OOOOOOOOOOOOOOOOOOOOOOOOOOOOOO Subject Index Abnormal uterine bleeding, see also Adenomyosis, Endometrial cancer, Menorrhagia dilatation and curettage 21, 22, 25 hysteroscopy of premenopausal women anesthesia 22 25 diagnostic findings 23 25 patient selection 22, 23 technique 22, 24 transvaginal sonography comparison 25 premenopausal etiology 21 Abortion, hysteroscopic findings in habitual abortion 15 Adenomyosis definition 42 diagnostic hysteroscopy biopsy technique 45, 46 signs 46 endometrial ablation 46, 47, 49 focal adenomyosis 47, 48 magnetic resonance imaging diagnosis 41, 44 needle biopsy diagnosis 44 overview 41, 42 pathology 42 symptoms 44 ultrasound diagnosis 41, 44, 47 Adhesion, see Intrauterine adhesiolysis Balloon therapy, endometrial ablation advantages 137 electroballoon coagulation with Vesta system application of electroballoon 139 complications 141, 146 long-term outcomes 140 142, 150, 151 scoring of outcomes 142 technical aspects 147, 148 patient selection 138 systems Cavaterm, see Cavaterm, endometrial ablation MenoTreat 102 Novacept 142 144 ThermaChoice 101, 145, 148, 151 Vesta 102, 103, 138, 145, 148 Bleeding, see Abnormal uterine bleeding, Menorrhagia, Postmenopausal bleeding Cavaterm, endometrial ablation complications 146, 150 contraindications 152 cost analysis compared with hysterectomy 146 outcomes 150, 151 overview 100, 101, 145, 146 patient selection 149, 152 technical aspects 147, 148 technique 149 189
Cervical cancer, diagnosis 27, 28 Complications, hysteroscopic surgery, see also specific techniques complications 162 intraoperative bleeding minimization 165 embolism 163, 165 fluid overload syndrome 163, 165, 166 perforation 162 prevention 164 166 thermal injury 162, 163 late 168, 169 postoperative bleeding 167 fluid overload management 166, 167 infection 167 prevention 167 quality management 169 Danazol endometrial ablation preoperative treatment 4 6 menorrhagia treatment 94, 95 Diagnostic hysteroscopy, consensus recommendations anesthesia 184 contraindications 183 distension medium 183 indications 183 instrumentation 183 outpatient setting 184 overview 182 preoperative evaluation 183 simultaneous laparoscopy 183 timing 183 value by suspicion of carcinoma 183 Dilatation and curettage hysteroscopy combination 36, 37, 56 menorrhagia treatment 95 premenopausal abnormal uterine bleeding 21, 22, 25 Electroballoon coagulation, see Balloon therapy, endometrial ablation EnAbl system 105 Endometrial ablation adenomyosis 46, 47, 49 balloon methods, see Balloon therapy, endometrial ablation combination transcervical resection of endometrium and rollerball 98, 99, 115 complications 146, 147 cryosurgery with Cryostat 113 endometrial laser intrauterine thermal therapy with GyneLase 105, 106 global three-dimensional ablation with Novasure 106 107, 144 historical perspective 91, 92 hormonal treatment postoperative treatment with estrogen-gestagen 7 or danazol 4 6 hot saline instillation methods EnAbl 105 Hydro ThermAblator, see Hydro ThermAblator, endometrial ablation hysterectomy outcome comparisons 113, 114 hysteroscopy consensus recommendations 186, 187 microwave endometrial ablation 110 112 ND:YAG laser ablation 91, 92, 96, 138 overview of techniques 91 93, 99, 100 photodynamic therapy 110 punctual vaporizing methods Vaportrode 107 109 Versapoint 109 radiofrequency thermal destruction with Menostat 112 rollerball electrocoagulation 91, 92, 97, 98 transcervical resection of endometrium, see Transcervical resection of endometrium Subject Index 190
Endometrial cancer abrasio fracta diagnosis 34, 36, 37 carcinogenesis 28 31 compliance with preventive examinations 37 diagnostic procedure 38, 39 endometrial cytology in diagnosis 33, 34, 37 hysteroscopy and histology in diagnosis advantages 35, 55 biopsy 35, 36 limitations 36 incidence 27, 28 Pipelle de Cornier for tissue sampling 33, 34, 37, 55 progression to clinical significance 38 tamoxifen risk 60, 66, 67 transcervical resection of endometrium association 126 types epidemiology 29 prognosis 29, 39 type I features 28 30 type II features 29 ultrasound in diagnosis diagnostic parameters 31, 32, 51, 53, 54 limitations 32, 33, 37 sensitivity 27, 31, 71 specificity 27, 31, 32, 54, 71 Endometrial resection, see Transcervical resection of endometrium Estrogen, postoperative treatment endometrial ablation 7 intrauterine adhesiolysis 4 septum dissection 3 Falloposcopy complications 171, 172 technique 19, 20 training, see HysteroTrainer Gonadotropin-releasing costs 6 menorrhagia treatment 94, 95 preoperative treatment endometrial ablation 4 6 myoma resection 7 9, 11, 86, 87 septum dissection 2, 3 side effects 6, 8 GyneLase, endometrial ablation 105, 106 Hormonal therapy, hysteroscopic surgery patients endometrial ablation postoperative treatment with estrogen-gestagen 7 or danazol 4 6 intrauterine adhesiolysis, postoperative treatment with estrogen or intrauterine device 4 myoma resection, preoperative treatment with gonadotropin-releasing 7 9, 11, 86, 87 overview 1, 2 septum dissection postoperative treatment with estrogen or intrauterine device 3 2, 3 Hydrosonography, see Saline infusion sonohysterography Hydro ThermAblator, endometrial ablation advantages 158 complications 154, 158 outcomes 157, 158 overview 104, 105, 154 patient selection 155, 158 technique 155 Hysterectomy Cavaterm cost analysis comparison 146 endometrial ablation outcome comparisons 113, 114 menorrhagia treatment 91, 95, 96, 114 transcervical resection of endometrium comparison 127 130 HysteroTrainer anatomic and gynecologic background 172 criteria for training model 174 falloposcopy trainer 177, 180 Subject Index 191
HysteroTrainer (continued) hysteroscopic procedure classification by difficulty 179 intracavity pressure measurements 172, 174, 175 materials evaluation 175, 180 types 173 organ modules 172, 173, 177, 178 patented devices 180 rationale for development 171, 172, 178, 179 set up 176, 177 styrofoam models 175, 176 uses 177 Infertility falloposcopy 19, 20 hysteroscopic findings diagnostic hysteroscopy role 14, 15 primary infertility 14 secondary infertility 15 operative hysteroscopy congenital uterine malformations 16 18 myoma 16, 82, 83 polyps 16 synechia 18, 19 salpingoscopy 20 Intrauterine adhesiolysis infertility treatment 18, 19 postoperative treatment with estrogen or intrauterine device 4 Levonorgestrel-containing intrauterine device menorrhagia treatment 95 use with transcervical resection of endometrium 121, 131 133 Magnetic resonance imaging, adenomyosis diagnosis 41, 44 Menorrhagia ablation therapy, see Endometrial ablation etiology 92, 94 nonablation therapies danazol 94, 95 dilatation and curettage 95 gonadotropin-releasing hormone analogs 94, 95 hysterectomy 91, 95, 96, 114 levonorgestrel-containing intrauterine device 95 overview 92 94 prevalence 114 MenoTreat, endometrial ablation 102 Microwave endometrial ablation 110 112 Myoma resection classification of submucous myomas 83 considerations for surgeon 82 historical perspective 81 indications 82, 83 infertility treatment 16, 82, 83 myoma shift phenomenon 84, 86 preoperative saline infusion sonohysterography 84 7 9, 11, 86, 87 pumps 87 safety aspects 87 technique flow rate 88 large myomas 89 morcellation 88 re-hysteroscopy 89, 90 resection 88, 89 termination 89 ND:YAG laser, endometrial ablation 91, 92, 96, 138 Novasure, endometrial ablation 106, 107, 144 Operative hysteroscopy, consensus recommendations classification of operations 184, 185 contraindications 184 distension medium 184 duration of operation 185 endometrial ablation 186, 187 Subject Index 192
facilities 185 fluid loss 185 instrumentation 184 overview 182 preoperative hormone therapy 184 quality control 185 timing 184 training 185 Photodynamic therapy, endometrial ablation 110 Pipelle de Cornier, endometrial tissue sampling 33, 34, 37, 55 Postmenopausal bleeding, see also Endometrial cancer definition 51, 52 endometrial histology 52 etiology 71 gynecological examination 52 hysteroscopy with dilatation and curettage 56 patient history 52 saline infusion sonohysterography applications 54 56, 75 technique 54 ultrasound 52 54 Rollerball electrocoagulation, endometrial ablation 91, 92, 97, 98 Saline infusion sonohysterography advantages 78 comparison with hysteroscopy 76 contraindications 78 indications 74 76 myoma characterization 72, 75, 76 myoma resection application 84 postmenopausal bleeding applications 54 56, 75 technique 54 sensitivity and specificity 74, 75 technique 72, 74 Salpingoscopy, infertility assessment 20 Septum dissection hormonal treatment postoperative treatment with estrogen or intrauterine device 3 2, 3 infertility treatment 16 18 Synechia, see Intrauterine adhesiolysis Tamoxifen endometrial cancer risk 60, 66, 67 endometrial hyperplasia induction histology 61, 66 hysteroscopy 64 overview 61 pathophysiology 66, 67 ultrasound findings 61, 63, 64, 70, 71 ThermaChoice, endometrial ablation 101, 145, 148, 151 Thermal balloon therapy, see Balloon therapy, endometrial ablation Training, see HysteroTrainer Transcervical resection of endometrium clinical trials and hysterectomy comparison 127 130 combination with rollerball electrocoagulation 98, 99, 115 complications endometrial carcinoma 126 fluid overload 126 hematometra 126 hemorrhage 125 infection 125, 126 perforation 125 rates 121, 124, 125 cost analysis 127, 128 counseling of patients 133, 134 levonorgestrel-containing intrauterine device use 121, 131 133 mental health outcomes 128, 129 overview 91, 92, 97 patient selection 130, 131 technique 122 124 Transvaginal sonography, see Ultrasound Ultrasound, see also Saline infusion sonohysterography adenomyosis diagnosis 41, 44, 47 Subject Index 193
Ultrasound (continued) endometrial cancer diagnosis diagnostic parameters 31, 32, 51, 53, 54 limitations 32, 33, 37 sensitivity 27, 31, 71 specificity 27, 31, 32, 54, 71 mean endometrial thickness 70 parameters for transvaginal sonography 69, 70 postmenopausal bleeding evaluation 52 54 tamoxifen endometrial hyperplasia induction findings 61, 63, 64, 70, 71 Uterine bleeding, see Abnormal uterine bleeding, Menorrhagia, Postmenopausal bleeding Vaportrode, endometrial ablation 107 109 Versapoint, endometrial ablation 109 Vesta, endometrial ablation 102, 103, 138, 145, 148 Subject Index 194