Prevalence of Infections After In-Office Hysteroscopy in Premenopausal and Postmenopausal Women |
| |
Authors: | Pasquale Florio Luigi Nappi Luca Mannini Giovanni Pontrelli Raffaele Fimiani Paolo Casadio Ivano Mazzon Gioacchino Gonzales Vittorio Villani Mario Franchini Giampietro Gubbini Liliana Mereu Fabrizia Santangelo Attilio Di Spiezio Sardo |
| |
Affiliation: | 1. Department of Obstetrics and Gynecology, S. Jacopo Hospital, Pistoia, Italy (Drs. Florio, Mannini, and Fimiani);2. Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy (Dr. Nappi);3. Department of Obstetrics and Gynecology, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy (Dr. Pontrelli);4. Department of Obstetrics, Gynecology, and Reproductive Biology, University Alma Mater Studiorum of Bologna, Bologna, Italy (Dr. Casadio);5. “Arbor Vitae” Centre, Nuova Villa Claudia Clinic, Rome, Italy (Dr. Mazzon);6. Department of Obstetrics and Gynecology, Civico Hospital, Palermo, Italy (Dr. Gonzales);7. Department of Obstetrics and Gynecology, Sandro Pertini Hospital, Rome, Italy (Dr. Villani);8. Freestanding Unit, Palagi Hospital, Florence, Italy (Dr. Franchini);9. Division of Gynecology, Madre Fortunata Toniolo Hospital, Bologna, Italy (Dr. Gubbini);10. Department of Gynecology and Obstetrics, Santa Chiara Hospital, Trento, Italy (Dr. Mereu);11. Department of Obstetrics and Gynecology, University of Naples "Federico II," Naples, Italy (Drs. Santangelo and Di Spiezio Sardo). |
| |
Abstract: |
Study ObjectiveTo estimate the incidence of infection after diagnostic and operative hysteroscopic procedures performed in an in-office setting with different distension media (saline solution or CO2).DesignProspective, multicenter, observational study (Canadian Task Force classification II-2).SettingTertiary women's health centers.PatientsA total of 42,934 women who underwent hysteroscopy between 2015 and 2017.InterventionsOf the 42,934 patients evaluated, 34,248 underwent a diagnostic intervention and 8686 underwent an operative intervention; 17,973 procedures used CO2 and 24,961 used saline solution as a distension medium. Patients were contacted after the procedure to record postprocedure symptoms suggestive of infection, including 2 or more of the following signs occurring within the 3 weeks after hysteroscopy: fever; lower abdominal pain; uterine, adnexal, or cervical motion tenderness; purulent leukorrhea; vaginal discharge or itchiness; and dysuria. Vaginal culture, clinical evaluation, transvaginal ultrasound, and histological evaluation were completed to evaluate symptoms.Measurements and Main ResultsOperative hysteroscopies comprised polypectomies (n?=?7125; 82.0%), metroplasty (n?=?731; 15.0%), myomectomy (n?=?378; 7.8%), and tubal sterilization (n?=?194; 4.0%). Twenty-five of the 42,934 patients (0.06%) exhibited symptoms of infection, including 24 patients (96%) with fever, 11 (45.8%) with fever as a single symptom, 7 (29.2%) with fever with pelvic pain, and 10 (41.7%) with fever with dysuria. In 5 patients with fever and pelvic pain, clinical examination and transvaginal ultrasound revealed monolateral or bilateral tubo-ovarian abscess. In these patients, histological examination from surgical specimens revealed the presence of endometriotic lesions.ConclusionThe present study suggests that routine antibiotic prophylaxis is not necessary before hysteroscopy because the prevalence of infections following in-office hysteroscopy is low (0.06%). |
| |
Keywords: | Antibiotics Endometrioma Endometriosis Hysteroscopy Infection Tubo-ovarian abscess |
本文献已被 ScienceDirect 等数据库收录! |
|