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    Advanced operative office hysteroscopy without anaesthesia: analysis of 501 cases treated with a 5 Fr. bipolar electrode

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    BACKGROUND: The aim of this study was to evaluate treatment efficacy and patient acceptability of a new bipolar probe used during office hysteroscopic treatment of benign intrauterine pathologies. METHODS: In this observational clinical study, 501 women were treated for benign intrauterine pathologies using an office hysteroscopic procedure, without analgesia or anaesthesia. A Versapoint 5 Fr. bipolar electrical generator was used to treat endometrial polyps ranging between 0.5 and 4.5 cm, as well as submucosal and partially intramural myomas between 0.6 and 2.0 cm. Treatment efficacy and patient compliance were evaluated. RESULTS: At follow-up, the uterine cavity was normal in all patients without any recurrence or persistence of the pathology. One focal adenocarcinoma was discovered at histology in an endometrial polyp of a menopausal patient. Patient acceptance was satisfactory; 47.6-79.3% of the patients underwent the procedure without discomfort. CONCLUSIONS: The combination of a new generation small diameter hysteroscope and a new bipolar 5 Fr. electrode enables the gynaecologist to treat intrauterine pathologies in an office setting without anaesthesia. Experimentation of a special set-up of the electrical generator reduced patient discomfort during the operative part of the hysteroscopic procedure

    Comparison of hysteroscopic and hysterectomy findings to assess the diagnostic accuracy of office hysteroscopy in tamoxifen-treated patients with breast cancer

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    Study Objective. To assess the diagnostic accuracy of office hysteroscopy by comparing hysteroscopic findings with histologic findings on hysterectomy specimens in postmenopausal women with breast cancer treated with tamoxifen. Design. Retrospective clinical study (Canadian Task Force classification II-2). Setting. University-affiliated hospital. Patients. Thirty-three women. Intervention. Record review. Measurements and Main Results. Compared with histologic diagnoses of uteri, hysteroscopic findings showed diagnostic sensitivity of 97%, specificity of 100%, positive predictive value of 100% and negative predictive value of 96%. The diagnostic accuracy of hysteroscopy is the same in patients taking tamoxifen as in the general population. Conclusion. Hysteroscopy is a powerful method for diagnosing endometrial disease because it provides a direct view of the uterine cavity, reveals focal lesions, and enables targeted biopsies to be performed at the same time

    Endometrial biopsies using small-diameter hysteroscopes and 5F instruments: how can we obtain enough material for a correct histologic diagnosis?

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    STUDY OBJECTIVE: To evaluate the quantity of biopsy tissue obtained by hysteroscopic grasp technique compared with classic punch technique. DESIGN: Observational study (Canadian Task Force classification II-2). SETTING: University hospital. PATIENTS: One thousand two hundred seventy-six women. INTERVENTION: Targeted biopsies performed in an office setting using two biopsy forceps, classic spoon and crocodile, and two methods, classic punch and grasp technique. MEASUREMENTS AND MAIN RESULTS: With either biopsy forceps, the mean increase in amount of tissue obtained by grasp technique compared with punch technique was statistically significant (p <0.005). With grasp technique, the mean amount of tissue obtained was even larger with crocodile than with spoon forceps. CONCLUSION: Targeted biopsy, when performed with the appropriate instrument and applying correct technique, can provide the pathologist with a large amount of tissue (mean 5.7 mm2) that is invariably adequate for histologic examination

    Endometrial biopsies using small-diameter hysteroscopes and 5F instruments: how can we obtain enough material for a correct histologic diagnosis?

    No full text
    STUDY OBJECTIVE: To evaluate the quantity of biopsy tissue obtained by hysteroscopic grasp technique compared with classic punch technique. DESIGN: Observational study (Canadian Task Force classification II-2). SETTING: University hospital. PATIENTS: One thousand two hundred seventy-six women. INTERVENTION: Targeted biopsies performed in an office setting using two biopsy forceps, classic spoon and crocodile, and two methods, classic punch and grasp technique. MEASUREMENTS AND MAIN RESULTS: With either biopsy forceps, the mean increase in amount of tissue obtained by grasp technique compared with punch technique was statistically significant (p <0.005). With grasp technique, the mean amount of tissue obtained was even larger with crocodile than with spoon forceps. CONCLUSION: Targeted biopsy, when performed with the appropriate instrument and applying correct technique, can provide the pathologist with a large amount of tissue (mean 5.7 mm2) that is invariably adequate for histologic examination
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