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Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(6):325-332
To evaluate the insertion of the hysteroscopic intratubal sterilization device for female sterilization concerning the technique and the feasibility.
Retrospective study with data collection of medical records of 904 patients who underwent device insertion between January and September 2016 in a public hospital in Rio de Janeiro (Brazil) with data analysis and descriptive statistics.
In 85.8% of the cases, the uterine cavity was normal, and themost commonlydescribed findings upon hysteroscopy were synechiae (9.5%). The procedure lasted an average of 3.56minutes (range: 1 to 10minutes), and the pain was considered inexistent or mild in 58,6% of the cases, mild or moderate in 32,8%, and severe or agonizing in less than 1% (0.8%) of the cases, based on a verbal scale ranging from 0 to 10. The rate of successful insertions was of 85.0%, and successful tubal placement was achieved in 99.5% of the cases. There were no severe complications related to the procedure, but transient vasovagal reactions occurred in 5 women (0.6%).
Female sterilization performed by hysteroscopy is a safe, feasible, fast, and well-tolerated procedure. The rates of successful insertions and tubal placements were high. There were few and mild adverse effects during the procedure, and there were no severe complications on the short term.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(6):325-332
To evaluate the insertion of the hysteroscopic intratubal sterilization device for female sterilization concerning the technique and the feasibility.
Retrospective study with data collection of medical records of 904 patients who underwent device insertion between January and September 2016 in a public hospital in Rio de Janeiro (Brazil) with data analysis and descriptive statistics.
In 85.8% of the cases, the uterine cavity was normal, and themost commonlydescribed findings upon hysteroscopy were synechiae (9.5%). The procedure lasted an average of 3.56minutes (range: 1 to 10minutes), and the pain was considered inexistent or mild in 58,6% of the cases, mild or moderate in 32,8%, and severe or agonizing in less than 1% (0.8%) of the cases, based on a verbal scale ranging from 0 to 10. The rate of successful insertions was of 85.0%, and successful tubal placement was achieved in 99.5% of the cases. There were no severe complications related to the procedure, but transient vasovagal reactions occurred in 5 women (0.6%).
Female sterilization performed by hysteroscopy is a safe, feasible, fast, and well-tolerated procedure. The rates of successful insertions and tubal placements were high. There were few and mild adverse effects during the procedure, and there were no severe complications on the short term.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(8):393-397
DOI 10.1590/S0100-72032010000800006
PURPOSE: to describe hysteroscopy findings in infertile patients. METHODS: this was a retrospective series of 953 patients with diagnosis of infertility evaluated by hysteroscopy. A total of 957 patients investigated for infertility were subjected to hysteroscopy, preferentially during the first phase of the menstrual cycle. When necessary, directed biopsies (under direct visualization during the exam) or guided biopsies were obtained using a Novak curette after defining the site to be biopsied during the hysteroscopic examination. Outcome frequencies were determined as percentages, and the χ2 test was used for the correlations. The statistical software EpiInfo 2000 (CDC) was used for data analysis. RESULTS: a normal uterine cavity was detected in 436 cases (45.8%). This was the most frequent diagnosis for women with primary infertility and for women with one or no abortion (p<0.05). Abnormal findings were obtained in 517 of 953 cases (54.2%), including intrauterine synechiae in 185 patients (19.4%), endometrial polyps in 115 (12.1%), endocervical polyps in 66 (6.0%), submucosal myomas in 47 (4.9%), endometrial hyperplasia in 39 (4.1%), adenomyosis in five (0.5%), endometritis (with histopathological confirmation) in four (0.4%), endometrial bone metaplasia in two (0.4%), and cancer of the endometrium in one case (0.1%). Morphological and functional changes of the uterus were detected in 5.6% of the cases, including uterine malformations in 32 (3.4%) and isthmus-cervical incompetence in 21 (2.2%). CONCLUSIONS: intrauterine synechiae were the most frequent abnormal findings in patients evaluated for infertility. Patients with a history of abortion and infertility should be submitted to hysteroscopy in order to rule out intrauterine synechiae as a possible cause of infertility.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(8):393-397
DOI 10.1590/S0100-72032010000800006
PURPOSE: to describe hysteroscopy findings in infertile patients. METHODS: this was a retrospective series of 953 patients with diagnosis of infertility evaluated by hysteroscopy. A total of 957 patients investigated for infertility were subjected to hysteroscopy, preferentially during the first phase of the menstrual cycle. When necessary, directed biopsies (under direct visualization during the exam) or guided biopsies were obtained using a Novak curette after defining the site to be biopsied during the hysteroscopic examination. Outcome frequencies were determined as percentages, and the χ2 test was used for the correlations. The statistical software EpiInfo 2000 (CDC) was used for data analysis. RESULTS: a normal uterine cavity was detected in 436 cases (45.8%). This was the most frequent diagnosis for women with primary infertility and for women with one or no abortion (p<0.05). Abnormal findings were obtained in 517 of 953 cases (54.2%), including intrauterine synechiae in 185 patients (19.4%), endometrial polyps in 115 (12.1%), endocervical polyps in 66 (6.0%), submucosal myomas in 47 (4.9%), endometrial hyperplasia in 39 (4.1%), adenomyosis in five (0.5%), endometritis (with histopathological confirmation) in four (0.4%), endometrial bone metaplasia in two (0.4%), and cancer of the endometrium in one case (0.1%). Morphological and functional changes of the uterus were detected in 5.6% of the cases, including uterine malformations in 32 (3.4%) and isthmus-cervical incompetence in 21 (2.2%). CONCLUSIONS: intrauterine synechiae were the most frequent abnormal findings in patients evaluated for infertility. Patients with a history of abortion and infertility should be submitted to hysteroscopy in order to rule out intrauterine synechiae as a possible cause of infertility.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):305-309
DOI 10.1590/S0100-72032004000400007
OBJECTIVE: to develop a new preoperative classification of submucous myomas to evaluate the viability and the degree of difficulty of hysteroscopic myomectomy. METHODS: forty-four patients were submitted to hysteroscopic resection of submucous myomas. The possibility of total resection of the myoma, the surgery duration, the fluid deficit, and the incidence of complications were evaluated. The myomas were classified by the Classification of the European Society of Endoscopic Surgery (CESES) and by the classification proposed (CP) by our group, that besides the degree of penetration of the myoma in the myometrium, adds the parameters: extent of the base of the myoma as related to the uterine wall, the size of the myoma in centimeters and its topography at the uterine cavity. For statistical analysis the Fisher test, the Student t test and the analysis of variance were used. Statistic significance was considered when the p-value was smaller than 0.05 in the bicaudal test. RESULTS: in 47 myomas the hysteroscopic surgery was considered complete. There was no significant difference among the three levels (0, 1 and 2) by CESES. By CP, the difference among the number of complete surgeries was significant (p=0.001) between the two levels (groups I and II). The difference between the surgery duration was significant when the two classifications were compared. In relation to the fluid deficit, just CP presented significant differences among the levels (p=0,02). CONCLUSIONS: the proposed classification includes more clues about the difficulties of the hysteroscopic myomectomy than the standard classification. It should be noted that the number of hysteroscopic myomectomies used for that analysis was modest, being interesting to evaluate the performance of the proposed classification in larger series of cases.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):305-309
DOI 10.1590/S0100-72032004000400007
OBJECTIVE: to develop a new preoperative classification of submucous myomas to evaluate the viability and the degree of difficulty of hysteroscopic myomectomy. METHODS: forty-four patients were submitted to hysteroscopic resection of submucous myomas. The possibility of total resection of the myoma, the surgery duration, the fluid deficit, and the incidence of complications were evaluated. The myomas were classified by the Classification of the European Society of Endoscopic Surgery (CESES) and by the classification proposed (CP) by our group, that besides the degree of penetration of the myoma in the myometrium, adds the parameters: extent of the base of the myoma as related to the uterine wall, the size of the myoma in centimeters and its topography at the uterine cavity. For statistical analysis the Fisher test, the Student t test and the analysis of variance were used. Statistic significance was considered when the p-value was smaller than 0.05 in the bicaudal test. RESULTS: in 47 myomas the hysteroscopic surgery was considered complete. There was no significant difference among the three levels (0, 1 and 2) by CESES. By CP, the difference among the number of complete surgeries was significant (p=0.001) between the two levels (groups I and II). The difference between the surgery duration was significant when the two classifications were compared. In relation to the fluid deficit, just CP presented significant differences among the levels (p=0,02). CONCLUSIONS: the proposed classification includes more clues about the difficulties of the hysteroscopic myomectomy than the standard classification. It should be noted that the number of hysteroscopic myomectomies used for that analysis was modest, being interesting to evaluate the performance of the proposed classification in larger series of cases.
