Cases reported "Hematometra"

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1/8. Resectoscopic treatment of uterus didelphys with unilateral imperforate vagina complicated by hematocolpos and hematometra: case report.

    OBJECTIVE: To describe a technique for treating hematocolpos and hematometra in patients with uterus didelphys and unilateral imperforate vagina involving the use of resectoscopy under ultrasonographic control. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 13-year-old girl with uterus didelphys with unilateral hematometra, hematocolpos, and ipsilateral renal agenesis. The girl complained of severe abdominal pain, which appeared with each of her menses. INTERVENTION(S): The intervention was performed by a vaginoscopic approach to preserve the integrity of the hymen. The first incision on the vaginal wall was performed in correspondence with the hematocolpos under continuous ultrasonographic guidance with the use of a straight resectoscopic loop. Resection of the vaginal septum was continued with the use of an angled resectoscopic loop until almost complete excision of the septum was achieved. MAIN OUTCOME MEASURE(S): Clinical, echographic, and vaginoscopic findings before the operation and 2 and 6 months after the operation. RESULT(S): The surgical procedure was easy to perform. Almost complete excision of the septum was achieved with just a few passages of the resectoscope. Complete drainage of both the hematocolpos and the hematometra was confirmed by ultrasonography. The postoperative period was completely uneventful. Clinical and vaginoscopic evaluations 6 months after the operation confirmed the integrity of the hymen, the complete resolution of clinical symptoms, and the persistence of a large communication between the two vaginas. CONCLUSION(S): Resectoscopic excision under ultrasonographic guidance of the vaginal septum in a girl with uterus didelphys with unilateral hematometra and hematocolpos was effective and easy to perform, and it fully respected the integrity of the reproductive system.
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ranking = 1
keywords = operative
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2/8. Heterotopic pregnancy in a natural conception cycle presenting as hematometra.

    BACKGROUND: Heterotopic pregnancy is a rare event in natural conception cycles. diagnosis of heterotopic pregnancy requires a high index of suspicion. Described herein is a reported case of a heterotopic pregnancy presenting as hematometra. CASE: A young, multiparous woman, with her last menstrual period 6 weeks before presentation, complained of a dark reddish-brown vaginal discharge and progressive left lower-quadrant discomfort during early pregnancy following a natural conception cycle. An intrauterine mass was observed, and subsequently a heterotopic pregnancy complicated by hematometra was diagnosed with the help of transvaginal ultrasonography and 3-dimensional power Doppler ultrasound angiography. CONCLUSION: women with intrauterine fluid accumulation during pregnancy may be at risk for coexistent ectopic pregnancy. High resolution transvaginal color Doppler sonography may be useful to identify a heterotopic pregnancy preoperatively.
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ranking = 1
keywords = operative
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3/8. hematometra in a patient with Cornelia de lange syndrome.

    BACKGROUND: hematometra is usually the result of developmental anomalies or may be secondary to cervical obstruction. Abnormal uterine contractile function (atony) would be an uncommon cause of hematometra. CASE: An 18-year-old female with Cornelia de lange syndrome and abdominal pain was found to have a hematometra on ultrasound examination. On pelvic examination, her cervical canal was patent and was easily dilated, but the hematometra did not drain until suprapubic pressure was applied. Two weeks postoperatively, pelvic magnetic resonance imaging showed a markedly thinned uterine myometrium and a recurrent hematometra, prompting the decision to perform a hysterectomy. CONCLUSION: hematometra in a patient with Cornelia de lange syndrome may be the result of abnormal uterine contractile function.
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ranking = 1
keywords = operative
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4/8. Preoperative ultrasound diagnosis of hematocolpos.

    A case of hematocolpos in a 17-yr-old girl is presented. The ultrasound findings are described and discussed. With careful ultrasound examination associated severe complications such as hematometra and/or hematosalpinx can be ruled out preoperatively.
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ranking = 5
keywords = operative
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5/8. A technique for uterine conservation in adolescents with vaginal agenesis and a functional uterus.

    Vaginal agenesis in association with a functional uterus occurs infrequently, and usually presents in adolescents. To preserve reproductive function, the uterus must be conserved, and a vagina must be constructed in one operative procedure. The authors describe a surgical technique that combines a modified McIndoe vaginoplasty with uterine conservation in which a special stent is fabricated to insert in the uterine cervix and the neovagina. Factors that must be considered when choosing between a hysterectomy and a uterine conservation procedure also are discussed.
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ranking = 1
keywords = operative
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6/8. Sonographic findings in a case of uterine and vaginal duplication (didelphys) with unilateral hematocolpometrasalpinx.

    The diagnostic capabilities of ultrasound provide an accurate assessment of the size, shape, and location of a mass. The reliability of sonography in evaluating this patient, both pre- and postoperatively, provided invaluable information, aiding the attending physician in his treatment and in his evaluation of the prognosis.
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ranking = 1
keywords = operative
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7/8. A case of unique communication between blind-ending ectopic ureter and ipsilateral hemi-hematocolpometra in uterus didelphys.

    uterus didelphys with double vagina and hemi-vaginal atresia is a rare syndrome of congenital anomalies. A 17-year-old girl had a right blind-ending ectopic ureter, the proximal end of which communicated with the ipsilateral uterine cervix of uterus didelphys. The patient presented with vaginal urinary incontinence after incision of the vaginal wall for right hemi-hematocolpometra. Following various examinations, the ipsilateral kidney was found to be absent. The ectopic ureter and communicating duct were resected, and the fistula was closed. The genesis of malformation of the female genitalia and urinary tract resulting in such a unique communication is discussed. The importance of preoperative meticulous examinations, including cysto-genitography, pelvic magnetic resonance imaging and panendoscopy with the patient under anesthesia, is emphasized.
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ranking = 1
keywords = operative
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8/8. Hematocolpometra presenting as urinary retention. A case report.

    Acute urinary retention is a symptom that often accompanies hematocolpometra. The imperforate hymen is a rare gynecologic abnormality that can be easily diagnosed on initial presentation. We report on a 14-year-old white girl with hematocolpometra and imperforate hymen. The symptoms, operative findings and postoperative involution of internal genitalia are described.
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ranking = 2
keywords = operative
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