No abstract available.
Hysteroscopy*

No abstract available.
Hysteroscopy*

No abstract available.
Hysteroscopy

No abstract available.
Absorption* ; Hysteroscopy*

BACKGROUND

Simulated video training has emerged as an effective method to enhance the surgical skills. However, in the local context, there is an absence of data contrasting the outcomes of unsupervised video training with the conventional supervised approach in surgical skill development.

The objective of this study was to evaluate and contrast the performance score and total operating time between unsupervised video training simulations and supervised video training simulations, specifically in the domain of 30° hysteroscopic camera navigation.

A single-blinded randomized controlled trial involved 24 obstetrics and gynecology residents in a tertiary government institution. Participants were randomized into Group A (unsupervised video training) and Group B (proctor-supervised simulation training). Utilizing a uterine model, both groups undertook nine designated tasks. The training process included a pretest simulation, 5 training repetitions, and a concluding posttest simulation. The principal investigator documented operating times and hand movements posteach session. Subsequently, a blinded Philippine Society for Gynecologic Endoscopy board-certified gynecologic endoscopist assessed these videos, using the Global Hysteroscopy Rating Scale for scoring.

The total operating time and performance score during posttest among Group A and Group B showed no significant difference (Group A 0.77 ± 0.19 min Group B 0.71 ± 0.15 min) (P = 0.377) (Group A 13.50 ± 1.73 Group B 13.83 ± 1.53) (P = 0.622) which suggest that participants performed comparably regardless of instructional method. On the Global Rating Scale (GRS) score, higher percentage of participants from Group B showed improved performance on respect for tissue, time and motion, and handling of hysteroscope as compared to Group A.

The video-based training simulation is effective as expert proctoring in hysteroscopic camera navigation. However, there was slightly greater improvement in the GRS scores in the proctor supervised group which suggest that feedback from proctors has a positive impact on the performance.

No abstract available.
Endometrial Neoplasms* ; Female ; Hysteroscopy*

Objective: To detail the experience and evaluate the effectiveness of hysteroscopy in the Philippine General Hospital. Setting: Tertiary care center Study population: All available records of patients admitted for hysteroscopy from July 1996 to December 2000. Results: There were 240 records available for review with a mean patient age of 39.4 +/- 14.2 years (range 15-75). There was an increasing number of hysteroscopy cases, especially operative cases performed through the years. Bleeding was the most common complaint. Indications for hysteroscopy were: endometrial mass (49 percent), abnormal uterine bleeding (16 percent), infertility (10 percent), and thickened endometrium (7 percent). There were 6 cases of lost IUD. A total of 58.7 percent intracavitary abnormalities were noted during hysteroscopy and were observed in the following subgroups: 65.7 percent in those with premenopausal bleeding, 46.7 percent in those with postmenopausal bleeding, 28.9 percent in infertility, and 74.5 percent with the diagnosis of an intracavitary mass. Conclusion: A summary of hysteroscopy cases done at a tertiary care center in the Philippines was presented. This review demonstrates the utility of hysteroscopy in the diagnosis of intracavitary abnormalities and in the removal of IUDs.
HYSTEROSCOPY ; UTERINE HEMORRHAGE ; MENORRHAGIA

Fibroids may produce a complications during pregnancy. A miscarriage may result especially if implantation occurs over a submucosal fibroid. The evidence would suggest that removal of submucosal fibroids or intramural fibroids with intracavitary component would increase pregnancy rates. Such fibroids may be easily removed through hysteroscopy.
LEIOMYOMA ; FERTILIZATION IN VITRO ; HYSTEROSCOPY

Background: Endometrial hyperplasia is a common gynecologic disorder seen in the clinics. Among patients with endometrial hyperplasia, an estimated 5-10% have underlying malignancy hence early diagnosis and management is important. Hysteroscopy, regarded as the gold standard for diagnosing intrauterine abnormalities, enables accurate study of the endometrial surface as well as target eye biopsy during the same procedure. These eye-directed biopsies have a high accuracy in the hands of experienced operators, but accuracy of this technique is dependent on recognition of suspected endometrial pathology.1 Objective: The objective of this study is to ascertain inter-observer agreement in describing hysteroscopic findings among patients with endometrial hyperplasia Methodology: This is a prospective interobserver study of gynecologists from the Department of Obstetrics and Gynecology, St. Luke’s Medical Center. Three invited, consenting gynecologists reviewed 22 hysteroscopy recordings with histologic diagnosis of normal endometrium or endometrial hyperplasia from the files of the section of Minimally Invasive Gynecologic Surgery. Then, evaluation of the hysteroscopy recordings was conducted using an assessment form containing questions about the quality of the recording, characteristics of the endometrium, and their diagnoses. The final outcome of this study is the inter-observer agreement among hysteroscopists in describing hysteroscopic findings of patients with endometrial hyperplasia. Results: There is a wide gap in the interobserver agreement between hysteroscopists in describing hysteroscopic findings of patients with endometrial hyperplasia. However, the interobserver agreement was found to be substantial among participants in identifying the correct diagnosis. Conclusion A clear, systematic and standard way of identifying and describing hysteroscopic findings should be developed and instituted for use among hysteroscopists and hysteroscopy training programs. This will help in precisely identifying the areas where adequate sampling should be done.
Endometrial Hyperplasia ; Hysteroscopy

INTRODUCTION

Hysteroscopy is the gold standard procedure for the evaluation and diagnosis of intrauterine pathologies. The optimal time to do hysteroscopy is during the proliferative phase. However, for women with irregular bleeding, the optimal time is unpredictable. Besides pharmacological means, mechanical endometrial preparation could be done.

The objective of this study was to determine the effect of suction curettage on visualization, operative time, fluid deficit, and histopathologic diagnosis among perimenopausal women with abnormal uterine bleeding (AUB) and unprepared endometrium prior to operative hysteroscopy.

Thirty-four (34) perimenopausal women admitted for AUB with unprepared endometrium for operative hysteroscopy who consented to participate were recruited and randomly divided into two groups: 18 women had suction curettage done prior to operative hysteroscopy and 16 women had operative hysteroscopy done alone. The following data were obtained for each group: (1) improvement in clarity (i.e., visualization of fundus and both tubal ostia), (2) operative time from entry to withdrawal of the resectoscope (measured in minutes), (3) fluid deficit, and (4) final histopathological diagnosis. P 

Women who underwent suction curettage prior to operative hysteroscopy had improved visualization (72.2%, P < 0.001), shorter operative time (29.06 ± 7.06 min vs. 35.5 ± 7.2 min, P = 0.013), no difference in fluid deficit (P = 0.276), and the histopathologic diagnosis (P = 0.470).

Suction curettage prior to operative hysteroscopy among perimenopausal women with AUB and unprepared endometrium improved visualization and shortened operative time without affecting fluid deficit and histopathologic diagnosis.