Book reviewshttp://onlinetog.orgThe Obstetrician & Gynaecologist

Hysteroscopy: OfficeEvaluation and Managementof the Uterine Cavity

Authors Linda Bradley / Tommaso Falcone

This book sets out to demonstrate all aspects of

hysteroscopy, including diagnostic and therapeutic

procedures. The list of contributors has a strong

American bias but I do not feel this precludes the

book from being read by British readers; most of

the content is relevant to practice in the UK.

The chapters are easy to read and accessible, with

useful references at the end of each one. These

include boxed sections and tables, which add clarity

to the text and serve as excellent aide-mémoire. One

of the book’s strengths is the accompanying

photographs, although these are occasionally

slightly grainy. Another is the rather innovative

DVD, which details 63 operative procedures.

This comprehensive text is divided into 22 chapters,

which guide the reader systematically through all

aspects of hysteroscopy. The initial chapters cover

instrumentation, indications, informed consent

and equipment. They describe pre-procedure hints

on creating the correct ambience and different drug

regimens prior to hysteroscopy for both analgesia

and cervical priming. There are good practical tips

from the experts; for example, on the vaginoscopic

approach by Bettocchi and on hysteroscopic

sterilisation. A useful basic science background to

the clinical and therapeutic aspects of hysteroscopy

is also provided; for example, there is a chapter on

the response of the uterus to medication.

A useful chapter entitled ‘Abnormal uterine bleeding

and hemostatic disorders’recognises the potential for

women with these problems to be underdiagnosed.

The authors give useful pointers for history taking,

investigation and management of women with

menorrhagia,who may have haemostatic disorders.

The role of imaging of the uterus is acknowledged

in a chapter on ultrasound scanning and magnetic

resonance imaging. It also gives practical advice on

saline infusion sonography, a procedure more

readily embraced by our American and European

counterparts.

The text details the procedure of uterine fibroid

embolisation, complemented by a clear schematic

diagram, which would be useful for patient

information and teaching. The book also

addresses the role of hysteroscopy in the

management of recurrent miscarriage. It gives

technical information on the lysis of intrauterine

adhesions and synechiae. There is an evaluation

of uterine anomalies and the resection of septa to

improve fertility.

A chapter on the complications of hysteroscopic

surgery outlines the recognition and management

of intra-operative problems, from distention media

to energy-related complications. It also addresses

postoperative complications, such as infection,

haematometra and endometrial cancer following

endometrial ablation.

This book would benefit nurse hysteroscopists,

trainee gynaecologists and the more established

surgeon wishing to develop their skills. It

complements the Advanced Training Skills

Module, ‘Benign Gynaecological Surgery:

Hysteroscopy’, both for the preceptor and for the

trainee. The text covers the assessment of

hysteroscopic skills, including the Objective

Structured Assessment of Technical Skills. It also

covers simulator models as a tool for teaching.

Hysteroscopy: Office Evaluation and Management

of the Uterine Cavity is a useful text for any

professional who undertakes outpatient

hysteroscopy, from the novice to the expert.

Reviewer Juhi Siddiqui MRCOG

Specialist Registrar

St James’s University Hospital, Leeds, UK

Mosby Elsevier, 2008

ISBN 9780323041010

Hardcover, 288 pages, £79.99

10.1576/toag.11.3.227.27519

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