| Office hysteroscopy and adenomyosis. | |
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MedLine Citation:
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PMID: 16554185 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Adenomyosis, the heterotopic presence of endometrial glands and stroma within the myometrium, has traditionally been diagnosed by the pathologist in hysterectomy specimens. However, the recent development of high-quality non-invasive techniques such as transvaginal sonography (TVS), magnetic resonance imaging (MRI) and hysteroscopy has renewed interest in diagnosing adenomyosis in the office prior to any treatment. Hysteroscopy offers the advantage of direct visualization of the uterine cavity, and since nowadays it is performed in the office, it can be offered as a first-line diagnostic tool for evaluation of uterine abnormalities in patients with abnormal uterine bleeding and/or infertility. The available data clearly indicate that high-quality mini-hysteroscopes, saline as a distension medium, and atraumatic insertion technique are essential for the success of office hysteroscopy. The procedure is indicated in any situation in which an intrauterine anomaly is suspected; it is immediately preceded by a physical exam and a TVS to evaluate uterine characteristics, and it is followed by a second TVS to take advantage of the intracavitary fluid for a contrast image of the uterus. Although diagnostic hysteroscopy does not provide pathognomonic signs for adenomyosis, some evidence suggests that irregular endometrium with endometrial defects, altered vascularization, and cystic haemorrhagic lesion are possibly associated with the entity. In addition to the direct visualization of the uterine cavity, the hysteroscopic approach offers the possibility of obtaining endometrial/myometrial biopsies under visual control. Since they can be performed in the office, the combination of TVS, fluid hysteroscopy and contrast sonography is therefore a powerful screening tool for detecting endometrial and myometrial abnormalities in association with adenomyosis. |
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Authors:
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Carlos Roger Molinas; Rudi Campo |
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Publication Detail:
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Type: Journal Article; Review Date: 2006-03-22 |
Journal Detail:
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Title: Best practice & research. Clinical obstetrics & gynaecology Volume: 20 ISSN: 1521-6934 ISO Abbreviation: Best Pract Res Clin Obstet Gynaecol Publication Date: 2006 Aug |
Date Detail:
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Created Date: 2006-09-15 Completed Date: 2007-09-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101121582 Medline TA: Best Pract Res Clin Obstet Gynaecol Country: England |
Other Details:
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Languages: eng Pagination: 557-67 Citation Subset: IM |
Affiliation:
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Centre for Gynaecological Endoscopy (Cendogyn), Centro Médico La Costa, Asunción, Paraguay. roger.molinas@lifeleuven.be |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Ambulatory Care Ambulatory Surgical Procedures Biopsy Endometriosis / diagnosis*, pathology Endometrium / pathology Female Humans Hysteroscopes Hysteroscopy / methods* Myometrium / pathology Sodium Chloride / diagnostic use Uterine Diseases / diagnosis*, pathology |
| Chemical | |
Reg. No./Substance:
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7647-14-5/Sodium Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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