European journal of obstetrics, gynecology, and reproductive biology · 2024
The Pivotal role of hysteroscopy in diagnosing subtle uterine lesions in infertile patients: Seeing the unseen can make the difference.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Saponara Stefania, Angioni Stefano, Parry John Preston, Pacheco Luis Alonso, Carugno Jose, Moawad Nash, Haimovich Sergio, Lasmar Ricardo Bassil, Dealberti Davide, Aksakal Ece, Urman Bulent, Nappi Luigi, Vitale Salvatore Giovanni
Аннотация
BACKGROUND: Subtle uterine lesions are abnormal intracavitary conditions that, while not causing significant anatomical changes, can adversely impact fertility. Identifying these "subtle" lesions is challenging due to arbitrary interpretation, varied management strategies, unclear clinical significance, and insufficient clinician training in recognizing them. Hysteroscopy offers direct visualization and the capacity to obtain targeted biopsies, making it an invaluable tool for the diagnosis and treatment of these often overlooked conditions.
PURPOSE: The lack of standardized and universally accepted terminology complicates the diagnosis and treatment of subtle uterine pathologies. A thorough understanding of how to identify and effectively manage these lesions is essential for the treatment of infertile patients. This review summarizes the critical and evolving subtle uterine lesions that clinicians frequently overlook during hysteroscopic procedures, highlighting the importance of accurate identification and its potential to improve reproductive outcomes.
METHODS: This literature review followed the Scale for the Quality Assessment of Narrative Review Articles (SANRA) guidelines. All articles discussing infertility-related issues and subtle lesions diagnosable with hysteroscopy were deemed eligible for inclusion.
RESULTS: We identified several subtle uterine lesions that are often overlooked during routine hysteroscopic evaluations but can adversely impact fertility. These include morphological abnormalities such as the T-shaped uterus, cystic lesions of the uterine wall, adenomyosis, cervicitis, cervical and tubal endometriosis, and endometrial conditions such as chronic endometritis, thin endometrium and endometrial calcifications.
CONCLUSIONS: Effective diagnosis and treatment of subtle uterine lesions is essential to fertility care. Knowing which lesions are commonly missed and understanding their endoscopic features and potential clinical implications, is crucial for enhancing the diagnostic capacity of hysteroscopy. This, in turn, may improve reproductive outcomes and the overall quality of care of infertile patients.
PURPOSE: The lack of standardized and universally accepted terminology complicates the diagnosis and treatment of subtle uterine pathologies. A thorough understanding of how to identify and effectively manage these lesions is essential for the treatment of infertile patients. This review summarizes the critical and evolving subtle uterine lesions that clinicians frequently overlook during hysteroscopic procedures, highlighting the importance of accurate identification and its potential to improve reproductive outcomes.
METHODS: This literature review followed the Scale for the Quality Assessment of Narrative Review Articles (SANRA) guidelines. All articles discussing infertility-related issues and subtle lesions diagnosable with hysteroscopy were deemed eligible for inclusion.
RESULTS: We identified several subtle uterine lesions that are often overlooked during routine hysteroscopic evaluations but can adversely impact fertility. These include morphological abnormalities such as the T-shaped uterus, cystic lesions of the uterine wall, adenomyosis, cervicitis, cervical and tubal endometriosis, and endometrial conditions such as chronic endometritis, thin endometrium and endometrial calcifications.
CONCLUSIONS: Effective diagnosis and treatment of subtle uterine lesions is essential to fertility care. Knowing which lesions are commonly missed and understanding their endoscopic features and potential clinical implications, is crucial for enhancing the diagnostic capacity of hysteroscopy. This, in turn, may improve reproductive outcomes and the overall quality of care of infertile patients.