Hysteroscopy is Superior to 3D Ultrasound in Gynecological Diagnosis
- PDF / 3,166,750 Bytes
- 15 Pages / 595.276 x 790.866 pts Page_size
- 83 Downloads / 188 Views
INVITED DEBATE
Hysteroscopy is Superior to 3D Ultrasound in Gynecological Diagnosis Fessy Louis1 · Chander P. Lulla2 Received: 6 August 2020 / Accepted: 13 October 2020 © Federation of Obstetric & Gynecological Societies of India 2020
Editor-In-Chief’s Note Ever since 3D ultrasound became available for us as a diagnostic modality, the opinions are divided regarding it being superior to hysteroscopy as diagnostic modality. Hysteroscopy was considered ideal to accurately diagnose intracavitary structural abnormalities, and later when 3D ultrasound was introduced, it was considered an option to reduce the number of hysteroscopies in such cases. Clinicians may find it difficult to choose the right modality in different clinical situations in their practice. Both these tools give valuable information on clinical conditions like abnormal uterine bleeding, infertility recurrent pregnancy loss, neoplastic conditions, etc. what are the indications for hysteroscopy? Can noninvasive 3D USG replace the time tested modality, hysteroscopy? To find answers to these queries, authors experienced in their own fields are debating in this article regarding which is the superior method and present their own views supported by reviews and reports in the literature. I hope readers find this debate interesting and it helps them clear doubts and queries on this debatable issue. Professor Suvarna Khadilkar, Editor in chief.
Dr. Fessy Louis is the Associate Professor and is in charge of MCH course in the Department of Reproductive Medicine, Amrita Institute Of Medical Sciences, Kochi, Kerala. Dr. Chander Lulla is Consultant Sonologist and Fetal Medicine Specialist. * Chander P. Lulla [email protected] Fessy Louis [email protected] 1
Amrita Institute of Medical Sciences, Kochi, Kerala, India
Ria Clinic, Mumbai, Maharashtra, India
2
For the motion Dr. Fessy Louis
Introduction Hysteroscopy, the word derives from Greek words ‘Skopeo’ – to view and ‘Hystera’ – Uterus. It is the process of viewing and operating in the endometrial cavity from a transcervical approach. If we look into the milestones in the evaluation of hysteroscopy, first documented usage of hysteroscopy was done by Pantaleoni in 1869. In 1925, Rubin used CO2 to distend the uterus, cold light source was first used in 1952. Transparent balloon was used to distend the cavity in 1963, and liquid distension media was first used in 1980. The distention media used during hysteroscopy opens the potential space of uterine cavity. The distention media leaves the uterine cavity either by cervical leakage, tubal leakage or intravasation. When using fluid distention medium, intrauterine distention can be achieved by gravity fall system or pressure cuff system or more effectively byendomat or hysteromat. Proper vision of the uterine cavity during hysteroscopy depends mainly on the distention of the uterine cavity. Uterine distention requires around 75 mm of pressure. If there is inadequate cavity distention, we must suspect leakage through cervix, equipment leakage, excessiv
Data Loading...
