Advanced operative office hysteroscopy without anaesthesia: analysis of 501 cases treated with a 5 Fr. bipolar electrode
Stefano Bettocchi,Oronzo Ceci,R Di Venere,MV Pansini,A Pellegrino,Fiorino Marello,Luigi Nappi +6 more
TL;DR: The combination of a new generation small diameter hysteroscope and a new bipolar 5 Fr.
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Abstract: Background The aim of this study was to evaluate treatment efficacy and patient acceptability of a new bipolar probe used during office hysteroscopic treatment of benign intrauterine pathologies. Methods In this observational clinical study, 501 women were treated for benign intrauterine pathologies using an office hysteroscopic procedure, without analgesia or anaesthesia. A Versapoint 5 Fr. bipolar electrical generator was used to treat endometrial polyps ranging between 0.5 and 4.5 cm, as well as submucosal and partially intramural myomas between 0.6 and 2.0 cm. Treatment efficacy and patient compliance were evaluated. Results At follow-up, the uterine cavity was normal in all patients without any recurrence or persistence of the pathology. One focal adenocarcinoma was discovered at histology in an endometrial polyp of a menopausal patient. Patient acceptance was satisfactory; 47.6-79.3% of the patients underwent the procedure without discomfort. Conclusions The combination of a new generation small diameter hysteroscope and a new bipolar 5 Fr. electrode enables the gynaecologist to treat intrauterine pathologies in an office setting without anaesthesia. Experimentation of a special set-up of the electrical generator reduced patient discomfort during the operative part of the hysteroscopic procedure.
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Citations
Effectiveness of Hysteroscopic Techniques for Endometrial Polyp Removal: The Italian Multicenter Trial.
Massimo Luerti,Amerigo Vitagliano,Attilio Di Spiezio Sardo,Stefano Angioni,Giancarlo Garuti,Carlo De Angelis,Serena Del Zoppo,Davide Dealberti,Luigi Nappi,Gaetano Perrini,Stefano Bettocchi,Paolo Casadio,Gian Luigi Marchino,Enrico Busato,Stefano Calzolari,Eleonora Castellacci,F. Leone,Gianluca Benassi,Francesco Paolo Mangino,Federica Scrimin,G. Giarrè,Vito Cela,Pasquale Florio +22 more
TL;DR: Outpatient polypectomy was associated with a minimal but significantly higher risk of residual EPs in comparison with inpatientpolypectomy, and office hysteroscopy may be considered, whenever possible, as the gold standard technique for removing EPs.
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New hysteroscopic techniques for submucosal uterine fibroids.
TL;DR: Innovations to the existing hysteroscopic techniques and the development of the hysteroscopic morcellator will hopefully result in a greater number of gynecologic surgeons being able to safely perform hysteroscopic resection of submucous uterine fibroids.
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Resectoscopic versus bipolar electrode excision of endometrial polyps: a randomized study.
Ludovico Muzii,Filippo Bellati,Milena Pernice,Natalina Manci,Roberto Angioli,Pierluigi Benedetti Panici +5 more
TL;DR: Operative resectoscopy appears to be the technique of choice for endometrial polyps >2 cm or with a fundal implant and bipolar electrode excision appears to been preferable for smaller, nonfundal polyps.
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Diagnostic hysteroscopy and saline infusion sonography: Prediction of intrauterine polyps and myomas
Frank Willem Jansen,Cornelis D. de Kroon,Heleen van Dongen,Carolien Grooters,Leoni A. Louwe,Trudy C.M. Trimbos-Kemper +5 more
TL;DR: Diagnostic hysteroscopy and saline infusion sonography are equivalent diagnostic tools for the detection of intrauterine myomas and polyps in patients with abnormal uterine bleeding.
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Fertility-Enhancing Hysteroscopic Surgery
TL;DR: Office hysteroscopy is a powerful tool for the diagnosis and treatment of intrauterine benign pathologies and is a simple, safe, reproducible, effective, quick, well-tolerated, and low-cost surgical procedure.
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Stefano Bettocchi,Luigi Selvaggi +1 more
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Intrauterine surgery using a new coaxial bipolar electrode in normal saline solution (Versapoint): a pilot study.
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How well do perimenopausal patients accept outpatient hysteroscopy? Visual analogue scoring of acceptability and pain in 100 women
Ellis Downes,F Al-Azzawi +1 more
TL;DR: It is demonstrated that outpatient hysteroscopy is well tolerated by perimenopause patients and the advantages of outpatient hysteroscope to the perimenopausal woman are discussed.
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Myomectomies by endo-uterine resection
TL;DR: Endo-uterine resection is a true surgical act, well defined and atraumatic, to perform elective and complete one-stage hysteroscopic myomectomies, sparing normal myometrium, is not easy.
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Hysteroscopic polypectomy in the office without anesthesia
TL;DR: The vaginoscopic approach without a speculum and tenaculum avoids discomfort to patients and ensures complete compliance in hysteroscopy, and all polyps were removed on diagnosis and women were able to resume their normal activity soon after the procedure.
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