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Oral Presentations
S3
THURSDAY, NOVEMBER 10, 2005 (11:02 AM–11:10 AM)
THURSDAY, NOVEMBER 10, 2005 (11:10 AM–11:18 AM)
Plenary 1—Hysteroscopy
Plenary 1—Hysteroscopy
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Prevalence of Atypical Hyperplasia and Cancer in Asymptomatic Postmenopausal Women with Endometrial Polyps Removed by Hysteroscopy: An Ad Interim Analysis of a Multicenter Italian Study Leone F, Ferrazzi E, Zupi E, Barbieri M, Bettocchi S, Busacca M, Cammareri G, Cicinelli E, Coccia E, Exacoustos C, Litta P, Savelli L, Solima E, Testa A. AGUI Study Group, Milan, Italy
A Randomized Trial to Compare the Differences Between Monopolar Surgery (Loop Resection) with Glycine 1.5% and Bipolar Surgery with Saline (Olympus, Versapoint) on Hysteroscopic Surgery Berg A, Istre O. Women’s Center, Ullevaal University Hospital, Oslo, Norway; Ullevaal University Hospital, Department of Obstetrics and Gynaecology, Hamar, Norway
Study Objective: To determine the prevalence of atypical hyperplasia, and endometrial cancer in asymptomatic postmenopausal women with endometrial polyps on atrophic endometrium, removed by hysteroscopic polypectomy. Design: Retrospective multicenter study. Setting: University and tertiary care hospitals. Patients: Asymptomatic postmenopausal women with standardized sonographic (endometrial thickness ⱕ 4mm), and/or hysteroscopic (visual diagnosis) diagnosis of endometrial polyp on atrophic endometrium, were retrospectively reviewed from 2000 to 2004. Patients on HRT and/or TMX treatment were excluded. Intervention: All women underwent transvaginal sonography (TVS) with color- and/or power-Doppler evaluation, sonohysterography in selected cases, and/or diagnostic hysteroscopy (HYS). Hysteroscopic polypectomy was performed by using office operative hysteroscope or by resectoscope. Demographic, sonographic and hysteroscopic data were recorded. Histology of the removed polyp was the main outcome. Measurements and Main Results: 637 consecutive patients were analyzed among those so far included. Mean age (⫾SD) was 62 years ⫾8. Mean years after menopause were 13⫾13. Mean BMI was 26⫾5. Mean diameter of endometrial polyp at TVS and/or HYS was 18⫾15mm. Typical, atypical hyperplasia, and cancer were 4.9%, 1.6%, and 0.2%, respectively. One polypoid cancer was found. Conclusion: This first ad interim analysis of a larger multicenter study observed one case of endometrial cancer in asymptomatic postmenopausal women with endometrial polyp on atrophic endometrium. This confirmed the reliability of endometrial thickness ⱕ 4mm and hysteroscopic visual diagnosis for the exclusion of endometrial disease. This retrospective study adds evidence to the feasibility of a conservative management of asymptomatic polyps. Monitoring criteria need to be established.
Study Objective: Evaluation of safety and effectiveness between hysteroscopic monopolar and bipolar equipment during resection of fibroids, polyps and endometrium. Intervention: A study of 100 premenopausal women with dysfunctional bleedings, fibroids or polyps. Patients are randomized to three arms, monopolar or bipolar (Olympus), or Versapoint (Gynecare) equipment. Safety evaluation includes use of irrigation, deficit and subsequent reduction in Se-Na. Additionally operating time, weight of tissue removed and easiness of operation is recorded during operation. Pre- and postoperatively levels of vaginal bleeding, measured by method of Higham (PBAC) and Se-Ferritin are recorded. Follow up at six and twelve months and need for secondary intervention is registered. Measurements and Main Results: Operating time is longer using Versapoint, 16 minutes compared to 10 and 11 minutes with both monopolar and bipolar Olympus equipment to remove the same amount of tissue. Fluid consumed in the Versapoint group is higher compared to the two other groups, reflecting increased operating time. Se-Sodium is lowered from mean 138 mmol/L preoperatively to mean 132 mmol/L postoperatively in the monopolar group, reflecting use of none sodium containing fluid compared to the no significantly reduction in the bipolar groups. Conclusion: A difference in Se-Na is seen between the monopolar and the two bipolar groups, and it seems to be more time consuming to achieve the same amount of tissue removed with the smaller Versapoint resection loop in resectoscopy. THURSDAY, NOVEMBER 10, 2005 (10:30 AM–10:40 AM) Plenary 2—Urogynecology 7 Vaginal Mesh Erosion After Transvaginal Repair of Cystocele Using Gynemesh or Gynemesh-Softsoft in 138 Women: A Comparative Study Deffieux X, Fernandez H, Huel C, Botero J, de Tayrac R, Gervaise A. Clamart, France; Clamart, France; Hoˆpital Saint Louis, DBIM Paris, France; Clamart, France; Clamart, France; Paris, France Study Objective: To compare mesh erosion after transvaginal repair of cystocele using GYNEMESH or GYNEMESH-SOFT mesh.
S3
THURSDAY, NOVEMBER 10, 2005 (11:02 AM–11:10 AM)
THURSDAY, NOVEMBER 10, 2005 (11:10 AM–11:18 AM)
Plenary 1—Hysteroscopy
Plenary 1—Hysteroscopy
5
6
Prevalence of Atypical Hyperplasia and Cancer in Asymptomatic Postmenopausal Women with Endometrial Polyps Removed by Hysteroscopy: An Ad Interim Analysis of a Multicenter Italian Study Leone F, Ferrazzi E, Zupi E, Barbieri M, Bettocchi S, Busacca M, Cammareri G, Cicinelli E, Coccia E, Exacoustos C, Litta P, Savelli L, Solima E, Testa A. AGUI Study Group, Milan, Italy
A Randomized Trial to Compare the Differences Between Monopolar Surgery (Loop Resection) with Glycine 1.5% and Bipolar Surgery with Saline (Olympus, Versapoint) on Hysteroscopic Surgery Berg A, Istre O. Women’s Center, Ullevaal University Hospital, Oslo, Norway; Ullevaal University Hospital, Department of Obstetrics and Gynaecology, Hamar, Norway
Study Objective: To determine the prevalence of atypical hyperplasia, and endometrial cancer in asymptomatic postmenopausal women with endometrial polyps on atrophic endometrium, removed by hysteroscopic polypectomy. Design: Retrospective multicenter study. Setting: University and tertiary care hospitals. Patients: Asymptomatic postmenopausal women with standardized sonographic (endometrial thickness ⱕ 4mm), and/or hysteroscopic (visual diagnosis) diagnosis of endometrial polyp on atrophic endometrium, were retrospectively reviewed from 2000 to 2004. Patients on HRT and/or TMX treatment were excluded. Intervention: All women underwent transvaginal sonography (TVS) with color- and/or power-Doppler evaluation, sonohysterography in selected cases, and/or diagnostic hysteroscopy (HYS). Hysteroscopic polypectomy was performed by using office operative hysteroscope or by resectoscope. Demographic, sonographic and hysteroscopic data were recorded. Histology of the removed polyp was the main outcome. Measurements and Main Results: 637 consecutive patients were analyzed among those so far included. Mean age (⫾SD) was 62 years ⫾8. Mean years after menopause were 13⫾13. Mean BMI was 26⫾5. Mean diameter of endometrial polyp at TVS and/or HYS was 18⫾15mm. Typical, atypical hyperplasia, and cancer were 4.9%, 1.6%, and 0.2%, respectively. One polypoid cancer was found. Conclusion: This first ad interim analysis of a larger multicenter study observed one case of endometrial cancer in asymptomatic postmenopausal women with endometrial polyp on atrophic endometrium. This confirmed the reliability of endometrial thickness ⱕ 4mm and hysteroscopic visual diagnosis for the exclusion of endometrial disease. This retrospective study adds evidence to the feasibility of a conservative management of asymptomatic polyps. Monitoring criteria need to be established.
Study Objective: Evaluation of safety and effectiveness between hysteroscopic monopolar and bipolar equipment during resection of fibroids, polyps and endometrium. Intervention: A study of 100 premenopausal women with dysfunctional bleedings, fibroids or polyps. Patients are randomized to three arms, monopolar or bipolar (Olympus), or Versapoint (Gynecare) equipment. Safety evaluation includes use of irrigation, deficit and subsequent reduction in Se-Na. Additionally operating time, weight of tissue removed and easiness of operation is recorded during operation. Pre- and postoperatively levels of vaginal bleeding, measured by method of Higham (PBAC) and Se-Ferritin are recorded. Follow up at six and twelve months and need for secondary intervention is registered. Measurements and Main Results: Operating time is longer using Versapoint, 16 minutes compared to 10 and 11 minutes with both monopolar and bipolar Olympus equipment to remove the same amount of tissue. Fluid consumed in the Versapoint group is higher compared to the two other groups, reflecting increased operating time. Se-Sodium is lowered from mean 138 mmol/L preoperatively to mean 132 mmol/L postoperatively in the monopolar group, reflecting use of none sodium containing fluid compared to the no significantly reduction in the bipolar groups. Conclusion: A difference in Se-Na is seen between the monopolar and the two bipolar groups, and it seems to be more time consuming to achieve the same amount of tissue removed with the smaller Versapoint resection loop in resectoscopy. THURSDAY, NOVEMBER 10, 2005 (10:30 AM–10:40 AM) Plenary 2—Urogynecology 7 Vaginal Mesh Erosion After Transvaginal Repair of Cystocele Using Gynemesh or Gynemesh-Softsoft in 138 Women: A Comparative Study Deffieux X, Fernandez H, Huel C, Botero J, de Tayrac R, Gervaise A. Clamart, France; Clamart, France; Hoˆpital Saint Louis, DBIM Paris, France; Clamart, France; Clamart, France; Paris, France Study Objective: To compare mesh erosion after transvaginal repair of cystocele using GYNEMESH or GYNEMESH-SOFT mesh.