[Study on the peritoneal dissemination of endometrial cells during hysteroscopy].
OBJECTIVE
To study prospectively the likelihood and the affecting factors of endometrial cell dissemination into the peritoneal cavity during hysteroscopic procedures.


METHODS
A total of 121 patients with benign endometrial pathology underwent hysteroscopy combined with laparoscopy. All the patients had pelvic washings performed just before and after the procedure of hysteroscopy. We collected the peritoneal washings and analyzed the peritoneal cytology changes in both groups pre- and post-hysteroscopy, as well as the dissemination rate related to the time of hysteroscopy, the intrauterine distention pressure, the volume of distention media, and the feature of endometrial conditions.


RESULTS
The ratio of positive endometrial cells in the peritoneal washings of post-hysteroscopy group was 51.2% (62/121), which was significantly higher than pre-hysteroscopy group, 38.0% (46/121) (P < 0.01). The mean operation time in the group of positive peritoneal cytology was (38 +/- 16) min, longer than the negative group (P < 0.05). However, there was no significant difference between the two groups with regard to the total volume of distention media, the distention pressure, and the endometrial feature (P > 0.05).


CONCLUSIONS
Hysteroscopic procedures may have a risk of disseminating the endometrial cells into peritoneal cavity. Under a certain uterine distention pressure, the rate of dissemination is correlated with hysteroscopic duration.
Duan
Hua
H
Department of Minimally Invasive Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital University of Medical Sciences, Beijing 100006, China.
Li
Wei
W
Zhang
Ying
Y
Zhao
Xia
X
Xia
En-Lan
EL
D000328:Adult; D004717:Endometrium / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000009:adverse effects*; D010535:Laparoscopy / Q000009:adverse effects; D009362:Neoplasm Metastasis / Q000517:prevention & control; D009366:Neoplasm Seeding; D010529:Peritoneal Cavity / Q000166:cytology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D007507:Therapeutic Irrigation; D013997:Time Factors; D014591:Uterine Diseases / Q000175:diagnosis* / Q000601:surgery*