Hysteroscopy at the Department of Gynecology and Obstetrics, University Hospital of Split : five-year retrospective study

Ciljevi istraživanja: Ciljevi istraživanja su bili retrospektivno analizirati pacijentice operirane histeroskopski u Klinici za ženske bolesti i porode KBC-a Split u petogodišnjem razdoblju i utvrditi broj histeroskopija po godinama, dob, paritet, komorbiditete, patohistološke dijagnoze i komplikacije. Materijali i metode: Analizirana medicinska dokumentacija povijesti bolesti pacijentica hospitaliziranih u Klinici za ženske bolesti i porode KBC-a Split od 2014. do 2018. godine zbog histeroskopije. Analizirani parametri su broj operacija po godinama, dob, paritet, komorbiditeti (dijebetes i hipertenzija), postojanje metroragije, prethodno izvršene kiretaže kao i njihov broj, patohistološka dijagnoza i nastale komplikacije pri izvođenju zahvata. Rezultati: U Klinici za ženske bolesti i porode KBC-a Split tijekom petogodišnjeg razdoblja obavljeno je 1511 histeroskopija. Najviše histeroskopija napravljeno je 2018. godine, a najmanje obavljenih histeroskopija bilo je 2014. godine. Prosječna dob pacijentica u trenutku zahvata iznosi 52,58 te se najviše pacijentica nalazi u dobnim skupinama 41 – 50 godina i 51 – 60 godina. Najmlađa pacijentica kojoj je obavljena histeroskopija imala je 19 godina, a najstarija pacijentica imala je 85 godina. Najčešća patohistološka dijagnoza kod ispitanica pokazao se endometralni polip (72,3 %). Najvišu prosječnu dob imaju ispitanice s dijagnozom adenokarcinoma endometrija, a najnižu prosječnu dob imaju ispitanice s dijagnosticiranim kroničnim endometritisom. Najmanji broj porođaja ispitanica je bio 0, a najveći je bio 6, prosječan broj porođaja je 1,81. Udio ispitanica koje boluju od dijabetesa je 5,8 %, od hipertenzije 27,5 %, a 14,6 % žena su prethodno podvrgnute kiretaži. Komplikacije su nastale u 0,8 % zahvata. Tentamen u 0,7 % slučajeva zbog kvara histeroskopa, stenoze cerviksa ili napadaja panike pacijentice. Perforacija maternice nastala je u 0,1 % zahvata. Zaključci: Tijekom petogodišnjeg razdoblja bilo je 1511 histeroskopija. Prosječna dob pacijentica u trenutku zahvata iznosi 52,58. Najčešće postavljena dijagnoza prema patohistološkom nalazu je endometralni polip. Komplikacije su nastale u 0,8 % zahvata. Najčešći uzrok tentamena bila je stenoza cerviksa (0,59 %). Histeroskopija je relativno nova, pouzdana i sigurna dijagnostička, ali i operativna metoda koja opravdano predstavlja zlatni standard u dobivanju biopsije endometrija.Aims and Objectives: The aim of the study was to retrospectively examine the occurrence of hysteroscopy at the Department of Gynecology and Obstetrics, University Hospital of Split in the five-year period and determine patients age, parity, comorbidity, patohistological diagnosis and complications. Materials and Methods: The medical records from Department of Gynecology and Obstetrics, University Hospital of Split were analyzed retrospectively in a period 2014. – 2018. The following parametres had been analysed: number of hysteroscopies, the patient's age at the time of procedure, parity, comorbidities (diabetes and hypertension), the pathohistological diagnosis, metrorrhagia, previous curettage and complications. Results: At the Department of Gynecology and Obstetrics, University Hospital of Split in the fiveyear period there were 1511 hysteroscopies. The maximum number of procedures occurred in 2018. and the minimum in 2014. The median age at the time of procedure was 52.58 and the highest number of patients was in the age group 41 - 50 and 51 – 60 years. The youngest patient was 19 and the oldest was 85 years old. According to the pathohistological findings the most commonly diagnosed was endometrial polyp (72.3 %). The highest median age was found in pacients with endometral adenocarcinoma and the lowest median age in pacients with chronic endometritis. The minimum number of the births was 0, and the maximum number was 6, the median number of births is 1.81. Share of patients that suffer from diabetes was 5.8 %, from hypertension 27.5 % and 14.6 % of patients previously had curettage. Complications occurred in 0.8 % of procedures. Tentamen in 0.7 % of cases because of cervical stenosis, panick attack or failure of hysteroscope. Uterus perforation occurred in 0.1% of cases. Conclusion: In five-year period there were 1511 hysteroscopies. The median age at the time of procedure was 52.58 and the most common pathohistological finding was endometrial polyp. Rate of complications was 0.8 %. The most common cause for tentamen was cervical stenosis (0.59%). Hysteroscopy is relatively new, safe and reliable diagnostic but also therapeutic method and it is justified to represent a golden standard of performing an endometrial biopsy