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Uterine adhesions

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https://www.readbyqxmd.com/read/29024798/hysteroscopic-management-of-asherman-s-syndrome-special-issue-report-on-uterine-surgery-in-the-journal-of-minimally-invasive-gynecology
#1
Zaraq Khan, Jeffrey M Goldberg
In developed countries, Asherman's Syndrome is almost always the result of a prior intrauterine operative trauma. This is often asymptomatic but may result in hypo- or amenorrhea and can contribute to infertility and pregnancy complications. We will review their etiology, clinical implications, and the systems which have been proposed to classify their extent. The numerous methods reported for performing lysis of intrauterine adhesions will be summarized along with the clinical results. Current strategies to prevent recurrence of intrauterine adhesions have not been conclusively shown to be clinically effective but the potential for endometrial regeneration using stem cells is an exciting modality under investigation...
October 9, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28974911/two-phase-laparoendoscopic-single-site-cervical-ligament-sparing-hysterectomy-an-initial-experience
#2
Mun-Kun Hong, Tang-Yuan Chu, Jen-Huang Wang, Dah-Ching Ding
OBJECTIVE: To report our initial experience with and the short-term outcomes of two-phase laparoendoscopic single-site cervical ligament-sparing hysterectomy (LESS-CLSH). MATERIALS AND METHODS: A retrospective case study included 40 women who underwent LESS-CLSH from January 2014 to December 2016 at Buddhist Tzu Chi General Hospital. Uterine specimens were extracted through contained manual morcellation with a tissue pouch. The first phase was LESS supracervical hysterectomy and conization of the internal orifice of the cervix...
July 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/28946860/severe-hydronephrosis-secondary-to-uterine-artery-pseudoaneurysm-in-the-early-second-trimester-of-pregnancy-a-case-report
#3
Tsukuru Amano, Shinsuke Tokoro, Shunichiro Tsuji, Takashi Inoue, Fuminori Kimura, Takashi Murakami
BACKGROUND: Uterine artery pseudoaneurysm (UAP) normally presents genital bleeding in the puerperal period, and severe hydronephrosis rarely presents during pregnancy. We report a rare case of severe ureteral obstruction accompanied by uterine artery pseudoaneurysm in the early second trimester of pregnancy, which was successfully treated by surgical intervention. CASE PRESENTATION: A 42-year-old nulligravid woman who had undergone myomectomy 3 years earlier was referred to our hospital for acute left abdominal pain at the 17th week of gestation...
September 25, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28939933/cellular-mechanics-of-primary-human-cervical-fibroblasts-influence-of-progesterone-and-a-pro-inflammatory-cytokine
#4
Vasudha Shukla, Victoria Barnhouse, William E Ackerman, Taryn L Summerfield, Heather M Powell, Jennifer L Leight, Douglas A Kniss, Samir N Ghadiali
The leading cause of neonatal mortality, pre-term birth, is often caused by pre-mature ripening/opening of the uterine cervix. Although cervical fibroblasts play an important role in modulating the cervix's extracellular matrix (ECM) and mechanical properties, it is not known how hormones, i.e., progesterone, and pro-inflammatory insults alter fibroblast mechanics, fibroblast-ECM interactions and the resulting changes in tissue mechanics. Here we investigate how progesterone and a pro-inflammatory cytokine, IL-1β, alter the biomechanical properties of human cervical fibroblasts and the fibroblast-ECM interactions that govern tissue-scale mechanics...
September 22, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28939480/title-hysteroscopic-removal-of-retained-products-of-conception-implanted-over-a-focal-area-of-adenomyosis-a-case-report
#5
Luis Alonso, Laura Nieto, Jose Carugno
STUDY OBJECTIVE: To describe a technique for hysteroscopic removal of retained products of conception (RPOC) implanted over an area of adenomyosis. DESIGN: Case report (Canadian Task Force classification III) SETTING: Retained products of conception is an unfortunate complication that may occur after resolution of a normal pregnancy, being more common after early pregnancy termination or spontaneous miscarriage. (1) Immediate consequences of RPOC include persistent vaginal bleeding, abdominal pain, pelvic infection, fever and dilated cervix...
September 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28911210/a20-an-essential-component-of-the-ubiquitin-editing-protein-complex-is-a-negative-regulator-of-inflammation-in-human-myometrium-and-foetal-membranes
#6
Martha Lappas
STUDY QUESTION: Does A20 regulate mediators involved in the terminal processes of human labour in primary myometrial and amnion cells? SUMMARY ANSWER: A20 is a nuclear factor-kappa B (NF-κB) responsive gene that acts as a negative regulator of NF-κB-induced expression of pro-labour mediators. WHAT IS KNOWN ALREADY: Inflammation is commonly implicated in spontaneous preterm birth and the processes involved in rupture of foetal membranes and uterine contractions...
September 1, 2017: Molecular Human Reproduction
https://www.readbyqxmd.com/read/28910183/the-effects-of-barrier-agents-in-postoperative-pelvic-adhesion-formation-a-comparative-study-of-a-temperature-sensitive-poloxamer-based-solution-gel-and-a-hyaluronic-acid-based-solution-in-a-rat-uterine-horn-model
#7
Hyeon-Ji Kim, Hyun Kang, Mi-Kyung Kim, Seung-Su Han
OBJECTIVE: The aim is to evaluate the efficacy of poloxamer/alginate/CaCl2 mixture (PACM) solution/gel and hyaluronic acid/carboxymethylcellulose (HA-CMC) solution for reducing pelvic adhesion in a rat uterine horn model. STUDY DESIGN: A total of 48 females, Sprague Dawley rats, were divided into three groups according to the applied materials. A uterine horn adhesion model was created. The control group (group CO; n = 16) received no special materials except saline infusion...
September 14, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28893657/the-effect-of-adjuvant-treatment-to-prevent-and-treat-intrauterine-adhesions-a-network-meta-analysis-of-randomized-controlled-trials
#8
REVIEW
Yu Yan, Dongmei Xu
Intrauterine adhesions (IUA) can lead to partial or complete closure of the uterine cavity, which may result in symptoms including abnormal menstruation, infertility, and pelvic pain. A network meta-analysis was performed to assess the effect of adjuvant therapy on the prevention and treatment of intrauterine adhesions. We searched electronic databases, including PubMed, EmBase, and the Cochrane Library, up to May 5, 2017 without language restrictions. The primary outcomes in the present analysis were the rate of IUAs for prevention and the rate of IUA recurrence for treatment...
September 8, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28893656/hysteroscopic-isthmoplasty-step-by-step-technique
#9
Attilio Di Spiezio Sardo, Brunella Zizolfi, Gloria Calagna, Pierluigi Giampaolino, Filomena Paolella, Giuseppe Bifulco
BACKGROUND: Isthmocele is a characteristic semi-diverticular anomaly of the anterior isthmic wall of the uterus, located at the site of a previous cesarean delivery scar. The etiopathogenesis of isthmocele is still poorly understood, and several hypotheses have been proposed. Possible factors that could play a role in niche development include a very low incision through cervical tissue, an inadequate suturing technique during the closure of the uterine scar surgical interventions that increase adhesion formation or patient-related factors that impair wound healing, or increase inflammation or adhesion formation...
September 8, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28883083/neupogen-and-mesenchymal-stem-cells-are-novel-therapeutic-agents-in-regeneration-of-induced-endometrial-fibrosis-in-experimental-rats
#10
Dina Sabry, Abeer Mostafa, Samar Marzouk, Walaa Ibrahim, Hanan H M Ali, Ayman Ahmed Hassan, Ashraf Shamaa
Endometrial fibrosis is the presence of intrauterine adhesions after any uterine surgery or curettage and it results in infertility and recurrent pregnancy loss. We evaluated the role of human mesenchymal stem cells (hMSCs) as a therapeutic agent of endometrial fibrosis. We also compared the effect of MSCs with the effect of estrogen and neupogen either each alone or as a combined therapy with MSCs. This experimental study was performed on 84 albino rats which were divided into seven groups (n=12 rats/group) as follows, group 1: normal control rats, group 2: induced fibrosis, group 3: induced fibrosis that received oral estrogen, group 4: induced fibrosis that received hMSCs, group 5: induced fibrosis that received hMSCs and estrogen, group 6: induced fibrosis that received neupogen, and group 7: induced fibrosis that received hMSCs and neupogen...
September 7, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/28836548/epidemiological-survey-and-risk-factor-analysis-of-recurrent-spontaneous-miscarriages-in-infertile-women-at-large-infertility-centers
#11
Hai-Yan Wang, Jie Qiao, Xiao-Xi Sun, Shu-Yu Wang, Xiao-Yan Liang, Yun Sun, Feng-Hua Liu
BACKGROUND: A higher frequency of spontaneous miscarriage has been observed in infertile couples, and there is a higher prevalence of infertility among patients with a history of recurrent spontaneous miscarriages (RSMs; ≥2 miscarriages). This study aimed to determine the proportion of infertile patients with RSM and examine risk factors associated in patients with RSM being treated with assisted reproductive technologies. METHODS: This cross-sectional observational study was conducted at six reproductive medicine centers in three cities of China...
September 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28835939/accuracy-of-color-doppler-ultrasonography-and-magnetic-resonance-imaging-in-diagnosis-of-placenta-accreta-a-survey-of-82-cases
#12
Sedigheh Ayati, Leila Leila, Masoud Pezeshkirad, Farokh Seilanian Toosi, Sirous Nekooei, Mohammad Taghi Shakeri, Mansoureh Sadat Golmohammadi
BACKGROUND: Placenta adhesive disorder (PAD) is one of the most common causes of postpartum hemorrhage and peripartum hysterectomy. The main risk factors are placenta previa and prior uterine surgery such as cesarean section. Diagnosis of placenta adhesive disorders can lead to a decrease of maternal mortality and morbidities. OBJECTIVE: The purpose of this study was to compare the accuracy of color Doppler ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of PADs...
April 2017: International Journal of Reproductive Biomedicine (Yazd, Iran)
https://www.readbyqxmd.com/read/28832907/complications-in-operative-hysteroscopy-is-prevention-possible
#13
Mee Kristine Aas-Eng, Anton Langebrekke, Gernot Hudelist
Operative hysteroscopy in a hospital setting has revolutionized surgical treatment of benign uterine disorders. It is minimally invasive, cost- and time-effective, and may spare patients major surgical interventions. Operative hysteroscopy in a day-case hospital setting is regarded as a safe and well-tolerated procedure with low complication rates. However, prevention of adverse events is crucial in daily practice to optimize patient care. Complications in operative hysteroscopy can be divided into early complications, including bleeding, uterine perforation, infection and fluid overload, or late complications and suboptimal outcomes, such as incomplete resection and intrauterine adhesions...
August 18, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28826369/literature-review-on-the-role-of-uterine-fibroids-in-endometrial-function
#14
Deborah E Ikhena, Serdar E Bulun
Uterine fibroids are benign uterine smooth muscle tumors that are present in up to 8 out of 10 women by the age of 50. Many of these women experience symptoms such as heavy and irregular menstrual bleeding, early pregnancy loss, and infertility. Traditionally believed to be inert masses, fibroids are now known to influence endometrial function at the molecular level. We present a comprehensive review of published studies on the effect of uterine fibroids on endometrial function. Our goal was to explore the current knowledge about how uterine fibroids interact with the endometrium and how these interactions influence clinical symptoms...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28821715/invasive-trophoblast-promote-stromal-fibroblast-decidualization-via-profilin-1-and-alox5
#15
E M Menkhorst, M L Van Sinderen, K Rainczuk, C Cuman, A Winship, E Dimitriadis
During the establishment of pregnancy, extravillous trophoblast (EVT) must invade into the uterine decidua to facilitate decidual artery remodelling to create the placental blood supply. The local decidual environment is thought to regulate trophoblast invasion, however these interactions are poorly defined in humans. Recent evidence in women suggests impaired decidualization is associated with miscarriage and preeclampsia. Primary human endometrial stromal cells (HESC) and first trimester extravillous trophoblast (EVTs) were used to assess the effect of EVT-secreted factors on HESC decidualization, adhesion, proliferation and migration...
August 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28819682/laparoscopy-or-laparotomy-as-the-way-of-entrance-in-myoma-enucleation
#16
REVIEW
Cristina Cezar, Sven Becker, Attilio di Spiezio Sardo, Anja Herrmann, Angelika Larbig, Vasilis Tanos, Luz Angela Torres de la Roche, Hugo Christian Verhoeven, Markus Wallwiener, Rudy Leon De Wilde
PURPOSE: Uterine myomas are the main cause of benign uterine diseases in premenopausal women. Objective of the present paper is to investigate the current best treatment modalities of myomas, depending on age of the patient and her desire to preserve fertility, as well as on clinical presentation of this pathology, such as size, number, and location of fibroids and, furthermore, on surgical experience of the gynecologist. METHODS: The design of our work is a systematic literature review of existing studies, reviews, and meta-analysis conducted in PubMed and Cochrane Library to identify relevant literature...
August 17, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28807808/safety-and-efficacy-of-amnion-graft-in-preventing-reformation-of-intra-uterine-adhesions
#17
Xuebing Peng, TinChiu Li, Yuting Zhao, Yan Guo, Enlan Xia
OBJECTIVE: To determine the safety and efficacy of amnion graft in the prevention of recurrence of intrauterine adhesions after hysteroscopic adhesiolysis in women with severe intrauterine adhesions. DESIGN: Retrospective matched cohort study including 120 patients treated during 62 months (Canadian Task Force classification II-2). SETTING: Tertiary referral center. PATIENTS: A total of one hundred and twenty patients who underwent intrauterine adhesiolysis for severe intrauterine adhesion, forty patients in the treatment group, eighty patients in the control group matched for age and adhesion scores...
August 11, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28805599/nationwide-trends-and-in-hospital-complications-of-trachelectomy-for-surgically-resectable-cervical-cancer-in-taiwanese-women-a%C3%A2-population-based-study-1998-2013
#18
Jerry Cheng-Yen Lai, Hung-Hui Chen, Kuei-Hui Chu, Chia-Sui Weng, Yiing-Jenq Chou, Nicole Huang, Yu-Ju Chien, Kung-Liahng Wang
OBJECTIVE: To describe the nationwide trends in the utilization of trachelectomy among Taiwanese women with surgically resectable cervical cancer over the past decade, and to compare associated demographic characteristics, in-hospital complications and related outcomes using a population-based dataset from 1998 to 2013. MATERIALS AND METHODS: We conducted a population-based, cohort study using inpatient admission claims data of Taiwan's National Health Insurance program...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28796686/a-transperineal-approach-to-hysterectomy-of-a-retained-didelphic-uterine-horn
#19
Mary M Mullen, Lindsay M Kuroki, Steven R Hunt, Kristy L Ratkowski, David G Mutch
BACKGROUND: Gynecologic surgeries are performed through abdominal, vaginal, laparoscopic, or robot-assisted laparoscopic routes. However, if the pelvis is not accessible by one of these routes, there are no published reports to guide pelvic surgeons. CASE: A 34-year-old conjoined twin status postseparation with uterine didelphys and absence of her left colon and sacrum underwent hemihysterectomy, at which time her müllerian anomaly was unknown. She re-presented with vaginal bleeding and pain eventually attributed to a retained uterine horn...
September 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28761872/urinary-bladder-injury-during-colonoscopy-without-colon-perforation
#20
Jung Wook Suh, Jun Won Min, Hwan Namgung, Dong-Guk Park
We report a case of urinary bladder perforation during colonoscopy. A 67-year-old female, who had undergone a transabdominal hysterectomy for uterine myomas 15 years ago, visited the emergency department with complaint of abdominal pain after a screening colonoscopy. Laparoscopic examination revealed severe adhesion between the sigmoid colon and the urinary bladder. The urinary bladder wall was weakened, and several perforation sites were found. The surgery was converted to a laparotomy. After a thorough examination, we performed primary repair for the perforation sites, followed by an omentopexy...
June 2017: Annals of Coloproctology
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