By Michael S. Baggish MD, Rafael F. Valle MD, Hubert Guedj MD
Thoroughly revised, up-to-date, and extended, the 3rd version of Diagnostic and Operative Hysteroscopy presents a accomplished pictorial and textual advisor to the anatomy, body structure, pathology, and scientific facets of the uterus and the newest diagnostic and operative hysteroscopy tactics. This version good points greater than 1,300 illustrations—over 900 in complete color—depicting anatomy, pathology, tools, and step by step operative ideas. New chapters conceal in-vitro fertilization, endometriosis, adenocarcinoma of the endometrium, results of gear at the uterus, hysteroscopy in gynecologic malignancy and premalignancy, and uterine infections. up-to-date chapters comprise many new minimally invasive operative systems that may now be performed.
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Extra resources for Hysteroscopy : visual perspectives of uterine anatomy, physiology and pathology
In difficult cases, thought may be given to dilation under ultrasound guidance. Since most dilators are sonographically opaque, the dilator may be more accurately directed into the cavity (Fig. 17). The ultrasound should be performed transabdominally, and bladder distention may be useful. This may be a useful adjunct, even in patients undergoing concomitant laparoscopy, because ultrasound may be able to guide the operator though a tortuous canal and decrease the rate of false passage formation.
1995;38:267–279. Leppert PC, Cerreta JM, Mandl I. Orientation of elastic fibers in the human cervix. Am J Obstet Gynecol. 1986;155:219–224. Leppert PC, Keller S, Cerreta J, et al. The content of elastin in the uterine cervix. Arch Biochem Biophys. 1983;1:53–58. Mais V, Kazer RR, Cetel MS, et al. The dependency of folliculogenesis and corpus luteum function on pulsatile gonadotropin secretion in cycling women using a gonadotropin releasing hormone antagonist as a probe. J Clin Endocrinol Metab. 1986;62:1250.
In such cases, progesterone withdrawal prior to hysteroscopic evaluation may improve the clinician's ability to access the uterine cavity. In contrast to the two previous clinical settings, we may also induce endometrial abnormalities by use of pharmacologic agents such as estrogens or tamoxifen. 35 of exogenous estrogen, regardless of the route, causes a direct effect on the endometrium. Estrogen has a profound mitogenic effect on endometrial cells. Multiple studies have now documented the increased incidence of endometrial hyperplasia in menopausal patients receiving only estrogen and no progesterone.