Objective: To study treatment outcome using the modified technique: Cavaterm(tm) plus. Study design: Retrospective postal questionnaire, in a large teaching hospital. One hundred and twenty-eight women with menorrhagi...Objective: To study treatment outcome using the modified technique: Cavaterm(tm) plus. Study design: Retrospective postal questionnaire, in a large teaching hospital. One hundred and twenty-eight women with menorrhagia were treated between February 2001 and April 2003. Data were collected prospectively for the duration of the procedure and alternatives offered. Followup questionnaire was distributed during November 2003 to assess menstrual status. Multiple binary logistic regression was performed to assess factors influencing success. Results: The mean follow up was 72 weeks, 103 patients (80.5%) completed the questionnaire. In 26 (25.2%) cases, there were one or more important deviations from recommended procedure. Twenty (19.4%) women had procedure-related amenorrhoea, 6 (5.8%) had spotting, 35 (34%) had light, and 26 (25.2%) had moderate bleeding. Eleven (10.7%) had a hysterectomy. The risk of failure was inversely related to age (OR 0.778, 95%CI 0.669-0.905), was higher in women who prior to surgery had longer duration of bleeding (OR 1.29, 95%CI 1.1-1.52), and when recommended selection or operative procedureswere not followed (OR 5.056, 95%CI 1.097-23.3). Conclusion: Cavaterm (tm) plus is associated with high patient satisfaction. The technique remains a good choice for women wishing to avoid hysterectomy, but there is a need to observe determinants of poor outcome.展开更多
Objective: To compare danazol and gestrinone treatment as preoperative endometrial preparation for operative hysteroscopy. Design: Prospective, randomized clinical study. Setting: University department of gynecologica...Objective: To compare danazol and gestrinone treatment as preoperative endometrial preparation for operative hysteroscopy. Design: Prospective, randomized clinical study. Setting: University department of gynecological, obstetrical sciences and reproductive medicine. Patient(s): One hundred thirty-five patients with endouterine pathologies (endometrial polyps, submucous myoma, septate uterus). Intervention(s): Patients pretreated with gestrinone (n = 68) and with danazol (n = 67)- underwent operative hysteroscopy. Main Outcome Measure(s): Endometrial response to the medical pretreatment, side effects, procedure time, intraoperative bleeding, infusion volume, patient satisfaction. Result(s): Side effects were infrequent in both groups, though the patients’ personal satisfaction was in favor of gestrinone. The rate of endometrial response was higher for the gestrinone group (97.1% vs. 83.6% ). Operative time (mean ± SD) was 12 ± 1.8 and 15.2 ± 1.9 minutes for the gestrinone and danazol groups, respectively. The gestrinone group showed a lower incidence of moderate bleeding (3% vs. 22.4% ) and a lower infusion volume (2,100 ± 200 mL vs. 2,400 ± 250 mL). Regarding cervical dilatation time, no significant difference was found between the two groups (1.6 ± 0.3 minutes vs. 1.5 ± 0.4 minutes). Conclusion(s): Both treatments are good ways to prepare the endometrium for operative hysteroscopy. However, the data suggest that gestrinone pretreatment is preferable to danazol.展开更多
文摘Objective: To study treatment outcome using the modified technique: Cavaterm(tm) plus. Study design: Retrospective postal questionnaire, in a large teaching hospital. One hundred and twenty-eight women with menorrhagia were treated between February 2001 and April 2003. Data were collected prospectively for the duration of the procedure and alternatives offered. Followup questionnaire was distributed during November 2003 to assess menstrual status. Multiple binary logistic regression was performed to assess factors influencing success. Results: The mean follow up was 72 weeks, 103 patients (80.5%) completed the questionnaire. In 26 (25.2%) cases, there were one or more important deviations from recommended procedure. Twenty (19.4%) women had procedure-related amenorrhoea, 6 (5.8%) had spotting, 35 (34%) had light, and 26 (25.2%) had moderate bleeding. Eleven (10.7%) had a hysterectomy. The risk of failure was inversely related to age (OR 0.778, 95%CI 0.669-0.905), was higher in women who prior to surgery had longer duration of bleeding (OR 1.29, 95%CI 1.1-1.52), and when recommended selection or operative procedureswere not followed (OR 5.056, 95%CI 1.097-23.3). Conclusion: Cavaterm (tm) plus is associated with high patient satisfaction. The technique remains a good choice for women wishing to avoid hysterectomy, but there is a need to observe determinants of poor outcome.
文摘Objective: To compare danazol and gestrinone treatment as preoperative endometrial preparation for operative hysteroscopy. Design: Prospective, randomized clinical study. Setting: University department of gynecological, obstetrical sciences and reproductive medicine. Patient(s): One hundred thirty-five patients with endouterine pathologies (endometrial polyps, submucous myoma, septate uterus). Intervention(s): Patients pretreated with gestrinone (n = 68) and with danazol (n = 67)- underwent operative hysteroscopy. Main Outcome Measure(s): Endometrial response to the medical pretreatment, side effects, procedure time, intraoperative bleeding, infusion volume, patient satisfaction. Result(s): Side effects were infrequent in both groups, though the patients’ personal satisfaction was in favor of gestrinone. The rate of endometrial response was higher for the gestrinone group (97.1% vs. 83.6% ). Operative time (mean ± SD) was 12 ± 1.8 and 15.2 ± 1.9 minutes for the gestrinone and danazol groups, respectively. The gestrinone group showed a lower incidence of moderate bleeding (3% vs. 22.4% ) and a lower infusion volume (2,100 ± 200 mL vs. 2,400 ± 250 mL). Regarding cervical dilatation time, no significant difference was found between the two groups (1.6 ± 0.3 minutes vs. 1.5 ± 0.4 minutes). Conclusion(s): Both treatments are good ways to prepare the endometrium for operative hysteroscopy. However, the data suggest that gestrinone pretreatment is preferable to danazol.
