HBT

Wednesday, 24 October 2012

Postmenopausal bleeding and endometrial polyp Dilatation and curettage, diagnostic hysteroscopy.



PREOPERATIVE DIAGNOSES: 
Postmenopausal bleeding and endometrial polyp.

POSTOPERATIVE DIAGNOSES:
Postmenopausal bleeding and endometrial polyp.

OPERATION: 
Dilatation and curettage, diagnostic hysteroscopy.

ANESTHESIA:
General given by Jean.

SURGEON:


ASSISTANTS:
None.

ESTIMATED BLOOD LOSS:

SPECIMENS REMOVED:

DESCRIPTION OF PROCEDURE/FINDINGS:
Under satisfactory general anesthesia, the patient was placed in the dorsal lithotomy position.  The perineum and the vagina were painted with Betadine before applying sterile drapes.  The pelvic examination disclosed a closed cervix.  The uterus was normal size, anteverted.  Adnexa was negative.  A heavy-weighted speculum was inserted into the vagina followed by the anterior retractor.  The anterior lip of the cervix was grasped with a tenaculum forceps.  After satisfactory dilatation, a rigid hysteroscope was introduced into the endocervical canal and brought through the endometrium which was described as being normal and pale without any evidence of polyp or point of bleeding.  No friable mass was also noted.  The ostium on the left side was identified as well as the ostium on the right side and appeared to be normal and patent.  Upon withdrawing slowly from the uterine cavity, anterior, posterior and lateral all were identified, they appeared to be normal.  The endocervical canal was identified as well and (_____) but no evidence of polyps was seen inside.  Then the scope was removed.  Then the endocervical canal was curetted, which has been given and scanty amount of tissue was obtained.  The endometrial cavity was also curetted and moderate amount of tissue was obtained.  The procedure was well tolerated, 4 L of fluid was used during the hysteroscope.

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