Reference : Hystéroscopie opératoire ou hystérectomie dans le traitement des lésions utérines bén...
Scientific journals : Article
Human health sciences : Reproductive medicine (gynecology, andrology, obstetrics)
http://hdl.handle.net/2268/74948
Hystéroscopie opératoire ou hystérectomie dans le traitement des lésions utérines bénignes. Que choisir en 1998?
French
[en] surgical Hysteroscopy or Hysterectomy in the Treatment of Benign Uterine Lesions. What to Choose in 1998?
Herman, Philippe mailto [Université de Liège - ULg > > Sénologie - Gynécologie-Obstétrique CHR >]
Gaspard, Ulysse mailto [Université de Liège - ULg > > Gynécologie-Obstétrique >]
Foidart, Jean-Michel mailto [Université de Liège - ULg > Département des sciences cliniques > Gynécologie - Obstétrique >]
Dec-1998
Revue Médicale de Liège
53
12
756-61
Yes (verified by ORBi)
0370-629X
[en] In the past, the treatment of benign uterine lesions required, in many instances, a hysterectomy. These days, most cases can be successfully treated by hysteroscopy. To be reliable, this technique must lead to a significant reduction in the number of hysterectomies performed for benign uterine lesions. The electroresection technique is preferred to that using the Nd-YAG laser because of its lower cost and its equivalent efficacy. By using the uterine perfusion pump device, the risk of resorption syndrome can be reduced to its minimum. Submucosal myomas < 1 cm, benign endometrial hyperplasia and adenomyosis are the commonest benign lesions treated. Dysfunctional uterine bleeding can also be treated by an endometrectomy. A preoperative workup includes a transvaginal ultrasound and a biopsy. This ensures that only benign lesions that are accessible to a hysteroscopy will be submitted to this technique and that no cases of endometrial cancer or atypical hyperplasia would be ignored. This study presents 270 cases of operative hysteroscopy with a follow-up to 4 years. 82.8% of myomatous lesions were treated with success. The results for patients with benign endometrial polyps or benign endometrial hyperplasia are also excellent with only 4.6% and 5.6% rate of secondary surgery respectively. Adenomyosis does not appear to be a good indication for hysteroscopy as only 37% of patients did not need a definitive hysterectomy. Rates of operative complications (post-operative bleeding, uterine perforation, resorption syndrome and difficulty of access) are acceptable and get less frequent as the surgeon experience increases.
http://hdl.handle.net/2268/74948

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