Minimally invasive and hysteroscopic diagnosis and treatment of patients after organ transplantation.
OBJECTIVE
To assess the safety of minimally invasive and hysteroscopic diagnosis and treatment of abnormal uterine bleeding and intrauterine abnormalities in patients after organ transplantation.


METHODS
After kidney, pancreas, or liver transplantation, patients who presented with menorrhagia, submucosal myoma or thickened endometrium on ultrasound were diagnosed and treated using a hysteroscopic system Versascope, Bipolar Resectoscopic System and intrauterine system ThermaChoice.


RESULTS
Twenty patients were included in this study and were aged 37-63 years (average +/- standard deviation: 48.8 +/- 5.86). The follow up was between 3 and 122 months (44.8 +/- 31.91). All hysteroscopic procedures were performed under general anesthesia, using local anesthetics (paracervical block) or short-term i.v. anesthesia, plus antibiotics. The procedures lasted 5 to 15 min (9.4 +/- 2.44). Five patients presented with minimal blood loss (< or =100 mL) and the rest had no blood loss. The hysteroscopic procedures had no adverse effects on the function of transplanted organs and there were no associated postoperative complications. Uterine bleeding was successfully regulated in all patients.


CONCLUSIONS
Minimally invasive procedures and hysteroscopy of organ-transplanted patients provide a safe solution for the treatment of menorrhagia, submucosal myoma and thick endometrium in postmenopausal patients.
Kuzel
David
D
Department of Obstetrics and Gynaecology, 1st Medical Faculty, Charles University and General Faculty Hospital, Czech Republic. kuzeld@centrum.cz
Toth
Dusan
D
Cindr
Josef
J
Bartosova
Lucie
L
Mara
Michal
M
Viklicky
Ondrej
O
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy; D016030:Kidney Transplantation; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016377:Organ Transplantation; D016035:Pancreas Transplantation; D014592:Uterine Hemorrhage / Q000628:therapy*