Hallazgos histeroscópicos en 70 procedimientos realizados en un curso de histeroscopia de consultorio

Histeroscopic findings in 70 procedures done in a course of office-hysteroscopy.

Objetivos: mostrar las bondades de la histeroscopia que se realiza en un consultorio médico, reportar la experiencia adquirida en el curso de histeroscopia que impartimos en el consultorio y revisar la bibliografía relacionada con los criterios que harán posible la adecuada preparación de los futuros cirujanos histeroscopistas.

Material y método: se incluyeron las histeroscopias que se realizaron en el consultorio durante el curso teórico-práctico de histeroscopia; en el curso, que se desarrolló en 14 sesiones sabatinas de ocho horas cada una, se practicaron 70 histeroscopias en pacientes previamente seleccionadas, quienes ingresaron al consultorio con ayuno de ocho horas; las histeroscopias se realizaron con un telescopio Storz^® –con diámetro externo de 2.9 mm, con fuente de luz de xenón y con endocámara digital Storz^® de tres chips–, con una camisa operatoria tipo Bettocchi^® y con una solución fisiológica. En 45 casos la histeroscopia se llevó a cabo sin anestesia y en 25 la histeroscopia se hizo con anestesia endovenosa, con apoyo ventilatorio y con monitoreo de los signos vitales; en todos los casos las afecciones se aliviaron eficazmente.

Resultados: de las 70 histeroscopias que se realizaron, se resecaron 24 pólipos endometriales, se llevaron a cabo 14 histeroscopias diagnósticas, se colocaron siete dispositivos Essure^®, se extirparon seis miomas, se retiraron cinco dispositivos intrauterinos, se hallaron cuatro malformaciones uterinas, se diagnosticaron y lisaron tres síndromes de Asherman y tres estenosis cervicales, se efectuaron dos ablaciones endometriales, se encontró un adenocarcinoma endometrial y hubo un caso especial.

Conclusiones: una de las bondades de este curso de histeroscopia de consultorio es impartirlo directamente con pacientes y, en todos los casos, las afecciones se aliviaron eficazmente.

Palabras clave: histeroscopia de consultorio, curso.

Objective: To show the advantages of office-hysteroscopy, to report the experience acquired in the office-hysteroscopy course and to review the bibliography related to criteria that will make possible the adequate training of the future hysteroscopist surgeons.

Material and method: Office-hysteroscopies during the theoretical-practical course of hysteroscopy were included; in the course, developed in 14 Saturday sessions of eight hours each, 70 hysteroscopies were done in previously selected patients, who entered to the office with an 8-hours-fasting; hysteroscopies were done with a Storz^® telescope –with external diameter of 2.9 mm, with xenon light source and with digital endo-camera Storz^® of three chips–, with an operatory type Bettocchi^® and a physiological solution. In 45 cases, hysteroscopy was done without anesthesia and in 25 hysteroscopy was done with endovenous anesthesia, with ventilatory support and with vital signs monitoring; in all cases, illnesses were relieved efficaciously.

Results: Out of the 70 hysteroscopies done, 24 endometrial polyps were resected, 14 diagnostic hysteroscopies were done, seven Essure^® device were placed, six myomas were removed, five intrauterine devices were removed, four uterine malformations were found, three Asherman syndromes and three cervix stenosis were diagnosed, two endometrial ablations were done, an endometrial adenocarcinoma was found and there was a special case.

Conclusions: One of the advantages of this office-hysteroscopy course is to teach it directly with patients and, in all cases, illnesses were relieved efficaciously.

Key words: office-hysteroscopy, course.