The Value of Hysteroscopy and Endometrial Biopsy in Evaluating Female Health Abnormalities
Hysteroscopy and endometrial biopsy are methods modern gynecologists and obstetricians use to diagnose and evaluate a vast range of female health abnormalities. As a medical professional, you already know that your patient’s initial complaints may be of abnormal or excessive bleeding, severe cramps, difficulty conceiving, or spotting in postmenopausal women.
You also know that hysteroscopy can be diagnostic or operative (or both) and that they occasionally lead to endometrial biopsy. Together, these procedures are incredibly valuable as they help us identify and treat:
- Endometrial polyps
- Cervical cancers
- Uterine adhesions
- Excessive scarring
- Retained products of conception
- Ectopic pregnancies
- Lastly, obscure conditions like lithopedions
However, any invasive procedure brings a risk of infection to our patients. Even non-invasive procedures carry concerns about infection and cross-contamination. With this article, we’ll provide a brief overview of the values of both procedures and explain that obp’s self-lit, single-use medical devices can help prevent the spread of infection within your practice and among your patients. We’ll take a look at human papillomavirus (HPV) as an example.
The Benefits of Hysteroscopy
Hysteroscopy allows visual examination of the vagina, cervical canal, cervix, uterine cavity, and the Fallopian tubes. Modern urologists will use cystoscopes to investigate urinary tract bleeding, and orthopedists use arthroscopes for patients with knee pain, for instance. The benefits of hysteroscopy for both patients and professionals are many!
- Procedures are relatively fast and straightforward
- Ability to perform in-office visual exams reduces scheduling conflicts and travel time
- Minimal anesthesia
- Lastly, billing and reimbursements can happen in-house
- Outpatient procedures are convenient, safe and fast
- May reduce long-term costs
- Patients benefit from a thorough, more immediate understanding of their condition(s), which can be meaningful for families who have been unable to conceive or to carry a pregnancy to term
- Lastly, hysteroscopy can reduce the likelihood of unneeded hysterectomy
For these reasons, we have seen the number of hysteroscopic procedures performed steadily increasing over the last decade. Indeed, there have been positive changes in techniques and the development of better devices. Most importantly, we have graduated from a two-step process of diagnostic hysteroscopy, followed by a second operative hysteroscopy to a faster, safer, more convenient “see and treat” system.
We attribute a great deal of this growing popularity to the global “My hysteroscope is my stethoscope” movement.
The Global Movement for Diagnostic Hysteroscopy
The Chair of the 2019 Global Congress on Hysteroscopy, Sergio Haimovich, MD, Ph.D., and also the Head of the Hysteroscopy Unit at Del Mar University Hospital in Barcelona, wrote in 2019 about the global movement to “encourage gynecologists to use hysteroscopy as a diagnostic tool to evaluate endometrial health, plan surgical procedures and make appropriate referrals, as needed.”
The movement “My hysteroscope is my stethoscope,” was introduced by Linda Bradley, MD, director of the Fibroid and Menstrual Disorders Center and director of Hysteroscopic Services at Cleveland Clinic and medical director of AAGL.
- She was concerned about the remarkable number of hysterectomies performed for non-life-threatening conditions, like uterine bleeding and fibroids.
- Bradley’s goal is to use the hysteroscope as a tool to reduce unnecessary hysterectomies. Thus, she began speaking and educating her peers on the diagnostic and therapeutic power of hysteroscopic surgery and the benefits it has for patients.
However, not every condition can be solved by operative hysteroscopy. Some infections cannot be accurately identified from a visual inspection. Further, other issues, like hormone levels, need a laboratory assessment. Thus, the need for endometrial biopsy.
An endometrial biopsy involves the removal of a small piece of tissue from the lining of the uterus (the endometrium). This sample helps us identify changes due to abnormal tissues, or variations in hormone levels. They help us screen for some cancers and uterine infections like endometriosis.
These procedures have much the same benefits as the initial hysteroscopy. There are safe, fast outpatient procedures that can be completed in less than ten minutes. They require no anesthesia at all, and can usually be performed (and billed) in-house.
- With uterine or menstrual issues, there is a risk of infection, secondary infection, contamination, and cross-contamination issues.
- Furthermore, healthcare-associated infections can not only increase the hospitalization period but also result in complications and even death.
Let’s consider the risks associated with the spread of HPV, for instance.
Human Papillomavirus (HPV) Infection and Contamination Risks
According to the CDC “HPV is the most common sexually transmitted infection (STI) […] 79 million Americans, most in their late teens and early 20s, are infected with HPV. There are many different types of HPV. Some types can cause health problems including genital warts and cancers.”
Consider these facts surrounding HPV risk:
- HPV affects more than 30,000 individuals in the US this year.
- Cervical cancers and genital warts are a significant concern for our patients.
- HPV spreads through sexual contact.
- Improper sterilization of medical devices can also spread the disease among your patients, and possibly your staff.
- As of 2020, there is no test to find out a person’s “HPV status”.
- There is no approved test to find HPV in the mouth or throat.
- Lastly, there is no treatment for the virus at this time — only a preventative vaccine.
Statistically, HPV is an epidemic. It’s responsible for as much as 95% of cervical cancers. It would be tragic to be spreading a potentially cancerous virus among the women we are trying to treat!
obp’s Single-Use Medical Devices Reduce the Risks
Sterile, single-use medical devices like specula and hysteroscopy kits reduce the risks of STI transmission. Also, they reduce your sterilization expenses and remove the entire stress of arranging for sterilization contracts, or delivery of dangerous gases.
Our story began a decade ago, developing products that facilitate the transition of minimally invasive procedures commonly performed in hospitals and ORs to office settings and away-clinics. Further, as part of this mission, we made advancements in LED technology to pioneer the creation of single-use medical devices with integrated light sources.