The use of operative hysteroscopy in acute uterine bleeding that does not respond to medical treatment is a change in diagnostic and therapeutic paradigm to improve the results, to avoid unnecessary repetition of procedures and increase significantly the diagnostic sensitivity, in addition to adapt to the international recommendations to classify HUA PALM-COEIN within the system.
The quality and quantity of material removed for biopsy, with the intact endometrium without lesions or disrupted areas without hemorrhagic material with measures that allow multiple cuts, and the presence of myometrium to evaluate the eventual depth of invasion, significantly increase the effectiveness of study.
The procedure will always be operative in an operating room with a resectoscopy of 10mm, with a liquid medium which may be glycine or irrigation water, to make a good washing of the cavity, to evacuate clots and achieve a correct view.
Methodology
1. Evacuation of blood clots.
2. Bleeding control and to form the image.
3. Evaluation and endometrial biopsy.
4. Treatment of concomitant disease.
5. Endometrial surgery.
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