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Амбулаторная гистероскопия. Практические рекомендации
Амбулаторная гистероскопия. Практические рекомендации
Коренная В.В. Амбулаторная гистероскопия. Практические рекомендации. Consilium Medicum. 2015; 17 (6): 28–31. DOI: 10.26442/2075-1753_2015.6.28-31
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Аннотация
Основной метод диагностики внутриматочной патологии на амбулаторном этапе – ультразвуковое исследование органов малого таза. Несмотря на высокую точность и специфичность, ложноположительные или ложноотрицательные результаты, по данным разных авторов, могут встречаться в 20–30% случаев. Уточнить состояние цервикального канала и полости матки, а также одномоментно провести терапию – по принципу «увидел – вылечи» – «see-and-treat» (англ.) – в амбулаторных условиях возможно при помощи офисной (амбулаторной) гистероскопии. Опыт преподавания теоретических и практических навыков офисной гистероскопии на кафедре акушерства и гинекологии ГБОУ ДПО «Российская медицинская академия последипломного образования» (rmapo@mail.ru) показал, что обучение данной методике занимает короткий срок, позволяя быстро внедрить ее выполнение в повседневную практику амбулаторного врача.
Ключевые слова: офисная гистероскопия, внутриматочная патология, стационарзамещающие технологии.
Ключевые слова: офисная гистероскопия, внутриматочная патология, стационарзамещающие технологии.
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The main method of diagnosis of endometrial pathology is outpatient ultrasonography (US) of the pelvic organs. Despite the high accuracy and specificity, false-positive or false-negative results, according to different authors, can occur in 20-30% of cases. To clarify the status of the cervix and uterus, as well as simultaneously provide treatment (the principle of «seeandtreat» (Eng.)) office hysteroscopy can be used. Our experience in teaching theoretical and practical skills of office hysteroscopy in the department of obstetrics and gynecology at Russian Medical Academy of Postgraduate Education (rmapo@mail.ru) showed that learning this technique takes a short period of time and allows its rapid integration into the daily practice of ambulatory physician.
Key words: office hysteroscopy, endometrial pathology, stationary substitution technology.
Key words: office hysteroscopy, endometrial pathology, stationary substitution technology.
Полный текст
Список литературы
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2. Serden SP. Diagnostic hysteroscopy to evaluate the cause of abnormal uterine bleeding. Obstet Gynecol Clin North Am 2000; 27 (2): 277–86.
3. Gebauer G, Hafner A, Siebzehnrübl E, Lang N. Role of hysteroscopy in detection and extraction of endometrial polyps: results of a prospective study. Am J Obstet Gynecol 2001; 184 (2): 59–63.
4. Bettocchi S, Selvaggi L. A vaginoscopic approach to reduce the pain of office hysteroscopy. J Am Assoc Gynecol Laparosc 1997; 4 (2): 255–8.
5. Cohen S, Greenberg JA. Hysteroscopic morcellation for treating intrauterine pathology. Rev Obstet Gynecol 2011; 4 (2): 73–80.
6. Valle RF. Hysteroscopy in the evaluation of female infertility. Am J Obstet Gynecol 1980; 137 (4): 425–31.
7. Bettocchi S, Nappi L, Ceci O, Selvaggi L. Office hysteroscopy. Obstet Gynecol Clin North Am 2004; 31 (3): 641–54, xi.
8. Cicinelli E. Hysteroscopy without anesthesia: review of recent literature. J Minim Invasive Gynecol 2010; 17 (6): 703–8.
9. Bettocchi S, Ceci O, Nappi L et al. Operative office hysteroscopy without anesthesia: analysis of 4863 cases performed with mechanical instruments. J Am Assoc Gynecol Laparosc 2004; 11 (1): 59–61.
10. Carta G, Palermo P, Marinangeli F et al. Waiting time and pain during office hysteroscopy. J Minim Invasive Gynecol 2012; 19 (3): 360–4. Doi: 10.1016/j.jmig.2012.01.017. Epub 2012 Mar 3.
11. Vleugels M. Hysteroscopic procedures in the office. Gyn Endoscopy 2001; 10.
12. Filiz T, Doǧer E, Corakçı A et al. The efficacy, cost and patient satisfaction of classic versus office hysteroscopy in cases with suspected intrauterine space occupying lesions with 3-dimension ultrasound and abnormal uterine bleeding, J Turk Ger Gynecol Assoc 2009; 10: 189–93.
13. Cararach M, Penella J, Ubeda A, Labastida R. Hysteroscopic incision of the septate uterus: scissors versus resectoscope. Hum Reprod 1994; 9 (1): 87–9.
14. Bettocchi S, Di Spiezio Sardo A, Ceci O et al. A new hysteroscopic technique for the preparation of partially intramural myomas in office setting (OPPIuM technique): A pilot study. J Minim Invasive Gynecol 2009; 16 (6): 748–54. Doi: 10.1016/j.jmig.2009.07.016.
15. Savel'eva G.M., Breusenko V.G., Kappusheva L.M. Gisteroskopiia. Atlas i rukovodstvo. M.: GEOTAR-Med, 2014. [in Russian]
16. Gulumser C, Narvekar N, Pathak M et al. See-and-treat outpatient hysteroscopy: an analysis of 1109 examinations. Reprod Biomed Online 2010; 20: 423–9.
17. Van Kerkvoorde TC, Veersema S, Timmermans A.Long-term complications of office hysteroscopy: analysis of 1028 cases. J Minim Invasive Gynecol 2012; 19 (4): 494–7. Doi: 10.1016/j.jmig.2012.03.003.
2. Serden SP. Diagnostic hysteroscopy to evaluate the cause of abnormal uterine bleeding. Obstet Gynecol Clin North Am 2000; 27 (2): 277–86.
3. Gebauer G, Hafner A, Siebzehnrübl E, Lang N. Role of hysteroscopy in detection and extraction of endometrial polyps: results of a prospective study. Am J Obstet Gynecol 2001; 184 (2): 59–63.
4. Bettocchi S, Selvaggi L. A vaginoscopic approach to reduce the pain of office hysteroscopy. J Am Assoc Gynecol Laparosc 1997; 4 (2): 255–8.
5. Cohen S, Greenberg JA. Hysteroscopic morcellation for treating intrauterine pathology. Rev Obstet Gynecol 2011; 4 (2): 73–80.
6. Valle RF. Hysteroscopy in the evaluation of female infertility. Am J Obstet Gynecol 1980; 137 (4): 425–31.
7. Bettocchi S, Nappi L, Ceci O, Selvaggi L. Office hysteroscopy. Obstet Gynecol Clin North Am 2004; 31 (3): 641–54, xi.
8. Cicinelli E. Hysteroscopy without anesthesia: review of recent literature. J Minim Invasive Gynecol 2010; 17 (6): 703–8.
9. Bettocchi S, Ceci O, Nappi L et al. Operative office hysteroscopy without anesthesia: analysis of 4863 cases performed with mechanical instruments. J Am Assoc Gynecol Laparosc 2004; 11 (1): 59–61.
10. Carta G, Palermo P, Marinangeli F et al. Waiting time and pain during office hysteroscopy. J Minim Invasive Gynecol 2012; 19 (3): 360–4. Doi: 10.1016/j.jmig.2012.01.017. Epub 2012 Mar 3.
11. Vleugels M. Hysteroscopic procedures in the office. Gyn Endoscopy 2001; 10.
12. Filiz T, Doǧer E, Corakçı A et al. The efficacy, cost and patient satisfaction of classic versus office hysteroscopy in cases with suspected intrauterine space occupying lesions with 3-dimension ultrasound and abnormal uterine bleeding, J Turk Ger Gynecol Assoc 2009; 10: 189–93.
13. Cararach M, Penella J, Ubeda A, Labastida R. Hysteroscopic incision of the septate uterus: scissors versus resectoscope. Hum Reprod 1994; 9 (1): 87–9.
14. Bettocchi S, Di Spiezio Sardo A, Ceci O et al. A new hysteroscopic technique for the preparation of partially intramural myomas in office setting (OPPIuM technique): A pilot study. J Minim Invasive Gynecol 2009; 16 (6): 748–54. Doi: 10.1016/j.jmig.2009.07.016.
15. Савельева Г.М., Бреусенко В.Г., Каппушева Л.М. Гистероскопия. Атлас и руководство. М.: ГЭОТАР-Мед, 2014. /Savel'eva G.M., Breusenko V.G., Kappusheva L.M. Gisteroskopiia. Atlas i rukovodstvo. M.: GEOTAR-Med, 2014. [in Russian]
16. Gulumser C, Narvekar N, Pathak M et al. See-and-treat outpatient hysteroscopy: an analysis of 1109 examinations. Reprod Biomed Online 2010; 20: 423–9.
17. Van Kerkvoorde TC, Veersema S, Timmermans A.Long-term complications of office hysteroscopy: analysis of 1028 cases. J Minim Invasive Gynecol 2012; 19 (4): 494–7. Doi: 10.1016/j.jmig.2012.03.003.
________________________________________________
2. Serden SP. Diagnostic hysteroscopy to evaluate the cause of abnormal uterine bleeding. Obstet Gynecol Clin North Am 2000; 27 (2): 277–86.
3. Gebauer G, Hafner A, Siebzehnrübl E, Lang N. Role of hysteroscopy in detection and extraction of endometrial polyps: results of a prospective study. Am J Obstet Gynecol 2001; 184 (2): 59–63.
4. Bettocchi S, Selvaggi L. A vaginoscopic approach to reduce the pain of office hysteroscopy. J Am Assoc Gynecol Laparosc 1997; 4 (2): 255–8.
5. Cohen S, Greenberg JA. Hysteroscopic morcellation for treating intrauterine pathology. Rev Obstet Gynecol 2011; 4 (2): 73–80.
6. Valle RF. Hysteroscopy in the evaluation of female infertility. Am J Obstet Gynecol 1980; 137 (4): 425–31.
7. Bettocchi S, Nappi L, Ceci O, Selvaggi L. Office hysteroscopy. Obstet Gynecol Clin North Am 2004; 31 (3): 641–54, xi.
8. Cicinelli E. Hysteroscopy without anesthesia: review of recent literature. J Minim Invasive Gynecol 2010; 17 (6): 703–8.
9. Bettocchi S, Ceci O, Nappi L et al. Operative office hysteroscopy without anesthesia: analysis of 4863 cases performed with mechanical instruments. J Am Assoc Gynecol Laparosc 2004; 11 (1): 59–61.
10. Carta G, Palermo P, Marinangeli F et al. Waiting time and pain during office hysteroscopy. J Minim Invasive Gynecol 2012; 19 (3): 360–4. Doi: 10.1016/j.jmig.2012.01.017. Epub 2012 Mar 3.
11. Vleugels M. Hysteroscopic procedures in the office. Gyn Endoscopy 2001; 10.
12. Filiz T, Doǧer E, Corakçı A et al. The efficacy, cost and patient satisfaction of classic versus office hysteroscopy in cases with suspected intrauterine space occupying lesions with 3-dimension ultrasound and abnormal uterine bleeding, J Turk Ger Gynecol Assoc 2009; 10: 189–93.
13. Cararach M, Penella J, Ubeda A, Labastida R. Hysteroscopic incision of the septate uterus: scissors versus resectoscope. Hum Reprod 1994; 9 (1): 87–9.
14. Bettocchi S, Di Spiezio Sardo A, Ceci O et al. A new hysteroscopic technique for the preparation of partially intramural myomas in office setting (OPPIuM technique): A pilot study. J Minim Invasive Gynecol 2009; 16 (6): 748–54. Doi: 10.1016/j.jmig.2009.07.016.
15. Savel'eva G.M., Breusenko V.G., Kappusheva L.M. Gisteroskopiia. Atlas i rukovodstvo. M.: GEOTAR-Med, 2014. [in Russian]
16. Gulumser C, Narvekar N, Pathak M et al. See-and-treat outpatient hysteroscopy: an analysis of 1109 examinations. Reprod Biomed Online 2010; 20: 423–9.
17. Van Kerkvoorde TC, Veersema S, Timmermans A.Long-term complications of office hysteroscopy: analysis of 1028 cases. J Minim Invasive Gynecol 2012; 19 (4): 494–7. Doi: 10.1016/j.jmig.2012.03.003.
Авторы
В.В.Коренная
ГБОУ ДПО Российская медицинская академия последипломного образования Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1
drkorennaya@mail.ru
ГБОУ ДПО Российская медицинская академия последипломного образования Минздрава России. 125993, Россия, Москва, ул. Баррикадная, д. 2/1
drkorennaya@mail.ru
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V.V.Korennaya
Russian Medical Academy of Postgraduate Education of the Ministry of Health of the Russian Federation. 125993, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1
drkorennaya@mail.ru
Russian Medical Academy of Postgraduate Education of the Ministry of Health of the Russian Federation. 125993, Russian Federation, Moscow, ul. Barrikadnaia, d. 2/1
drkorennaya@mail.ru
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