Objective: To estimate the effect of concomitant supracervical hysterectomy compared with total hysterectomy during abdominal sacrocolpopexy on the rate of mesh erosion by performing a systematic review and meta-analysis of the existing literature.
Data Sources: From database inception through January 2022, we explored MEDLINE, Web of Science, EMBASE, CINAHL, ClinicalTrials.gov , and Cochrane Central Register of Controlled Trials.
Endometriosis is the presence of endometrial tissue outside the uterine cavity usually in the ovaries, fallopian tube, and pelvic cavity. It's a chronic enigmatic gynecological condition associated with dysmenorrhea, dyspareunia, pelvic pain, and infertility. Endometriosis lesions exist in a unique microenvironment characterized by increased concentrations of hormones, inflammation, and oxidative stress.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
December 2021
Objective: To compare the efficacy of dienogest with the combined oral contraceptive pill (COC) Yasmin for the control of endometriosis-associated pelvic pain.
Study Design: Seventy women with endometriosis-associated chronic pelvic pain, dysmenorrhoea or both for >6 months were randomized to either dienogest (Visanne) 2 mg/day or monophasic COC (Yasmin, 0.03 mg ethinyl estradiol and 3 mg drospirenone) for 24 weeks.
Background: Laparoscopic surgery has become a standard of care for many gynecological surgeries due to its lower morbidity, pain and cost compared to open techniques. Unfortunately, the use of carbon dioxide (CO) to insufflate the abdomen is the main contributor to post-operative shoulder pain.
Methods: We aim to assess the effect of postoperative Trendelenburg position on shoulder pain after gynecological laparoscopic procedures.
Due to its decreased recovery time and increased patient satisfaction, laparoscopic surgery has witnessed an exponential rise in the last decade. In fact, the indications for laparoscopic surgery are currently numerous and involve multiple disciplines, including gastro-intestinal and gynecological surgery. With this boom, there is much focus on decreasing the rate of complications due to laparoscopy.
View Article and Find Full Text PDFA hematologic disorder occurred simultaneously with an ovarian cystic teratoma in a young woman. The blood disorder was a severe thrombocytopenia, with no spontaneous remission, or improvement after steroids tapering. To date, this is the second report in literature of immune thrombocytopenia associated with an ovarian teratoma, completely resolving following surgical excision of the ovarian teratoma.
View Article and Find Full Text PDFNabothian cysts are mucinous retention cysts formed through the accumulation of cervical mucus inside blocked cervical crypts leading to non-neoplastic mucinous cystic lesion in relation to the uterine cervix. The formation of Nabothian cysts is a common gynecological benign condition in women of reproductive age. While the presence of small-sized Nabothian cysts is usually clinically asymptomatic and requires no treatment or intervention, the diagnosis of larger Nabothian cysts can be mistaken with malignant tumors, including mucin producing carcinomas such as Adenoma malignum.
View Article and Find Full Text PDFClinical breast examination (CBE) is traditionally taught to third-year medical students using a lecture and a tabletop breast model. The opportunity to clinically practice CBE depends on patient availability and willingness to be examined by students, especially in culturally sensitive environments. We propose the use of a hybrid simulation model consisting of a standardized patient (SP) wearing a silicone breast simulator jacket and hypothesize that this, compared to traditional teaching methods, would result in improved learning.
View Article and Find Full Text PDFLaparoscopic myomectomy, a minimally invasive procedure performed for the management of uterine leiomyomas, involves a challenging aspect: excessive local bleeding. Hemorrhage control during laparoscopic myomectomy can be achieved through the use of a wide range of vasoconstrictors, including epinephrine. Epinephrine is frequently used for the control of local bleeding during surgery; however, it has been associated with several complications.
View Article and Find Full Text PDFRaynaud's phenomenon (RP) is characterized by exaggerated cold-induced vasoconstriction. This augmented vasoconstriction occurs by virtue of a reflex response to cooling via the sympathetic nervous system as well as by local activation of α adrenoceptors (α-AR). In a cold-initiated, mitochondrion-mediated mechanism involving reactive oxygen species and the Rho/ROCK pathway, cytoskeletal rearrangement in vascular smooth muscle cells orchestrates the translocation of α-AR to the cell membrane, where this receptor readily interacts with its ligand.
View Article and Find Full Text PDFMayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a congenital disorder characterized by uterine aplasia and aplasia of the upper part of the vagina. It presents with primary amenorrhea in a 46, XX individual. In this paper, we report the cases of two patients with MRKH syndrome treated with the laparoscopic modified Vecchietti technique using the optimized new instruments.
View Article and Find Full Text PDFBackground: Intracranial hemorrhage due to arteriovenous malformation or intracranial aneurysm is a rare but severe complication of pregnancy with maternal and fetal mortality of 20% and 33% respectively. Whether to deliver the patient first, or to treat the aneurysm first is still controversial, but an emergency cesarean section followed by aneurismal treatment appears to be a widely accepted strategy in pregnant women with cerebral aneurysmal complications.
Case: A 38-year-old patient, G3P2A0, presented at 36 gestational weeks with a diffuse bilateral subarachnoid hemorrhage with fourth ventricle bleeding and hydrocephalus.
Objective: To evaluate the effect of preoperative anaemia and blood transfusion on 30-day postoperative morbidity and mortality in patients undergoing gynecological surgery.
Study Design: Data were analyzed from 12,836 women undergoing operation in the American College of Surgeons National Surgical Quality Improvement Program. Outcomes measured were; 30-day postoperative mortality, composite and specific morbidities (cardiac, respiratory, central nervous system, renal, wound, sepsis, venous thrombosis, or major bleeding).
Multiple gestations are on the rise with the advent of artificial reproductive technologies. Even with ovulation induction using clomiphene citrate alone, the twinning rate can reach up to 9 percent. We report a case of recurrent twin gestation after treatment with clomiphene citrate, with the second pregnancy being heterotopic.
View Article and Find Full Text PDFIntroduction And Hypothesis: Congenital vesicovaginal fistula is an exceedingly rare entity. There is no consensus regarding the nature and origin of this condition. We report two cases with congenital vesicovaginal fistula and compile previously reported cases in the English literature.
View Article and Find Full Text PDFDiabetic nephropathy (DN), a major complication of diabetes, is characterized by hypertrophy, extracellular matrix accumulation, fibrosis and proteinuria leading to loss of renal function. Hypertrophy is a major factor inducing proximal tubular epithelial cells injury. However, the mechanisms leading to tubular injury is not well defined.
View Article and Find Full Text PDFWe report the resection of a vaginal septum while preserving the virginity of a 12-year-old girl with Herlyn-Werner-Wunderlich Syndrome (HWWS) having a didelphys uterus, obstructed hemivagina, and an ipsilateral renal agenesis with follow-up at 18 months. Successful resection of the vaginal septum with conservation of the hymenal ring and complete drainage of both the hematocolpos and the hematometra were achieved. Cyclic dysmenorrhea and pelvic pain were completely resolved on follow-up visits at 4, 6, and 18 months.
View Article and Find Full Text PDFEur J Obstet Gynecol Reprod Biol
December 2012
Objectives: To describe the outcomes of laparoscopic surgery for severe ureteric endometriosis.
Study Design: Retrospective descriptive study of the clinical and surgical outcomes for patients who underwent laparoscopic surgery for severe ureterohydronephrosis due to endometriosis. The surgery consisted of laparoscopic ureterolysis, ureteric end-to-end anastomosis and ureteral stenting at the Department of Obstetrics and Gynecology, Strasbourg Hospitals, between June 2004 and June 2009.
Objective: To report on the prevalence, surgical management, and outcome of urinary tract endometriosis (UTE) in a cohort of 221 patients undergoing laparoscopic surgery for severe endometriosis. UTE can cause significant morbidity, such as silent kidney or progressive renal function loss. Its frequency is underestimated and data on laparoscopic management are scarce.
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