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Doctors from all over Latvia learn the latest diagnostic and minimally invasive treatment trends in gynaecology at Riga East University Hospital

The masterclass ‘Hysteroscopy’ organised by the East Hospital Academic Centre was held at the Riga East University Hospital (East Hospital) Clinical Centre of Emergency Medicine Gaiļezers. The masterclass was led by Ursula Catena, MD, PhD, Chair of the Hysteroscopy Special Interest Group of the European Society of Gynecological Endoscopy (ESGE), from CLASS Hysteroscopy Center of the Fondazione A. Gemelli IRCCS University Hospital in Rome, who shared her experience in the practical application of this procedure – in surgery and theoretical lectures. The event was attended by almost 150 medical professionals from all over Latvia, who watched live the four surgeries using the specific procedure.

The East Hospital Academic Centre offered a unique opportunity for doctors and residents from Latvian hospitals, as well as from municipal and private outpatient medical facilities – to connect and watch live streaming of four surgeries. These surgeries were a demonstration of an innovative minimally invasive technique for complex gynaecological diseases, performed by Ursula Catena, MD, PhD from CLASS Hysteroscopy Center of the Fondazione A. Gemelli IRCCS University Hospital in Rome, in collaboration with Professor Jana Žodžika, Head of the Gynaecology Clinic at the East Hospital, Professor Natālija Vedmedovska, leading gynaecological and obstetrical ultrasound specialist in Latvia from the Riga Maternity Hospital, who demonstrated the use of 3D ultrasound in the diagnosis and treatment of gynaecological abnormalities during surgery.

Surgeries were performed in four patients. Two women were diagnosed with uterine septal defects, which led to unsuccessful pregnancies. Removal of the uterine septum restores reproductive function. Two surgeries were performed on patients with myoma nodules, which caused severe bleeding and anaemia.

After the practical demonstrations, all participants took part in the lecture delivered by Ursula Catena, MD, PhD, on the use of minimally invasive hysteroscopic technologies in the treatment of various uterine abnormalities, such as congenital abnormalities, myomas and fertility-sparing treatment methods for endometrial cancer in young women.

Professor Jana Žodžika, Head of the Gynaecology Clinic at the East Hospital, emphasises: “Doctors in our hospital have a lot of experience in this field, but we want to be even more innovative and more focused on fertility-sparing treatment. We need to keep up with scientific developments and work with the most modern technologies. The East Hospital is the leading provider of gynaecology services in Latvia, and we organise various educational events, sharing our knowledge with all gynaecology clinics in Latvia. We learn and practice to ensure that all women in Latvia have the opportunity to receive the most innovative treatment possible. The event was attended by medical professionals from all over Latvia, all of whom do not have the opportunity to travel to congresses and leading clinics in the world, so we appreciate the visit of Ursula Catena, to bring this new and important knowledge to Latvian medical professionals.”

Prompt technological development contributes to innovation in diagnosis and treatment, so it is vital to continuously update medical knowledge to provide patients with more fertility-sparing and advanced treatment methods, replacing aggressive methods such as uterine removal or uterine curettage. Hysteroscopy is widely used to treat women diagnosed with myoma nodules, polyps, and various uterine abnormalities, such as uterine septum.

Professor Jana Žodžika explains: “One of the remnants of Soviet gynaecology is the so-called “uterine cleaning” or uterine curettage in case of bleeding. This manipulation was often unhelpful, unnecessary, and inaccurate.  In modern world, this procedure is very rare, moreover, it is not acceptable for diagnostic purposes. The hysteroscopic technique is not aggressive, which is important for women planning a pregnancy. The size of the instruments is gradually decreasing – only diagnostics were possible with this method in the past, but now treatment is also possible. This fertility-sparing treatment takes place in a day-care hospital, so the patient can go home the same day, and faster recovery is ensured.”

Hysteroscopy is a widely used procedure all over the world, and it is not new to Latvia. This procedure is a minimally invasive gynaecological procedure used to diagnose and treat various abnormalities of the uterine cavity. In Latvia, diagnostic hysteroscopy is performed in some outpatient facilities, while surgery is provided in hospitals and day-care hospitals.

Gynaecologists at the East Hospital performed 426 such manipulations in 2023, treating a variety of conditions, and this number is expected to increase in 2025, when the hospital’s new day-care facility clinic is due to open.

Ursula Catena, MD, is a gynaecologist based at the Centre of Excellence for Hysteroscopy at the Italian Institute for Research and Healthcare in Rome. The Rome Centre of Excellence for Hysteroscopy is one of the three largest digital hysteroscopy centres in the world, performing more than 6,600 minimally invasive treatments per year for all types of uterine abnormalities using the latest hysteroscopy and 3D ultrasound technologies. Chair of the Special Interest Group “Hysteroscopy” of the European Association of Gynaecological Endoscopy, accredited European trainer in gynaecological endoscopy. Author of numerous international publications on inherited gynaecological abnormalities and fertility-sparing treatment of early endometrial cancer. She regularly participates in and organises various national and international congresses on hysteroscopy.

About the East Hospital 

Riga East University Hospital is the largest and most strategically important multi-profile hospital in the country. The hospital consists of five clinical centres: Clinical Centre of Emergency Medicine Gailezers, Oncology Centre of Latvia, Clinical Centre Biķernieki, Centre of Tuberculosis and Lung Diseases and Latvian Centre of Infectious Diseases with centres and clinics of different profiles. The hospital provides highly specialised inpatient and secondary outpatient healthcare, providing multidisciplinary tertiary-level treatment and care in line with modern technologies and medical knowledge. The hospital provides treatment for about 80% of all cancer patients in Latvia. The hospital provides a practical training base for both Latvian and foreign students and provides continued professional development and knowledge transfer for health professionals in our country and abroad. The hospital conducts scientific research and develops innovative methods for treating patients. The hospital is the third largest employer in the country, with around 5,000 employees.