Subject(s)
Cesarean Section , Cicatrix , Humans , Pregnancy , Female , Cesarean Section/adverse effects , Pilot Projects , Cicatrix/pathology , HysteroscopyABSTRACT
To develop an efficient and practical pathway to reduce the waiting list for outpatient hysteroscopy in patients with post menopausal bleeding. The clinical data was retrospectively analysed in Welsh Clinical Portal of 1339 patients who were referred for hysteroscopy as urgent suspected cancer over a period of 12 months (1st January to 31st December 2019) in Hywel DDA University Health Board in Wales, United Kingdom. A total of 1339 patients were referred for hysteroscopy over 12 months. Among them 133 patients underwent hysteroscopy for evaluation of PMB despite ET being less than 4 mm; 1.50% patients were on tamoxifen and 16.45% were on HRT. Biopsy was taken for 86.00% of patients. Among them 1.50% were reported as malignant, 72.00% benign and 9.80% as insufficient sample. Patients with PMB and ET less than 4 mm and without suspicious features on ultrasound and who are without clinical risk factors can be reviewed virtually (in virtual clinics) by consultants or senior doctor and can be discharged. They should be instructed to report back if they experience persistent bleeding and then they would need hysteroscopy for further evaluation.
Subject(s)
COVID-19 , Hysteroscopy , Female , Humans , Pandemics , Postmenopause , Pregnancy , Retrospective Studies , Waiting ListsABSTRACT
Coronavirus 2, or SARS-CoV-2 disease (COVID-19) is a global public health concern. Although there is a paucity of evidence to advise on the best practice, we recommend postponement of elective gynecological endoscopic surgeries until the pandemic is contained. Emergency surgeries should preferably be done through open surgeries than laparoscopy or hysteroscopy approach. However, if or when laparoscopy or hysteroscopy is considered, health personnel in theatre must wear appropriate personal protective equipment (PPE) and all standard precautions should be observed to prevent COVID-19 infection. When COVID-19 is highly suspected or confirmed, the patient should be referred to centers equipped in taking care of such cases.