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Diagnostics
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Advances in Hysteroscopy
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Advances in Hysteroscopy

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 October 2022) | Viewed by 18842

Special Issue Editor

Dr. Benito Chiofalo

E-Mail Website
Guest Editor
Unit of Gynecologic Oncology, Department of Experimental Clinical Oncology, IRCCS “Regina Elena” National Cancer Institute, Rome, Italy
Interests: gynecology; gynecologic oncology; minimally invasive surgery

Special Issue Information

Dear Colleagues, 

Hysteroscopy represents the gold-standard technique for the diagnosis and treatment of endometrial pathologies. General interest in the field of hysteroscopy is continuously increasing. In recent years, many efforts have been made to minimize the size of instruments and to improve the effectiveness of hysteroscopy in the diagnosis and treatment of intrauterine pathologies. 

This Special Issue focuses on recent advances in hysteroscopy, not only in the technological field, but also in patients’ management, in both the diagnostic and operative setting. Furthermore, translational research involving hysteroscopy will be appreciated.

Invited topics are:

  1. New technologies in hysteroscopy.
  2. Advances in the diagnosis of intrauterine pathologies.
  3. Advances in the treatment of intrauterine pathologies.
  4. Comparison of different techniques in diagnostic, office and operative hysteroscopy.
  5. Outcomes after hysteroscopic surgery.
  6. New preoperative therapies.
  7. New methods for pain reduction during outpatient hysteroscopy.
  8. Cost analyses.
  9. New diagnostic and prognostic biomarkers following endometrial biopsy.

Submissions may include original articles and review articles.

Dr. Benito Chiofalo
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hysteroscopy
  • diagnostic hysteroscopy
  • office hysteroscopy
  • operative hysteroscopy
  • endometrial cancer
  • endometrial hyperplasia
  • endometrial polyps
  • intrauterine pathologies
  • submucous myomas
  • pain control
  • uterine septum
  • uterine synechiae
  • morcellator
  • hysteroscopic tissue removal system
  • minimally invasive surgery
  • endometrial biopsy
  • translational research

Published Papers (5 papers)

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Editorial

Jump to: Research, Review, Other

3 pages, 183 KiB  
Editorial
A New Methodology to Assess Fallopian Tubes Microbiota and Its Impact on Female Fertility
by Salvatore Giovanni Vitale, Jose Carugno, Maurizio Nicola D’Alterio, Mislav Mikuš, Pasquale Patrizio and Stefano Angioni
Diagnostics 2022, 12(6), 1375; https://doi.org/10.3390/diagnostics12061375 - 02 Jun 2022
Cited by 6 | Viewed by 1480
Abstract
Tubal factor is an important contributor to female infertility, and the current diagnostic approaches cannot correctly identify many subtle causes of tubal dysfunction. While it is known that the most common cause of tubal factor infertility is pelvic inflammatory disease (PID), creating critical [...] Read more.
Tubal factor is an important contributor to female infertility, and the current diagnostic approaches cannot correctly identify many subtle causes of tubal dysfunction. While it is known that the most common cause of tubal factor infertility is pelvic inflammatory disease (PID), creating critical alterations of the tubal epithelium, little attention has been devoted to understanding the tubal modifications caused by the resident microbial population and their interaction with the surrounding tubal epithelium. Furthermore, most of these samples are obtained by traumatic procedures such as direct sampling during laparoscopy using a cytobrush. However, as in any other organ of the female genital tract, the microbiota environment of the fallopian tube plays an essential role in maintaining tubal functioning, counteracting the pathogenic effect of acquired microbes. Consequentially, to better analyze the tubal microbiota without causing anatomical and/or functional alteration of the fallopian tube and preserving fertility, the hysteroscopic approach might be the method of choice, guarantying maximal integrity of the uterine cavity and tubal lumen. Here we describe our plan for using atraumatic hysteroscopic sampling methods to investigate the correlation between tubal microbiota and female infertility. Full article
(This article belongs to the Special Issue Advances in Hysteroscopy)

Research

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9 pages, 524 KiB  
Article
Outpatient Hysteroscopic Polypectomy—A Retrospective Study Comparing Rigid and Semirigid Office Hysteroscopes
by Benito Chiofalo, Mauro Calandra, Valentina Bruno, Vincenzo Tarantino, Giovanni Esposito, Enrico Vizza, Giacomo Corrado, Giovanni Scambia and Ursula Catena
Diagnostics 2023, 13(5), 988; https://doi.org/10.3390/diagnostics13050988 - 05 Mar 2023
Cited by 1 | Viewed by 1423
Abstract
Endometrial polyps are one of the most common pathological conditions in gynecology. Hysteroscopy is the gold standard for the diagnosis and treatment of endometrial polyps. The purpose of this multicenter, retrospective study was to compare patients’ pain perception during an operative hysteroscopic endometrial [...] Read more.
Endometrial polyps are one of the most common pathological conditions in gynecology. Hysteroscopy is the gold standard for the diagnosis and treatment of endometrial polyps. The purpose of this multicenter, retrospective study was to compare patients’ pain perception during an operative hysteroscopic endometrial polypectomy in an outpatient setting with two different hysteroscopes (rigid and semirigid) and to identify some clinical and intraoperative characteristics that are related to worsening pain during the procedure. We included women that underwent, at the same time as an diagnostic hysteroscopy, the complete removal of an endometrial polyp (using the see-and-treat strategy) without any kind of analgesia. A total of 166 patients were enrolled, of which 102 patients underwent a polypectomy with a semirigid hysteroscope and 64 patients underwent the procedure with a rigid hysteroscope. No differences were found during the diagnostic step; on the contrary, after the operative procedure, a statistically significant greater degree of pain was reported when the semirigid hysteroscope was used. Cervical stenosis and menopausal status were risk factors for pain both in the diagnostic step and in the operative one. Our results confirm that operative hysteroscopic endometrial polypectomy in an outpatient setting is an effective, safe, and well-tolerated procedure and indicate that it might be better tolerated if a rigid rather than semirigid instrument is used. Full article
(This article belongs to the Special Issue Advances in Hysteroscopy)
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Review

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15 pages, 469 KiB  
Review
Hysteroscopic Endometrial Ablation: From Indications to Instrumentation and Techniques—A Call to Action
by Salvatore Giovanni Vitale, Luigi Della Corte, Michał Ciebiera, Josè Carugno, Gaetano Riemma, Ricardo Bassil Lasmar, Bernardo Portugal Lasmar, Ilker Kahramanoglu, Bulent Urman, Mislav Mikuš, Carlo De Angelis, Péter Török and Stefano Angioni
Diagnostics 2023, 13(3), 339; https://doi.org/10.3390/diagnostics13030339 - 17 Jan 2023
Cited by 5 | Viewed by 2425
Abstract
The development of minimally invasive techniques has led to the creation of innovative alternatives in cases where traditional methods are not applicable. In modern gynecology, hysteroscopy has become the gold standard for the evaluation and treatment of intrauterine pathology. Endometrial ablation (EA) is [...] Read more.
The development of minimally invasive techniques has led to the creation of innovative alternatives in cases where traditional methods are not applicable. In modern gynecology, hysteroscopy has become the gold standard for the evaluation and treatment of intrauterine pathology. Endometrial ablation (EA) is a procedure that uses different types of energy to destroy the endometrium and is currently used as an alternative technique in cases of heavy menstrual bleeding when medical treatment has failed and uterine preservation is desired. The aim of this review was to evaluate the feasibility, safety, and clinical outcomes of hysteroscopic EA as an alternative in patients with abnormal uterine bleeding. A detailed computerized search of the literature was performed in the main electronic databases (MEDLINE, EMBASE, Web of Science, PubMed, and Cochrane Library), from 1994 to June 2022, to evaluate the outcomes in patients with abnormal uterine bleeding (AUB) undergoing EA using hysteroscopic and non-hysteroscopic techniques. Only scientific publications in English were included. Twelve articles on the current use of endometrial ablation were included. Data on patient symptoms, tools used for EA, primary outcomes, and adverse events were recorded. EA should be considered an effective and safe approach in the management of patients with abnormal uterine bleeding caused by benign pathology, in whom medical treatment has failed or is contraindicated. Due to the lack of evidence, it would be interesting to determine whether EA would also have a role in the treatment of women with premalignant lesions, avoiding invasive surgical procedures or medical treatment in those patients for whom hysterectomy or the use of hormonal treatment is contraindicated. Full article
(This article belongs to the Special Issue Advances in Hysteroscopy)
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15 pages, 1581 KiB  
Review
Abnormal Uterine Bleeding in Perimenopausal Women: The Role of Hysteroscopy and Its Impact on Quality of Life and Sexuality
by Salvatore Giovanni Vitale, Rafał Watrowski, Fabio Barra, Maurizio Nicola D’Alterio, Jose Carugno, Thozhukat Sathyapalan, Ilker Kahramanoglu, Enrique Reyes-Muñoz, Li-Te Lin, Bulent Urman, Simone Ferrero and Stefano Angioni
Diagnostics 2022, 12(5), 1176; https://doi.org/10.3390/diagnostics12051176 - 09 May 2022
Cited by 12 | Viewed by 7978
Abstract
Abnormal uterine bleeding (AUB) is a frequent symptom in perimenopausal women. It is defined as uterine bleeding in which the duration, frequency, or amount of bleeding is considered excessive and negatively affects the woman’s quality of life (QoL) and psychological well-being. In cases [...] Read more.
Abnormal uterine bleeding (AUB) is a frequent symptom in perimenopausal women. It is defined as uterine bleeding in which the duration, frequency, or amount of bleeding is considered excessive and negatively affects the woman’s quality of life (QoL) and psychological well-being. In cases of structural uterine pathology, hysterectomy (usually performed via a minimally invasive approach) offers definitive symptom relief and is associated with long-lasting improvement of QoL and sexuality. However, over the past 30 years, uterus-preserving treatments have been introduced as alternatives to hysterectomy. Hysteroscopic polypectomy, myomectomy, or endometrial resection/endometrial ablation are minimally invasive techniques that can be used as an alternative to hysterectomy to treat AUB due to benign conditions. Although associated with high patient satisfaction and short-term improvement in their QoL, hysteroscopic treatments do not eliminate the risk of AUB recurrence or the need for further intervention. Therefore, considering the impact of different treatment options on QoL and sexuality during preoperative shared decision making could help identify the most appropriate and personalized treatment options for perimenopausal women suffering from AUB. Full article
(This article belongs to the Special Issue Advances in Hysteroscopy)
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Other

26 pages, 3731 KiB  
Systematic Review
Chronic Endometritis in Infertile Women: Impact of Untreated Disease, Plasma Cell Count and Antibiotic Therapy on IVF Outcome—A Systematic Review and Meta-Analysis
by Amerigo Vitagliano, Antonio Simone Laganà, Dominique De Ziegler, Rossana Cicinelli, Carla Mariaflavia Santarsiero, Giovanni Buzzaccarini, Vito Chiantera, Ettore Cicinelli and Marco Marinaccio
Diagnostics 2022, 12(9), 2250; https://doi.org/10.3390/diagnostics12092250 - 18 Sep 2022
Cited by 20 | Viewed by 4548
Abstract
This systematic review and meta-analysis aims to evaluate the impact of chronic endometritis (CE) and its therapy on in vitro fertilization (IVF) outcome. Additionally, we aim to investigate whether various degrees of CE severity may exert a different effect on IVF outcome. Ongoing-pregnancy [...] Read more.
This systematic review and meta-analysis aims to evaluate the impact of chronic endometritis (CE) and its therapy on in vitro fertilization (IVF) outcome. Additionally, we aim to investigate whether various degrees of CE severity may exert a different effect on IVF outcome. Ongoing-pregnancy rate/live-birth-rate (OPR/LBR), clinical-pregnancy rate (CPR), and miscarriage rate (MR) were calculated. A total number of 4145 patients (from ten studies) were included. Women with CE had lower OPR/LBR (OR 1.97, p = 0.02) and CPR (OR 2.28, p = 0.002) compared to those without CE. CE cure increased OPR/LBR (OR 5.33, p < 0.0001) and CPR (OR 3.64, p = 0.0001). IVF outcome was comparable between women with cured CE and those without CE (OPR/LBR, CPR and MR: p = ns). Women with severe CE had lower OPR/LBR (OR 0.43, p = 0.003) and CPR (OR 0.40, p = 0.0007) compared to those mild CE. Mild CE showed no influence on the IVF outcome as compared to women without CE (OPR/LBR, CPR and MR: p = ns). Based on this data analysis, CE significantly reduces OPR/LBR and CPR in women undergoing IVF. Importantly, CE resolution after antibiotic therapy may improves IVF outcome, leading to similar OPR/LBR and CPR as compared to unaffected patients. The negative effects of CE on IVF outcome may be restricted to severe disease, whereas mild CE may have no influence on IVF success. Full article
(This article belongs to the Special Issue Advances in Hysteroscopy)
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