OBJECTIVE: To evaluate the diagnosis and treatment of hysteroscopy and its complications. METHODS: Reviewed 415 cases treated by hysteroscopy during 1994.9-2003.2 at Ajou University Hospital. RESULTS: Major indications were infertility (321 cases, 77.3%) and gynecologic indications such as myoma, polyps etc (94 cases, 22.7%). Hysteroscopic findings were polyp (192 cases, 46.3%), synechiae (72 cases, 17.3%), submucosal myoma (21 cases, 5.1%) and uterine anomaly (13 cases, 3.1%). Complications were 2 cases of uterine perforations and one case of bowel injury. CONCLUSION: Hysteroscopy is a safe, minimally invasive procedure with a low rate of complications.
Diagnosis* ; Hysteroscopy* ; Infertility ; Myoma ; Polyps ; Uterine Perforation

Pyometra is an accumulation of purulent fluid in the uterine cavity. Generalized peritonitis secondary to a perforated pyometra is extremely rare. Most of the pyometra perforation is associated with malignancy. We have experienced a case of generalized peritonitis secondary to a perforated pyometra with no associated malignancy.
Abdomen, Acute ; Peritonitis ; Pyometra ; Uterine Perforation

High-intensity focused ultrasound (HIFU) is a non-invasive uterine fibroid treatment option for patients who want to preserve fertility. However, according to several reports regarding ablation of solid tumors by HIFU, there are rare complications in patients with uterine leiomyomas, and overall data are still insufficient. Here, we report rare and major complications of HIFU, such as delayed intestinal perforation, uterine perforation with recto-uterine fistula, and osteomyelitis 29 days after the HIFU procedure to treat multiple myomas. Thus, we present a very serious case resulting from HIFU treatment of uterine fibroids and a review of the literature.
Fertility ; Fistula ; Humans ; Intestinal Perforation* ; Leiomyoma* ; Myoma ; Osteomyelitis* ; Ultrasonography* ; Uterine Perforation

OBJECTIVE: to evaluate the incidence of complications of hysteroscopic surgery. METHODS: A total of 150 patients who was done by hysteroscopic surgery from February 1997 to February 2000 were retrospectively analyzed at Choon Hae Hospital, Pusan, Korea. We classified complications into 6 groups - infection, surgeon-related complication, distension-media related complication, energy source related complication, hemorrhage and others. RESULTS: Overall complication rates were 6% (9 to 150). Surgeon-related complication rate was 1.3% (2 of 150), media-related complication rate was 0.7% (1 of 150), hemorrhage was 4% (6 of 150). And there's no complications of infection, energy-source related, or others. CONCLUSION: Hysteroscopy is a safe procedure if you know the complications of hysteroscopy & its mechanisms.
Busan ; Hemorrhage ; Humans ; Hysteroscopy* ; Incidence* ; Korea ; Retrospective Studies ; Uterine Perforation

OBJECTIVE: to evaluate the incidence of complications of hysteroscopic surgery. METHODS: A total of 150 patients who was done by hysteroscopic surgery from February 1997 to February 2000 were retrospectively analyzed at Choon Hae Hospital, Pusan, Korea. We classified complications into 6 groups - infection, surgeon-related complication, distension-media related complication, energy source related complication, hemorrhage and others. RESULTS: Overall complication rates were 6% (9 to 150). Surgeon-related complication rate was 1.3% (2 of 150), media-related complication rate was 0.7% (1 of 150), hemorrhage was 4% (6 of 150). And there's no complications of infection, energy-source related, or others. CONCLUSION: Hysteroscopy is a safe procedure if you know the complications of hysteroscopy & its mechanisms.
Busan ; Hemorrhage ; Humans ; Hysteroscopy* ; Incidence* ; Korea ; Retrospective Studies ; Uterine Perforation

Uterine perforation and displacement of intrauterine device (IUD) are the most serious complications associated with insertion of that. An IUD may perforate through the uterine wall into the pelvic or abdominal cavity or into adjacent organs. We experienced a case of displacement of IUD into abdominal cavity by uterine perforation in early normal pregnancy and removed an IUD with laparoscopy. So we report one case with a brief review of the literature.
Abdominal Cavity ; Displacement (Psychology) ; Intrauterine Devices ; Laparoscopy ; Pregnancy ; Uterine Perforation

Loop electrosurgical excision procedure (LEEP) is commonly performed for the management of cervical intraepithelial neoplasia. Although LEEP is considered to be a relatively simple procedure, several unexpected complications have been reported in the literature. Herein, we report a case of hemoperitoneum caused by uterine perforation following LEEP. Blood collection in pelvic cavity and two small defects of the uterus were confirmed by diagnostic laparoscopy. The defects were sutured and the patient recovered well after the operation.
Cervical Intraepithelial Neoplasia ; Conization ; Hemoperitoneum ; Humans ; Laparoscopy ; Uterine Perforation ; Uterus

OBJECTIVES: Intrauterine adhesion (IUA) is mainly caused by intrauterine operations such as pregnancy-related curettage and hysteroscopic surgery, resulting in the trauma to the basal layer of the endometrium. Hysteroscopic adhesiolysis is a crucial step in the comprehensive treatment of IUA, and the most common complication is uterine perforation. More than half of all uterine perforations occur during the hysteroscopy or probe/dilator pass through the internal os. Furthermore, inappropriate surgical procedures may lead to endometrial injury, recurrence or even aggravation of adhesions, and complications such as cervix laceration and false passage formation. This study aims to explore the usage of the hysteroscopic dilatation techniques to dilate the internal os and lower uterine segment, which is via hysteroscopy entering the internal os laterally and swinging, or by directly opening the forceps or scissors and bluntly spreading dissection under direct hysteroscopic vision. By using the hysteroscopic dilatation techniques, we intend to improve the effectiveness and safety of cervical dilation in patients with IUA in the internal os and/or lower uterine segment. METHODS: A total of 282 patients with adhesions in the internal os or lower uterine segment underwent HA in the Third Xiangya Hospital of Central South University from January 2020 to June 2021 were included, ranging from 21 to 46 (33.0±4.8) years old in age and 5 to 12 in the American Fertility Society score. Among them, there were 2 cases of false passage formation caused by traditional dilatation in other hospitals. All patients underwent hysteroscopy with integrated hysteroscopy with 5Fr instrument channel and 4.9 mm outer sheath diameter. The internal orifice of cervix and the lower segment of uterine cavity were dilated under the microscope. After the hysteroscopy entered the uterine cavity, the separation of uterine cavity adhesion and the placement of uterine contraceptive ring or uterine stent into the uterine cavity were performed routinely. Age, surgical records, and surgical videos of all included cases were collected. The success rate of dilation and the incidence of surgical complications were assessed. RESULTS: In all cases, the hysteroscopys successfully entered into the uterine cavity by using the hysteroscopic dilatation techniques without failure and switching to cervical dilators. In the 2 cases of false passage due to previous cervical dilation, the uterine cavity was identified and found successfully under direct hysteroscopic vision. During the whole surgery, the vision was clear, and no complications (such as cervix laceration, false passage formation, uterine perforation or water intoxication) occurred. One to 3 months postoperative hysteroscopy revealed no significant fibrotic stenosis in the internal os and lower uterine segment. CONCLUSIONS The hysteroscopic dilation techniques are a strategy for separation methods that is following structural hierarchy anatomy in the mode of "see and treat" for the adhesion in the internal os and uterine cavity under direct hysteroscopic vision. This method not only has ultrasound guidance, but also has the judgment of structural hierarchy anatomy under direct hysteroscopic vision, so there is less chance of anatomical level judgment error. This method makes full use of the hysteroscopic judgement of the experienced hysteroscopic surgeons, so that surgeons can timely find and avoid re-entering the old false passage caused by previous surgery. The adhesions in the internal os and lower uterine segment were separated by the hysteroscopic dilation techniques. In this way, the damage to the endometrium caused by forced insertion of the hysteroscopy can be avoided. Meticulous separation of adhesions and cervical dilation under direct hysteroscopic vision can effectively reduce the occurrence of surgical complications such as false passage formation, cervical laceration, and uterine perforation. The use of mini-hysteroscopy eliminates the need for preoperative cervical preparation, avoiding associated risks and side effects. Moreover, for patients with adhesions in the internal os and lower uterine segment, preoperative cervical preparation is not effective in cervical dilation, while the hysteroscopic dilation techniques are effective, with higher patient acceptance due to the absence of preoperative cervical preparation. For the skilled hysteroscopic surgeons, the hysteroscopic dilation technique is easy to operate and worthy of clinical application.
Humans ; Female ; Child, Preschool ; Child ; Adult ; Uterine Perforation

Spontaneous perforation of the uterus and subsequent generalized peritonitis is an extremely rare complication of pyometra. Although generalized peritonitis secondary to perforated pyometra is rare in patients with an acute abdomen, this condition should be considered in the differential diagnosis. We report a case of a spontaneous uterine perforation of a pyometra in a patient with cervical cancer with brief review of the literature.
Abdomen, Acute ; Diagnosis, Differential ; Humans ; Peritonitis ; Pyometra ; Uterine Cervical Neoplasms ; Uterine Perforation ; Uterus

OBJECTIVE: Transrectal ultrasound (TRUS) has been widely used for guiding prostate implants, but not much for interstitial brachytherapy (IBT) of cervix cancer. The aim of our study is to report our experience with TRUS guided high dose rate (HDR) IBT in patients with carcinoma of uterine cervix. METHODS: During the year 2005-2006, 25 patients of cervical cancer not suitable for intracavitary radiotherapy (ICRT), were enrolled in this prospective study. We used B-K Medical USG machine (Falcon 2101) equipped with a TRUS probe (8658) having a transducer of 7.5 MHz for IBT. Post procedure, a CT scan was done for verification of needle position and treatment planning. Two weekly sessions of HDR IBT of 8-10 Gy each were given after pelvic external beam radiation therapy. RESULTS: A total of 40 IBT procedures were performed in 25 patients. Average duration of implant procedure was 50 minutes. There was no uterine perforation in any of 11 patients in whom central tandem was used. CT scan did not show needle perforation of bladder/rectum in any of the patients. During perioperative period, only 1 procedure (2.5%) was associated with hematuria which stopped within 6 hours. Severe late toxicity was observed in 3 (12%) patients. Overall pelvic control rate was 64%. CONCLUSION: Our experience suggests that TRUS is a practical and effective imaging device for guiding the IBT procedure of cervical cancer patients. It helps in accurate placements of needles thus avoiding the injury to normal pelvic structures.
Brachytherapy ; Cervix Uteri ; Female ; Hematuria ; Humans ; Needles ; Perioperative Period ; Prospective Studies ; Prostate ; Transducers ; Uterine Cervical Neoplasms ; Uterine Perforation