TITLE:
Prospective Assessment of Direction of Cervical Canal in Routine Hysteroscopy
AUTHORS:
Divyesh V. Shukla, Shilpi D. Shukla, Sangita Patel, Amit Shah
KEYWORDS:
Cervical Canal Direction, 5 fr Bettocchi Hysteroscope, Down, Right, Up, Straight
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.11 No.6,
June
10,
2021
ABSTRACT: Introduction: If the direction of the cervical canal is known, the
commonly performed procedures as sono salpingography, embryo transfer, IUD
insertion, cervical dilation etc. will be easier. The reported resultant trauma
to the cervical canal and uterus during these procedures also can be avoided.
As we know the cervical canal is tortuous in majority of cases, but the exact
course is not yet reported or known. Objective: The
objective of the present study was to try to identify the various directions of
cervical canal while performing routine hysteroscopic surgeries. Methods: Four-point cervical canal direction was assessed while performing routine
hysteroscopic procedures using 5fr Bettocchi operative assembly with 2.9 mm
12-degree telescope (Karl-Storz). The study group was patients with infertility
who required hysteroscopy and laparoscopic evaluation as per infertility
treatment protocol or else required hysteroscopy for AUB. The study was carried
out at tertiary care referral hospital for minimal access surgeries for a
period was of 2 yr. 9 months year from May 2017 to Feb 2020. Results: Down-right
or left-up-straight combination of movement (DRUS, DLUS) was the most common
cervical direction found in 72 % patients. If DURS (down-up-right-straight)
movement is added these 3 movements together are seen in about 82% of patients.
No cervical dilation is required when 5 fr hysteroscopic assembly was used in
study group. No operative complications were found. Conclusion: DRUS and
DLUS (down-right or left-up and straight) combination of movements are most
frequent direction of cervical canal observed in 72% of patients.