An articulated rotating brush for office endometrial evaluation of climacteric outpatients
| Autor: | R. Monteverde, Puche Rc, E.C. Roncoroni, J. Ben, M. González Garcia, A.R. Bocanera, I. Schlaen, R. Tozzini |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Adult
medicine.medical_specialty Biopsy medicine.medical_treatment Endometrium General Biochemistry Genetics and Molecular Biology Cohen's kappa Predictive Value of Tests Ambulatory Care Hysteroscopes medicine Carcinoma Humans Aged Climacteric Hysterectomy medicine.diagnostic_test business.industry Obstetrics and Gynecology Equipment Design Middle Aged medicine.disease Surgery Menopause medicine.anatomical_structure Hysteroscopy Etiology Female Uterine Hemorrhage Radiology business |
| Zdroj: | Maturitas. 19:67-76 |
| ISSN: | 0378-5122 |
| DOI: | 10.1016/0378-5122(94)90043-4 |
| Popis: | This paper reports the experience obtained in the last 8 years with an instrument (articulated rotative brush) that allows access to the entire endometrial surface, obtaining material for both histological and cytological study. The latter has the advantage of reducing the number of cases in which insufficient material frustrates endometrial assessment. In addition to the overall experience gained with this instrument, the proportion of agreement with anatomo-pathological diagnosis after hysterectomy in 61 patients was high (96%) and the unweighted kappa statistic (0.862) indicated very good accordance between these techniques. Comparison between the present method and hysteroscopic observations in 84 patients with perimenopausal bleeding revealed a general conformity of 0.65 and an unweighted kappa statistic of 0.368 (fair agreement). In a group of 72 cases with postmenopausal bleeding a general conformity value of 0.92 was obtained, with an unweighted kappa statistic of 0.84 (very good agreement). In 90% of the cases the procedure was well accepted. In 57.3% of the cases, no difficulties were encountered using the brushing technique; in 25.9% slight dilatation was deemed necessary, whereas in 16.8% technical difficulties could not be overcome and general anesthesia was indicated. A total of 769 outpatients were investigated, 75.3% of which had normal endometria, 12.7% benign hyperplasias, 2.6% precursor lesions, 1.7% suspect carcinoma, and 4.2% carcinomas. Insufficient material for diagnosis occurred in 3.5% of cases tested. The combined cytohistological and hysteroscopic assessment of the endometrium provides satisfactory results in the etiological diagnosis of peri and postmenopausal bleeding, and in the follow up of patients undergoing hormonal replacement therapy (HRT). |
| Databáze: | OpenAIRE |
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