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Hysteroscopy combined with endometrial ablation for recurrent benign endometrial polyp in the postmenopausal patient: A pilot study
Oral Presentations
be advocated for removal of all emps from these two groups regardless of size or symptoms.
156. Hysteroscopic Surgery for Submucous Myoma LV Adamyan, ER Tkachenko, SI Kiselev. Research Centre for Obstetrics, Gynecology & Perinatology, Moscow, Russian Federation.
Objective. To evaluate the results of hysteroscopic surgery for submucous myoma. Design. Out of total number of 1200 cases of different intrauterine conditions managed by hysteroscopy, 140 hysteroresectoscopic procedures performed in patients with submucous myoma were submitted to the analysis. Setting. Department of Operative Gynecology of Scientific Center for Obst., Gyn. & Perinatology, Moscow, Russia. Patients. One hundred forty women with submucous myoma (aged 26-45 yrs). Interventions. All patients underwent resectoscopy, assisted by laparoscopy in 53 cases, used for final diagnosis and correction of associated pathology (endometriosis, ovarian mass, fibroids of intramural or subserous localisation) and safety control. Measurements and Main Results. Operating time (av. 34.2+11.1), blood loss (47.8+33.1), complications rate (0.7%), postoperative hospital stay (av. 2.3 +1.2) were compared to the parameters of analogous laparotomic procedures, showing the advantage of hysteroresectoscopy. Histologic, histochemical and electron-microscopical studies of endometrial bioptates from the sites of surgery and outside, obtained 3-6 months after procedures revealed complete restoration and functional adequacy of endometrium in all patients. 51.1% of 84 patients willing to conceive, succeeded, and in 83.7% cases pregnancies fulltermed by via naturalis. Conclusion. The study advocates for hysteroscopic management of submucous myoma, beneficial for morphofunctional restoration of endometrium and resulting in good reproductive outcomes.
157. Hysteroscopy Combined with Endometrial Ablation for Recurrent Benign Endometrial Polyp in the Postmenopausal Patient: A Pilot Study A Sharon, O Brandes-Klein, B Feiner, Z Alter, A Lissak. Carmel Medical Center, Haifa, Israel.
Objective. To determine the efficacy of hysteroscopy combined with endometrial ablation for recurrent endometrial polyp in the postmenopansal women for prevention of future endometrial polyp. Design. A prospective pilot study. Setting. University-affiliated hospital. Patients. Sixteen postmenopansal patients with a recurrent endometrial polyp, who were planned to undergo a hysteroscopic polypectomy.
Intervention. A hysteroscopic polypectomy followed by an endometrial balloon ablation or resection at the same session, performed on a day-care basis. Measurements and Main Results. Of 16 postmenopausal patients which were recruited to the study, 5 complained of postmenopansal bleeding (PMB). A transvaginal sonography revealed a recurrent endometrial polyp in all patients. The polyp size ranged from 10-30 mm in the longest diameter. A histology was made following the removal of the polyp by hysteroscopy. In 2 cases no polyp was demonstrated. In order to prevent additional recurrence of a polyp or PMB, endometrial balloon ablation was performed. Eight patients underwent endometrial ablation or resection in the same session (ThermaChoice, Gynecare). The histology of the specimen from all patients was of a benign endometrial polyp. The follow-up period was 1-3 years, at which time no recurrent of PMB or endometrial polyp was found. Conclusion. Our preliminary result of this approach suggest the benefit of endometrial ablation in cases of recurrent endometrial polyp, are encouraging and may prevent the growth of future polyps, and thus avoid additional surgical interventions.
158. Successful Hysteroscopic Treatment of Benign Intrauterine Pathologies with a 5 Ft. Bipolar Electrode 10 Ceci, 1S Bettocchi, 1L Nappi, 1A Pellegrino, 1R Di Venere, 1V Pansini, 1A Santoro, 2L Selvaggi. 1University of Bari, Italy; 2University "Cattolica del Sacro Cuore," Rome, Italy.
Objective. Demonstration of advanced operative office hysteroscopy: the treatment of benign intrauterine pathologies using a 5 Fr. bipolar probe and its efficacy in terms of recurrence of the pathologies and patient compliance. Methods. From 1999 to 2001 we performed, at our Center 1860 Office hysteroscopic procedures, without analgesia or anaesthesia, for the treatment of benign intrauterine pathologies. In 501 cases we used a Versapoint bipolar electrical generator to remove submucosal and partially intramural myomas ranging between 0.6 and 2.0 cm, as well as endometrial polyps between 0.5 and 4.5 cm. Results. After 6 months of follow-up we demonstrated any recurrence or persistence of the pathologies in the uterine cavity of all treated patients. Only in one case we discovered at histology a focal adenocarcinoma on the base of endometrial polyp in a menopausal patient. Concerning patient compliance, more than half of the patients (from 47.6 % to 79.3 %) accepted the procedure without discomfort, with a pain score ranging from 0 to 4; in 21,7% of the cases, patients referred a pain score ranging from 5 to 10, but the majority was menopausal women with a small and atrophic uterine cavity Conclusion. The combined use of a new generation small diameter hysteroscope and a new bipolar 5 Fr electrode (Versapoint) allows to the endoscopic gynaecologist to perform office hysteroscopy without analgesia and anaesthesia
$50
be advocated for removal of all emps from these two groups regardless of size or symptoms.
156. Hysteroscopic Surgery for Submucous Myoma LV Adamyan, ER Tkachenko, SI Kiselev. Research Centre for Obstetrics, Gynecology & Perinatology, Moscow, Russian Federation.
Objective. To evaluate the results of hysteroscopic surgery for submucous myoma. Design. Out of total number of 1200 cases of different intrauterine conditions managed by hysteroscopy, 140 hysteroresectoscopic procedures performed in patients with submucous myoma were submitted to the analysis. Setting. Department of Operative Gynecology of Scientific Center for Obst., Gyn. & Perinatology, Moscow, Russia. Patients. One hundred forty women with submucous myoma (aged 26-45 yrs). Interventions. All patients underwent resectoscopy, assisted by laparoscopy in 53 cases, used for final diagnosis and correction of associated pathology (endometriosis, ovarian mass, fibroids of intramural or subserous localisation) and safety control. Measurements and Main Results. Operating time (av. 34.2+11.1), blood loss (47.8+33.1), complications rate (0.7%), postoperative hospital stay (av. 2.3 +1.2) were compared to the parameters of analogous laparotomic procedures, showing the advantage of hysteroresectoscopy. Histologic, histochemical and electron-microscopical studies of endometrial bioptates from the sites of surgery and outside, obtained 3-6 months after procedures revealed complete restoration and functional adequacy of endometrium in all patients. 51.1% of 84 patients willing to conceive, succeeded, and in 83.7% cases pregnancies fulltermed by via naturalis. Conclusion. The study advocates for hysteroscopic management of submucous myoma, beneficial for morphofunctional restoration of endometrium and resulting in good reproductive outcomes.
157. Hysteroscopy Combined with Endometrial Ablation for Recurrent Benign Endometrial Polyp in the Postmenopausal Patient: A Pilot Study A Sharon, O Brandes-Klein, B Feiner, Z Alter, A Lissak. Carmel Medical Center, Haifa, Israel.
Objective. To determine the efficacy of hysteroscopy combined with endometrial ablation for recurrent endometrial polyp in the postmenopansal women for prevention of future endometrial polyp. Design. A prospective pilot study. Setting. University-affiliated hospital. Patients. Sixteen postmenopansal patients with a recurrent endometrial polyp, who were planned to undergo a hysteroscopic polypectomy.
Intervention. A hysteroscopic polypectomy followed by an endometrial balloon ablation or resection at the same session, performed on a day-care basis. Measurements and Main Results. Of 16 postmenopausal patients which were recruited to the study, 5 complained of postmenopansal bleeding (PMB). A transvaginal sonography revealed a recurrent endometrial polyp in all patients. The polyp size ranged from 10-30 mm in the longest diameter. A histology was made following the removal of the polyp by hysteroscopy. In 2 cases no polyp was demonstrated. In order to prevent additional recurrence of a polyp or PMB, endometrial balloon ablation was performed. Eight patients underwent endometrial ablation or resection in the same session (ThermaChoice, Gynecare). The histology of the specimen from all patients was of a benign endometrial polyp. The follow-up period was 1-3 years, at which time no recurrent of PMB or endometrial polyp was found. Conclusion. Our preliminary result of this approach suggest the benefit of endometrial ablation in cases of recurrent endometrial polyp, are encouraging and may prevent the growth of future polyps, and thus avoid additional surgical interventions.
158. Successful Hysteroscopic Treatment of Benign Intrauterine Pathologies with a 5 Ft. Bipolar Electrode 10 Ceci, 1S Bettocchi, 1L Nappi, 1A Pellegrino, 1R Di Venere, 1V Pansini, 1A Santoro, 2L Selvaggi. 1University of Bari, Italy; 2University "Cattolica del Sacro Cuore," Rome, Italy.
Objective. Demonstration of advanced operative office hysteroscopy: the treatment of benign intrauterine pathologies using a 5 Fr. bipolar probe and its efficacy in terms of recurrence of the pathologies and patient compliance. Methods. From 1999 to 2001 we performed, at our Center 1860 Office hysteroscopic procedures, without analgesia or anaesthesia, for the treatment of benign intrauterine pathologies. In 501 cases we used a Versapoint bipolar electrical generator to remove submucosal and partially intramural myomas ranging between 0.6 and 2.0 cm, as well as endometrial polyps between 0.5 and 4.5 cm. Results. After 6 months of follow-up we demonstrated any recurrence or persistence of the pathologies in the uterine cavity of all treated patients. Only in one case we discovered at histology a focal adenocarcinoma on the base of endometrial polyp in a menopausal patient. Concerning patient compliance, more than half of the patients (from 47.6 % to 79.3 %) accepted the procedure without discomfort, with a pain score ranging from 0 to 4; in 21,7% of the cases, patients referred a pain score ranging from 5 to 10, but the majority was menopausal women with a small and atrophic uterine cavity Conclusion. The combined use of a new generation small diameter hysteroscope and a new bipolar 5 Fr electrode (Versapoint) allows to the endoscopic gynaecologist to perform office hysteroscopy without analgesia and anaesthesia
$50