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Hysteroscopy has been carried out in hospitals, surgical centers and doctors' offices. It is best carried out when the endometrium is relatively thin, that is after a menstruation. Both diagnostic and simple operative hysteroscopy can be carried out in an office or clinic setting on suitably selected patients. Local anesthesia can be used.
Other treatments target the underlying cause of the hematometra; for example, a hysteroscopy may be required to resect adhesions that have developed following a previous surgery. [1] If the cause of the hematometra is unclear, a biopsy of endometrial tissue can be taken to test for the presence of a neoplasm (cancer). [5]
Hysteroscopy only shows the gross anatomy of the endometrium, which is often not indicative of cancer, and is therefore not used, unless in conjunction with a biopsy. [44] Hysteroscopy can be used to confirm a diagnosis of cancer. New evidence shows that D&C has a higher false negative rate than endometrial biopsy. [22]
Diagnosis of EIN lesions is of clinical importance because of the increased risk of coexisting (39% of women with EIN will be diagnosed with carcinoma within one year) or future (the long term endometrial cancer risk is 45 times greater for a woman with EIN compared to one with only a benign endometrial histology) endometrial cancer.
There are a number of indications for obtaining an endometrial biopsy from a non-pregnant woman: [citation needed]. Women with chronic anovulation such as the polycystic ovary syndrome are at increased risk for endometrial problems and an endometrial biopsy may be useful to assess their lining specifically to rule out endometrial hyperplasia or cancer.
Factors that influence prognosis across types of uterine cancer are age at diagnosis, the stage of the cancer, the grade of the cancer, histology, depth of invasion into the myometrium, and the presence of spread to nearby lymph nodes or other regions. [17] Endometrial cancer typically has a good 5-year-survival when diagnosed early. [18]
Gynecologic oncology is a specialized field of medicine that focuses on cancers of the female reproductive system, including ovarian cancer, uterine cancer, vaginal cancer, cervical cancer, and vulvar cancer. As specialists, they have extensive training in the diagnosis and treatment of cancers.
HSG is contraindicated during menstruation, suspected cancer, pregnancy, unprotected sexual intercourse during the menstrual cycle, any purulent discharge from the vagina, or if the individual was diagnosed with pelvic inflammatory disease six months previously. For those with hypersensitivity to contrast, HSG is relatively contraindicated.