Biomedical subjects
Publications and source records attributed to R J Gimpelson.
Gynecologists must have a good model for practice before performing Nd:YAG laser ablation on humans. The New Zealand white rabbit has been used as a teaching model in courses. Knowing the anatomy and technique enables gynecologists to acquire the skill and dexterity needed to perform this useful procedure.
A total of 276 women underwent both panoramic hysteroscopy and dilatation and curettage. All of these patients underwent directed endometrial biopsies through the hysteroscope. Indications for operation included abnormal bleeding, postmenopausal bleeding, suspected leiomyoma with bleeding, follow-up for adenomatous hyperplasia, intrauterine contraceptive device with bleeding, retained products of conception, infertility with bleeding, abnormal hysterosalpingogram with bleeding, and abnormal endometrial cells on Papanicolaou smear. In 223 cases the results of hysteroscopy and curettage were in agreement. Hysteroscopy revealed more information than curettage in 44 patients, whereas curettage revealed more information than hysteroscopy in only nine patients. When the results of this study are combined with those of previous studies, there is little doubt that panoramic hysteroscopy is superior to curettage in making an accurate diagnosis of pathologic conditions in the uterine cavity.
Reflux of the distention medium through the cervix can reduce the quality of a hysteroscopic procedure. A new tenaculum was developed to minimize reflux yet be easily applied to the cervix. The tenaculum offers certain advantages over other cervical sealing devices and was able to be applied to 14 of 15 patients, with enhancement of the hysteroscopic findings. No complications were noted.
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Sixty-six women underwent panoramic hysteroscopy prior to dilatation and curettage. In 51 of these patients, a directed biopsy was performed through the hysteroscope. The indications for surgery were abnormal bleeding, postmenopausal bleeding, leiomyoma with bleeding, follow-up for adenomatous hyperplasia, infertility with bleeding and lost intrauterine devices with bleeding. In 48 cases the results of hysteroscopy and curettage were in agreement. Hysteroscopy revealed more information than curettage in 16 patients, whereas curettage revealed more information than hysteroscopy in only 2. Thus, panoramic hysteroscopy may prove to be superior to curettage in making an accurate diagnosis of pathology in the uterine cavity.