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Epidemics and complications of hysteroscopy

وبائيات واختلاطات تنظير باطن الرحم

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 Publication date 2014
and research's language is العربية
 Created by Shamra Editor




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Hysteroscopy is a very important procedure to diagnose many lesions inside the uterus like: endometrial polyps, Leiomyomas , uterine malformations , adhesions in uterine endometrium. Hysteroscopy's benefit is shown in the way it provides us with direct vision to the uterus . Our Research is conducted around complications of hysteroscopy and its percentage . This research included 82 patients visited the department of obstetrics and gynecology with these complaints : infertility, abnormal uterine bleeding, menstrual disorders, recurrent abortions , Missing strings of IUDs . the complication rate of the hysteroscopy were ( 4.88% ) the most ommon complication was: bleeding ( 2.44% ) , it was the same rate of uterine perforation and acute abdominal pain ( 1.22% ) We never found any differences of complications rates According to different indications of hysteroscopy or according to the technique . As we found the Zero rate of vaginal delivery to the patient plays a role as a dangerous factor in the high rate of complications . Then , the Complication rate in our study are little, this explain that hysteroscopy is a safe procedure, and that push us to recommend to us it routinely which reduce the hospitalization time and the cost

References used
ANTHONY, M ; PROPST ; REBECCA, F ; LIBERMAN ; BERNARD , L ; HARLOW . Complicathion Of Hysteroscopyic Surgery. Obstet Gynecol USA .2000, 7844.P:517-520
<ATTILIO,D ; SEPIZIO,S ;ALEXANDAR, T ; PANOS ,T ;GEORGES,M ; MALINI , S ;ADAM , M . Hysteroscpoy:A Technique For All ?Analysis Of 5000 Outpatient Hysteroscopy . UK .2007.<WWW.Sciensedirect.Com
<AUBERT , A ; LUDOVIC , C ; RAHA, S ; RANDA, I ; ROGER ,V; BLANCE, B.Postoperative Infection And Surgical Hysteroscpoy . India .2006. <WWW.Sciensedirect.Com
FRANK, W ; VREDEVOOGD ,C; VAN VLZEN , K; HERMANS, J; Baptist, J ; TRUDY, C ; TRIMBOS, K. Complications Of Hysteroscpy : Aprospective ; Multicentre Study. Obstet Gynecol. Netherlande . 2005 , 7844 , P:266-270
JAI , B ; KALLOL , K ; MOHANRAJ, P ; DEBJYOTY , K; SUNESH , K . Increased Difficulties and Complications encountered During Hysteroscopy. India .2011, www.sciencedirect . com

Artificial intelligence review:
Research summary
تتناول هذه الدراسة موضوع تنظير باطن الرحم وأهميته في تشخيص وعلاج العديد من الحالات المرضية النسائية مثل العقم، النزف التناسلي الشاذ، الاضطرابات الطمثية، الإسقاطات المتكررة، وضياع خيط اللولب. أجريت الدراسة على 82 مريضة في مشفى الأسد الجامعي باللاذقية، حيث تم تقييم نسبة الاختلاطات الناجمة عن هذا الإجراء. بلغت نسبة الاختلاطات 4.88%، وكانت الاختلاطات الأكثر شيوعاً هي النزف بنسبة 2.44%، تليها نسبة متساوية لكل من انثقاب الرحم والألم البطني الحاد بنسبة 1.22% لكل منهما. لم تُلاحظ أي اختلافات في نسب الاختلاطات بناءً على الاستطبابات المختلفة للتنظير، ولكن لوحظ أن عدم وجود ولادات سابقة عند المريضة يشكل عامل خطورة لارتفاع نسبة الاختلاطات. توصي الدراسة باستخدام تنظير باطن الرحم بشكل أوسع نظراً لأمانه وانخفاض نسبة الاختلاطات، مما يقلل من مدة الاستشفاء والتكلفة الاقتصادية.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة جداً في تسليط الضوء على أهمية تنظير باطن الرحم كوسيلة تشخيصية وعلاجية فعالة. ومع ذلك، يمكن توجيه بعض النقد البنّاء لتحسين الدراسة مستقبلاً. أولاً، كان من الممكن توسيع حجم العينة لتشمل عدد أكبر من المريضات للحصول على نتائج أكثر دقة وشمولية. ثانياً، لم تتطرق الدراسة بشكل كافٍ إلى العوامل النفسية والاجتماعية التي قد تؤثر على نتائج التنظير. أخيراً، كان من الممكن تقديم توصيات أكثر تفصيلاً حول كيفية تقليل نسبة الاختلاطات بشكل أكبر، مثل تحسين تقنيات التخدير أو استخدام أدوات أكثر تطوراً.
Questions related to the research
  1. ما هي نسبة الاختلاطات الناجمة عن تنظير باطن الرحم في هذه الدراسة؟

    بلغت نسبة الاختلاطات الناجمة عن تنظير باطن الرحم في هذه الدراسة 4.88%.

  2. ما هو الاختلاط الأكثر شيوعاً في الدراسة؟

    الاختلاط الأكثر شيوعاً في الدراسة هو النزف بنسبة 2.44%.

  3. هل هناك علاقة بين نوع الاستطباب ونسبة حدوث الاختلاطات؟

    لم تُلاحظ أي علاقة بين نوع الاستطباب ونسبة حدوث الاختلاطات في هذه الدراسة.

  4. ما هي التوصيات الرئيسية للدراسة؟

    توصي الدراسة باستخدام تنظير باطن الرحم بشكل أوسع كوسيلة تشخيصية وعلاجية نظراً لأمانه وانخفاض نسبة الاختلاطات، مما يقلل من مدة الاستشفاء والتكلفة الاقتصادية.

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Hysteroscopy was done at the New Damascus University Maternity hospital in the period between 1/1/1998 and 30/9/1999. The hysteroscopied cases were 90 and the indications were as follow: (71) Cases were infertility (78.88 %); 45 of these were prim ary while the other 26 were secondary. (6) Cases were lost IUD (6.66%), and the IUD was removed by hysteroscopy. (4) Cases were recurrent spontaneous abortion (4.44%) (3) Cases were untreatable uterine bleeding (3.33%). (2) Cases were endometrial polyps (2.22%). (2) Cases were Asherman’s Syndrome (2.22%). One case was primary amenorrhea and one case was leiomyoma.
This study evaluates the efficacy and the safety of local anaesthesia with lidocaine spray to avoid the need for additional or general anaesthesia and reducing pain during out-patient hysteroscopy. This study evaluates also the efficacy and the sa fety of local anaesthesia with paracervical injection of lidocaine and giving of midazolam intravenously during out-patient culdoscopy. Design: Prospective study between 01.03.1999 and 30.06.1999. Patients: 62 patients underwent out-patient hysteroscopy clinic between 01.03.1999 and 30.06.1999. Culdoscopy performed in 10 of them as infertility-workup. Setting: Out-patient hysteroscopy clinic in the University Hospital of Vienna.
Mankind is still suffering from many diseases , and with the development of civilization there are many diseases that appear with different clinical types , but tumors, especially malignant , are still very important. Cervical cancer is the secon d common cancer in women , as it is the cause of more than 200.000 deaths annually. Hence the importance of early detection of cervical cancer and of decreasing mortality.
Uterine curettage is considered the fundamental procedure in the treatment of abortions especially in complete and missed abortions in many counties despite the availability of many alternative methods to treat these cases. It is also widely used as a diagnostic means to diagnoses the endometrial abnormalities which cause abnormal uterine bleeding. This research aims to figure out complications rate which occur during uterine curettage and the subsequent complications rate and to identify the most important causes of them for the purpose of knowing the efficiency and the safety of the diagnostic and therapeutic uterine curettage.
Objectives: This was a prospective study, conducted to analyze the intraoperative and postoperative complications between abdominal and vaginal hysterectomy. METHODS: This study was carried out on 120 patients (85 cases abdominal and 35 cases vagi nal hysterectomy),in the department of gynecology at Al-Assad university hospital in Lattakia in the period between 1/7/2013-1/7/2014. Results: the mean duration of surgery of abdominal hysterectomy was 103 min and that of vaginal was 91 min (p=0.0192). Wound infection was the main cause for febrile morbidity in abdominal hysterectomy group where as urinary tract infection was the main cause for febrile morbidity in vaginal hysterectomy. There was 3)3,5%(case of bladder injury and 2(2,8%) case of ureteric injury in abdominal hysterectomy group while none in vaginal hysterectomy group Postoperatively there was 3 (3,5%) cases of secondary haemorrage in TAH group while 1(2,8%) case in vaginal hysterectomy .there were 8 (9,4%) cases of paralytic ileus in abdominal hysterectomy while none in vaginal hysterectomy . Overall 45 (52.9%) cases of abdominal hysterectomy and 12 (34.2%) case of vaginal hysterectomy had complications (p=0.029). Conclusions: This study showed that vaginal hysterectomy was associated with less intraoperative complications and postoperative complications as compared to abdominal hysterectomy.
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