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6 recordsLinked to original sources
PubMed1992

[Myomectomy via hysteroscopy. Indications, technics, results].

Nowadays operative hysteroscopy represents the elective treatment of submucous and partially intramural fibroids. Seventy patients underwent hysteroscopic resection of fibroids, because of abnormal uterine bleeding in 58 (82.8%) cases, and infertility in 12 (17.2%) cases. The evaluation of the lesion was performed by diagnostic hysteroscopy and abdominal (57 patients) or transvaginal (13 patients) ultrasounds. In particular, for the evaluation of the intramural portion of the lesion, the hysteroscopic study of the angle between fibroid and myometrium was fundamental: the more acute the angle is the more intracavitary the myoma is. Forty-six (65.7%) out of 70 had a completely intracavitary fibroid; in 14 (20%) cases the intramural development was less than 1.5 cm and in the remaining 10 (14.3%) cases was more than 1.5 cm. Integration of hysteroscopy and ultrasounds for the assessment of myomas and the preoperative preparation by LH-RH analogues allow to perform an endoscopic resection of myomas which has up to, and sometimes over, 50% of their volume in the uterine wall.

Female↗
PubMed1993

Transvaginal hysterosonography for differential diagnosis between submucous and intramural myoma.

Thirty-six patients with hypermenorrhea, dysmenorrhea, and/or anemia were examined by transvaginal sonography (TVS) and by transvaginal hysterosonography using an endometrial balloon catheter and saline (TVHS). Those patients who showed distinct intramural myomas by TVS were excluded from this study. Of 36 patients, 22 were diagnosed with submucous myomas, 10 with intramural myomas, and 4 with endometrial polyps by TVS, but 20 patients were diagnosed as having submucous myomas, 12 patients intramural myomas, and 4 patients endometrial polyps by TVHS. The correlation between ultrasound findings and surgery (hysterectomy or hysteroscopy) indicated that there were 13 misdiagnoses (36%) by TVS and only one misdiagnosis (2.8%) by TVHS.

Diagnosis, Differential↗
PubMed1989

D&C results improved by hysteroscopy.

A review of the records of 287 women examined hysteroscopically prior to dilatation and curettage (D&C) and a review of the international literature on hysteroscopy indicate that there is significant evidence to support the routine use of hysteroscopy as an adjunct to D&C.

Dilatation and Curettage↗
PubMed1995

Dilutional hyponatremia during hysteroscopic myomectomy with sorbitol-mannitol distention medium.

To determine the frequency of hyponatremic complications during hysteroscopic myoma resections using sorbitol-mannitol distending medium and its relationship to operative time, fluid balance, and myoma size, we reviewed all operative hysteroscopic procedures performed by the Section of Reproductive Endocrinology and Fertility at Yale-New Haven Hospital over a 1-year period during which that medium was used. Twenty-six cases were identified of which seven involved hysteroscopic myoma resections. Hyponatremia occurred in four of the seven patients, and in one it was associated with severe posttransurethral prostatic resection (post-TURP) syndrome. The degree of hyponatremia varied roughly in direct proportion to fibroid volume and fibroid volume as a percentage of uterine volume. No relationship was found between the degree of hyponatremia and operating time, estimated submucosal volume, and uterine volume. We conclude that dilutional hyponatremia and the post-TURP syndrome may occur with the use of sorbitol-mannitol distension medium during hysteroscopy. They occur more frequently during operative hysteroscopy to resect myomata, with myoma size and myoma volume expressed as a percentage of uterine volume possibly influencing the degree of hyponatremia.

Abdominal Pain↗
PubMedDate not supplied

Therapeutic hysteroscopy.

It is the responsibility of physicians in gatherings such as ours to set the tone and speak forthrightly about accomplishments and limitations. The fundamentals of diagnostic hysteroscopy are well known and now is the time for us to push forward to ascertain whether this endoscopic approach, in selected patients, is more innocuous than the conventional laparotomy. I have tried to indicate the clinician's dilemma in the search for the proper approach to several types of uterine abnormalities. As enthusiastic hysteroscopists, we must continue to analyze and document our findings, with careful concern so as to avoid poorly substantiated claims.

Catheterization↗