Effectiveness of Hysteroscopic Techniques for Endometrial Polyp Removal: The Italian Multicenter Trial.

Study Objective: To compare the effectiveness and safety of different techniques of hysteroscopic polypectomy.

Design: Multicenter, prospective observational trial (Canadian Task Force classification II-2).

Setting: Nineteen Italian gynecologic departments (university-affiliated or public hospitals).

Essure Permanent Birth Control, Effectiveness and Safety: An Italian 11-Year Survey.

Study Objective: To describe safety, tolerability, and effectiveness results through a minimum 2-year follow-up of patients who underwent permanent sterilization with the Essure insert.

Design: A retrospective multicenter study (Canadian Task Force classification II2).

Setting: Seven general hospitals and 4 clinical teaching centers in Italy.

Hysteroscopic bipolar surgery: a valuable progress or a technique under investigation?

Purpose Of Review: Bipolar technology was introduced in the hysteroscopy field with resectoscopic loops and electrodes adaptable to mini-hysteroscopes. The use of isotonic saline as a distension medium and the proximity of electrodes reduce the risk of electrolyte imbalance and electrical burns. Delivering an electrosurgical device throughout mini-hysteroscopes avoids cervical dilatation, limiting uterine wall damages.

Uterine tumor resembling ovarian sex cord tumors treated by resectoscopic surgery.

Uterine tumors resembling ovarian sex cord tumors (UTROSCTs) are rare neoplasms of uncertain malignancy, affecting either pre or menopausal women. Only 48 cases of UTROSCTs have been reported and in most patients the diagnosis was made incidentally, after a hysterectomy as a result of the assumption of a leiomyoma. Although no death from progressive disease was reported, locoregional spread or abdominal relapse was detected in some patients.

Outpatient hysteroscopic polypectomy in postmenopausal women: a comparison between mechanical and electrosurgical resection.

Study Objective: Comparison of operating outcomes of office hysteroscopic polypectomy accomplished by mechanical or bipolar electrosurgical instrumentation.

Design: Prospective study (Canadian Task Force classification II-1).

Setting: Public hospital.

Hysteroscopic view in atypical endometrial hyperplasias: A correlation with pathologic findings on hysterectomy specimens.

Study Objective: To evaluate whether hysteroscopic imaging can contribute to decrease the rate of undetected endometrial carcinomas concurrent with atypical hyperplasia diagnosed by endometrial biopsy.

Design: Retrospective study.

Design Classification: Canadian Task Force Classification II-3.

Prospective endometrial assessment of breast cancer patients treated with third generation aromatase inhibitors.

Objective: A prospective evaluation of the effects on endometrium of third generation aromatase inhibitors (AIs), administered as adjuvant up-front therapy or switched therapy in menopausal patients suffering from breast cancer.

Methods: Forty-five patients suffering from estrogen-receptor positive breast cancer were treated with AIs as adjuvant endocrine therapy; 27 patients switched from tamoxifen to AIs (group 1) due to adverse medical events related to tamoxifen intake (22 patients) or to an extended endocrine treatment after 60 months of tamoxifen therapy (5 patients); whereas 18 patients received AIs as up-front adjuvant therapy (group 2). All patients underwent endometrial investigation before the start of AIs therapy and, thereafter, at 12 month intervals.

Pretreatment and prospective assessment of endometrium in menopausal women taking tamoxifen for breast cancer.

Objectives: To estimate the pretreatment incidence of endometrial pathology and to prospectively assess the endometrial morbidity emerging during tamoxifen intake for breast cancer.

Study Design: One-hundred and forty-six menopausal breast cancer patients, candidate to receive tamoxifen underwent endometrial assessment by Transvaginal Ultrasonography (TU) before the start of therapy. A double-layered endometrial stripe measuring more than 4mm indicated hysteroscopy and endometrial biopsy.

Histopathologic behavior of endometrial hyperplasia during tamoxifen therapy for breast cancer.

Objective: The purpose of the present study is to prospectively evaluate the effects of tamoxifen on the pathological behavior of endometrial hyperplasias without atypia, diagnosed before the start of adjuvant endocrine therapy, in menopausal patients suffering from breast cancer.

Methods: Twenty-six patients suffering from estrogen-receptor positive breast cancer and candidate to receive adjuvant tamoxifen, were found to be affected by endometrial hyperplasias before the start of endocrine therapy. All women showed a baseline endometrial stripe, measured by transvaginal ultrasonography, thicker than 4 mm and the diagnosis of endometrial hyperplasia was made by hysteroscopy and endometrial biopsy.

Accuracy of hysteroscopic diagnosis of endometrial hyperplasia: a retrospective study of 323 patients.

Study Objective: To evaluate the diagnostic accuracy of hysteroscopic view in endometrial hyperplasia.

Design: Retrospective study (Canadian Task Force classification II-2).

Setting: Public hospital in northern Italy.

Baseline endometrial assessment before tamoxifen for breast cancer in asymptomatic menopausal women.

Objective: The aim of this study is to estimate the prevalence of endometrial pathology before the start of tamoxifen therapy in menopausal breast cancer patients.

Methods: Ninety-one gynecologically asymptomatic patients, suffering from estrogen receptor-positive breast cancer and scheduled for adjuvant tamoxifen, underwent pretreatment endometrial assessment. In all patients, a transvaginal ultrasonography was carried out; a double-layered endometrial stripe measuring above 4 mm was considered as abnormal.

Outpatient hysteroscopic polypectomy in 237 patients: feasibility of a one-stop "see-and-treat" procedure.

Study Objective: To evaluate the feasibility of a "see-and-treat" office polyp resection, using a 5-mm sheathed operative hysteroscope.

Design: Retrospective study (Canadian Task Force classification II-2).

Setting: Public hospital.

Hysteroscopically targeted biopsies compared with blind samplings in endometrial assessment of menopausal women taking tamoxifen for breast cancer.

Study Objective: To determine the validity of tissue sampling accomplished by hysteroscopically targeted or blind biopsies in the assessment of endometrial morbidity associated with tamoxifen treatment.

Design: Retrospective, unrandomized study (Canadian Task Force classification II-2).

Setting: Public hospital.

Saline infusion sonography and office hysteroscopy to assess endometrial morbidity associated with tamoxifen intake.

Objective: The objective of this study was to compare office feasibility, patient acceptance, and diagnostic accuracy of hysteroscopy (HYS) and saline infusion sonography (SIS) in breast cancer patients taking tamoxifen.

Methods: Sixty-six asymptomatic postmenopausal women on tamoxifen for breast cancer underwent SIS, followed by outpatient HYS with endometrial biopsy. In all women an endometrial stripe over 4 mm was previously measured by transvaginal ultrasonography (TU).

Hysteroscopic assessment of menopausal breast-cancer patients taking tamoxifen; there is a bias from the mode of endometrial sampling in estimating endometrial morbidity?

The aim of this study is to evaluate the accuracy of hysteroscopy in detecting tamoxifen-associated endometrial morbidity. Ninety-eight menopausal breast cancer patients taking tamoxifen underwent hysteroscopy because of an endometrial thickness above 4mm measured by Transvaginal Ultrasonography. Thirty-one women recorded uterine bleeding while 67 were asymptomatic.