Maedica (Bucur). 2012 Dec;7(4):309-14.
Diagnostic hysteroscopy - a retrospective study of 1545 cases.
Maedica
Andreea Stefanescu, Bogdan Marinescu
Affiliations
Affiliations
- Elias University Hospital, Department of Obstetrics and Gynecology.
PMID: 23483793
PMCID: PMC3593281
Abstract
INTRODUCTION: The development of hysteroscopy has provided a minimally invasive approach to common gynecologic problems, such as abnormal uterine bleeding. Diagnostic hysteroscopy is considered now "the gold standard" by the Association of Professors of Gynecology and Obstetrics (2002) in investigation of abnormal uterine bleeding (AUB) in order to rule out organic endouterine causes of AUB. Although the World Health Organization (WHO) recommends hysterosapingography (HSG) alone for management of infertile women many specialists use hysteroscopy as a first-line routine exam for infertility patients regardless of guidelines.
MATERIAL AND METHOD: This paper is a retrospective study of 1545 diagnostic hysteroscopies performed in the "Prof. Dr. Panait Sirbu" Obstetrics and Gynecology Hospital between January 1, 2008 and June 30, 2011. The following parameters were studied: diagnostic hysteroscopy indications, type of anesthesia used, correlation between pre-and postoperative diagnoses.
OUTCOMES: Of 1545 diagnostic hysteroscopies, 78% of cases were performed without anesthesia; of the total of 299 cases of primary infertility diagnostic hysteroscopy showed in 34% of cases tubal obstruction and endouterine pathology; of the total 396 cases of secondary infertility under investigation, diagnostic hysteroscopy showed in 40% of cases tubal obstruction and endouterine pathology; the highest accuracy of HSG was noted for uterine malformation and minimal accuracy was observed for intrauterine adhesions.
CONCLUSIONS: Our experience supports the opinion that diagnostic hysteroscopy should be a first-line routine exam in infertility.Because of the high rate of false positive results for HSG in our study and considering the other studies in specialty literature, we always perform a diagnostic hysteroscopy before Assisted Human Reproduction procedures regardless of the HSG aspect.
Keywords: abnormal uterine bleeding; diagnostic hysteroscopy; infertility
References
- Acta Obstet Gynecol Scand. 1996 Aug;75(7):654-6 - PubMed
- Br J Obstet Gynaecol. 1998 Jun;105(6):672-6 - PubMed
- Hum Reprod. 1994 Dec;9(12):2353-5 - PubMed
- Obstet Gynecol. 2001 Nov;98(5 Pt 2):954-6 - PubMed
- Obstet Gynecol Clin North Am. 1995 Sep;22(3):507-18 - PubMed
- Hum Reprod. 2002 Sep;17(9):2435-8 - PubMed
- J Am Assoc Gynecol Laparosc. 2000 Feb;7(1):71-5 - PubMed
- J Am Assoc Gynecol Laparosc. 1996 Aug;3(4):581-4 - PubMed
- Hum Reprod. 1999 Aug;14(8):1923-4 - PubMed
- Am J Obstet Gynecol. 1980 Jun 15;137(4):425-31 - PubMed
- Obstet Gynecol. 2006 Jul;108(1):225-34 - PubMed
- Hum Reprod. 2006 Nov;21(11):2996-3000 - PubMed
- J Am Assoc Gynecol Laparosc. 1997 Feb;4(2):255-8 - PubMed
- Br J Obstet Gynaecol. 1992 Sep;99(9):777-9 - PubMed
- Med J Armed Forces India. 2004 Jan;60(1):39-41 - PubMed
- J Reprod Med. 2005 Jul;50(7):501-6 - PubMed
- Acta Obstet Gynecol Scand. 2000 Jul;79(7):593-7 - PubMed
- Hum Reprod Update. 1999 Jan-Feb;5(1):73-81 - PubMed
- Obstet Gynecol Int. 2010;2010:168096 - PubMed
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