Felipe Ventura Sessa

Predictors of fluid intravasation during operative hysteroscopy: a preplanned prospective observational study with 200 cases

PURPOSE To verify the predictors of intravasation rate during hysteroscopy. METHODS Prospective observational study (Canadian Task Force classification II(-1)). All cases (n=200 women; 22 to 86 years old) were treated in an operating room setting. Considering respective bag overfill to calculate water balance, we tested two multiple linear regression models: one for total intravasation (mL) and the other for absorption rate (mL.min(-1)). The predictors tested (independent variables) were energy (mono/bipolar), tube patency (with/without tubal ligation), hysterometry (cm), age ≤ 50 years, body surface area (m(2)), surgical complexity (with/without myomectomy) and duration (min). RESULTS Mean intravasation was significantly higher when myomectomy was performed (442 ± 616 versus 223 ± 332 mL; p<0.01). In the proposed multiple linear regression models for total intravasation (adjusted R(2)=0.44; p<0.01), the only significant predictors were myomectomy and duration (p<0.01).In the proposed model for intravasation rate (R(2)=0.39; p<0.01), only myomectomy and hysterometry were significant predictors (p=0.02 and p<0.01, respectively). CONCLUSIONS Not only myomectomy but also hysterometry were significant predictors of intravasation rate during operative hysteroscopy.

Interrelationships among endometriosis-related pain symptoms and their effects on health-related quality of life: a sectional observational study

Objective To assess the correlation between different pain symptoms and different domains of womens health-related quality of life (HRQoL). Methods Seventy-seven women with deep infiltrating endometriosis were successively enrolled between June 2011 and August 2013 while being prepared to undergo laparoscopy due to pain and/or infertility. We quantified the intensities of dysmenorrhea, deep dyspareunia, chronic pelvic pain, and dyschezia (menstrual and non-menstrual) using a 11-point visual analog scale (VAS: 0–10) and the validated full versions of the Short Form 36 (SF36) and Endometriosis Health Profile (EHP30) questionnaires to assess HRQoL. The pain symptoms were considered simultaneously in a hierarchical agglomerative clustering method (exploratory multivariate approach) and the associations among scores were tested by bivariate correlation. Results Dysmenorrhea showed the lowest similarity on to the multivariate cluster analysis and no statistically significant correlation with the other pain symptoms: deep dyspareunia (P=0.244), chronic pelvic pain (P=0.108), menstrual dyschezia (P=0.238), and non-menstrual dyschezia (P=0.380). Dysmenorrhea and chronic pelvic pain were the main symptoms correlated with all domains of the SF36 and the EHP30 (core instrument) questionnaires (P<0.05). Conclusion Dysmenorrhea and chronic pelvic pain were independent factors associated with HRQoL.