Hysteroscopic Management of Uterine Arteriovenous Malformation
| Autor: | Mauro Cozzolino, Eleonora Castellacci, Alfonso Farruggia, Valeria Dubini, Stefano Calzolari, Giovanni Sisti |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Hysteroscopic technique medicine.medical_specialty Metrorrhagia Adolescent Pregnancy Rate medicine.medical_treatment Hysteroscopy Scientific Paper Miscarriage Arteriovenous Malformations Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans Embolization Ultrasonography Doppler Color Menorrhagia Retrospective Studies Uterine arteriovenous malformation 030219 obstetrics & reproductive medicine medicine.diagnostic_test Transvaginal ultrasonography business.industry Uterus Pregnancy Outcome Arteriovenous malformation Retrospective cohort study medicine.disease Surgery Fertility 030220 oncology & carcinogenesis Cohort Female business |
| Zdroj: | JSLS : Journal of the Society of Laparoendoscopic Surgeons |
| ISSN: | 1938-3797 1086-8089 |
| DOI: | 10.4293/jsls.2016.00109 |
| Popis: | Background and objectives Uterine arteriovenous malformation (AVM) is characterized by shunts between the myometrial arteries and veins. Treatment is based on the severity of uterine bleeding and ranges from conservative medical approaches to embolization of affected arteries. The aim of study was to evaluate the feasibility and safety of hysteroscopy for management of uterine AVM. Methods This was a retrospective study of a cohort of 11 cases occurring between March 2012 and December 2015 in our Regional Center of Excellence in Hysteroscopy, University of Florence. The diagnosis of AVM was made by transvaginal ultrasonography with high-definition flow in patients with mild to moderate symptoms. In all cases, we used the hysteroscopic platform Gynecare VersaPoint II (Ethicon, Somerville, New Jersey, USA), equipped with a 4-mm electrosurgical loop and associated with the SPIES (Storz Professional Image Enhancement System) system (Karl Storz, Tuttlingen, Germany). Results All patients were successfully treated with operative hysteroscopy with no reported complications. No patient had residual disease detected by ultrasonography performed after a month. At this writing, of the 11 patients treated with operative hysteroscopy, 4 had achieved a pregnancy that carried to term, 1 was pregnant at 20 wk, and 1 had a miscarriage in the first trimester. Conclusions Hysteroscopy is a feasible and safe alternative treatment modality for AVM. Patients treated with surgical hysteroscopy have high fertility outcomes, a 100% success rate after the first treatment, no complications related to the surgical procedure, and a short hospital stay. |
| Databáze: | OpenAIRE |
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