UNASSIGNED: This was a retrospective study including women with AUB. All patients underwent 2D, 3D and power Doppler TVS evaluation of the uterine cavity, and patients with suspicion on ultrasound (US) of endometrial pathology (EP) underwent hysteroscopy with morcellator without anesthesia. The painful symptomatology was assessed during the procedure using a visual analogue scale (VAS). Additionally, histological evaluation was performed.
UNASSIGNED: A total of 182 women underwent US imaging, of whom 131 (72%) had hysteroscopy. 130/131 patients completed the hysteroscopic examination with good compliance (VAS <4). One patient (0.8%) was unable to complete the procedure due to nulliparity and cervical stenosis. Of the 130 patients the US diagnosis was confirmed in 120 (92.3%), while in 10 patients (7.7%) the hysteroscopic diagnosis was different from the US diagnosis. Histological examination confirmed benign endometrial polyps in 115/130 patients (88.5%), while premalignant conditions were diagnosed in 3/130 patients (2.3%) and malignant conditions in 2/130 (1.5%). Of the 10 patients with endometrial thickening, two were diagnosed with a malignant condition.
UNASSIGNED: This study confirmed the feasibility of managing patients with AUB and suspicion of EP using \"see-and-treat\" hysteroscopy with morcellator without anesthesia. This procedure has the potential to yield desired outcomes while minimizing pain and discomfort, presenting a feasible outpatient approach for both treating and preventing endometrial carcinoma without requiring anesthesia.
■这是一项包括AUB患者的回顾性研究。所有患者都接受了2D,3D和能量多普勒TVS评估子宫腔,怀疑子宫内膜病理(EP)超声(US)的患者在没有麻醉的情况下接受了宫腔镜检查。在手术过程中使用视觉模拟量表(VAS)评估疼痛症状。此外,进行组织学评估。
■共有182名女性接受了美国成像,其中131人(72%)进行了宫腔镜检查。130/131例患者完成宫腔镜检查,依从性好(VAS<4)。一名患者(0.8%)由于无胎和宫颈狭窄而无法完成手术。在130例患者中,120例(92.3%)确诊为美国诊断,而在10例患者(7.7%)中,宫腔镜诊断与美国诊断不同。组织学检查证实良性子宫内膜息肉115/130例(88.5%),而3/130(2.3%)的患者诊断为癌前病变,2/130(1.5%)的患者诊断为恶性病变。在子宫内膜增厚的10例患者中,两人被诊断患有恶性疾病。
■这项研究证实了在没有麻醉的情况下,使用“观察并治疗”宫腔镜与分割器治疗AUB和怀疑EP的患者的可行性。这个过程有可能产生预期的结果,同时尽量减少疼痛和不适,提出了一种可行的门诊治疗和预防子宫内膜癌的方法,而无需麻醉。