Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-03T02:19:29.793Z Has data issue: false hasContentIssue false

Chapter 5 - Hysteroscopy Techniques and Treatment Settings

Published online by Cambridge University Press:  10 September 2020

By
Jonathan M. Chester  and
T. Justin Clark
Edited by
Mary E. Connor  and
T. Justin Clark
Mary E. Connor
Affiliation:
Royal Hallamshire Hospital, Sheffield
T. Justin Clark
Affiliation:
Birmingham Women’s Hospital
Get access

Summary

This chapter covers the process of performing hysteroscopy, paying close attention to optimising patient comfort and maximising the effectiveness of the procedure. Tips are provided for successfully inserting the device and visualising the entire uterine cavity. The possible settings for performing a hysteroscopic investigation are outlined, with suggestions as to which setting may suit an individual patient. Oral anticoagulants have changed in recent years and the effect they may have on patients attending hysteroscopy clinics is discussed, with advice about how to avoid and manage excessive vaginal bleeding.

Type
Chapter
Information
Diagnostic and Operative Hysteroscopy , pp. 57 - 71
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Royal College of Obstetricians and Gynaecologists. Best Practice in Outpatient Hysteroscopy. Green-top Guideline No. 59. London: RCOG; 2011. www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg59 (accessed November 2019).Google Scholar
Smith, PP, Kolhe, S, O’Connor, S, Clark, TJ. Vaginoscopy Against Standard Treatment (VAST): a randomised controlled trial. BJOG 2019; 126: 891–9.CrossRefGoogle Scholar
Cooper, NAM, Smith, P, Khan, KS, Clark, TJ. Vaginoscopic approach to outpatient hysteroscopy: a systematic review of the effect on pain. BJOG 2010; 117: 532–9. Review. Erratum in BJOG 2010; 117: 1440.Google Scholar
Madari, S, Al-Shabibi, N, Papalampros, P, Papadimitriou, A, Magos, A. A randomised trial comparing the H pipelle with the standard pipelle for endometrial sampling at ‘no-touch’ (vaginoscopic) hysteroscopy. BJOG 2009; 116: 32–7.Google Scholar
Clark, TJ, Gupta, JK. Handbook of Outpatient Hysteroscopy: A Complete Guide to Diagnosis and Therapy. London: Hodder Arnold; 2005.Google Scholar
National Institute for Health and Care Excellence. Heavy Menstrual Bleeding: Assessment and Management. NICE Guideline NG88. London: NICE; 2018. www.nice.org.uk/guidance/ng88 (accessed November 2019).Google Scholar
Clark, TJ, Mann, CH, Shah, N, et al. Accuracy of outpatient endometrial biopsy in the diagnosis of endometrial cancer: a systematic quantitative review. BJOG 2002; 109: 313–21.CrossRefGoogle ScholarPubMed
Rodriguez, GC, Yaqub, N, King, ME. A comparison of the pipelle device and the Vabra aspirator as measured by endometrial denudation in hysterectomy specimens: the pipelle device samples significantly less of the endometrial surface than the Vabra aspirator. Am J Obstet Gynecol 1993; 168: 55–9.Google Scholar
Guido, RS, Kanbour‐Shakir, A, Rulin, MC, Christopherson, WA. Pipelle endometrial sampling: sensitivity in the detection of endometrial cancer. J Reprod Med 1995; 40: 553–5.Google ScholarPubMed
van Hanegem, N, Breijer, MC, Slockers, SA, et al. Diagnostic workup for postmenopausal bleeding: a randomised controlled trial. BJOG 2017; 124: 231–40.Google Scholar
van Hanegem, N, Prins, MM, Bongers, MY, et al. The accuracy of endometrial sampling in women with postmenopausal bleeding: a systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2016; 197: 147–55.CrossRefGoogle ScholarPubMed
Gimpelson, RJ, Rappold, HO. A comparative study between panoramic hysteroscopy with directed biopsies and dilatation and curettage: a review of 276 cases. Am J Obstet Gynecol 1988; 158: 489–92.Google Scholar
Emanuel, MH. New developments in hysteroscopy. Best Pract Res Clin Obstet Gynaecol 2013; 27: 421–9.CrossRefGoogle ScholarPubMed
Nezhat, C. History of endoscopy. Chapter 4: Hovering on the brink of modernity. Online blog. https://laparoscopy.blogs.com/endoscopyhistory/chapter_04 (accessed November 2019).Google Scholar
Nikolaou, D, Slamn, G, Richardson, R. Operative hysteroscopy in the outpatient setting: its role within a gynaecology service. Gynecol Surg 2009; 6: 21–4.Google Scholar
Kremer, C, Duffy, S, Moroney, M. Patient satisfaction with outpatient hysteroscopy versus day case hysteroscopy: randomised controlled trial. BMJ 2000; 320: 279–82.CrossRefGoogle ScholarPubMed
Cooper, NAM, Clark, TJ, Middleton, L, et al. Outpatient versus inpatient uterine polyp treatment for abnormal uterine bleeding: randomised controlled non-inferiority study. BMJ 2015; 350: h1398.CrossRefGoogle ScholarPubMed
Marsh, F, Kremer, C, Duffy, S. Delivering an effective outpatient service in gynaecology. BJOG 2004; 111: 243–8.Google Scholar
Scheres, LJJ, Brekelmans, MPA, Ageno, W, et al. Abnormal vaginal bleeding in women of reproductive age treated with edoxaban or warfarin for venous thromboembolism: a posthoc analysis of the Hokusai-VTE study. BJOG 2018; 125: 1581–9.Google Scholar
Myers, B. Abnormal vaginal bleeding in the ‘DOAC’ era. BJOG 2018; 125: 1591.CrossRefGoogle ScholarPubMed
Curto, A. Management of patients taking rivaroxaban for dental treatments. Eur J Gen Dent 2017; 6: 1–4.Google Scholar
Curto, A, Albaladejo, A, Alvarado, A. Dental management of patients taking novel oral anticoagulants (NOAs): dabigatran. J Clin Exp Dent 2017; 9: e289–93.Google Scholar
Torn, M, Rosendaal, FR. Oral anticoagulation in surgical procedures: risks and recommendations. Br J Haematol 2003; 123: 676–82.Google Scholar
Hunt, BJ, Levi, M. Urgent reversal of vitamin K antagonists. BMJ 2018; 360: j5424.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×