The Hysteroscopy Encyclopedia

[Immunohistochemical markers expression in hysteroscopy and hysterectomy specimens from endometrial cancer patients: comparison]

Ceska Gynekol. 2010 May;75(3):165-70

Authors: Pilka R, Marková I, Dusková M, Zapletalová J, Tozzi M, Kudela M

OBJECTIVE: To assess the immunohistochemical expression of p53, bcl-2, c-erbB-2, Ki-67, estrogen (ER) and progesterone receptors (PR), MMP-7, MMP-26 in samplex from diagnostic hysteroscopy and therapeutic hysterectomy in endometrial cancer patients. DESIGN: Experimental prospective study. SETTING: Department of Obstetrics and Gynecology, Institute of Human Genetics, Department of Pathology, Palacky University Medical School and University Hospital, Olomouc. METHODS: We studied 43 cases of primary untreated endometrial carcinoma in which the grade and immunomarkers assessed by histoscore were investigated in specimens obtained at hysteroscopy and hysterectomy. RESULTS: Based on hysterosopy, 31 (72.1%) patients were classified as G1, G2 7 (16.3%) and G3 5 (11.6%) respective. In grade 1 the concordance rate was 77.4% of cases, in grade 2 it was in 14.3% of cases and in grade 3 it was in 80.0% of cases. In hysterosocpy samples the p53 expression was found in 23 (53.5%), bcl-2 in 37 (86.0%), c-erbB-2 in 20 (46.5%), Ki-67 in 29 (67.4%), ER in 37 (86.0%), PR in 36 (83.7%), MMP-7 in 25 (58.1%) and MMP-26 in 23 (53.5%) cases. Expression in hysterectomy specimens was p53 positive in 13 (30.2%), bcl-2 positive in 33 (76.7%), c-erbB-2 positive in 24 (55.8%), Ki-67 positive in 25 (58.1%), ER positive in 36 (83.7%), PR positive in 40 (93.0%), MMP-7 positive in 27 (62.8%) and MMP-26 positive in 23 (53.5%) of total 43 cases. CONCLUSION: We found high concordance in expression of p53, bcl-2, PR and MMP-7 in hysteroscopy and hysterectomy samples which could be of importance for therapeutic algorithm in endometrial cancer patients.

PMID: 20731294 [PubMed - in process]

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[Surgical management of intrauterine adhesions: Is benefice bigger than risk?]

Gynecol Obstet Fertil. 2010 Aug 19;

Authors: Piketty M, Lesavre M, Prat-Ellenberg L, Benifla JL

Management of intrauterine synechiae in a context of infertility remains a challenge, in spite of hysteroscopic microsurgery progress. There is no published prospective study to be used as a guideline. Anatomic, but most of all functional prognosis are directly correlated to the severity of adhesions and the number of surgical procedures required to complete treatment. Complications during surgery are not infrequent, but are well known and often benign. Obstetrical complications are much less frequent but often severe (abnormal placentation, uterine rupture). Recurrences are common enough to impose a systematic second-look diagnostic hysteroscopy. However, the benefit gained by the recovery of fertility (either spontaneous or not) remains superior, in my opinion, to the risks of the surgical management.

PMID: 20728396 [PubMed - as supplied by publisher]

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Effectiveness of misoprostol for office hysteroscopy without anesthesia in infertile patients.

Fertil Steril. 2010 Aug 19;

Authors: Sordia-Hernández LH, Rosales-Tristan E, Vazquez-Mendez J, Merino M, Iglesias JL, Garza-Leal JG, Morales A

OBJECTIVE: To evaluate and compare the effectiveness of oral and vaginal misoprostol versus placebo to facilitate office hysteroscopy without anesthesia during infertile diagnostic evaluation. DESIGN: Randomized, prospective trial. SETTING: Patients scheduled for diagnostic office hysteroscopy at a university hospital. PATIENT(S): Seventy-five infertile patients scheduled for diagnostic office hysteroscopy. INTERVENTION(S): Patients were divided into three groups: group A received oral misoprostol 600 mug; group B, vaginal misoprostol 400 mug; and group C, oral placebo. MAIN OUTCOME MEASURE(S): Pain, evaluated by visual analogue scale, and surgical time were recorded and compared. Statistical analysis was done using Student's t-test. RESULT(S): Pain was low in the vaginal misoprostol group. Mean visual analogue scale in the oral misoprostol group was 6.04 +/- 1.5; in the vaginal misoprostol group 2.85 +/- 1.2; and in the placebo group 7.50 +/- 1.5. Procedural time for office hysteroscopy was shorter in the vaginal misoprostol group (2.7 +/- 1.0 minutes) compared with group A (5.5 +/- 1.1 minutes) and group C (6.3 +/- 3.8 minutes). CONCLUSION(S): Vaginal misoprostol, 400 mug, administered the day before office hysteroscopy considerably reduces pain and the time needed for hysteroscopy. This simple strategy may facilitate office hysteroscopy during an infertility work-up.

PMID: 20728083 [PubMed - as supplied by publisher]