The use of hysteroscopy in the setting of endometrial carcinoma raises two major concerns: That distention of the uterus will propel cancerous cells into the abdomen via the fallopian tubes and that those cells will seed the abdomen and either increase the risk of recurrence of the cancer or cause implants to be viable and grossly present at the time of staging. Hysteroscopy improves the likelihood of diagnosing endometrial pathology by affording the surgeon a direct visualization of the cavity and therefore any lesions that may be present. Quantifying this benefit must be weighed against the potential risks and costs of the procedure. Some have described protocols for managing endometrial cancer in the setting of fertility preservation or a poor surgical candidate using hysteroscopy as a tool for either following a lesion treated with progesterones or resecting the lesion altogether with a hysteroscopic resectoscope. In this chapter we review the use of hysteroscopy in endometrial cancer, focusing on diagnosis, treatment, and possible impact on the disease. Hysteroscopy And Diagnosis Of Endometrial Cancer: Since its introduction in 1869 by Pantaleoni to treat abnormal bleeding from an endometrial polyp, hysteroscopy has been utilized in the diagnosis and treatment of abnormal vaginal bleeding. Endometrial cancer presents as abnormal bleeding in approximately 93% of cases, and a reported 5% to 15% of postmenopausal women with abnormal bleeding will have endometrial carcinoma.
|Title of host publication||Nezhat's Operative Gynecologic Laparoscopy and Hysteroscopy|
|Publisher||Cambridge University Press|
|Number of pages||5|
|State||Published - 1 Jan 2008|