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Download Diagnostic Hysteroscopy: A practical guide 2nd Edition by Thomas Römer PDF

By Thomas Römer

The diagnostic research of menstrual disorder and sterility is a regimen a part of gynecological perform. Hysteroscopy can extend the spectrum of diagnostic percentages. The 2d revised version of this guide goals to familiarise the gynecologist with diagnostical hysteroscopy. approximately a hundred color plates facilitate the purchase of this system in addition to the proper overview of findings. The publication is conceived for beginners to hysteroscopy and may give a contribution to the extra institution of this technique. This 2d revised variation contains ninety case reviews of gynecological perform.

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Hysteroscopy small cavity with only one ostium, circular structures, suspicion of uterus unicornis 5. Therapy dilatation/curettage after dilatation of the cervix laparoscopy: uterus unicornis on the right without rudimentary cornua on the left ! bilateral adnexectomy and resection of the left rudimentary cornua À atrophic endometrium À rudimentary uterine cornua without remains of endometrium À serous adenocyst in the right ovary 6. Histology Attention: Even an obstetric anamnesis without pathological findings does not exclude the existence of uterus malformations.

5-cm submucous-intramural myoma, endometrium thickness: 6 mm 4. Hysteroscopy submucous-intramural myoma in the left fundal area, left tubal ostium not visible 5. Therapy 6. Histology transcervical myoma resection parts of a leiomyoma (40 g) Attention: Submucous myomas are rarely the cause of sterility (obstruction of the tubal ostium), but a frequent cause of infertility (higher incidence of abortions by nidation problems and lack of space). Classification of myomas (see table 4, p. 74) Uterus septus 45 29-year-old patient 1.

Documentation of the findings 31 Description of a hysteroscopic finding: 1. g. cervical polyp) 2. corpus: size (length, width, symmetry) À endometrium thickness (test with sheath of hysteroscope) endometrium sliding test À vascularisation ( free-running vessels) À local change (polyp, hyperplasia) À myomas (submucous/intramural) – grade scale À ostia open/obstructed (landmarks of hysteroscopy) Attention: Especially with pathological changes hysteroscopic findings should be precisely described. Attention: Myomas, uterine malformations and intrauterine adhesions should be classified according to the standard grades of ESGE.

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