Mastering the Techniques in Hysteroscopy

A hysteroscopy is a minimally invasive procedure used to examine the inside of the womb (uterus). It is performed using a hysteroscope – a narrow telescope with a light and camera at the end. Images are sent to a monitor to allow clinicians to see inside the womb.

This book is a complete guide to the use of hysteroscopy in the investigation and diagnosis of gynaecological disorders and diseases.

The second edition has been fully revised and updated and new topics added to provide clinicians with information on the latest advances and technologies in the field.

Beginning with an introduction to the technique, discussion on anatomy and physiology of the uterus, and descriptions of other imaging technologies, the book then explains the hysteroscope and procedural techniques.

Each of the following chapters covers the diagnosis of different disorders using hysteroscopy, including polyps and fibroids, abnormal bleeding, infertility, intrauterine adhesions, and much more.

The final sections discuss potential complications, medico-legal aspects and anaesthesia in hysteroscopy.

Written by an experienced team of recognised editors and authors, this comprehensive guide is highly illustrated with clinical images and figures.

A QR code inside the book provides access to operative videos demonstrating techniques.

Contents
Section 1: The Beginning with Hysteroscopy
1. Introduction: Hysteroscopy and Its Philosophy 3
Sushma Deshmukh
y Knowing about Hysteroscopy 3
y Philosophy of Uterus and Hysteroscope 4
y Let us Begin 4
y Knowing Indications and Contraindications 5
y What Facilities We Should Provide 7
y Mastering the Technique 7
2. History and Evolution of Hysteroscopy 8
Adam Magos
y The Foundations of Endoscopy 8
y The Beginning of Endoscopy 9
y The First Hysteroscopy 10
y The Era of Modern Hysteroscopy 16
y Final Words 18
Section 2: Knowing the Uterus
3. Anatomy, Embryology and Hysteroscopy 25
Swati Shiradkar
y Anatomy of Uterus and Tubes 25
y Changes in Uterus with Age and Parity 30
y Positions of the Uterus 30
y Embryology of Uterus and Tubes 31
4. Physiology: The Uterus, Cervix and Practical Aspect 34
Manju P Jilla
y Hypothalamic-Pituitary-Ovarian Axis 34
y Cervico-Uterine Changes at Birth, Puberty and Adult 35
y Uterine Endometrial Histology 35
y Receptors in the Uterus 37
y Uterine Contractions 37
y Cervix 38
y Color Doppler Ultrasound and Utero-Ovarian Physiology 39
y Applied Aspects 40
y Cervix: Applied Aspects 41
Mastering the Techniques in Hysteroscopyxx
5. Histology and Hysteroscopic View of Normal Endometrium 44
Rujuta Ayachit, Anuja Kulkarni
y Cyclic Histological Changes 44
y Endometrial Dating 45
y Atrophic Endometrium 45
y Hysteroscopic Assessment of Endometrium 46
y Traditional Classification of Hysteroscopic Appearance of Normal Endometrium 47
y Atrophic (Postmenopausal) Endometrium 47
6. Abnormal Endometrium and Hysteroscopy 50
Suprita Nayak, Sushma Deshmukh
y Abnormal Endometrium 50
y Endometrial Hyperplasia 50
y Endometrial Polyp 52
y Well-Differentiated Endometrial Carcinoma 53
y Evaluation of Endometrium 54
7. Effects of Drugs on the Uterus 60
Sanjeev Khurd, Sadhana Khurd, Aditya Khurd
y Pharmacologic Principles in Hormone Action 60
y Oral Contraceptive Pills 61
y Hormone Replacement Therapy 61
y Androgens 63
y Gonadotropin-Releasing Hormone Analogs 64
y Misoprostol 65
8. How to Date Endometrium through Hysteroscopy without the Need of Biopsy 66
Alicia Ubeda Hernandez
y Place of Endoscopic Techniques: Hysteroscopy 66
y Endometrium Through Hysteroscopy 67
Section 3: Imaging Technologies for Intrauterine Diagnosis
9. Hysterosalpingography for Intrauterine Diagnosis and Hysteroscopy 73
Veerendra Kumar CM
y Scope of Hysterosalpingography 73
y Techniques 73
y Procedure 74
y Intrauterine Diagnosis 76
y Hysterosalpingography and Hysteroscopy—Diagnostic Fallacies and Comparative Studies 80
10. Imaging Modalities for Assessment of Uterine Abnormalities 85
Sonal Panchal, Chaitanya B Nagori
y Congenital Uterine Abnormalities 85
y Acquired Uterine Abnormalities 91
11. Ultrasonography 2D, 3D and Sonohysterography in Abnormal Uterine
Bleeding and Correlation with Hysteroscopy 102
Neema Acharya, Narendra Malhotra, Neharika Malhotra 102
y Transvaginal Sonography 102
y Role of 3D Ultrasound and 3D Saline Infusion Sonohysterography 102
y Role of Hysteroscopy 104
Author information

Osama Shawki MD
Professor of Gynaecologic Surgery, Department of Gynaecology, Cairo University School of Medicine, Egypt; Editor, European Journal of Gynaecologic Surgery; Faculty Professor, Giessen School of Endoscopy, Germany; Board Member, International Society Gynaecologic Endoscopy (ISGE); Director of Ebtesama Centre for Advanced Endoscopic Surgery; Director, Hysteroscopy Academy for Research and Training (HART), AI Ebtesama Hospital, Heliopolis, Cairo, Egypt

Sushma Deshmukh MD DGO
Director, Central India Test Tube Baby Centre; Head, Department of Obstetrics and Gynaecology, Get-well Super Speciality Hospital; In-Charge of Deshmukh Hospital, Nagpur, Maharashtra, India

Luis Alonso Pacheco MD
Unidad Endoscopia Centro Gutenberg, URA Quiron, Malaga, Spain