Pub Date : 2022-04-01DOI: 10.19852/j.cnki.jtcm.20220218.001
Zhang Chengfei, Qin Lingling, Wang Haiyan, Sun Boju, Zhao Dan, Zhang Qiue, Zhong Fengying, W U Lili, Liu Tonghua
Objective: To observe the effects of the flower of Edgeworthia gardneri (Wall.) Meisn (EWM) on glucose and lipid metabolism in KK/upj-Ay/J (KKAy) mice and investigate the possible mechanism of EWM in the liver of KKAy mice by transcriptome analysis.
Methods: Forty KKAy mice were fed a high-sugar and high-fat diet for 3 weeks to establish the animal model of metabolic syndrome. After 5 weeks of continuous administration of EWM, serum high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), total cholesterol (TC), and free fatty acids (FFA) were detected by radioimmunoassay. Serum fasting insulin (Fins) and adiponectin levels were measured by enzyme-linked immunosorbent assay. Liver tissue fixed with paraformaldehyde was stained with hematoxylin-eosin and oil red O. Transcriptome analysis was used to evaluate the liver tissue. The expressions of lipoprotein lipase (LPL), peroxisome proliferator-activated receptor-γ (PPARγ), adenosine 5'-monophosphate-activated protein kinase (AMPK), sterol regulatory element binding protein-1c (SREBP-1c), and fatty acid synthase (Fas) mRNA and protein in liver tissue were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis.
Results: EWM slightly reduced FBG and Fins in KKAy mice. Furthermore, EWM was able to downregulate serum LDL, TG, TC, and FFA and upregulate the expression of serum HDL and adiponectin. Transcriptome analysis revealed the following differential pathways: the peroxisome proliferator-activated receptor (PPAR) signaling pathway and the AMPK signaling pathway. RT-PCR and western blot analysis detected the associated genes and proteins. In addition, EWM was able to upregulate the expression of AMPK and downregulate the expression of PPARγ, SREBP1c, and Fas mRNA and protein and upregulate the expression of LPL mRNA.
Conclusions: EWM can alleviate lipid metabolism disorders and to some extent improve glucose metabolism disorders in KKAy mice. These effects may be related to regulating PPARγ/LPL and activating the AMPK/SREBP1c/Fas pathway.
{"title":"Efficacy of aqueous extract of flower of Edgeworthia gardneri (Wall.) Meisn on glucose and lipid metabolism in KK/Upj-Ay/J mice.","authors":"Zhang Chengfei, Qin Lingling, Wang Haiyan, Sun Boju, Zhao Dan, Zhang Qiue, Zhong Fengying, W U Lili, Liu Tonghua","doi":"10.19852/j.cnki.jtcm.20220218.001","DOIUrl":"10.19852/j.cnki.jtcm.20220218.001","url":null,"abstract":"<p><strong>Objective: </strong>To observe the effects of the flower of Edgeworthia gardneri (Wall.) Meisn (EWM) on glucose and lipid metabolism in KK/upj-Ay/J (KKAy) mice and investigate the possible mechanism of EWM in the liver of KKAy mice by transcriptome analysis.</p><p><strong>Methods: </strong>Forty KKAy mice were fed a high-sugar and high-fat diet for 3 weeks to establish the animal model of metabolic syndrome. After 5 weeks of continuous administration of EWM, serum high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), total cholesterol (TC), and free fatty acids (FFA) were detected by radioimmunoassay. Serum fasting insulin (Fins) and adiponectin levels were measured by enzyme-linked immunosorbent assay. Liver tissue fixed with paraformaldehyde was stained with hematoxylin-eosin and oil red O. Transcriptome analysis was used to evaluate the liver tissue. The expressions of lipoprotein lipase (LPL), peroxisome proliferator-activated receptor-γ (PPARγ), adenosine 5'-monophosphate-activated protein kinase (AMPK), sterol regulatory element binding protein-1c (SREBP-1c), and fatty acid synthase (Fas) mRNA and protein in liver tissue were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis.</p><p><strong>Results: </strong>EWM slightly reduced FBG and Fins in KKAy mice. Furthermore, EWM was able to downregulate serum LDL, TG, TC, and FFA and upregulate the expression of serum HDL and adiponectin. Transcriptome analysis revealed the following differential pathways: the peroxisome proliferator-activated receptor (PPAR) signaling pathway and the AMPK signaling pathway. RT-PCR and western blot analysis detected the associated genes and proteins. In addition, EWM was able to upregulate the expression of AMPK and downregulate the expression of PPARγ, SREBP1c, and Fas mRNA and protein and upregulate the expression of LPL mRNA.</p><p><strong>Conclusions: </strong>EWM can alleviate lipid metabolism disorders and to some extent improve glucose metabolism disorders in KKAy mice. These effects may be related to regulating PPARγ/LPL and activating the AMPK/SREBP1c/Fas pathway.</p>","PeriodicalId":75741,"journal":{"name":"Contributions to gynecology and obstetrics","volume":"6 1","pages":"187-193"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86879274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although postmenopausal bleeding (PMPB) is a frequent problem in clinical practice and as such has major clinical relevance, the management strategies are often quite different. This review, after an introduction describing the various causes of PMPB, analyses in which order diagnostic procedures are indicated. There is much concern in decreasing the rate of invasive procedures; this is possible with the aid of transvaginal ultrasound (TVS) which is very reliable in excluding endometrial cancer at a thickness of < or = 4 mm. The vast majority of benign and malignant endometrial changes have an endometrial thickness of > 4 mm. Since the specificity of TVS for a pathological finding at a thickness of > 4 mm is low, other investigations are needed. Saline infusion sonohysterography (SIS), an easy complementary tool to TVS, and office hysteroscopy seem to give the same results, the first one being better accepted by the patients, the latter permitting biopsies and resections to be performed at the same time. Anyway, in all these cases a histological diagnosis is mandatory (endometrial biopsy/D&C/hysteroscopic resection). In cases of persisting or recurrent PMPB, independent of the TVS result, a hysteroscopy (with biopsy and/or resection) is mandatory.
{"title":"Hysteroscopy in the assessment of postmenopausal bleeding.","authors":"L. Bronz","doi":"10.1159/000060282","DOIUrl":"https://doi.org/10.1159/000060282","url":null,"abstract":"Although postmenopausal bleeding (PMPB) is a frequent problem in clinical practice and as such has major clinical relevance, the management strategies are often quite different. This review, after an introduction describing the various causes of PMPB, analyses in which order diagnostic procedures are indicated. There is much concern in decreasing the rate of invasive procedures; this is possible with the aid of transvaginal ultrasound (TVS) which is very reliable in excluding endometrial cancer at a thickness of < or = 4 mm. The vast majority of benign and malignant endometrial changes have an endometrial thickness of > 4 mm. Since the specificity of TVS for a pathological finding at a thickness of > 4 mm is low, other investigations are needed. Saline infusion sonohysterography (SIS), an easy complementary tool to TVS, and office hysteroscopy seem to give the same results, the first one being better accepted by the patients, the latter permitting biopsies and resections to be performed at the same time. Anyway, in all these cases a histological diagnosis is mandatory (endometrial biopsy/D&C/hysteroscopic resection). In cases of persisting or recurrent PMPB, independent of the TVS result, a hysteroscopy (with biopsy and/or resection) is mandatory.","PeriodicalId":75741,"journal":{"name":"Contributions to gynecology and obstetrics","volume":"20 1","pages":"51-9"},"PeriodicalIF":0.0,"publicationDate":"2000-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000060282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65036163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Within just a few years, operative hysteroscopy has largely replaced laparotomy in the treatment of submucous myomas. Due to the rapid expansion of hysteroscopic surgery techniques, guidelines must be defined to standardize the procedure and at the same time provide the basis for highly individualized treatment of each patient. The choice of an appropriate therapeutic approach in this context is an issue of logistics, rather than surgery. Factors contributing to the individualized decision regarding the therapeutic approach include indications, individual anatomical conditions encountered, necessity of medical pretreatment, available equipment and adequate premises at the surgical center, and intraoperative procedure of choice. Taking into consideration all these issues, the present article aims at presenting to the surgeon not only a summary of the state-of-the-art techniques, but also a guideline for sophisticated strategy planning for and performance of the hysteroscopic technique of myoma resection.
{"title":"Hysteroscopic resection of submucous myomas.","authors":"P. Brandner, K. Neis, P. Diebold","doi":"10.1159/000060289","DOIUrl":"https://doi.org/10.1159/000060289","url":null,"abstract":"Within just a few years, operative hysteroscopy has largely replaced laparotomy in the treatment of submucous myomas. Due to the rapid expansion of hysteroscopic surgery techniques, guidelines must be defined to standardize the procedure and at the same time provide the basis for highly individualized treatment of each patient. The choice of an appropriate therapeutic approach in this context is an issue of logistics, rather than surgery. Factors contributing to the individualized decision regarding the therapeutic approach include indications, individual anatomical conditions encountered, necessity of medical pretreatment, available equipment and adequate premises at the surgical center, and intraoperative procedure of choice. Taking into consideration all these issues, the present article aims at presenting to the surgeon not only a summary of the state-of-the-art techniques, but also a guideline for sophisticated strategy planning for and performance of the hysteroscopic technique of myoma resection.","PeriodicalId":75741,"journal":{"name":"Contributions to gynecology and obstetrics","volume":"20 1","pages":"81-90"},"PeriodicalIF":0.0,"publicationDate":"2000-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000060289","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65036276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. König, A. Meyer, B. Aydeniz, R. Kurek, D. Wallwiener
During the last few years, diagnostic hysteroscopy has become a standard procedure in the diagnosis of abnormal uterine bleeding, sonographically suspicious endometrial reflex and fertility disorders. At the same time the hysteroscopic treatment of intrauterine pathology is becoming more common. Today, hysteroscopic resection of uterine myomas, dissection of uterine septa, and endometrial ablation are standard procedures. Using monopolar cutting devices and saline-free distension media, hysteroscopic surgery bears specific risks. The knowledge of these risks is important to avoid typical complications of operative hysteroscopy. This article gives an overview about the most common procedures of operative hysteroscopy and the combined risks. Criteria for a safe procedure are defined in order to increase the quality management of operative hysteroscopy.
{"title":"Hysteroscopic surgery--complications and their prevention.","authors":"M. König, A. Meyer, B. Aydeniz, R. Kurek, D. Wallwiener","doi":"10.1159/000060275","DOIUrl":"https://doi.org/10.1159/000060275","url":null,"abstract":"During the last few years, diagnostic hysteroscopy has become a standard procedure in the diagnosis of abnormal uterine bleeding, sonographically suspicious endometrial reflex and fertility disorders. At the same time the hysteroscopic treatment of intrauterine pathology is becoming more common. Today, hysteroscopic resection of uterine myomas, dissection of uterine septa, and endometrial ablation are standard procedures. Using monopolar cutting devices and saline-free distension media, hysteroscopic surgery bears specific risks. The knowledge of these risks is important to avoid typical complications of operative hysteroscopy. This article gives an overview about the most common procedures of operative hysteroscopy and the combined risks. Criteria for a safe procedure are defined in order to increase the quality management of operative hysteroscopy.","PeriodicalId":75741,"journal":{"name":"Contributions to gynecology and obstetrics","volume":"20 1","pages":"161-70"},"PeriodicalIF":0.0,"publicationDate":"2000-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000060275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65035941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hydrothermablation is a new method which could replace the electrosurgical method of endometrial ablation. Some prospective studies were carried out to assess efficacy, safety and tolerability of hydrothermablation in the treatment of recurrent menorrhagias. Hydrothermablation is an intervention with coagulation at the endometrium: temperature 90 degrees C and duration 10 min with simultaneous hysteroscopic control. In a follow-up of least 12 months, about 35% of the patients had an amenorrhea and the treatment was successful (reduction of pathological blood flow) in about 87% of the patients. Complications were vaginal burns in 2 cases. No other intra- or postoperative complications occurred. Hydrothermablation is a safe and effective method for treatment of recurrent menorrhagias. This method offers a simple possibility to perform endometrial ablation without extensive training of the surgeon and can contribute to avoid hysterectomy.
{"title":"Hydrothermal ablation. A new simple method for coagulating endometrium in patients with therapy-resistant recurring hypermenorrhea.","authors":"T. Römer, J. Müller, D. Foth","doi":"10.1159/000060276","DOIUrl":"https://doi.org/10.1159/000060276","url":null,"abstract":"Hydrothermablation is a new method which could replace the electrosurgical method of endometrial ablation. Some prospective studies were carried out to assess efficacy, safety and tolerability of hydrothermablation in the treatment of recurrent menorrhagias. Hydrothermablation is an intervention with coagulation at the endometrium: temperature 90 degrees C and duration 10 min with simultaneous hysteroscopic control. In a follow-up of least 12 months, about 35% of the patients had an amenorrhea and the treatment was successful (reduction of pathological blood flow) in about 87% of the patients. Complications were vaginal burns in 2 cases. No other intra- or postoperative complications occurred. Hydrothermablation is a safe and effective method for treatment of recurrent menorrhagias. This method offers a simple possibility to perform endometrial ablation without extensive training of the surgeon and can contribute to avoid hysterectomy.","PeriodicalId":75741,"journal":{"name":"Contributions to gynecology and obstetrics","volume":"20 1","pages":"154-60"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000060276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65035970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Endometrial resection (TRCE) is a well-examined alternative therapy to hysterectomy in the treatment of menorrhagia that preserves the uterus at long term in at least 70% of patients. The technique and safety considerations are described and an overview of the existing evidence is given. Complication rates (2.5%) and performance of the personal series of 465 operative hysteroscopies including 244 endometrial resections with a follow-up of at least 18 months are shown. 3.3% of patients with endometrial resection needed a hysterectomy up to now (follow-up 18-90 months). The combination of endometrial resection and the insertion of the levonorgestrel hormone-releasing intrauterine device (LNG-IUD) is described. Especially in patients with adenomyosis, the combination of LNG-IUD with endometrial resection augments the success rate. 96 of 99 patients with the combined therapy (TRCE and LNG-IUD) and a follow-up of 18-48 months still have their uterus.
{"title":"Hysteroscopic endometrial resection.","authors":"H. Bratschi","doi":"10.1159/000060291","DOIUrl":"https://doi.org/10.1159/000060291","url":null,"abstract":"Endometrial resection (TRCE) is a well-examined alternative therapy to hysterectomy in the treatment of menorrhagia that preserves the uterus at long term in at least 70% of patients. The technique and safety considerations are described and an overview of the existing evidence is given. Complication rates (2.5%) and performance of the personal series of 465 operative hysteroscopies including 244 endometrial resections with a follow-up of at least 18 months are shown. 3.3% of patients with endometrial resection needed a hysterectomy up to now (follow-up 18-90 months). The combination of endometrial resection and the insertion of the levonorgestrel hormone-releasing intrauterine device (LNG-IUD) is described. Especially in patients with adenomyosis, the combination of LNG-IUD with endometrial resection augments the success rate. 96 of 99 patients with the combined therapy (TRCE and LNG-IUD) and a follow-up of 18-48 months still have their uterus.","PeriodicalId":75741,"journal":{"name":"Contributions to gynecology and obstetrics","volume":"33 1","pages":"121-36"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000060291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65036382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Tercanli, O. Köchli, I. Hoesli, G. Feichter, A. Schaub, W. Holzgreve
Transvaginal sonography is an established method for numerous clinical indications in the assessment of endometrium pathology. The investigation of the endometrium consists of the measurement of the thickness, the visualization of the echogenity and echotexture and of the demonstration of focal masses. However, evaluation of the uterine cavity by transvaginal sonography is limited and an abnormal ultrasound of the endometrium may reflect benign or malignant conditions. Furthermore, small structures can be missed or overlooked. If indicated, hydrosonography offers various advantages compared to dilatation and curettage and hysteroscopy in terms of costs, availability and risks. Additional informations obtained after hydrosonography may influence the management before consideration of curettage or hysteroscopy.
{"title":"Differentiation and management of endometrium abnormalities and leiomyomas by hydrosonography.","authors":"S. Tercanli, O. Köchli, I. Hoesli, G. Feichter, A. Schaub, W. Holzgreve","doi":"10.1159/000060288","DOIUrl":"https://doi.org/10.1159/000060288","url":null,"abstract":"Transvaginal sonography is an established method for numerous clinical indications in the assessment of endometrium pathology. The investigation of the endometrium consists of the measurement of the thickness, the visualization of the echogenity and echotexture and of the demonstration of focal masses. However, evaluation of the uterine cavity by transvaginal sonography is limited and an abnormal ultrasound of the endometrium may reflect benign or malignant conditions. Furthermore, small structures can be missed or overlooked. If indicated, hydrosonography offers various advantages compared to dilatation and curettage and hysteroscopy in terms of costs, availability and risks. Additional informations obtained after hydrosonography may influence the management before consideration of curettage or hysteroscopy.","PeriodicalId":75741,"journal":{"name":"Contributions to gynecology and obstetrics","volume":"20 1","pages":"69-80"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000060288","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65036527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Different techniques of global endometrial ablation have been developed during the last 5 years, starting with the introduction of the thermal and the electrocoagulation balloon up to the latest development of bipolar coagulation techniques. Balloon application has many advantages to traditional hysteroscopic laser or electrotechniques. No pre-operative hormonal treatment is required. The operation itself is easier to perform and there is no need for experience in operative hysteroscopy. The main advantage is the lack of a distention medium. Even anesthesiological high risk patients can be treated by balloon techniques without problems. Hysterectomy can be avoided more and more. Essential for global endometrial ablation, in my mind, is a diagnostic hysteroscopy best performed immediately prior to endometrial ablation. In this way, the uterine cavity is evaluated and complications can be avoided or detected early. This combination results in excellent outcome with the lowest complication rate.
{"title":"Endometrial ablation by balloon coagulation.","authors":"A. Gallinat","doi":"10.1159/000060274","DOIUrl":"https://doi.org/10.1159/000060274","url":null,"abstract":"Different techniques of global endometrial ablation have been developed during the last 5 years, starting with the introduction of the thermal and the electrocoagulation balloon up to the latest development of bipolar coagulation techniques. Balloon application has many advantages to traditional hysteroscopic laser or electrotechniques. No pre-operative hormonal treatment is required. The operation itself is easier to perform and there is no need for experience in operative hysteroscopy. The main advantage is the lack of a distention medium. Even anesthesiological high risk patients can be treated by balloon techniques without problems. Hysterectomy can be avoided more and more. Essential for global endometrial ablation, in my mind, is a diagnostic hysteroscopy best performed immediately prior to endometrial ablation. In this way, the uterine cavity is evaluated and complications can be avoided or detected early. This combination results in excellent outcome with the lowest complication rate.","PeriodicalId":75741,"journal":{"name":"Contributions to gynecology and obstetrics","volume":"20 1","pages":"137-44"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000060274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65035935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adenomyosis, a disease of the myometrium, can be diagnosed by hysteroscopy. Histologic specimens removed by transcervical punch biopsies or loop resection give more information on the depth of the adenomyosis. Symptomatic superficial adenomyosis can be treated sufficiently by transcervical endometrial coagulation or resection but can lead to iatrogenic adenomyosis, which can be treated by second-look hysteroscopy. Adenomyosis may also be caused by incomplete transcervical endometrial ablation or resection. In selected cases, hysteroscopic treatment of symptomatic focal adenomyosis becomes possible.
{"title":"Hysteroscopy and adenomyosis.","authors":"J. Keckstein","doi":"10.1159/000060287","DOIUrl":"https://doi.org/10.1159/000060287","url":null,"abstract":"Adenomyosis, a disease of the myometrium, can be diagnosed by hysteroscopy. Histologic specimens removed by transcervical punch biopsies or loop resection give more information on the depth of the adenomyosis. Symptomatic superficial adenomyosis can be treated sufficiently by transcervical endometrial coagulation or resection but can lead to iatrogenic adenomyosis, which can be treated by second-look hysteroscopy. Adenomyosis may also be caused by incomplete transcervical endometrial ablation or resection. In selected cases, hysteroscopic treatment of symptomatic focal adenomyosis becomes possible.","PeriodicalId":75741,"journal":{"name":"Contributions to gynecology and obstetrics","volume":"20 1","pages":"41-50"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000060287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65036216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diagnostic hysteroscopy should be included routinely in the work-up of invasive examinations for infertility patients. Anyhow, one can rarely expect to find the definite underlying reason for infertility. In infertile patients about 20% of hysteroscopic examinations show some grade of intrauterine abnormalities. Congenital uterine malformations are the most frequently found disorders. In the group of patients with habitual abortions abnormalities are found much more often and can also be more often interpreted as the mainly underlying factor for the repeated abortions. Operative hysteroscopy has become the surgical method of first choice for the treatment of uterine septa, submucous myomas, polyps and synechia. After septum dissection results are excellent. Myoma removal also shows beneficial effects on fertility; nevertheless, cases are not too frequent among infertility patients. In cases of high-grade Asherman's syndrome, the prognosis after hysteroscopic surgery is still often poor.
{"title":"Hysteroscopy in infertility--diagnosis and treatment including falloposcopy.","authors":"J. Hucke, F. De Bruyne, P. Balan","doi":"10.1159/000060272","DOIUrl":"https://doi.org/10.1159/000060272","url":null,"abstract":"Diagnostic hysteroscopy should be included routinely in the work-up of invasive examinations for infertility patients. Anyhow, one can rarely expect to find the definite underlying reason for infertility. In infertile patients about 20% of hysteroscopic examinations show some grade of intrauterine abnormalities. Congenital uterine malformations are the most frequently found disorders. In the group of patients with habitual abortions abnormalities are found much more often and can also be more often interpreted as the mainly underlying factor for the repeated abortions. Operative hysteroscopy has become the surgical method of first choice for the treatment of uterine septa, submucous myomas, polyps and synechia. After septum dissection results are excellent. Myoma removal also shows beneficial effects on fertility; nevertheless, cases are not too frequent among infertility patients. In cases of high-grade Asherman's syndrome, the prognosis after hysteroscopic surgery is still often poor.","PeriodicalId":75741,"journal":{"name":"Contributions to gynecology and obstetrics","volume":"20 1","pages":"13-20"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1159/000060272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65035929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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