patients with severe cervical stenosis and concomitant intrauterine pathology. DESIGN: Video article introducing the hysteroscopic morcellator for overcoming severe cervical stenosis. SETTING: Academic-based practice. PATIENT(S): A 36-year-old G0 female with primary infertility and uterine polyps and a 34-year-old G0 female with uterine polyps and a difficult trial transfer before undergoing an IVF cycle...
August 16, 2016: Fertility and Sterility
A Dimirov, T Garnizov, V Zlatkov, B Frundeva, A Masseva
Conservative management of placenta accrete consists in leaving the entire placenta accreta in situ after vaginal delivery of the fetus. This behavior requires active monitoring the vital signs of mother, genital status and paraclinical indicators for an extended period after birth. Monitoring is suspended after full absorption of the placenta. The success of the conservative approach depends on: the adopted protocol formanagement of placenta accreta, whether the diagnosis is known before birth, the possible of application techniques, reducing blood flow to the uterus, keeping the placental period and others...
2016: Akusherstvo i Ginekologii︠a︡
Janu Mangala Kanthi, Chithra Remadevi, Sudha Sumathy, Deepti Sharma, Sarala Sreedhar, Amrutha Jose
INTRODUCTION: Endometrial polyp is one of the common causes of Abnormal Uterine Bleeding (AUB) in the reproductive age group as well as postmenopausal age group. AIM: To study the clinical features of endometrial polyp and the safety and feasibility of blind polypectomy following diagnostic hysteroscopy. MATERIALS AND METHODS: Total of 256 women who were diagnosed to have endometrial polyp by transvaginal ultrasound and underwent diagnostic hysteroscopy and blind polypectomy by simple avulsion in the period of January 2008 to December 2014 were included in our study...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Ludovico Muzii, Violante Di Donato, Terenzio Boni, Raffaele Gaglione, Riccardo Marana, Ivan Mazzon, Ludovica Imperiale, Caterina De Medici, Alfonso Ruggiero, Pierluigi Benedetti Panici
OBJECTIVE: To evaluate the incidence of infectious complications and effect of prophylactic antibiotic administration during operative hysteroscopic procedures. METHODS: A multicentric randomized controlled trial was conducted between January 2012 and December 2013. Women (n = 180) affected by endometrial hyperplasia, myomas, or endometrial polyps undergoing operative hysteroscopy were randomized to receive cefazolin 2 g intravenously 30 minutes prior to the procedure (n = 91) and no treatment (n = 89)...
July 28, 2016: Reproductive Sciences
Jacques Donnez, Marie-Madeleine Dolmans
Uterine fibroids (also known as leiomyomas or myomas) are the most common form of benign uterine tumors. Clinical presentations include abnormal bleeding, pelvic masses, pelvic pain, infertility, bulk symptoms and obstetric complications.Almost a third of women with leiomyomas will request treatment due to symptoms. Current management strategies mainly involve surgical interventions, but the choice of treatment is guided by patient's age and desire to preserve fertility or avoid 'radical' surgery such as hysterectomy...
July 27, 2016: Human Reproduction Update
Daniella De Batista Depes, Ana Maria Gomes Pereira, Umberto Gazi Lippi, João Alfredo Martins, Reginaldo Guedes Coelho Lopes
OBJECTIVE: To evaluate results of early tubal occlusions performed by hysteroscopy (Essure®). METHODS: This prospective study included 38 patients, 73.7% of them were white, mean age 34.5 years, they have had on average 3 pregnancies and 2.7 of deliveries. A total of 86.8% of patients previously prepared the endometrium. All procedures were carried out at outpatient unit without anesthesia. RESULTS: Insertion rate of the device was 100% at a mean time of 4 minutes and 50 seconds...
April 2016: Einstein
E Scott Sills, Gianpiero D Palermo
We describe the successful removal of a pelvic contraceptive coil in a symptomatic 46-year-old patient who had Essure devices for four years, using a combined hysteroscopy-laparoscopy-fluoroscopy approach. Following normal hysteroscopy, at laparoscopy the right Essure implant was disrupted and its outer nitinol coil had perforated the fallopian tube. However, the inner rod (containing polyethylene terephthalate) had migrated to an extrapelvic location, near the proximal colon. In contrast, the left implant was situated within the corresponding tube...
July 2016: Obstetrics & Gynecology Science
Angelo Hooker, Donachienne Fraenk, Hans Brölmann, Judith Huirne
OBJECTIVES: Termination of pregnancy (TOP) is one of the most performed interventions in women worldwide: approximately one in three women will have at least one TOP in their reproductive life. Intrauterine adhesions (IUAs) have been reported as a possible complication after TOP, but their prevalence has not been established, as women are not routinely evaluated. IUAs are associated with menstrual disturbances, infertility and obstetric complications. METHODS: We searched Ovid MEDLINE, Ovid EMBASE and CENTRAL from inception until November 2015 for studies evaluating women following TOP...
August 2016: European Journal of Contraception & Reproductive Health Care
Shilpa Bhandari, Ishita Ganguly, Pallavi Agarwal, Aparna Singh, Nitika Gupta
CONTEXT: Fibroids are the most common tumors of the uterine cavity. Most of them are diagnosed during the reproductive age when the fertility is an important concern for the female. However, complications can occur after removal of fibroid (myomectomy) too for future pregnancy. Though myomectomy has been sighted as a cause of intrauterine adhesions data regarding the effect of myomectomy on endometrial cavity is lacking. AIMS: Evaluate the incidence of intrauterine adhesion formation after myomectomy and to identify the associated factors...
April 2016: Journal of Human Reproductive Sciences
Ibrahim Alkatout, Liselotte Mettler, Veronika Günther, Nicolai Maass, Christel Eckmann-Scholz, Mohamed Elessawy, Michael Anapolski
Uterine leiomyomas are the most frequent benign tumors of the female genital tract. Fibroids are associated with a variety of clinical problems, e.g. bleeding disorders, bulk-related symptoms or infertility. For women wishing to preserve their uterus, fibroids can be surgically removed by hysteroscopy, laparoscopy or laparotomy. The purpose of our review is to show that hysterectomy offers the only definitive solution. The indication for treatment has to be taken carefully after weighing up alternative treatment methods, such as expectant management, medical treatment or interventional radiologic methods, and after obtaining informed consent...
June 22, 2016: Minimally Invasive Therapy & Allied Technologies: MITAT
Aarathi Cholkeri-Singh, Kirsten Jill Sasaki
PURPOSE OF REVIEW: Hysteroscopy is a very common tool providing the gynecologist the ability to diagnose and treat a variety of intrauterine disorders. This outpatient therapy has provided quick and effective relief for women worldwide. Although simple in concept, hysteroscopy is associated with minor and major complications. Awareness of these difficulties and methods of prevention and management is key to good surgical outcomes. This article reviews well tolerated practices for hysteroscopy complications...
August 2016: Current Opinion in Obstetrics & Gynecology
J Mairos, P Di Martino
According to World Health Organization (WHO), about 1 out of 10 hospitalized patients suffers an adverse event, in developed countries, being an adverse event an injury related to medical management, in contrast to complications of disease. These events cause both unnecessary suffering and huge cost to health systems. This issue is so important that WHO has defined it as a global health problem and in 2004 launched the World Alliance for Patient Safety, with the aim to coordinate, disseminate and accelerate improvements in Patient Safety...
2016: Gynecological Surgery
Stephanie Leung, Nicholas Leyland, Ally Murji
OBJECTIVES: At our institution, diagnostic hysteroscopy (DH), often combined with uterine curettage, commonly has been performed in the main OR with the patient under general anaesthesia. Our objective was to create targeted interventions aimed at decreasing the number of DHs performed in the OR by 75% over one year. METHODS: This quality improvement initiative had a quasi-experimental (time-series) design. To obtain baseline numbers of DHs performed each month, we conducted a retrospective chart audit at a university teaching hospital...
April 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Luisa Casadei, Eleonora Piccolo, Claudia Manicuti, Silvia Cardinale, Matteo Collamarini, Emilio Piccione
OBJECTIVE: To assess the efficacy and safety of vaginal misoprostol after a pretreatment with vaginal estradiol to facilitate the hysteroscopic surgery in postmenopausal women. METHODS: In this observational comparative study, 35 control women (group A) did not receive any pharmacological treatment,26 women (group B) received 25 µg of vaginal estradiol daily for 14 days and 400 µg of vaginal misoprostol 12 hours before hysteroscopic surgery, 32 women (group C) received 400 µg of vaginal misoprostol 12 hours before surgery...
May 2016: Obstetrics & Gynecology Science
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