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bleeding after total hysterectomy

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https://www.readbyqxmd.com/read/28618723/evaluation-of-quality-of-life-and-cost-effectiveness-of-definitive-surgery-and-the-levonorgestrel-intrauterine-system-as-treatment-options-for-heavy-menstrual-bleeding
#1
Cevdet Adigüzel, Sevtap Seyfettinoğlu, Deniz Aka Satar, Sefa Arlier, Eda Eskimez, Fatma Kaya, Hakan Nazik
BACKGROUND/AIM: This study aimed to compare the levonorgestrel intrauterine system (LNG-IUS) with abdominal hysterectomy (TAH) and total laparoscopic hysterectomy (TLH) as first-line treatments for heavy menstrual bleeding (HMB). MATERIALS AND METHODS: Ninety-eight patients aged 20-55 years who complained of regular heavy menstrual bleeding were enrolled in the study. The TAH group included 29 patients, the LNG-IUS group included 34, and the TLH group included 35...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28577182/economic-burden-of-cancer-among-patients-with-surgical-resections-of-the-lung-rectum-liver-and-uterus-results-from-a-us-hospital-database-claims-analysis
#2
Iftekhar Kalsekar, Chia-Wen Hsiao, Hang Cheng, Sashi Yadalam, Brian Po-Han Chen, Laura Goldstein, Andrew Yoo
OBJECTIVES: To determine hospital resource utilization, associated costs and the risk of complications during hospitalization for four types of surgical resections and to estimate the incremental burden among patients with cancer compared to those without cancer. METHODS: Patients (≥18 years old) were identified from the Premier Research Database of US hospitals if they had any of the following types of elective surgical resections between 1/2008 and 12/2014: lung lobectomy, lower anterior resection of the rectum (LAR), liver wedge resection, or total hysterectomy...
December 2017: Health Economics Review
https://www.readbyqxmd.com/read/28570643/maternal-outcome-after-abdominal-packing-for-uncontrolled-postpartum-hemorrhage-despite-peripartum-hysterectomy
#3
Xavier Deffieux, Marie Vinchant, Ingrid Wigniolle, François Goffinet, Loïc Sentilhes
BACKGROUND: Intra-abdominal packing is a possible option for persistent bleeding following hysterectomy for postpartum hemorrhage. However, to date, only very limited data about maternal outcome after intra-abdominal packing for surgically uncontrolled hemorrhage following hysterectomy are available. The objective of the current study was to estimate maternal outcome after intra-abdominal packing following unsuccessful peripartum hysterectomy for postpartum hemorrhage. METHODS: A questionnaire was mailed to all maternity units performing more than 850 deliveries per year...
2017: PloS One
https://www.readbyqxmd.com/read/28515922/primary-primitive-neuroectodermal-tumor-of-the-cervix-a-report-of-two-cases-and-review-of-the-literature
#4
Xiaofeng Wang, Yan Gao, Yanning Xu, Yixin Liu, Pengpeng Qu
Peripheral primitive neuroectodermal tumor (PNET) of the cervix uteri is extremely rare. Two cases of PNET of the cervix are presented herein. Two female patients, aged 48 and 43 years, presented with irregular uterine bleeding over the course of 1 year, and increased urinary frequency for 1 month, respectively. On gynecological examination, a mass in the cervix was palpated and a biopsy performed. The findings of the initial biopsy revealed small-cell carcinoma in both patients. Following neoadjuvant chemotherapy and radiotherapy, radical hysterectomy was performed in both patients...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28377136/perceptions-and-practices-regarding-women-s-vaginal-health-following-radiation-therapy-a-survey-of-radiation-oncologists-practicing-in-the-united-states
#5
Lisa A Kachnic, Deborah W Bruner, Muhammad M Qureshi, Gregory A Russo
PURPOSE: Vaginal stenosis (VS) is a recognized complication of pelvic and vaginal radiation therapy (RT). METHODS AND MATERIALS: A 26-item survey assessing the signs/symptoms, risk factors, diagnosis, prevention, treatment, and impact of VS on women's sexual health was distributed to radiation oncologists. Descriptive statistics were calculated. Chi-square tests examined differences in categorical responses. RESULTS: A total of 233 (10.5%) participants completed the entire survey...
February 14, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28271093/uterine-sarcoma-with-ambiguous-histomorphology-a-case-report
#6
Eirwen M Miller, Yumei Fu, Ruben Barrera Vera, Gary L Goldberg, Rouzan G Karabakhtsian
BACKGROUND: Leiomyosarcomas (LMS) and endometrial stromal sarcomas (ESS) may display overlapping histomorphology, which may challenge diagnostic accuracy. Since LMS and ESS have vastly different clinical behavior and adjuvant therapy recommendations, accurate diagnosis is critical. CASE: We present the case of an 83-year-old female with postmenopausal bleeding who underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy for clinically atypical appearing leiomyomata...
May 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28228885/omental-flap-transposition-for-inferior-vena-cava-filter-penetration
#7
Junji Yamaguchi, Takamichi Miyamoto, Nobuhiro Hara, Tetsuo Yamaguchi, Tomoyuki Umemoto
A 40-year-old woman presented with uterine malignancy, deep vein thrombosis, and nonmassive pulmonary embolism in both lungs. Gunter-tulip filter was inserted, because she had severe genital bleeding, which is one of the contraindications to anticoagulation therapy. Total hysterectomy was conducted and anticoagulation therapy was started afterward. The thrombus worsened perioperatively, and the filter could not be retrieved. Since there was lymph node recurrence, the second time operation was performed. During operation, the struts were found to be penetrating the inferior vena cava...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28197351/a-case-of-malignant-melanoma-of-the-uterine-cervix-with-disseminated-metastases-throughout-the-vaginal-wall
#8
Tomoko Noguchi, Nami Ota, Yasushi Mabuchi, Shigetaka Yagi, Sawako Minami, Hisako Okuhira, Yuki Yamamoto, Yasushi Nakamura, Kazuhiko Ino
Malignant melanoma (MM) in the female genital tract accounts for less than 2% of all melanomas, and the vast majority associated occur in the vulva and vagina. Primary MM of the uterine cervix is extremely rare and its prognosis is very poor. We report a case of primary MM of the cervix with dissemination throughout the vaginal wall. A 66-year-old woman presented with postmenopausal bleeding. Gynecologic examination demonstrated a 2 cm polypoid blackish-pigmented tumor on the cervix with multiple small blackish-pigmented lesions throughout the vaginal wall...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28065219/uterine-artery-embolization-for-management-of-primary-postpartum-hemorrhage-associated-with-placenta-accreta
#9
Wang Zhi-Wei, Li Xiao-Guang, Pan Jie, Zhang Xiao-Bo, Shi Hai-Feng, Yang Ning, Jin Zheng-Yu
Objective To evaluate the efficacy and safety of uterine artery embolization (UAE) in the management of primary postpartum hemorrhage associated with placenta accreta. Methods We retrospectively reviewed the medical records of patients with placenta accreta between January 2010 and August 2014. Totally 18 women (mean age 30.8±4.2 years) of primary massive postpartum hemorrhage with diagnosis of placenta accrete received treatment of UAE after delivery. Images of DSA and medical records were reviewed. Technical success was defined as control of bleeding after embolization...
November 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28004170/uterine-artery-embolization-for-retained-products-of-conception-with-marked-vascularity-a-safe-and-efficient-first-line-treatment
#10
Paul Bazeries, Francine Paisant-Thouveny, Sultan Yahya, Antoine Bouvier, Cosmina Nedelcu, Francoise Boussion, Loic Sentilhes, Serge Willoteaux, Christophe Aubé
OBJECTIVE: To report our clinical practice regarding a case series of retained products of conception (RPOC) with marked vascularity (MV) managed with selective uterine artery embolization (UAE) as first-line treatment. METHODS: This was a monocentric, retrospective study of 31 consecutive cases of RPOC with MV diagnosed by Doppler ultrasound in the context of postpartum/postabortal bleeding. The primary outcome was the absence of rebleeding following embolization...
April 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27836091/initial-management-of-postpartum-hemorrhage-a-cohort-study-in-benin-and-mali
#11
Julie Tort, Mamadou Traoré, Benjamin Hounkpatin, Cécile Bodin, Patrick Rozenberg, Alexandre Dumont
OBJECTIVE: To determine the components of initial management associated with a decreased risk of severe postpartum hemorrhage (PPH) in Benin and Mali. METHODS: A cohort study was conducted between May 2013 and September 2014 that included all women who delivered vaginally in seven participating centers and who presented excessive bleeding after birth. Severe PPH was defined as PPH that required surgical treatment (vascular ligature and/or hysterectomy), and/or blood transfusion, and/or transfer to an intensive care unit, and/or an outcome of maternal death...
November 2016: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/27718296/which-type-of-placenta-previa-requires-blood-transfusion-more-frequently-a-new-concept-of-indiscernible-edge-total-previa
#12
Yosuke Baba, Hironori Takahashi, Akihide Ohkuchi, Rie Usui, Shigeki Matsubara
AIM: During cesarean section (CS) for placenta previa (PP), the size/area/portion of the lower uterine segment occupied by the placenta may affect the bleeding amount and the subsequent need for a blood transfusion (BT). We propose a new concept, indiscernible edge total PP (IEPP), when vaginal ultrasound does not discern the lower placental edge because the placenta covers the visible lower segment. We characterized IEPP, focusing on its allogeneic BT requirement. METHODS: We classified PP (n = 307) into four types: marginal, partial, discernible edge total PP (DEPP) and IEPP: internal ostium (os)-placental edge distance measurable or unmeasurable on vaginal ultrasound in DEPP or IEPP, respectively...
November 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27651652/efficacy-of-use-of-long-term-low-dose-mifepristone-for-the-treatment-of-fibroids
#13
Anupam Kapur, Ranjeeta Angomchanu, Madhusudan Dey
BACKGROUND: Fibroid or myoma is the commonest reported tumor of uterus, and is one of the important reasons for hysterectomy in our setting. Different drugs are available for medical management of fibroid uterus including mifepristone, a progesterone antagonist. Varying dosage regimen for mifepristone was studied as medical management of fibroid uterus. The aim of the project was to study the effect of mifepristone on the symptoms and size of fibroids, especially using a low-dose regimen for 6 months...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27627607/successful-conservative-treatment-of-cervical-pregnancy-with-uterine-artery-embolization-followed-by-curettage-a-report-of-19-cases
#14
J Hu, X Tao, L Yin, Y Shi
OBJECTIVE: The purpose of this retrospective study was to evaluate the safety and efficacy of uterine artery embolization (UAE) followed by curettage for conservative management of cervical pregnancy. DESIGN: Retrospective review. SETTING: Peking University First Hospital. SAMPLE: Patients with cervical pregnancy diagnosed by trans-vaginal ultrasound at Peking University First Hospital between January 2003 and December 2014...
September 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27610194/small-cell-neuroendocrine-tumour-of-the-endometrium-and-the-importance-of-pathologic-diagnosis
#15
Adriana Estruch, Lucas Minig, Carmen Illueca, Ignacio Romero, Jose Luis Guinot, Andrés Poveda
Small cell carcinoma of the endometrium is a very rare entity. They are very aggressive tumours, with a poor prognosis. They represent a clinical challenge because of a lack of a standardised treatment. We see here a case of a 67-year-old woman with a history of a lobular breast carcinoma, diagnosed in 2002. After presenting with postmenopausal vaginal bleeding in October 2014, she underwent a hysteroscopy-guided biopsy which revealed a metastasis of breast carcinoma. A hysterectomy and bilateral oophorectomy was performed because of uncontrolled uterine bleeding...
2016: Ecancermedicalscience
https://www.readbyqxmd.com/read/27597909/bleeding-versus-clotting-a-complex-case-of-a-large-fibroid-uterus-causing-menorrhagia-and-a-dvt
#16
Sangeeta Ramanan, Jude Chapman-Wardy, Roy Watson
A 43-year-old woman presented with severe anaemia secondary to menorrhagia. Pelvic ultrasound showed a large intramural posterior fundal fibroid. Hysteroscopy showed the fibroid distorting the endometrial cavity, precluding Mirena® device insertion. As she was initially hesitant to have a hysterectomy, medical management with the oral contraceptive pill (OCP) and tranexamic acid was instituted, with good effect. Months later, after a long road trip, she presented with left leg swelling, and a Doppler ultrasound confirmed an extensive deep vein thrombosis (DVT)...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27579179/analysis-of-a-standardized-technique-for-laparoscopic-cuff-closure-following-1924-total-laparoscopic-hysterectomies
#17
Katherine A O'Hanlan, Pamela L Emeney, Alfred Peters, Margaret S Sten, Stacey P McCutcheon, Danielle M Struck, Joseph K Hoang
Objective. To review the vaginal cuff complications from a large series of total laparoscopic hysterectomies in which the laparoscopic culdotomy closure was highly standardized. Methods. Retrospective cohort study (Canadian Task Force Classification II-3) of consecutive total and radical laparoscopic hysterectomy patients with all culdotomy closures performed laparoscopically was conducted using three guidelines: placement of all sutures 5 mm deep from the vaginal edge with a 5 mm interval, incorporation of the uterosacral ligaments with the pubocervical fascia at each angle, and, whenever possible, suturing the bladder peritoneum over the vaginal cuff edge utilizing two suture types of comparable tensile strength...
2016: Minimally Invasive Surgery
https://www.readbyqxmd.com/read/27578036/a-case-of-uterine-leiomyosarcoma-with-long-term-disease-control-by-pazopanib
#18
Satoshi Nagamata, Yasuhiko Ebina, Yumika Yamano, Takeo Miyamoto, Mitsuhiro Nishijima, Hideto Yamada
Uterine leiomyosarcoma (ULMS) is an aggressive tumor associated with high rates of progression, recurrence, and mortality. Pazopanib is the only approved molecular targeted drug for advanced soft tissue sarcoma, and it has been proven to prolong progression-free survival relative to placebo. We herein report a case of ULMS with multiple lung metastases treated with pazopanib, which led to sustained disease control for 44 weeks. A 53-year-old woman was referred to our hospital due to massive uterine bleeding from a uterine corpus tumor mass...
July 5, 2016: Kobe Journal of Medical Sciences
https://www.readbyqxmd.com/read/27485234/the-manchester-procedure-versus-vaginal-hysterectomy-in-the-treatment-of-uterine-prolapse-a-review
#19
Cæcilie Krogsgaard Tolstrup, Gunnar Lose, Niels Klarskov
INTRODUCTION AND HYPOTHESIS: Uterine prolapse is a common health problem and the number of surgical procedures is increasing. No consensus regarding the surgical strategy for repair of uterine prolapse exists. Vaginal hysterectomy (VH) is the preferred surgical procedure worldwide, but uterus-preserving alternatives including the Manchester procedure (MP) are available. The objective was to evaluate if VH and the MP are equally efficient treatments for uterine prolapse with regard to anatomical and symptomatic outcome, quality of life score, functional outcome, re-operation and conservative re-intervention rate, complications and operative outcomes...
January 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/27444140/breast-metastasis-from-vaginal-cancer
#20
Neeraja Chandrasekaran, Daniel Scharifker, George Varsegi, Zoyla Almeida
Vaginal cancer is a rare malignancy accounting for 1-2% of all pelvic neoplasms. Dissemination usually occurs through local invasion and rarely metastasises to distal locations. Metastasis of vaginal cancer to the breast is extremely infrequent and unique. A 66-year-old Asian woman presented with vaginal bleeding and was found to have a vaginal mass and a left breast mass. Pathological assessment of the biopsies revealed identical squamous cell characteristics of both masses. We describe a very rare and novel case of a distally located vaginal carcinoma with metastasis to the breast Federation of Gynecology and Obstetrics (FIGO) stage IV (FIGO IVB)...
July 21, 2016: BMJ Case Reports
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