1/42. Vaginal expulsion of submucosal fibroids after uterine artery embolization. A report of three cases.BACKGROUND: Since October 1996, at our fibroid center, we have been using the uterine artery embolization (UAE) procedure as a nonsurgical means to treat patients with fibroids and menorrhagia. We have performed this procedure on over 180 patients, 3 of whom experienced vaginal expulsion of submucosal fibroids from two to seven months later. CASES: A 37-year-old woman underwent UAE in November 1997 and expelled five submucosal fibroids two to three months later. A 43-year-old woman underwent UAE in August 1997 and expelled a submucosal fibroid four months later. A 46-year-old woman underwent UAE in April 1997 and expelled a submucosal fibroid seven months later. CONCLUSION: The use of UAE to treat patients with fibroids and menorrhagia is relatively new. Our experience has revealed that a significant percentage of patients who have had the embolization procedure will have reduction in menorrhagia and also in the volume of their fibroids. Complications and side effects have been few. Vaginal expulsion of submucosal fibroids can be viewed as a side effect of the procedure, and, to the best of our knowledge, these are the first reported cases of this postembolization occurrence.- - - - - - - - - - ranking = 1keywords = fibroid (Clic here for more details about this article) |
2/42. Medical treatment of a grossly enlarged adenomyotic uterus with the levonorgestrel-releasing intrauterine system.adenomyosis is an important cause of menorrhagia. Besides hysterectomy, the treatment options for adenomyosis have been limited. Presented here is the successful treatment of adenomyosis in a woman presenting with menorrhagia, dysmenorrhea, and an enlarging uterus, for whom conservative therapy initiated with mefenamic acid was unsatisfactory. The patient had insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS). A marked decrease in uterine size occurred within 12 months of insertion accompanied by resolution of the menorrhagia and dysmenorrhea. Thus, the LNG-IUS is a viable option and represents a real advance in the treatment of adenomyosis.- - - - - - - - - - ranking = 0.00092196521458859keywords = uterus (Clic here for more details about this article) |
3/42. Endometrial stromal sarcoma diagnosed after hysteroscopic endometrial resection.Endometrial ablation and resection is now common therapy for dysfunctional uterine bleeding that is unresponsive to conservative management. Opponents argue that it may predispose patients to potentially hazardous malignancies of the uterus. In our patient, endometrial resection was performed to treat menorrhagia after a negative workup. Pathologic interpretation of the resected tissue showed a low-grade stromal sarcoma of the endometrium. The woman underwent definitive treatment, which included total abdominal hysterectomy, and has remained recurrence free over the past 3 years. Although rare, uterine malignancies have been documented after hysteroscopic management of menorrhagia. It is suggested that intraoperative endometrial resection or tissue sampling be done to prevent or diagnose endometrial hyperplasia and uterine malignancies.- - - - - - - - - - ranking = 0.00018439304291772keywords = uterus (Clic here for more details about this article) |
4/42. Endometrial stromal sarcoma of the uterus: MR and US findings.We describe the MRI and US features of two patients with endometrial stromal sarcoma of the uterus. Both lesions appeared as voluminous polypoid masses within an expanded endometrial cavity on both US and MRI. They had mixed echo-texture and heterogenous signal intensity on both T1- and T2-weighted sequences. T2-weighted images were most helpful in detecting the endometrial nature of the disease and its relationships with surrounding myometrium.- - - - - - - - - - ranking = 0.00092196521458859keywords = uterus (Clic here for more details about this article) |
5/42. Case of hemorrhagic shock due to hypermenorrhea during anticoagulant therapy.We report the case of a patient with uterine myoma who developed uncontrollable massive hemorrhage from the uterus during anticoagulant therapy after cardiac valve replacement and required hysterectomy. There was a discrepancy between the laboratory findings regarding the blood coagulation system and the clinical manifestations, suggesting a combination of multiple factors, such as a hormonal imbalance. This was a case that demanded strict attention to the management of the uterine lesions during the conduct of anticoagulant treatment.- - - - - - - - - - ranking = 0.00018439304291772keywords = uterus (Clic here for more details about this article) |
6/42. One-step hysteroscopic removal of sinking submucous myoma in two infertile patients.OBJECTIVE: To report one-step resectoscopic removal of submucous myomas that were pushed back into the muscular layer by increased intrauterine pressure during hysteroscopic procedures. DESIGN: Case report. SETTING: Kawasaki Municipal Hospital, Kawasaki, japan. PATIENT(S): Two infertile women presenting with menorrhagia in whom submucous myoma with a broad base was diagnosed. INTERVENTION(S): One patient was pretreated with GnRH agonist for 4 months; the other patient did not receive this treatment. Resectoscopic myomectomies were performed under close sonographic monitoring. MAIN OUTCOME MEASURE(S): Clinical symptoms and conception status. RESULT(S): Tumor sinking occurred during the hysteroscopic procedures, but complete resectoscopic removal of the submucous myomas was achieved under sonographic and hysteroscopic visualization. One patient experienced hyponatremia but recovered after conservative treatment. Both patients conceived after myoma removal. CONCLUSION(S): Sinking myomas, which may cause infertility, can be removed with a one-step hysteroscopic procedure. Sinking of submucous myomas during hysteroscopy might be caused by pretreatment with GnRH agonist and by increased intrauterine pressure during hysteroscopy. We recommend that intrauterine pressure be <45 mmHg, equivalent to hanging a bag of fluid under gravity control 70 cm above the patient's uterus, at the beginning of operations for sinking myomas.- - - - - - - - - - ranking = 0.00018439304291772keywords = uterus (Clic here for more details about this article) |
7/42. Hysteroscopic appearance of the uterine cavity before and after microwave endometrial ablation.STUDY OBJECTIVE: To evaluate the appearance of the uterine cavity before and after microwave endometrial ablation (MEA). DESIGN: Prospective observational study (Canadian Task Force classification II-2). SETTING: University teaching hospital. patients: Sixty-two women with menorrhagia. INTERVENTION: Hysteroscopic examination the uterine cavity before and after MEA. MEASUREMENTS AND MAIN RESULTS: Ablation was complete in 55 patients (group A). Seven women had a small island of intact endometrium (group B); the uterine cavity was severely distorted in six of these patients due to submucous myomas in five and adenomyosis in one. Another patient in this group had an acutely retroverted uterus, a 15-mm intramural myoma, and a normal uterine cavity. women in group B had deeper uterine cavity than those in group A (101.4 /- 15.5 and 84.7. /- 12.8 mm, respectively, p = 0.008). The duration of ablation was also longer in group B (329.1 /- 158.4 sec) than in group A (206.1 /- 67.4 sec, p = 0.01). CONCLUSION: Microwave endometrial ablation tends to be incomplete in women with a large and severely distorted uterine cavity. Whether, this results in a lower success rate remains to be seen. (J Am Assoc Gynecol Laparosc 8(1):83-86, 2001)- - - - - - - - - - ranking = 0.00018439304291772keywords = uterus (Clic here for more details about this article) |
8/42. MRI findings of a case of uterine tumor resembling ovarian sex-cord tumors coexisting with endometrial adenoacanthoma.A case of uterine tumor resembling ovarian sex-cord tumors is reported. MRI was performed for the staging of the endometrial adenoacanthoma diagnosed by biopsy. A well-defined, slightly hyperintense mass with central hypointensity was noted in the myometrium on T2-weighted images. Pathological diagnosis of the myometrial mass was uterine tumor resembling ovarian sex-cord tumors. The central hypointense area was a leiomyomatous component. Adenoacanthoma was also confirmed. These features of coexisting tumors correlated well with the MRI findings.- - - - - - - - - - ranking = 0.00034713668631007keywords = leiomyoma (Clic here for more details about this article) |
9/42. menorrhagia and adenomyosis in a patient with hyperhomocysteinemia, recurrent pelvic vein thromboses and extensive uterine collateral circulation treatment by supracervical hysterectomy.A 37-year-old patient had recurring thromboses, occlusion of the left femoral vein with hereditary hyperhomocysteinemia, hypermenorrhea and anaemia. Conservative therapy with endometrium ablation and gestagene failed. A supracervical hysterectomy was done to preserve the presacral and left lateral, dorsal and caudal collaterals beside the uterus, and prevent a postoperative congestion, especially of the left leg.- - - - - - - - - - ranking = 0.00018439304291772keywords = uterus (Clic here for more details about this article) |
10/42. Non-Hodgkin lymphoma of the endometrium in human immunodeficiency virus infection.BACKGROUND: Non-Hodgkin lymphoma has become a common malignancy in patients infected with the human immunodeficiency virus (hiv), being classified as an acquired immunodeficiency syndrome-defining malignancy. The female genital tract is involved usually with non-Hodgkin lymphoma as part of disseminated disease. It is extremely rare for this tumor to originate in the female reproductive tract, especially in the endometrium. CASE: An hiv-positive woman underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy for intractable menometorrhagia and resultant anemia thought to be secondary to uterine leiomyoma. The histologic diagnosis was high-grade, immunoblastic, non-Hodgkin lymphoma with plasmacytoid features originating in the endometrium. CONCLUSION: This unusual presentation obligates the clinician to include non-Hodgkin lymphoma in the differential diagnosis when evaluating hiv-positive patients with abnormal uterine bleeding that cannot be explained after thorough evaluation.- - - - - - - - - - ranking = 0.00034713668631007keywords = leiomyoma (Clic here for more details about this article) |
| | Next -> |