The Gynaecological Endoscopy Team conduct clinical and basic research not only in gynaecological endoscopic surgeries, but also in endometriosis, uterine fibroids and postmenopausal bleeding.  Please refer to the selected publications below.

Endometriosis

Current hormonal and surgical treatment for endometriosis still cannot avoid undesired endocrine side effects and disease recurrence. We are the first group studying the therapeutic effects of green tea on endometriosis (Xu et al Hum Reprod 2009). It is shown that a green tea polyphenol, epigallocatchin-3-gallate (EGCG), is a potent anti-angiogenesis agent for endometriosis (Xu et al Fertil Steril 2011, Xu et al Angiogenesis 2013a). We have also patented an acetylated EGCG as a prodrug of EGCG, pro-EGCG, and successfully achieved higher bioavailability and better inhibition in angiogenesis and growth of endometriosis (Wang et al Angiogenesis 2013b).

A prospective long-term observational study is being conducted to comprehensively assess the health profiles of patients with endometriosis and adenomyosis through structured questionnaires evaluating quality of life and reproductive health, document clinical and sonographic characteristics, identify risk factors associated with severe disease, and propose optimal treatment modalities tailored to different patient subgroups, including those with and without a desire for fertility.

We are conducting research to investigate predictive biomarkers in menstrual blood for persistent postsurgical pelvic pain (PPSPP) in women with endometriosis. This study also examines the associations of these biomarkers with preoperative pain levels, subtypes of pain and response to analgesics. We anticipate that identifying such biomarkers preoperatively will enable personalized risk stratification, facilitate tailored interventions on an individual basis, and ultimately improve patient outcomes and quality of care.

Postmenopausal Bleeding

Endometrial cancer is currently the most common malignancy of female genital tract in Hong Kong with up to 90 % of women presenting as postmenopausal bleeding (PMB). We have been running a one-stop PMB clinic since 2002 with the aim to streamline the management of PMB in women. We have found that the E. coli, B. fragilis, and Enterococcus are the most common microorganisms isolated in PMB women with uterine collection ( Yeung et al 2014 ). From our study ( n=4383 ), the sensitivity in detecting endometrial malignancy using endometrial thickness 3-, 4-, 5-mm cut-offs were 97%, 94.1% and 93.5% respectively . The specificities were 45.3%, 66.8% and 74% respectively (Wong et al BJOG 2016).

Uterine Fibroid

Our studies have found that the transcervical intralesional injection of vasopressin is useful in decreasing fluid absorption and blood loss in hysteroscopic myomectomy patients (Wong et al J Laparoendose Adv Surg Tech 2013; Wong et al Obstetrics and Gynecology 2014). Apart from the surgical treatment, we also collaborate with the Department of Imaging and Interventional Radiology to provide alternative treatments to uterine fibroids, such as uterine artery embolization, high-intensity focused ultrasound, especially to women who have previously experienced failed medical treatments (Leung et al J Ultrasound Med 2014).

We are conducting a randomized controlled trial is to compare the effectiveness, safety, and impact on quality of life of women who received HIFU versus myomectomy in the treatment of symptomatic uterine fibroids. Our hypothesis is that HIFU is as effective as myomectomy in treating symptomatic uterine fibroids with the added benefit of less invasiveness and faster recovery.