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Abstract Background This study aimed to investigate the safety and efficacy of suture fixation of the levonorgestrel-releasing intrauterine device (LNG-IUD) by hysteroscope for the treatment of adenomyosis in patients at high risk of device expulsion, to provide a viable treatment option for these patients. Methods Twenty-one patients with large symptomatic adenomyosis were sewed and fixed with the LNG-IUD in the uterus by hysteroscopy to prevent the device expulsion. Results In this prospective case series, all 21 patients were successfully sewed and fixed with the LNG-IUD in the uterus by hysteroscopy. The amount of menstruation was significantly decreased and dysmenorrhea was significantly relieved in 3, 6, and 12 months after surgery compared with before surgery. Only one patient underwent a laparoscopic hysterectomy due to dysmenorrhea which was not alleviated one month later. Serious IUD complications including expulsion and perforation were not observed. There was no development of new side effects than LNG-IUD insertion. Conclusion Our findings indicate that suture fixation of the LNG-IUD by hysteroscope is a safe, effective, and minimally invasive surgical procedure to prevent the device expulsion. It is a good solution for the treatment of large symptomatic adenomyosis and has shown to be effective in managing symptoms related to adenomyosis.

Background: This study aimed to investigate the safety and efficacy of suture fixation of the levonorgestrel-releasing intrauterine device (LNG-IUD) by hysteroscope for the treatment of adenomyosis in patients at high risk of device expulsion, to provide a viable treatment option for these patients. Methods: Twenty-one patients with large symptomatic adenomyosis were sewed and fixed with the LNG-IUD in the uterus by hysteroscopy to prevent the device expulsion. Results: In this prospective case series, all 21 patients were successfully sewed and fixed with the LNG-IUD in the uterus by hysteroscopy. The amount of menstruation was significantly decreased and dysmenorrhea was significantly relieved in 3, 6, and 12 months after surgery compared with before surgery. Only one patient underwent a laparoscopic hysterectomy due to dysmenorrhea which was not alleviated one month later. Serious IUD complications including expulsion and perforation were not observed. There was no development of new side effects than LNG-IUD insertion. Conclusion: Our findings indicate that suture fixation of the LNG-IUD by hysteroscope is a safe, effective, and minimally invasive surgical procedure to prevent the device expulsion. It is a good solution for the treatment of large symptomatic adenomyosis and has shown to be effective in managing symptoms related to adenomyosis. [ABSTRACT FROM AUTHOR]

Copyright of Laser Technology is the property of Gai Kan Bian Wei Hui and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the differences of different clinical indicators between patients with severe and non-severe intrauterine adhesions （IUA）. Methods Clinical data of 118 patients with IUA diagnosed by hysteroscopy were analyzed retrospectively. According to the AFS scoring standard of IUA, all patients were divided into the severe IUA group （severe group） and mild-moderate IUA group （non-severe group）, and the differences of different clinical indicators between two groups were analyzed. Results Compared with the patients in the non-severe group, the patients in the severe group had more pregnancies, more than two times of uterine curettage, and more times of hysteroscopic resection （all P < 0.05）. There were statistically significant differences between the severe and non-severe groups after induced abortion, hysteroscopic resection, and uterine artery embolization combined with curettage （all P < 0.05）. Among the patients undergoing different times of uterine cavity operations, the difference between the severe and non-severe groups was statistically significant. Compared with the 1-time and 2-time uterine cavity operation groups, the proportion of severe group （85%） in the ≥3-time uterine cavity operation was significantly increased （both P < 0.05）. In the severe group, the proportion of abnormal uterine cavity （heterogenous echoes, continuous interruption, unclear display or adhesion） revealed by transvaginal color Doppler ultrasound was significantly higher than that in the non-severe group （P < 0.05）. Conclusions Induced abortion, hysteroscopic electrosurgery and uterine curettage after uterine artery embolization can increase the risk of IUA. Transvaginal color Doppler ultrasound has good diagnostic value for severe IUA.

Copyright of Journal of New Medicine is the property of Sun Yat Sen University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Endometrial polyps are a main cause of Abnormal Uterine Bleeding (AUB) in premenopausal & postmenopausal women and are suggested by screening transvaginal ultrasound. The current study aimed to determine the effectiveness and acceptability of outpatient hysteroscopic endometrial polypectomy by vaginoscopic approach, and if the technique confers any advantage in terms of patient discomfort and reduction in procedure time over the traditional technique. Methods: This study was a prospective randomized clinical trial, and it was carried out in the Endoscopy Unit in the Department of Obstetrics and Gynecology at Zagazig University Hospitals, in the period from May 2018 to April 2019. Results: There was a statistically significant difference between the traditional and vaginoscopic groups in procedure time as the traditional technique needed more time than vaginoscopic one (7.8 VS 6.1 minutes), and all cases had (100.0%) success rate of polypectomy in both groups without complication. But histopathology results discovered one case (2.5%) of all study groups had adenocarcinoma and the patient was sent to the oncology unit for further evaluation and appropriate management. Conclusions: Office vaginoscopic polypectomy for small polyp is a feasible and safe minimally invasive procedure. [ABSTRACT FROM AUTHOR]

Herlyn–Werner–Wunderlich syndrome (HWWS) is a rare congenital malformation characterized by uterus didelphys, unilateral blind hemivagina, and ipsilateral renal agenesis. The obstructed vagina affects menstrual flow, leading to related clinical symptoms after menarche. However, the age of onset, initial symptoms, and clinical complications differ among patients owing to the different types of vaginal septum. Herein, we report 2 cases. The first case is of a 20-year-old woman who presented with fever; she was diagnosed with vaginitis and pelvic inflammation due to the vaginal septum with ostiole. The second case is of a 12-year-old girl who complained of abdominal pain; she was diagnosed as having pelvic inflammation, omentitis, and suppurative appendicitis due to the atretic vaginal septum.

Background: The purpose of this study was to compare the effect of pre- and post-treatment furosemide on reducing intravascular absorption syndrome in complex hysteroscopic leiomyoma surgery. Methods: This randomized controlled study enrolled 62 patients who underwent hysteroscopic leiomyoma surgery in Fuxing Hospital, Capital Medical University. Patients were randomly allocated to pre- and post-treatment furosemide groups. Information on patient age, body mass index, sum of the three diameters of the uterus, sum of diameter of submucosal myoma, and intimal thickness were recorded. The mean arterial pressure and heart rate were recorded at entry to the operating room, after anesthesia induction, at the end of operation, and after laryngeal mask pulled out. The duration of anesthesia, recovery time after withdrawal of anesthetic drug, amount of sufentanil, amount of propofol, amount of uterine perfusion fluid, the amount of perfusion fluid flowing out, the actual amount of fluid intake, the proportion of pulmonary diffuse B-line in perioperative period, and uterine perfusion pressure during operation were also recorded, together with postoperative adverse reactions (drowsiness, nausea, vomiting, chills). Results: No significant differences were observed between the pre- and post-treatment groups in terms of patient age, body mass index, sum of the three diameters of the uterus, sum of diameter of submucosal myoma, and intimal thickness. The mean arterial pressure and heart rate at the four different time points were not significantly different between the two groups, nor were there any significant differences in the duration of anesthesia, the amount of sufentanil, the amount of propofol, the amount of intrauterine perfusion fluid, the amount of perfusion fluid flowing out, the actual amount of fluid intake, the intrauterine perfusion pressure, or the incidence of postoperative drowsiness, nausea and vomiting. However, pre-treatment with furosemide was associated with a significantly reduced recovery time (p = 0.037) and incidence of postoperative chills (p = 0.032) compared to the post-treatment group. Furosemide significantly reduces the number of B-lines. Conclusions: Furosemide preconditioning can reduce the recovery time and occurrence of postoperative chills, both of which are conducive to better postoperative recovery. Clinical Trial Registration: The study was registered at https://www.chictr.org.cn (registration number ChiCTR2200062840).

Congenital external cervical os stenosis is a form of Mullerian duct abnormality which is rare in virginal adolescents. Pre-operatively, two non-sexually active adolescents of 12 and 14 years of age, with history of light menses and severe lower abdominal pain for 2 and 4 months respectively, were diagnosed with an obstructed, oblique vaginal septum syndrome. However, at operative vaginoscopy, a single cervix with a duplicated cervical os and unilateral cervical stenosis was discovered, confirming the diagnosis of a complete uterine septum involving the cervix and unilateral cervical stenosis. They were treated by expanding the affected external cervical os while leaving the hymen intact. A year following the treatment, follow up results found no recurrence of symptoms. Operative vaginoscopy using a hysteroscope is crucial and recommended for the diagnosis and treatment of congenital external cervical os stenosis in virginal adolescents. [ABSTRACT FROM AUTHOR]

A urinary bladder stone in young adults is uncommon. Dislocation of an IUD to adjection organs is a rare condition. We present a case of a 28-year female with a chief complaint of right side pelvis discomfort, off and on with the urinary system. In this case, we performed cystoscopy assisted laser lithotripsy, hysteroscopy to localize and remove IUD, transurethral resectoscope for removing IUD residual, and resection sinus tract.This article's objective states that the multidisciplinary approach to removing dislocated IUD is safe and effective and raises awareness of forgotten contraceptive devices and their potential complications.

Background: Almost all cases of cervical cancer can be attributed to human papillomavirus (HPV) infection. The loop electrosurgical excision procedure (LEEP) is widely used to treat HPV-mediated disease; thus, cervical cancer is highly preventable. However, LEEP does not necessarily clear HPV rapidly and may affect the accuracy of the results of ThinPrep cytology test (TCT) and cervical biopsy due to the formation of cervical scars., Case Summary: A 40-year-old woman underwent LEEP for cervical intraepithelial neoplasia grade 1 approximately 10 years ago. Subsequent standard cervical cancer screening suggested persistent HPV-52 infection, but TCT results were negative. Cervical biopsy under colposcopy was performed thrice over a 10-year period, yielding negative pathology results. She developed abnormal vaginal bleeding after sexual activity, persisting for approximately 1 year, and underwent hysteroscopy in our hospital. Histopathologic evaluation confirmed adenocarcinoma in situ of the uterine cervix., Conclusion: Patients with long-term persistent, high-risk HPV infection and negative pathology results of cervical biopsy after LEEP are at risk of cervical cancer. Hysteroscopic resection of cervical canal tissue is recommended as a supplement to cervical biopsy because it helps define the lesion site and may yield a pathologic diagnosis., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Hysteroscopy is the gold standard for diagnosing and managing endocervical and endometrial pathology. The development of today’s hysteroscopy begins in the early 19th century. Initially, hysteroscopy was used solely for diagnostics. Operative hysteroscopy surfaced with the development of distension media, the hysteroscope, and its associated instruments. Operative hysteroscopy underwent the most significant development in the early 1970s, when new hysteroscopes were introduced, and the distension media became more widely used. A multitude of hysteroscopic procedures are performed with the common goal of removing pathological changes in the endometrial cavity. In the 1980s, small cameras, also known as “chip” cameras, were developed, leading to the transition of endoscopy into videoendoscopy. Bettocchi revolutionized modern hysteroscopy in 1996 when he used the first operative office hysteroscope. Operative resectoscopes, containing monopolar and bipolar energy, were also constructed. Hysteroscopic morcellators have been in use since the beginning of the 21st century. Today’s modern hysteroscopy represents a safe diagnostic and operative endoscopy.

Granular cell tumors (GCTs) are usually benign and occur primarily in the trunk and head. Vaginal tumors are rare, particularly in children. A 9-year-old girl was admitted with irregular vaginal bleeding for 1 year. The bleeding had worsened in the previous 1 month. B-ultrasound and computed tomography showed a round mass in the vagina. We performed vaginoscopy using a hysteroscopic exploration and tumor resection via an open technique. The pathology of the resected tumor confirmed a vaginal wall GCT. No recurrence was noted in the following 16 months. To our knowledge, our prepubescent girl is the youngest patient with GCT in the literature. Histopathological evaluation and complete tumor resection with clear margins is the primary treatment for benign or malignant GCTs. [ABSTRACT FROM AUTHOR]

The objective was to assess the method of chromopertubation (CPT) in cases of difficult cannulation to minimize the false-negative cases of tubal block. We had performed laparoscopy and hysteroscopy in 66 females as infertility workup. In all these females, cannulation through the cervical canal was difficult and tubal patency test showed tubal block with Leech–Wilkinson cannula. Then, through the inlet of hysteroscope, methylene blue dye was injected and the patency of tubes was assessed again. In 59 out of the 66 females, we observed that when cannulation and dilation of cervix was difficult, then CPT with hysteroscope showed positive tubal patency test. Introduction of hysteroscope with visualization bypasses cervical factor and reduces false-negative results of tubal patency that is an added advantage of hysteroscope that has not been reported earlier.

Objective: This network meta-analysis compared treatment via laparoscopy, hysteroscopy (HP), combined laparoscopy with HP (LH), and vaginal repair (VR) for reducing intermittent abnormal uterine bleeding and cesarean scar defect (CSD) diverticulum depth in patients with CSD.Data Sources: Electronic databases (PubMed, EMBASE, The Cochrane Central Register of Controlled Trials, MEDLINE, ClinicalTrials.gov, Chinese Biomedical Literature Database, and China National Knowledge Integrated) were searched for articles published through June 13, 2018.Methods Of Study Selection: The search included randomized controlled trials (RCTs) and observational studies of surgical treatment for CSD. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were reported. RCTs were evaluated by the Cochrane risk-of-bias tool, observational studies by Risk of Bias in Nonrandomized Studies of Intervention, and overall evidence quality by grade. Data were analyzed by STATA (version 15.0; StataCorp, College Station, TX) and R software for windows (version 3.5.0; R Core Team, 2018).Tabulation, Integration, and Results: Ten studies (n = 858; 4 RCTs and 6 observational studies) were included. Patients who underwent uterine diverticulum resection by LH had a shorter duration of abnormal uterine bleeding than those by HP (SMD = 1.36, 95% CI, 0.37-2.36; p = .007) and VR (SMD = 1.58, 95% CI, 0.97-2.19; p <.0001). LH reduced the CSD diverticulum depth more than VR (SMD = 1.57, 95% CI, 0.54-2.61; p = .003). There was no significant difference in efficacy among the surgical procedures.Conclusion: LH reduced intermittent abnormal uterine bleeding and scar depth more than the other surgical interventions. Larger clinical trials are warranted to verify this analysis. [ABSTRACT FROM AUTHOR]

The breaking of the tip of the 'Karman cannula' inside the uterine cavity while performing suction curettage for missed abortion is an extremely rare phenomenon. Ideally, such foreign bodies should be removed using a hysteroscope under direct vision. In the absence of a hysteroscope, retrieval may be attempted using retrieving forceps either under ultrasonographic guidance or blindly. A 26-year-old female patient presented as a case of missed abortion at 6 weeks of gestation and underwent suction and evacuation. The tip of the cannula broke during the procedure. Multiple attempts were made to retrieve the cannula tip using forceps under ultrasound guidance without success. The patient was planned to be shifted to a higher centre as the hysteroscope was not available at this centre. However, owing to travel restrictions and lockdown imposed for the coronavirus disease 2019 (COVID 2019) pandemic, the patient could not be transferred. An innovative method using the fibre optic bronchoscope was devised by the otorhinolaryngologist and gynaecologist, and the retained impacted cannula was safely removed from the left uterine cornu under vision. [ABSTRACT FROM AUTHOR]

Hysteroscopy is becoming fairly common in most centers these days, both as a diagnostic and therapeutic tool especially for short day-care procedures, reducing unnecessary hospital admissions and overuse of resources. However, these procedures are not without complications, and some could be delayed and potentially fatal if a high index of suspicion is not maintained. One such rare yet one with a high mortality among urological patients is the transurethral resection syndrome on which there is a cornucopia of literature in the form of articles and chapters. There are very few highlighting a similar syndrome of sorts called the operative hysteroscopy intravascular absorption syndrome. Here, we describe one such case, and in brief, the anesthetic management options for hysteroscopic procedures to prevent such a complication.

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. In the hysteroscopic surgical procedure, the laminaria was cut, and the two halves were excised using resectoscope electrodes and hooked to the electrodes for removal. Thereafter, a year later, she conceived spontaneously and gave birth to a baby by cesarean delivery due to the arrest of labor progress. We are the first to present a pregnant case after the removal of a six-year retained laminaria., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Miyamori et al.)

Objective: To find out the clinical effects of post hysteroscopic progesterone hormone therapy in the treatment of endometrial polyps in terms of clinical outcome and the expression of endometrial Vascular Endothelial Growth Factor (VEGF).Methods: Ninety-eight patients who were confirmed as endometrial polyp in the hospital from April 2014 and December 2016 were selected and divided into treatment group and a control group using random number table, 49 in each group. Patients in both groups were given hysteroscopic operation. Patients in the treatment group were treated by progesterone hormone drugs after hysteroscopic operation, while patients in the control group were not given progesterone hormone. The changes of menstrual blood volume, menstrual cycle and expression of VEGF were compared between the two groups after treatment, and the recurrence condition, thickness of endometrium and hemoglobin were followed up one year after treatment.Results: The pictorial blood loss assessment chart (PBAC) scores of patients in the two groups had no significant difference before treatment (P>0.05); but the score of the treatment group was much lower than that of the control group. The improvement rate of menstrual cycle of the treatment group was much higher than that of the control group, and the difference had statistical significance (P<0.05). Compared to before treatment, the serum VEGF level of the patients in both groups had a remarkable decline in the 1st, 3rd and 6th month after treatment, and the difference had statistical significance (P<0.05). The difference of the serum VEGF level between the two groups in the 1st and 3rd month after treatment had no statistical significance (P>0.05). The serum VEGF level of the treatment group was notably lower than that of the control group six months after treatment, and the difference had statistical significance (P<0.05). The follow-up results demonstrated that the treatment group had smaller thickness of endometrium and higher level of hemoglobin compared to the control group, and the recurrence rate of the treatment group was lower than that of the control group (P<0.05).Conclusion: Post hysteroscopic progesterone hormone therapy has favorable clinical effect in treating endometrial polyps as it can effectively prevent the recurrence of endometrial polyps, relieve the level of hemoglobin and reduce endometrial thickness. [ABSTRACT FROM AUTHOR]

Objective：To explore the effect of pharmacological preconditioning and uterine arterial embolization on the curative effect of hysteroscopic uterus curettage for cesarean scar pregnancy (CSP). Methods：The clinical data of 120 patients with CSP treated in the department of gynaecology of Xinyang Central Hospital of Henan Province from January 2016 to November 2017 were collected retrospectively. According to different treatment methods, the patients were divided into the study group (72 cases) and the control group (48 cases). The two groups were treated by pharmacological preconditioning with mifepristone + methotrexate (MTX) and uterine arterial embolization, respectively, and then they were treated by hysteroscopic uterus curettage. The completion of operation, postoperative recovery progress and occurrence of complications were observed and statistically analyzed. Results：There was no statistically significant difference in the incidence of secondary uterus curettage, massive hemorrhage, conversion to laparotomy or hysterectomy, operative time or intraoperative blood loss between the 2 groups (P＞0.05). The postoperative length of hospital stay, vaginal bleeding time, menstrual recovery time and blood β- subunit of human chorionic gonadotropin (β-HCG) recovery time of the study group were significantly shorter than those of the control group (P＜0.05). In the study group, the main complications were gastrointestinal reactions, and the incidence rate (22.22%) was significantly higher than that in the control group (7.14%) (P＜0.05). The incidence rates of fever and pain in the control group (18.75% and 33.33%) were significantly higher than those in the study group (2.78% and 8.33%) (P＜0.05). There was no statistically significant difference in the incidence of infection, liver function damage, intrauterine adhesion or uterine perforation between the 2 groups (P＞0.05). Conclusions：The application of pharmacological preconditioning with mifepristone+ MTX before hysteroscopic uterus curettage could improve the clinical curative effect of patients with CSP. Postoperative recovery is fast and complications are few. Attention should be paid to control of complications such as gastrointestinal reactions. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical value of transvaginal ultrasonography and hysteroscopy in the diagnosis of en­dometrial lesions, to provide a theoretical basis for the clinical diagnosis of endometrial lesions. Methods: A total of 158 cases of suspected endometrial lesions, who were treated in Beijing First Flospital of Integrated Chinese and Western Medicine from March 2011 to March 2014, were selected and were detected by transvaginal sonography and hysteroscopy respectively. The diagnostic value of the two meth­ods was compared with the results of pathological diagnosis as the gold standard. Results: In the results of pathological examination, 143 patients were diagnosed as endometrial lesions, including 23 cases of endometrial hyperplasia (16.08%), 31 cases of endometrial polyps (21.68%), 24 cases of uterine submucosal myoma(16.78%), 19 cases of endometrial carcinoma(13.29%), 46 cases of chronic nonspecific endometritis(32.17%). The accuracy rate(94.41%) of hysteroscopy in the diagnosis of endometrial lesions was higher than that(81.12%) of transvaginal ultrasound, and the difference was significant (P<0.05); there were no statistical differences in the accuracy rate of the di­agnosis of submucosal myoma of uterus and endometrial carcinoma between transvaginal ultrasonography and hysteroscopy(P>0.05), and the accuracy rate of transvaginal ultrasound in endometrial hyperplasia, endometrial polyps and chronic nonspecific endometritis was lower than that of hysteroscopy, and the difference was statistically significant (P<0.05). The specificity of transvaginal ultrasonography in the diagnosis of endometrial lesions was lower than that of hysteroscopy (P<0.05), but there were no significant differences in sensitivity and AUC between the two methods (P>0.05). Conclusion: Transvaginal ultrasonography is a simple and effective method in diagnosis of endometrial diseases, and Flysteroscopy has higher accuracy and higher specificity in diagnosis of endometrial diseases. [ABSTRACT FROM AUTHOR]

Study Objective: To evaluate the accuracy of traditional blind uterine sounding in measuring uterine cavity length (UCL), compared with measurement by hysteroscopic guidance.Design: A cross-sectional descriptive study (Canadian Task Force classification III).Setting: Academic multispecialty medical center.Patients: Fifty-eight women undergoing elective hysteroscopic procedures.Intervention: UCL measurement.Measurements: UCL measurements were obtained by the traditional blind sounding technique and by hysteroscopically directed measurement. Hysteroscopic measurements were assumed to represent true uterine cavity length. Differences between the 2 measurements were calculated to analyze error and bias.Results: Mean UCL for blind sounding and hysteroscopically directed measurements were 80.81 mm and 86.55 mm, respectively. The magnitude of error between measurements was >10 mm in 36.2% of cases, with underestimation of true UCL in 55.17% of cases.Conclusion: True UCL is underestimated by blind sounding, and the frequency, magnitude, and direction of error may be greater than are clinically acceptable. [ABSTRACT FROM AUTHOR]

Objective: To explore the efficacy of hysteroscope combined with laparoscope combined with in the treatment of salpingemphraxis infertility and differences in efficacy of different ages and types of obstruction. Methods: A total of 70 patients with salpingemphraxis infertility, who were admitted to Dazhou Integrated Traditional Chinese and Western Medicine Hospital of Sichuan Province from February 2013 to February 2015, were randomly divided into control group (n=35) and observation group (n=35). The control group (n=35) underwent dredge tubal operation guided by hysteroscope, while the observation group was received laparoscopic treatment on the treatment plan of the control group. The clinical effects of the two groups were compared, at the same time, the clinical effects of hysteroscopy combined with laparoscopy on different age groups and different types of obstruction were compared. Results: The patency of fallopian tube in the observation group was better than that in the control group (Z= -2.207, P=0.027). The fallopian tube recanalization rate in the observation group was higher than that in the control group [82.86%vs60.00%], the difference was statistically significant (x2=4.480, P=0.034). There was no difference in the incidence of complications after treatment between the two groups (P>0. 05). The overall pregnancy rate in the observation group 1 year after treatment was higher than that in the control group [82.86%vs57. 14%], the difference was statistically significant (P<0.05). The intrauterine pregnancy rate in the observation group was higher than that in the control group [80.00%vs51.43%], the difference was statistically significant (P<0.05). There were no statistical differences in tubal recanalization rate, overall pregnancy rate, intrauterine pregnancy rate of patients between ≤ 30 years and >30 years (P>0.05). The fallopian tube recanalization rate, total pregnancy rate and uterine pregnancy rate in the patients with ampulla or umbrella obstruction were higher than those in interstitial obstructive patients and isthmus obstructive patients,the difference was statistically significant (P<0. 05). Conclusion: Hysteroscope combined with laparoscope in the treatment of salpingemphraxis infertility has better clinical efficacy, and the recanalization rate and pregnancy rate of fallopian tube are obviously improved,with less postoperative complications and the highest recanalization rate of fallopian tube, ampulla or umbrella block. [ABSTRACT FROM AUTHOR]

Objective: To explore the feasibility and efficacy of hysteroscopic excision of myometrial adenomyotic lesions.Design: A case-series study.Setting: A university medical centre.Population: 51 women with myometrial adenomyosis completed the study.Methods: The patients underwent hysteroscopic excision of myometrial adenomyosis and were followed up for 24 months. The degree of symptoms, uterine volume, and serum CA125 concentrations were recorded. The degrees of menorrhagia and dysmenorrhea were evaluated.Results: The mean MVJ and VAS score significantly decreased from the baseline. The uterine volume and the serum CA125 significantly reduced.Conclusions: Hysteroscopic excision of myometrial adenomyotic lesions is feasible and may be effective in improving symptoms.Tweetable Abstract: Hysteroscopic excision is feasible for patients with symptomatic adenomyosisis. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical effect of hysteroscope in treatment of intrauterine adhesion(IUA) and analyze the risk factors for IUA. Methods: A total of 213 patients, who underwent abortion in University City Affiliated Hospital of Medical University Of Chongqing from June 2014 to June 2015, were selected and divided into adhesion group(n=103) and no adhesion group(n=110) according to the status of IUA, and the adhesion group underwent surgery under hysteroscope. The basic information and relevant disease history of the two groups were recorded. The risk factors of IUA and the curative effectof adhesion group were analyzed. Results: The single factor analysis showed that there were significant differences in the gravidity times, negative pressure of suck palace and time of suck palace between the two groups(P<0.05). Multiple factor analysis showed negative pressure of suck palace and time of suck palace were the risk factors for IUA(P<0.05). The total effective rates of mild, moderate and severe IUA patients were 100. 00%, 88. 24% and75. 00% respectively after operation under hysteroscopy, the differences were statistically significant(x2=13. 870, P=0.001). Conclusion:Negative pressure of suck palace and time of suck palace are the risk factors of IUA, and hysteroscope has a good effect in treatment of IUA, which is worthy of clinical application. [ABSTRACT FROM AUTHOR]

Hysteroscopy is becoming fairly common in most centers these days, both as a diagnostic and therapeutic tool especially for short day-care procedures, reducing unnecessary hospital admissions and overuse of resources. However, these procedures are not without complications, and some could be delayed and potentially fatal if a high index of suspicion is not maintained. One such rare yet one with a high mortality among urological patients is the transurethral resection syndrome on which there is a cornucopia of literature in the form of articles and chapters. There are very few highlighting a similar syndrome of sorts called the operative hysteroscopy intravascular absorption syndrome. Here, we describe one such case, and in brief, the anesthetic management options for hysteroscopic procedures to prevent such a complication. [ABSTRACT FROM AUTHOR]

Study Objective The purpose of this article is to review the published literature and perform a systematic review to evaluate the effectiveness and feasibility of the use of a hysteroscope for vaginoscopy or hysteroscopy in diagnosing and establishing therapeutic management of adolescent patients with gynecologic problems. Design A systematic review. Setting PubMed, Web of science, and Scopus searches were performed for the period up to September 2013 to identify all the eligible studies. Additional relevant articles were identified using citations within these publications. Participants Female adolescents aged 10 to 18 years. Results A total of 19 studies were included in the systematic review. We identified 19 case reports that described the application of a hysteroscope as treatment modality for some gynecologic conditions or diseases in adolescents. No original study was found matching the age of this specific population. Conclusions A hysteroscope is a useful substitute for vaginoscopy or hysteroscopy for the exploration of the immature genital tract and may help in the diagnosis and treatment of gynecologic disorders in adolescent patients with an intact hymen, limited vaginal access, or a narrow vagina. [ABSTRACT FROM AUTHOR]

Background: Hysteroscopy is an efficient procedure of management in many gynecologic conditions. There are few published data on hysteroscopy and recurrent pregnancy loss especially in developing countries. Objectives: To assess hysteroscopic findings in patients with consecutive miscarriages, and to compare the prevalence of uterine abnormalities between women with two and three or more miscarriages. Methods: Three hundred and twenty four women with two or more consecutive miscarriages were enrolled in the study. All participants underwent a diagnostic hysteroscopy. Congenital (arcuate uterus, septate uterus, unicornuate uterus) and acquired uterine abnormalities (intrauterine adhesions, polyp and submucous myoma) were documented. The findings were compared between the groups of women with two miscarriages and women who had three or more miscarriages. Results: Out of a total of 324 women [their mean (SD) of the age and gravidity was 28.3 (6.5) years and 5.1(1.5), respectively] 135 (41.7%) and 189 (58.3%) had two consecutive miscarriages and three or more consecutive miscarriages, respectively. While 194 (59.9%) women had no pathological findings on hysteroscopy, 130 (40.1%) women were found to have uterine anomalies. The congenital anomalies were found in 79 (24.4%) and the acquired were in 51 (15.7%) women. In comparison with women who had three or more miscarriages, women who had two miscarriages had significantly higher number of congenital anomalies, 53/135 (39.2%) vs. 26/189 (13.8%), P < 0.001. However there was no significant difference in the acquired anomalies between women who had two miscarriages and women who had three or more miscarriages. Conclusions: Patients who had two consecutive miscarriages were found to have a higher prevalence of congenital anatomical abnormalities Diagnostic hysteroscopy should be carried out after two such miscarriages. [ABSTRACT FROM AUTHOR]

The objective was to assess the method of chromopertubation (CPT) in cases of difficult cannulation to minimize the false-negative cases of tubal block. We had performed laparoscopy and hysteroscopy in 66 females as infertility workup. In all these females, cannulation through the cervical canal was difficult and tubal patency test showed tubal block with Leech–Wilkinson cannula. Then, through the inlet of hysteroscope, methylene blue dye was injected and the patency of tubes was assessed again. In 59 out of the 66 females, we observed that when cannulation and dilation of cervix was difficult, then CPT with hysteroscope showed positive tubal patency test. Introduction of hysteroscope with visualization bypasses cervical factor and reduces false-negative results of tubal patency that is an added advantage of hysteroscope that has not been reported earlier. [ABSTRACT FROM AUTHOR]

Objective: To explore the diagnosis and treatment of duplex uterus. Methods: Totally 16 cases with duplex uterus were diagnosed and treated with hysteroscopy and laparoscopic technology simultaneously. Results: Sixteen cases were finally diagnosed with hysteroscopy and B-ultrasound examination. Of the 16 cases, 12 cases underwent vaginal septum resection and hysteroscopic transcervical resection of septum (TCRS), 2 cases underwent lysis of pelvic adhesions, vaginal septum resection and hysteroscopic transcervical resection of septum, and 2 unmarried cases underwent hysteroscopy in women with intact-hymen. All the 16 cases underwent the surgery successfully. Conclusion: Hysteroscopy in combination with B-ultrasound examination is a major option for duplex uterus diagnosis, and hysteroscopic transcervical resection of septum and vaginal septum resection under B-ultrasound monitoring is the primary surgery treatment alternative for duplex uterus. [Copyright &y& Elsevier]

Abstract: Study objective: To assess the efficacy of sublingual buprenorphine in the relief of pain associated with office hysteroscopy. Design: Prospective, randomized study (Canadian Task Force classification I). Setting: Tertiary medical center. Patients: One hundred sixty-four women referred for office hysteroscopy from September 2003 through March 2004. Intervention: Before hysteroscopy, 80 women received a tablet of buprenorphine (group A), and 84 women received a placebo (group B). Their pain sensations were evaluated on a 10-cm visual analog scale, and they were asked about the adverse reactions and level of satisfaction on the following day. Measurements and main results: The pain score in group A was 3.3 ± 1.1, which was similar to 3.2 ± 1.3 in group B. The pain scores in subgroups of women also were similar within the same group and between the two groups. Thirty-one women (38.8%) in group A reported adverse reactions, including nausea, vomiting, and drowsiness, while none in group B reported any adverse reactions. Conclusion: Office hysteroscopy with a 3.1-mm flexible hysteroscope is a well-tolerated procedure. Sublingual buprenorphine is not helpful in relieving the pain associated with hysteroscopy but is associated with significant adverse reactions. [Copyright &y& Elsevier]

Background: Levonorgestrel-releasing intrauterine systems (LNG-IUSs) gradually release levonorgestrel into the uterus and is effective against hypermenorrhoea and dysmenorrhea. Complications associated with the insertion include expulsion, displacement, and uterine perforation. Ultrasonic identification of copper intrauterine devices (IUDs) is possible due to echogenicity from the copper coils. However, the barium sulfate coatings of LNG-IUSs do not always provide hyperechoic images. Both barium sulfate and copper are radiopaque and clearly identifiable on X-ray. Thus, X-ray imaging is required to locate LNG-IUSs., Case Summary: A 46-year-old woman with hypermenorrhoea due to submucosal myomas was treated with LNG-IUS at another hospital. Three LNG-IUS insertions had apparently been followed by spontaneous expulsion, although objective confirmation using imaging was not performed. The patient was referred to our institution for surgery. At the first visit, there appeared to be no device in the uterus, and none was observed on transvaginal ultrasound. However, two LNG-IUSs were observed in the pelvis on abdominal plain X-rays prior to surgery. Hysteroscopic myomectomy was performed, and the two LNG-IUSs were found to have perforated the myometrium. The devices were safely removed during surgery, and the submucosal myomas were also removed. The perforated section of the myometrium was minimal+ADs- therefore, a repair operation was not required., CONCLUSIONPlain abdominal X-rays facilitate the determination of whether an LNG-IUS is in the uterine cavity. Therefore, it is important to confirm a device's location, regardless of whether spontaneous expulsion is suspected, prior to inserting another device., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflicts of interest., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)

Objective To explore the diagnosis and treatment for uterine septum， and the effect on pregnancy before and after the operation. Methods Fifty-three patients with uterus septum at the third people's hospital in Yunnan province from January 2010 to December 2011 were collected and analyzed retrospectively. All patients were diagnosed by HSG, B ultrasonic, and a combined diagnostic laparoscopy and hysteroscopy. After resection of uterus septum and putting of intrauterine device, patients were given adjuvant artificial menstrual cycle for three months and periodical follow-up. When the second hysteroscopic inspection was applied, the intrauterine device was removed. Results After hysteroscopy combined with laparoscopy， the rate of spontaneous abortion decreased from 85.4% to 35.1%, and the rates of pregnancy and parturition increased （35.8% vs 81.1% and 5.6% vs 48.6%, respectively). Conclusion Diagnosed by HSG, B ultrasonic, and hysteroscopy combined with laparoscopy, operated with resection of uterus septum and putting of intrauterine device, treated with artificial menstrual cycle for 3 months, and then reexamined by hysteroscopy and removing of intrauterine device, which could be regarded as a good choice to diagnose and treat the uterus septum. It can effectively improve the rates of pregnancy and parturition. [ABSTRACT FROM AUTHOR]

Abstract: The vaginal speculum can be safely and efficaciously replaced by the less traumatic small diameter continuous flow hysteroscopic vaginoscopy for diagnosis and treatment of genital tract lesion in children and adolescents. [Copyright &y& Elsevier]

To find out the importance of hysteroscopy in patients with irregular bleeding on HRT. Retrospective case note analysis of women attending outpatient hysteroscopy clinic between 1 August 2000 and 31 July 2001. A total of 352 patients were referred to hysteroscopy clinic at Castle Hill Hospital, UK. The mean age of the patients was 57 years (range 48–69 years). The mean duration of HRT usage was 3.5 years (range 2–10 years). Seventy-seven (22%) patients had irregular bleeding on HRT, where hysteroscopy showed normal endometrial appearance. All these patients underwent an endometrial biopsy. Eleven (14%) of the patients had an intrauterine polyp and a polypectomy was performed in each case. The histology results of the endometrial biopsy/polyp were as follows: 42 had atrophic or inactive endometrium; 11 had benign endometrial polyp; 10 had insufficient sample all in women with hysteroscopically normal endometrial cavities; 8 had HRT effect; and 6 had progestogenic effect. There were no cases of malignancy. The incidence of significant pathology in patients with irregular bleeding on HRT is very low; however, benign polyps are common. It is better to adopt “see and treat” policy, where facilities are available. If facilities are not available, consider ultrasound scan or saline infusion sonohysteroscopy and target appropriately. [ABSTRACT FROM AUTHOR]

Objective: To show that hysteroscopy is a feasible and safe method of evaluation in females with limited vaginal access. Design: Retrospective review of two patients who received hysteroscopy for evaluation of uterus didelphys with hemivagina and a cervical polyp. Setting: Private hospital. Patient(s): Two patients with either a vagina septum or cervical polyp. Intervention(s): Hysteroscopy for visualization and resection. Main Outcome Measure(s): Resection of a vagina septum and cervical polyp. Result(s): No more cyclic dysmenorrhea in the patient with uterus didelphys and cessation of abnormal bleeding in the patient with a cervical polyp. Our results suggest that hysteroscopy can provide precise visualization of vagina and cervical lesions if the approach is difficult with decreased access, and allows concurrent treatment of pathologic conditions accordingly. Conclusion(s): Hysteroscopy is favorable in the diagnosis and treatment of vaginal and cervical lesions in women with limited vaginal access because of age or a narrower vagina. In the Eastern culture, it is very important for females to maintain their state of virginity signified by an uninjured hymen ring. This problem is solved, as hysteroscopy allows the evaluation of malformations of the female genital tract. [Copyright &y& Elsevier]

Study Objective: To investigate the number and type of adverse events associated with hysteroscopic morcellation of intrauterine disease., Design: Systematic review of Manufacturer and User Device Experience (MAUDE) database from 2005 to June 2014 (Canadian Task Force classification III)., Setting N/a Patients: Women undergoing hysteroscopic surgery for removal of intrauterine polyps or myomas with use of a reciprocating morcellator., Interventions: The MAUDE database was searched for the key words "Hysteroscope," "Hysteroscopic reciprocating morcellator," "Interlace," "MyoSure," "Smith & Nephew," and "TRUCLEAR," to identify reported incidences of device malfunction, injury, or death. A total of 119 adverse events were analyzed. Reports were reviewed individually and categorized by date of occurrence, type of morcellation device, type of complication, and a brief description. Each company was contacted to provide an estimate of the number of procedures performed or units sold to date., Measurements and Main Results: From 2005 to June 2014, 119 adverse events were reported to the MAUDE database. On the basis of severity, adverse events were categorized as major or minor complications. Major events included intubation/admission to an intensive care unit (n = 14), bowel damage (n = 12), hysterectomy (n = 6), and death (n = 2). Minor events included uterine perforation requiring no other treatment (n = 29), device failure (n = 25), uncomplicated fluid overload (n = 19), postoperative bleeding controlled using noninvasive measures (n = 6), and pelvic infection (n = 4). These events were then categorized according to manufacturer. The number of adverse events reported to the MAUDE database was divided by the total units sold as a surrogate for the estimated number of procedures performed. Understanding the limitation of the numbers used as a numerator and denominator, we concluded that adverse events complicated hysteroscopic morcellation in <0.1% cases., Conclusions: The suction-based, mechanical energy, rotating tubular cutting system was developed to overcome adverse events that occur during traditional resectoscopy. On the basis of acknowledged limited information from the MAUDE database, it seems that life-threatening complications such as fluid overload, uterine perforation, and bleeding do occur with hysteroscopic morcellation but less frequently than with traditional electrocautery., (Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.)

Study Objective: Cervical stenosis can be an impediment to embryo transfer (ET) and intrauterine insemination (IUI). We propose a technique of hysteroscopic cervical resection to overcome cervical stenosis., Design: Prospective clinical study (Canadian Task Force classification III)., Setting: Private general hospital., Patients: Forty-three infertile women in whom trial ET or IUI had failed with 3 available catheters., Interventions: The procedure was performed with a hysteroscope under ultrasound guidance. Starting from the external os, the loop electrode gradually resected protrusions and cervical tissue until the hysteroscope could enter the uterine cavity. Repeat trial ET/IUI was performed 1 month later. The women who became pregnant underwent sonographic measurement of the cervical length and dilatation in the second and third trimesters., Measurements and Main Results: Excluding 13 patients in whom the sound could pass through the cervical canal after anesthesia, 30 patients were included for analysis. The procedure failed in 1 patient (3.3%). The mean operation time was 18.0 (±7.4) minutes. Repeat trial ET/IUI was successful in all patients. There were 5 twin pregnancies and 9 singleton pregnancies after IUI or ET. From the 5 women with twin pregnancies; 2 underwent premature delivery at 34 weeks; and 3 underwent elective cesarean delivery at 35, 36, and 37 weeks, respectively. From the 9 women with singleton pregnancies, 1 underwent cesarean section at 36 weeks because of preeclampsia, and the other 8 delivered at term., Conclusion: Hysteroscopic cervical resection is a safe and effective treatment for cervical stenosis., (Copyright © 2013 AAGL. Published by Elsevier Inc. All rights reserved.)