RESUMEN
Hysteroscopy has truly revolutionized the field of diagnostic and operative gynecology. It is presently regarded as the gold standard method for both the diagnosis and treatment of intrauterine diseases and it has fundamentally altered the way gynecologists treat patients with such conditions. These pathologies can now be diagnosed and treated in an outpatient setting, thanks to technological advancements and instrument downsizing. Two hundred years of development and notable innovation are now reflected in the present hysteroscopic practice. This review attempts to trace the boundaries-pushing history of hysteroscopy by highlighting the advancements in technology and the therapeutic and diagnostic benefits offered by this groundbreaking approach.
Asunto(s)
Histeroscopía , Femenino , Humanos , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Histeroscopía/historia , Histeroscopía/instrumentación , Histeroscopía/métodos , Enfermedades Uterinas/diagnóstico , Enfermedades Uterinas/cirugíaAsunto(s)
Cirugía General/historia , Laparoscopios/historia , Laparoscopía/historia , Australia , Distinciones y Premios , Broncoscopía/historia , Cistoscopía/historia , Diseño de Equipo/historia , Esofagoscopía/historia , Docentes Médicos/historia , Cirugía General/ética , Cirugía General/tendencias , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Hungría , Histeroscopía/historia , Laparoscopios/tendencias , Laparoscopía/tendencias , Estados UnidosRESUMEN
Hysteroscopy today represents 200 years of salient innovations in instrumentation, new clinical applications for existing instruments, and continual modification of techniques, all aiming at observing, diagnosing, and treating pathologic conditions of the uterine cavity. Pioneers established the fundamental principles of intrauterine observation that steady technological advances would simplify and refine, all the way to the instrumentation and ancillary equipment now in use. Homage should be given and tribute paid to predecessors who made instrumentation, intrauterine distention, and illumination safe and practical for diagnostic and therapeutic hysteroscopy. Their accomplishments are remembered as we look with optimism to the many advances that undoubtedly will mark the future of hysteroscopy.
Asunto(s)
Histeroscopios/historia , Histeroscopía/historia , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Histeroscopía/métodos , Histeroscopía/tendenciasRESUMEN
OBJECTIVE: To review the physiology, pathology, and treatment of proximal tubal disease. DATA IDENTIFICATION: Relevant reports on the pathophysiology of proximal tubal disease were reviewed. All studies in English of microsurgery and macrosurgery, and of radiographic and hysteroscopic cannulation in women with proximal tubal blockage were identified through MEDLINE searches. STUDY SELECTION: All studies of therapy for proximal blockage that included pregnancy rates were considered. Series of sterilization reversals, series of unilateral or combined procedures, and series in which the location of tubal blockage was not given were excluded from the data analyses. DATA ANALYSIS: Raw data were assessed for homogeneity, then standardized and pooled. Total and ongoing pregnancy rates after microsurgery and macrosurgery, as well as radiographic and hysteroscopic transcervical cannulation, were compared by the chi2 test. Relative risks for total and ongoing pregnancies were calculated for all treatment methods. RESULT(S): This meta-analysis suggests that, overall, microsurgical anastomosis results in higher total and ongoing pregnancy rates than macrosurgery or radiographic tubal cannulation. However, pregnancy rates in selected series of transcervical tubal cannulation are similar to those reported for microsurgery. CONCLUSION(S): Ongoing intrauterine pregnancy rates near 50% can be achieved in patients with proximal blockage of the fallopian tube. Selective salpingography and transcervical cannulation under fluoroscopic guidance are effective at establishing patency in appropriately selected patients and are less invasive and costly than the surgical alternatives.
Asunto(s)
Enfermedades de las Trompas Uterinas/fisiopatología , Enfermedades de las Trompas Uterinas/cirugía , Anastomosis Quirúrgica , Constricción Patológica/fisiopatología , Constricción Patológica/cirugía , Enfermedades de las Trompas Uterinas/complicaciones , Enfermedades de las Trompas Uterinas/patología , Trompas Uterinas/patología , Trompas Uterinas/cirugía , Femenino , Historia del Siglo XX , Humanos , Histerosalpingografía/historia , Histeroscopía/historia , Infertilidad Femenina/etiología , Metaanálisis como Asunto , Microcirugia , Embarazo , Resultado del Embarazo , Útero/cirugíaRESUMEN
Müllerian anomalies usually come to medical attention when they become problematic and require treatment. Most of these complications require surgical correction. The most commonly presenting anomaly is the double uterus which can be the source of recurrent abortion and preterm deliveries. The Strassman, Jones and Tompkins metroplasties have been shown to greatly improve the rate of successful deliveries in these patients. Hysteroscopic metroplasty, using either scissors, resectoscope or laser is now the recommended treatment for most septate uteri due to its relative simplicity, low morbidity and excellent reproductive outcome.
Asunto(s)
Histeroscopía , Conductos Paramesonéfricos/anomalías , Procedimientos Quirúrgicos Operativos/métodos , Útero/anomalías , Vagina/anomalías , Femenino , Historia del Siglo XX , Humanos , Histeroscopía/historia , Conductos Paramesonéfricos/cirugía , Útero/cirugía , Vagina/cirugíaRESUMEN
A quiet resurgence of interest in an old endoscopic technique began in the late 1960s. Today hysteroscopy, both diagnostic and operative, has become an integral part of the gynecologist's technique. The question, "Hysteroscopy: where have we been, where are we going?" can be addressed by an examination of the past, present and future. Tribute will be paid to the pioneers. The clinical applications as practiced today are described. Critical appraisal of the risks and benefits of these procedures will permit predictions to be made about the future of gynecologic hysteroscopy.
Asunto(s)
Histeroscopía/historia , Femenino , Historia del Siglo XIX , Historia del Siglo XX , Historia Antigua , Humanos , Histeroscopios , Histeroscopía/tendencias , Enfermedades Uterinas/diagnóstico , Enfermedades Uterinas/historia , Enfermedades Uterinas/cirugíaRESUMEN
Os autores expöem, de modo sintético, o evoluir da histeroscopia através dos tempos. Discorrem desde a primeira tentativa de se vizualizar o interior da cavidade uterina até aos dias atuais, quando a cavidade endometrial pode ser explorada satisfatoriamente com histeroscópicos de calibres variados, com propósitos diagnósticos (histeroscopia panorâmica), documentários e operatórios.