Skip to main content
SpringerLink
Log in

Postmenstrual Bleeding

  • Chapter
  • First Online:
Hysteroscopy

  • 2462 Accesses

Abstract

Persistence of trophoblastic or placental tissue after abortion or delivery is a common issue that induces some problems such as abnormal uterine bleeding (AUB), infection of the residual tissue, or secondary infertility as well as complications derived from repeated D&C as uterine perforation or the development of uterine adhesions or Asherman syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Goldenberg M, Schiff E, Achiron R, Lipitz S, Mashiach S. Managing residual trophoblastic tissue hysteroscopy for directing curettage. J Reprod Med. 1997;42:26–8.

    CAS  PubMed  Google Scholar 

  2. Ben-Ami I, Schneider D, Maymon R, Vaknin Z, Herman A, Halperin R. Sonographic versus clinical evaluation as predictors of residual trophoblastic tissue. Hum Reprod. 2005;20:1107–11.

    Article  PubMed  Google Scholar 

  3. Achiron R, Goldenberg M, Lipitz S, Mashiach S. Transvaginal duplex Doppler ultrasonography in bleeding patients suspected of having residual trophoblastic tissue. Obstet Gynecol. 1993;81:507–11.

    CAS  PubMed  Google Scholar 

  4. Jiménez JS, Gonzalez C, Alvarez C, Muñoz L, Pérez C, Muñoz JL. Conservative management of retained trophoblastic tissue and placental polyp with diagnostic ambulatory hysteroscopy. Eur J Obstet Gynecol Reprod Biol. 2009;145:89–92.

    Article  PubMed  Google Scholar 

  5. Cohen SB, Kalter-Ferber A, Weisz BS, et al. Hysteroscopy may be the method of choice for management of residual trophoblastic tissue. J Am Assoc Gynecol Laparosc. 2001;8:199–202.

    Article  CAS  PubMed  Google Scholar 

  6. Pérez-Medina T, Sancho-Saúco J, Ríos M, Pereira A, Argila N, Cabezas E, Cayuela E. Hysteroscopy in pregnancy-related conditions: descriptive analysis in 273 patients. J Minim Invasive Gynecol. 2014;21(3):417–25.

    Article  PubMed  Google Scholar 

  7. Vakiani M, Vavilis D, Agorastos T, Stamatopoulos P, Assimaki A, Bontis J. Histopathological findings of the endometrium in patients with dysfunctional uterine bleeding. Clin Exp Obstet Gynecol. 1996;23(4):236–9.

    CAS  PubMed  Google Scholar 

  8. Fraser IS, Hickey M, Song JY. A comparison of mechanisms underlying disturbances of bleeding caused by spontaneous dysfunctional uterine bleeding or hormonal contraception. Hum Reprod. 1996;11(Suppl 2):165–78.

    Article  CAS  PubMed  Google Scholar 

  9. Livingstone M, Fraser IS. Mechanisms of abnormal uterine bleeding. Hum Reprod Update. 2002;8(1):60–7.

    Article  PubMed  Google Scholar 

  10. Stewart CJ, Bharat C, Leake R. Asynchronous glands in secretory pattern endometrium: clinical associations and immunohistological changes. Histopathology. 2015;67(1):39–47.

    Article  PubMed  Google Scholar 

  11. Vervoort AJ, Van der Voet LF, Witmer M, Thurkow AL, Radder CM, van Kesteren PJ, Quartero HW, Kuchenbecker WK, Bongers MY, Geomini PM, de Vleeschouwer LH, van Hooff MH, van Vliet HA, Veersema S, Renes WB, van Meurs HS, Bosmans J, Oude Rengerink K, Brölmann HA, Mol BW, Huirne JA. The HysNiche trial: hysteroscopic resection of uterine caesarean scar defect (niche) in patients with abnormal bleeding, a randomised controlled trial. BMC Womens Health. 2015;15:103.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Tower AM, Frishman GN. Cesarean scar defects: an underrecognized cause of abnormal uterine bleeding and other gynecologic complications. J Minim Invasive Gynecol. 2013;20(5):562–72.

    Article  PubMed  Google Scholar 

  13. Ofili-Yebovi D, Ben-Nagi J, Sawyer E, et al. Deficient lower-segment cesarean section scars: prevalence and risk factors. Ultrasound Obstet Gynecol. 2008;31:72–7.

    Article  CAS  PubMed  Google Scholar 

  14. Armstrong V, Hansen WF, Van Voorhis BJ, Syrop CH. Detection of cesarean scars by transvaginal ultrasound. Obstet Gynecol. 2003;101:61–5.

    PubMed  Google Scholar 

  15. Osser OV, Jokubkiene L, Valentin L. High prevalence of defects in cesarean section scars at transvaginal ultrasound examination. Ultrasound Obstet Gynecol. 2009;34:90–7.

    Article  PubMed  Google Scholar 

  16. Nieuwenhuis LL, de Vaate MA, Hehenkamp WJ, Heymans MW, van Baal MW, Brölmann HA, Huirne JA. Diagnostic and clinical value of 3D gel installation sonohysterography in addition to 2D gel installation sonohysterography in the assessment of intrauterine abnormalities. Eur J Obstet Gynecol Reprod Biol. 2014;175:67–74.

    Article  PubMed  Google Scholar 

  17. Fabres C, Aviles G, De La Jara C, et al. The cesarean delivery scar pouch: clinical implications and diagnostic correlation between transvaginal sonography and hysteroscopy. J Ultrasound Med. 2003;22:695–700.

    Article  PubMed  Google Scholar 

  18. van der Voet LF, Vervoort AJ, Veersema S, BijdeVaate AJ, Brölmann HA, Huirne JA. Minimally invasive therapy for gynaecological symptoms related to a niche in the caesarean scar: a systematic review. BJOG. 2014;121(2):145–56.

    Article  PubMed  Google Scholar 

  19. Gubbini G, Centini G, Nascetti D, et al. Surgical hysteroscopic treatment of cesarean-induced isthmocele in restoring fertility: prospective study. J Minim Invasive Gynecol. 2011;18:234–7.

    Article  PubMed  Google Scholar 

  20. Raimondo G, Grifone G, Raimondo D, Seracchioli R, Scambia G, Masciullo V. Hysteroscopic treatment of symptomatic cesarean-induced isthmocele: a prospective study. J Minim Invasive Gynecol. 2015;22(2):297–301.

    Article  PubMed  Google Scholar 

  21. Shih CL, Chang YY, Ho M, et al. Hysteroscopic transcervical resection: a straightforward method corrects bleeding related to cesarean section scar defects. Am J Obstet Gynecol. 2011;204:278.e1–2.

    Article  Google Scholar 

  22. Feng Y, Li M, Liang X, Li X. Hysteroscopic treatment of postcesarean scar defect. J Minim Invasive Gynecol. 2012;19:498–502.

    Article  PubMed  Google Scholar 

  23. Nirgianakis K, Oehler R, Mueller M. The Rendez-vous technique for treatment of caesarean scar defects: a novel combined endoscopic approach. Surg Endosc. 2016;30(2):770–1.

    Article  PubMed  Google Scholar 

  24. Marotta ML, Donnez J, Squifflet J, Jadoul P, Darii N, Donnez O. Laparoscopic repair of post-cesarean section uterine scar defects diagnosed in non-pregnant women. J Minim Invasive Gynecol. 2013;20:386–91.

    Article  PubMed  Google Scholar 

  25. Luo L, Niu G, Wang Q, Xie HZ, Yao SZ. Vaginal repair of cesarean section scar diverticula. J Minim Invasive Gynecol. 2012;19(4):454–8.

    Article  PubMed  Google Scholar 

  26. Sorinola O, Kamal NG, Condie RG, Wats JF. Subfertility due to osseous metaplasia of the endometrium treated by hysteroscopic resection. Curr Obstet Gynaecol. 2000;10:42–3.

    Article  Google Scholar 

  27. Adamson NE, Sommers SC. Endometrial ossification: report of two cases. Am J Obstet Gynecol. 1954;67:187–90.

    Article  PubMed  Google Scholar 

  28. Cicinelli E, Stanziano A, Parisi C, Narinaccio M, Causio F. Hysteroscopic diagnosis and treatment of endocervical ossification: a case report. J Minim Invasive Gynecol. 2005;12:159–61.

    Article  PubMed  Google Scholar 

  29. Cayuela E, Pérez-Medina T, Vilanova J, Alejo M, Cañadas P. Osseous metaplasia: the bone is not from a fetus. Fertil Steril. 2009;91(1293):e1–4.

    Google Scholar 

  30. Clark TJ, Stevenson H. Endometrial polyps and abnormal uterine bleeding (AUB-P): what is the relationship, how are they diagnosed and how are they treated? Best Pract Res Clin Obstet Gynaecol. 2016; pii: S1521-6934(16)30082-7.

    Google Scholar 

  31. Perez-Medina T, Martínez O, Folgueira G, Bajo JM. Which endometrial polyps should be resected? J Am Assoc Gynecol Laparosc. 1999;6:71–4.

    Article  CAS  PubMed  Google Scholar 

  32. Salim S, Won H, Nesbitt-Hawes E, Campbell N, Abbott J. Diagnosis and management of endometrial polyps: a critical review of the literature. J Minim Invasive Gynecol. 2011;18(5):569–8.

    Article  CAS  PubMed  Google Scholar 

  33. Perez-Medina T, Bajo J, Huertas MA, Rubio A. Predicting atypia inside endometrial polyps. J Ultrasound Med. 2002;21:125–8.

    Article  PubMed  Google Scholar 

  34. Kanthi JM, Remadevi C, Sumathy S, Sharma D, Sreedhar S, Jose A. Clinical study of endometrial polyp and role of diagnostic hysteroscopy and blind avulsion of polyp. J Clin Diagn Res. 2016;10(6):QC01–4.

    PubMed  PubMed Central  Google Scholar 

  35. Di Spiezio Sardo A, Calagna G, Guida M, Perino A, Nappi C. Hysteroscopy and treatment of uterine polyps. Best Pract Res Clin Obstet Gynaecol. 2015;29(7):908–19.

    Article  PubMed  Google Scholar 

  36. Yang JH, Chen CD, Chen SU, Yang YS, Chen MJ. Factors influencing the recurrence potential of benign endometrial polyps after hysteroscopic polypectomy. PLoS One. 2015;10(12):e0144857.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Clark TJ, Middleton LJ, Cooper NA, Diwakar L, Denny E, Smith P, Gennard L, Stobert L, Roberts TE, Cheed V, Bingham T, Jowett S, Brettell E, Connor M, Jones SE, Daniels JP. A randomised controlled trial of Outpatient versus inpatient Polyp Treatment (OPT) for abnormal uterine bleeding. Health Technol Assess. 2015;19(61):1–194.

    Article  Google Scholar 

  38. AAGL Practice Report. AAGL practice report: practice guidelines for the diagnosis and management of submucous leiomyomas. J Minim Invasive Gynecol. 2012;19:152–71.

    Article  Google Scholar 

  39. Emanuel MH, Verdel MJC, Stas H, et al. An audit of true prevalence of intrauterine pathology: the hysteroscopical findings controlled the patient selection in 1202 patients with abnormal uterine bleeding. Gynaecol Endosc. 1995;4:237–41.

    Google Scholar 

  40. Lasmar RB, Barrozo PR, Dias R, Oliveira MA. Submucous myomas: a new presurgical classification to evaluate the viability of hysteroscopic surgical treatment—preliminary report. J Minim Invasive Gynecol. 2005;12:308–11.

    Article  PubMed  Google Scholar 

  41. van Dongen H, de Kroon CD, Jacobi CE, Trimbos JB, Jansen FW. Diagnostic hysteroscopy in abnormal uterine bleeding: a systematic review and meta-analysis. BJOG. 2007;114:664–75.

    Article  PubMed  Google Scholar 

  42. Dueholm M, Lundorf E, Sorensen JS, Ledertoug S, Olesen F, Laursen H. Reproducibility of evaluation of the uterus by transvaginal sonography, hysterosonographic examination, hysteroscopy and magnetic resonance imaging. Hum Reprod. 2002;17:195–200.

    Article  PubMed  Google Scholar 

  43. Hart R, Molnar BG, Magos A. Long-term follow-up of hysteroscopic myomectomy assessed by survival analysis. Br J Obstet Gynaecol. 1999;106:700–5.

    Article  CAS  PubMed  Google Scholar 

  44. Loffer FD. Improving results of hysteroscopic submucosal myomectomy for menorrhagia by concomitant endometrial ablation. J Minim Invasive Gynecol. 2005;12:254–60.

    Article  PubMed  Google Scholar 

  45. Vercellini P, Zaina B, Yaylayan L, Pisacreta A, De Giorgi O, Crosignani PG. Hysteroscopic myomectomy: long-term effects on menstrual pattern and fertility. Obstet Gynecol. 1999;94:341–7.

    CAS  PubMed  Google Scholar 

  46. Vercellini P, Oldani S, DeGiorgi O, Cortesi II, Moschetta M, Crosignani PG. Endometrial ablation with a vaporizing electrode in women with regular uterine cavity or submucous leiomyomas. J Am Assoc Gynecol Laparosc. 1996;3:S52.

    Article  CAS  PubMed  Google Scholar 

  47. Emanuel MH, Wamsteker K. The Intra Uterine Morcellator: a new hysteroscopic operating technique to remove intrauterine polyps and myomas. J Minim Invasive Gynecol. 2005;12:62–6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Autónoma University of Madrid, Madrid, Spain

    Tirso Pérez-Medina & Mar Ríos M.D.

  2. Department of Obstetrics and Gynecology, Puerta de Hierro University Hospital, Madrid, Spain

    Tirso Pérez-Medina, Laura Calles M.D. & Mar Ríos M.D.

Authors
  1. Tirso Pérez-Medina
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Laura Calles M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mar Ríos M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tirso Pérez-Medina .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynaecology, Ospedale Vito Fazzi, Lecce, Italy

    Andrea Tinelli

  2. Hysteroscopy Unit, Gutenberg Institute, Malaga, Spain

    Luis Alonso Pacheco

  3. Hysteroscopy Unit, Hospital Del Mar, Barcelona, Spain

    Sergio Haimovich

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Pérez-Medina, T., Calles, L., Ríos, M. (2018). Postmenstrual Bleeding. In: Tinelli, A., Alonso Pacheco, L., Haimovich, S. (eds) Hysteroscopy. Springer, Cham. https://doi.org/10.1007/978-3-319-57559-9_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-57559-9_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-57558-2

  • Online ISBN: 978-3-319-57559-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation