{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T03:30:37Z","timestamp":1771039837667,"version":"3.50.1"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Ensign Endowment for Gynecologic Cancer Research"},{"DOI":"10.13039\/100006034","name":"University of Southern California","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006034","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arch Gynecol Obstet"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>To examine the utilization and characteristics related to the use of hysteroscopy at the time of endometrial evaluation for endometrial hyperplasia in the outpatient surgery setting.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This cross-sectional study queried the Healthcare Cost and Utilization Project\u2019s Nationwide Ambulatory Surgery Sample. The study population was 3218 patients with endometrial hyperplasia who underwent endometrial evaluation from January 2016 to December 2019. Performance and clinical characteristics of hysteroscopic endometrial evaluation were assessed with multivariable binary logistic regression models.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 2654 (82.5%) patients had hysteroscopic endometrial tissue evaluation. Patients with postmenopausal bleeding, heavy menstrual bleeding, and polycystic ovary syndrome were more likely to undergo hysteroscopic endometrial evaluation in multivariable analysis (all, adjusted-<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Uterine injury occurred in 4.9 per 1000 hysteroscopic endometrial evaluations; none had uterine injury in the non-hysteroscopy cohort. Among the 2654 patients who had hysteroscopic endometrial evaluation, 106 (4.0%) patients had intrauterine device insertion at surgery, and the utilization increased from 2.9 to 5.8% during the study period (<jats:italic>P-trend<\/jats:italic>\u2009&lt;\u20090.001). Younger age, more recent year surgery, and obesity were independently associated with increased utilization of intrauterine device insertion at hysteroscopic endometrial evaluation (all, adjusted-<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Among 2023 reproductive-age patients with endometrial hyperplasia, 1666 (82.4%) patients underwent hysteroscopic endometrial evaluation. On multivariable analysis, patients with heavy menstrual bleeding were more likely to have hysteroscopic endometrial evaluation (adjusted-<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). Intrauterine device insertion increased from 3.7% in 2016 to 8.0% in 2019 (<jats:italic>P-trend<\/jats:italic>\u2009=\u20090.007).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This nationwide analysis suggests that the insertion of intrauterine devices at the time of hysteroscopic endometrial tissue evaluation for endometrial hyperplasia is increasing among reproductive-age population.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00404-024-07411-7","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T09:02:31Z","timestamp":1711098151000},"page":"2709-2718","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Increasing utilization of intrauterine device insertion at hysteroscopic endometrial evaluation for patients with endometrial hyperplasia"],"prefix":"10.1007","volume":"309","author":[{"given":"Katharine M.","family":"Ciesielski","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavan K.","family":"Mann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel S.","family":"Mandelbaum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Klar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynda D.","family":"Roman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason D.","family":"Wright","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6232-8701","authenticated-orcid":false,"given":"Koji","family":"Matsuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"issue":"5","key":"7411_CR1","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1097\/AOG.0b013e31826bb121","volume":"120","author":"CL Trimble","year":"2012","unstructured":"Trimble CL, Method M, Leitao M et al (2012) Management of endometrial precancers. 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The Nationwide Ambulatory Surgery Sample is a part of the Healthcare Cost and Utilization Project by the Agency for Healthcare Research and Quality and\u00a0is the source of the de-identified data used; and the program has not verified and is not responsible for the statistical validity of the data analysis or the conclusions derived by the study team.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Transparency"}}]}}