11/68. Prostaglandin levels in endometrial jet wash specimens in patients with dysmenorrhea before and after indomethacin therapy. A patient with functional primary dysmenorrhea of over two years duration was subjected to the endometrial jet wash technique during the period of active menstrual flow. Prostaglandin F analysis of the jet washings revealed significantly elevated levels during menstruation over normal control levels. Following indomethacin therapy, jet wash prostaglandin F levels were dramatically reduced and the patient became asymptomatic. A cause and effect relationsship between prostaglandin F and dysmenorrhea is suggested by these studied. ( info) |
12/68. Fixed drug eruption to rofecoxib. Rofecoxib, used for dysmenorrhea, caused a herpetiform fixed drug eruption predominantly involving the lips with classic clinical and histological findings in a red-brown lesion on the dorsal hand. ( info) |
13/68. Laparoscopic management of non-communicating rudimentary horn in a dysmenorrheic and infertile patient. A case of laparoscopic excision of non-communicating rudimentary horn. The anatomical features of this case were unique. A 19-year-old nulligravida presented with severe dysmenorrhea and primary infertility. Hysterosalpingogram revealed a left uterine horn that had a solitary patent tube. Magnetic resonance imaging showed a left unicornuate uterus continuous with the cervix and the vagina, and a rudimentary right uterine horn. This confirmed the diagnosis of non-communicating cavitated right rudimentary horn. At laparoscopy the patient had stage III endometriosis, and non-communicating right rudimentary horn, which was attached to the unicornuate uterus by a long fibrous band. The rudimentary horn was freed from the pelvic side wall, excised and removed laparoscopically with no complication. ( info) |
| Abdominal hysterectomy was performed in a patient because of complaints of dysmenorrhoea and menorrhagia and the uterus was sent for histopathological analysis. Besides adenomyosis an extensive granulomatous infection with schistosoma mansoni eggs was found. ( info) |
15/68. Unusual late complications after two previous cesarean deliveries: a case report. BACKGROUND: women with multiple previous cesarean deliveries (CDs) risk the development of uterine synechiae and ventral fixation of the uterus to the abdominal wall. CASE: A para 2, gravida 2 women who had two prior CDs experienced prolonged menstrual bleeding with persistent cramps, both of which became more severe after insertion of an intrauterine contraceptive device that was subsequently removed. Pelvic ultrasound revealed an enlarged uterus with fibroids. After a failed attempt to perform a dilation and curettage because of uterine synechiae, the patient underwent a total abdominal hysterectomy. During surgery, the gynecologist observed a total dehiscence of the previous uterine incision, with ventral fixation of the uterus to the lower anterior abdominal wall and marked elongation of the portio cervix. CONCLUSION: dysmenorrhea in a patient with multiple previous CDs, mainly of the classical type, should be carefully evaluated and, in addition, when such patient requires a dilation and curettage, the possibility of cervical stenosis and uterine synechiae should be kept in mind. Having had a number of previous CDs may have an adverse impact on the uterine complication rate. ( info) |
16/68. uterine prolapse after laparoscopic uterosacral transection. A case report. Two cases of severe uterine prolapse are reported following laser uterosacral nerve ablation (LUNA). Both patients had a history of vaginal childbirth and subsequent development of secondary infertility and severe dysmenorrhea. It is suggested that this procedure be performed with caution on vaginally parous patients, and that it be reserved for use in patients who have adequate uterine support. Future studies are needed to determine the long-term incidence of uterine procidentia following this procedure. ( info) |
17/68. Laparoscopic excision of myometrial adenomyomas in patients with adenomyosis uteri and main symptoms of severe dysmenorrhea and hypermenorrhea. Preoperative magnetic resonance imaging accurately diagnosed adenomyosis uteri in three women. We performed laparoscopic excision of myometrial adenomyomas and localized portions of adenomyosis uteri in all women in whom the disorder was accompanied by severe dysmenorrhea and hypermenorrhea. We used the same procedure as for laparoscopic myomectomy. There were no intraoperative or postoperative complications, and patients were hospitalized only 3 days. The women's dysmenorrhea and hypermenorrhea disappeared by the end of the first postoperative menses. ( info) |
18/68. splenosis presenting with adnexal mass: a case report. CASE REPORT: A 21-year-old woman presenting with low abdominal discomfort, dysmenorrhoea and pelvic mass was misdiagnosed as endometriosis. She had post-traumatic splenic rupture and laparotomy history. RESULTS. Pelvic splenosis was diagnosed at laparotomy. Pelvic mass was removed and the other implants were left. ( info) |
19/68. Fixed drug eruption to mefenamic acid: a report of three cases. mefenamic acid (Ponstan) is widely used in the treatment of dysmenorrhoea, menorrhagia, and musculoskeletal pain. Although only 17 cases of fixed drug eruption provoked by mefenamic acid have been reported in the world literature, in a 7-day period a further three patients with fixed drug eruption due to mefenamic acid presented to the dermatology out-patient clinic of the University Hospital of wales, Cardiff. The lesions of all the patients became inflamed within a few hours of taking the drug, but two of the three patients failed to appreciate the association. There have been no further episodes of inflammation since the patients avoided mefenamic acid. ( info) |
20/68. A bicornuate uterus with a unilateral cornual adenomyosis. BACKGROUND: Few reports have described adenomyosis in association with congenital uterine abnormalities. The authors present a case involving unilateral adenomyosis in a bicornuate uterus. CASE: A 41-year-old married gravida 1, para 1, first became aware that she had a double uterus 14 years earlier at her first prenatal examination when the gestation was identified in the left uterine cavity because of intractable dysmenorrhea. The patient underwent laparoscopically assisted vaginal hysterectomy. Pathological examination confirmed that adenomyosis had affected only the left uterine myometrium. CONCLUSION: The right uterine cornua of a bicornuate uterus served as the control after a pregnancy in the left cornua. The subsequent development of adenomyosis in the left cornua lends weight to theories that suggest pregnancy or other acquired factors may be involved in the pathogenesis and development of adenomyosis. ( info) |