Does vaginal cleansing with iodine decreases infection rate in office hysteroscopy?

Archives of gynecology - 2023
Nadav Cohen1,2, Hagit Itzhak Kedem1, Luna Abu-Foul1, Moran Paz1,2, Yuval Kaufman1,2, Ofer Lavie1,2, Ariel Zilberlicht1,2
1Ruth and Bruch Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel
2Department of Obstetrics and Gynecology, Lady Davis Carmel Medical Center, Haifa, Israel

Tóm tắt

To determine whether preoperative vaginal cleansing with iodine-based solution prior to hysteroscopy, reduces postoperative infection rate compared to no vaginal cleansing. A retrospective study at a single tertiary, university affiliated hospital of all individuals who have had an office hysteroscopy. Study group consisted of patients who have had preoperative vaginal cleansing with iodine-based solution and were compared to those who have not. Any procedural related complaints at the 30 days following the hysteroscopy were recorded. A total of 505 were available for analysis, 183 in the study group and 322 in the control group. The most common indications for operation were infertility evaluation (33.9% vs. 28.6%) and retained products of conception (33.3% vs. 29.2%), and most common procedures were diagnostic only (49.7% vs. 42.5%) followed by adhesiolysis (12% vs. 14.3%). No statistical differences were noted with regards to postoperative infections, as only one case of pelvic inflammatory disease was noted, in the iodine cleansing group (0.19% for postoperative infection). Our comparative study may suggest that the use of preoperative iodine solution prior to office hysteroscopy does not decrease the postoperative infection rate up to 30 days, thus can be avoided.

Từ khóa


Tài liệu tham khảo

Campo R, Santangelo F, Gordts S et al (2018) Outpatient hysteroscopy. Facts Views Vis Obgyn 10:115–122

Smith PP, Kolhe S, O’Connor S et al (2019) Vaginoscopy against standard treatment: a randomised controlled trial. BJOG 126:891–899

Salazar CA, Isaacson KB (2018) Office operative hysteroscopy: an update. J Minim Invasive Gynecol 25:199–208

Florio P, Nappi L, Mannini L et al (2019) Prevalence of infections after in-office hysteroscopy in premenopausal and postmenopausal women. J Minim Invasive Gynecol 26:733–739

Muzii L, Donato VD, Tucci CD et al (2020) Efficacy of antibiotic prophylaxis for hysteroscopy: a meta-analysis of randomized trials. J Minim Invasive Gynecol 27:29–37

American College of Obstetricians and Gynecologists and others (2020) The use of hysteroscopy for the diagnosis and treatment of intrauterine pathology: ACOG committee opinion number 800. Obstet Gynecol 135:e138–e148

Royal College of Obstetricians and Gynaecologists. Best Practice in Outpatient Hysteroscopy, Green Top 59, RCOG

Deffieux X, Gauthier T, Menager N et al (2014) Hysteroscopy: guidelines for clinical practice from the french college of gynaecologists and obstetricians. Eur J Obstet Gynecol Reprod Biol 178:114–122

Zimmer M, Pomorski M, Kamiński P et al (2019) Polish society of gynecologists and obstetricians guidelines for the application of hysteroscopy in gynecology. Ginekol Pol 90:482–489

ACOG practice bulletin no (2018) 195: prevention of infection after gynecologic procedures. Obstet Gynecol 131:e172–e189

Gregoriou O, Bakas P, Grigoriadis C et al (2012) Antibiotic prophylaxis in diagnostic hysteroscopy: is it necessary or not? Eur J Obstet Gynecol Reprod Biol 163:190–192

Jansen FW, Vredevoogd CB, van Ulzen K et al (2000) Complications of hysteroscopy: a prospective, multicenter study. Obstet Gynecol 96:266–270

The Society for Hospital Epidemiology of America; The Association for Practitioners in Infection Control; The Centers for Disease Control; The Surgical Infection Society (1992) Consensus paper on the surveillance of surgical wound infections. Infect Control Hosp Epidemiol 13:599–605

Aas-Eng MK, Langebrekke A, Hudelist G (2017) Complications in operative hysteroscopy-is prevention possible? Acta Obstet Gynecol Scand 96:1399–1403

Damiani GR, Pellegrino A, Seghezzi U et al (2012) A dangerous trigger. Eur J Obstet Gynecol Reprod Biol 165:133–134

Damiani GR, Landi S, D’Addario V et al (2013) Pivotal points to prevent iatrogenic infections triggered by hysteroscopy. Aust N Z J Obstet Gynaecol 53:99–100

De Silva PM, Mahmud A, Smith PP et al (2020) Analgesia for office hysteroscopy: a systematic review and meta-analysis. J Minim Invasive Gynecol 27:1034–1047

Fouks Y, Kern G, Cohen A et al (2022) A virtual reality system for pain and anxiety management during outpatient hysteroscopy-a randomized control trial. Eur J Pain 26:600–609

Rastogi S, Glaser L, Friedman J et al (2020) Tolerance of chlorhexidine gluconate vaginal cleansing solution: a randomized controlled trial. J Gynecol Surg 36:13–19

Lewis LA, Lathi RB, Crochet P et al (2007) Preoperative vaginal preparation with baby shampoo compared with povidone-iodine before gynecologic procedures. J Minim Invasive Gynecol 14:736–739

Abbas AM, Shaltout AS, Ali SS et al (2017) Povidone–iodine versus normal saline solution in preoperative vaginal cleansing before office hysteroscopy: a randomized controlled trial. Int J Reprod Contracept Obstet Gynecol 7:5

Thông tin
Thông tin xuất bản

Archives of gynecology

Thông tin tác giả