Tersiyer merkezde 5 yıllık Histeroskopi deneyiminin sonuçları

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Burak Sezgin Melike Nur Akın Eren Akbaba Ercan Saruhan

https://doi.org/10.16948/zktipb.801519

Öz

Amaç: Bu çalışmada akademik bir hastanede son 5 yılda yapılan histeroskopi deneyimimizin sonuçlarını değerlendirmek istedik.
Gereç ve Yöntem: Herhangi bir endikasyonla histeroskopi yapılan hastaları verileri retrospektif olarak analiz edildi. Diagnostik veya operatif histeroskopi yapılan hastaların klinik ve histopatolojik sonuçları dokümante edildi.
Bulgular: Çalışmaya dahil edilen 202 olgunun ortalama yaşları 42.83 ± 9.58 yıl, gravidaları 2.67 ± 1.29, pariteleri 2.04 ± 0.95 olarak hesaplandı. Hastaların 162 si (% 80.2) premenopozal 40 ı (% 19.8) postmenopozal dönemdeydi. Hastalarda saptanan en sık komorbid hastalıklar sırasıyla, hipertansiyon (9.4%), diabetes mellitus (4.5%), tiroid hastalığı (4%) ve meme kanseri (3.5%) olarak görüldü. Preoperatif endometrial kalınlık ortalaması 12.80 ± 6.10 mm idi. Histeroskopi öncesi hastaların 135 ine SIS işlemi uygulandı ve bunların 97.8% inde kavitede yer kaplayan kitle tespit edildi. Tespit edilen bu intrakaviter kitlelerin ortalama en büyük çapı 13.72 ± 6.21 mm idi. Tüm hastaların 7 sinde (3.5%) tekrar histeroskopi yapılma ihtiyacı oldu. Histeroskopi öncesi hastalarda en sık görülen semptomlar; menometroraji (%54.5), polimenore (%14.4), postmenopozal kanama (%10.9) ve infertilite (%9.4) olarak saptandı. Komplikasyon olarak vakaların 1’inde (%0.5) uterus perforasyonu ve 2’sinde (1%) aşırı kanama görüldü. Kavite içinde kitlelerin yerleşim yerlerine bakıldığında en sık fundus lokalizasyonu (43.4%) tespit edildi. Histopatolojik inceleme sonucu 142 olguda (%70.3) endometrial polip, 19 (%9.4) olguda myoma uteri olarak raporlandı. 3 (1.5 %) vakada endometrial kanser saptandı
Sonuç: Kliniğimizde en sık endometrial polip nedeniyle histeroskopi yapılmış olup en sık semptom ve girişim, menometroraji ve polip rezeksiyonu olarak belirlendi. Kavitede yer kaplayan lezyonların tespitinde Histeroskopi öncesi SİS kullanımının yaygın olduğu görüldü. Komplikasyon oranımız literatür ile uyumlu olarak düşük bulundu.

Anahtar Kelimeler

Diagnostik histeroskopi, operatif histeroskopi, salin infüzyon sonografi, endometrial polip, submukozal myom

5 years Outcomes of Hysteroscopy experience in a Tertiary Center

Öz

Objective: We aimed to document our hysteroscopy experience at five years period in an academic hospital.
Material and Method: Data from patients who underwent hysteroscopy for any indication were retrospectively analyzed. The clinical and histopathological outcomes of patients with diagnostic or operative hysteroscopy were documented.
Results: The mean age of 202 patients included in the study was 42.83 ± 9.58 years, their mean gravid was 2.67 ± 1.29, and their mean parity was 2.04 ± 0.95. 162 (80.2%) of the patients were at premenopausal period and 40 (19.8%) of them were at postmenopausal period. The most common comorbidities detected in patients were hypertension (9.4%), diabetes mellitus (4.5%), thyroid disease (4%) and breast cancer (3.5%), respectively. The mean preoperative endometrial thickness was 12.80 ± 6.10 mm. 135 patients underwent SIS procedure before hysteroscopy, and a mass like lesion in the uterine cavity was detected in 97.8% of them. The average largest diameter of these intracavitary masses detected was 13.72 ± 6.21 mm. 7 (3.5%) of all patients needed hysteroscopy again. The most common symptoms in patients before hysteroscopy were menometrorrhagia (54.5%), polymenorrhea (14.4%), postmenopausal bleeding (10.9%) and infertility (9.4%). As a complication, uterine perforation was detected in 1 (0.5%) of cases and excessive bleeding in 2 (1%) of them. The most common localization of the masses in the uterine cavity was fundus (43.4%). As a result of histopathological examination, endometrial polyps were reported in 59 cases (70.3%) and myoma uteri in 21 (9.4%) cases.
Conclusion: The most common reason for hysteroscopy in our clinic was endometrial polyp. The most common symptom and surgical intervention were determined as menometrorrhagia and resection of polyp, respectively. In the detection of intracavitary lesions, the use of SIS before hysteroscopy was a common procedure. Our complication rate was found to be low in line with the literature.

Anahtar Kelimeler

Diagnostic hysteroscopy, operative hysteroscopy, saline infusion sonography, endometrial polyp, submucosal myoma

Kaynakça

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