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https://www.readbyqxmd.com/read/28933575/unexpected-uterine-leiomyosarcoma-in-a-woman-with-multiple-myomas-treated-with-ulipristal-acetate-case-report-and-literature-review
#1
Paola Modaffari, Marta D'alonzo, Marta Garbagnati, Silvia Pecchio, Guido Menato, Nicoletta Biglia
Ulipristal acetate (UPA) has been recognized as an alternative strategy to surgery in the management of symptomatic women with uterine fibroids. We present a case report on a woman with hereditary fibrinogen deficiency exclusively treated with UPA for myoma-related menorrhagia and abdominal pain, who subsequently underwent a hysterectomy because of clinical worsening. A FIGO IB uterine leiomyosarcoma was found among multiple myomas. A review of the literature found two other cases of uterine leiomyosarcoma in patients treated with UPA: clinical data are reported...
September 21, 2017: Gynecological Endocrinology
https://www.readbyqxmd.com/read/28864044/transvaginal-ultrasound-for-the-diagnosis-of-adenomyosis-systematic-review-and-meta-analysis
#2
REVIEW
Marina Paula Andres, Giuliano Moysés Borrelli, Juliana Ribeiro, Edmund Chada Baracat, Mauricio Simões Abrão, Rosanne M Kho
Adenomyosis is characterized by the presence of ectopic foci of endometrial glandular tissue and/or stroma within the myometrium. The diagnosis of adenomyosis is made traditionally through histological evaluation of the post-surgical specimen. More recently, imaging with transvaginal ultrasound (TVUS) has been used for the pre-operative diagnosis of adenomyosis. As yet, there is no consensus regarding the best imaging feature or combination thereof for the non-surgical diagnosis of adenomyosis. This study systematically evaluates the literature in the last 10 years to determine the accuracy of TVUS 2D, different imaging features, enhancing methods such as TVUS 3D, elastography and color Doppler in the non-surgical diagnosis of adenomyosis...
August 29, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28852453/myomectomies-for-massive-hemoperitoneum-from-spontaneous-bleeding-of-a-uterine-myoma
#3
I Kassegne, K Kolani, B Tchangai, K Kanassoua, K Adabra, F Alassani, A K Amavi, E D J Dosseh
Massive hemoperitoneum from spontaneous bleeding of uterine myoma is an extremely rare condition, that needs urgent surgical exploration. We report a 40-year-old woman, admitted for acute onset of abdominal pain. Physical examination revealed hypovolemic shock. The hemoglobin level was of 5 g/dL. Ultrasonography revealed hemoperitoneum. Emergency surgical exploration was planned. There was hemoperitoneum of 3 L, uterine myomas with multiple subserous myomas, bleeding from superficial ruptured varice overlying the most largest subserous myoma, which measured 15 cm...
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28835425/polycystic-ovary-syndrome-with-asynchronous-bilateral-adnexal-torsion-in-a-natural-cycle
#4
Shozo Matsuoka, Toru Kobayashi, Soshi Kusunoki, Daiki Ogishima
Cases involving polycystic ovaries (PCOs) with adnexal torsion in a natural cycle without ovulation induction are rare, and no reports of such cases have described asynchronous bilateral adnexal torsion. Here, we report a case of PCO syndrome (PCOS) with asynchronous bilateral adnexal torsion in a natural cycle. The patient was a 37-year-old woman with a history of 2 gravidas 1 para. Her primary complaint was left lower abdominal pain. Ultrasonography and MRI identified multiple uterine myomas occupying the pelvis and the left ovary, with oedematous swelling that had moved ventrally to the uterus...
August 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28753380/ct-and-mr-imaging-of-gynecologic-emergencies
#5
Yuko Iraha, Masahiro Okada, Rin Iraha, Kimei Azama, Tsuneo Yamashiro, Maho Tsubakimoto, Yoichi Aoki, Sadayuki Murayama
Gynecologic emergencies include various diseases that result from adnexal and uterine disorders. Adnexal disorders may be classified into the following three categories: (a) disorders that cause hemorrhage (hemorrhagic ovarian cysts and ectopic pregnancies); (b) disorders related to adnexal tumors (adnexal torsion and rupture of ovarian tumors); and (c) disorders related to pelvic inflammatory disease, such as tubo-ovarian abscesses. Unusual adnexal torsion, such as massive ovarian edema, isolated fallopian tube torsion, and paraovarian cyst torsion, has also been described...
September 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28735628/novel-algorithm-including-ca-125-he4-and-body-mass-index-in-the-diagnosis-of-endometrial-cancer
#6
Tamara Knific, Joško Osredkar, Špela Smrkolj, Irena Tonin, Katja Vouk, Andrej Blejec, Snježana Frković Grazio, Tea Lanišnik Rižner
OBJECTIVES: To evaluate the diagnostic and prognostic potential of preoperative serum CA-125 and HE4 levels in patients with endometrial cancer. METHODS: Prospective case-control study of 133 women who underwent surgical treatment at the University Medical Centre Ljubljana (64 patients with endometrial cancer, 69 control patients with prolapsed uterus or myoma). Serum CA-125 and HE4 levels were determined using electrochemiluminescent assays. RESULTS: Serum CA-125 and HE4 levels were significantly higher in patients with endometrial cancer, compared to the controls (p=2...
July 20, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28732252/update-on-medical-treatment-of-uterine-fibroids
#7
REVIEW
Fátima Faustino, Margarida Martinho, José Reis, Fernanda Águas
OBJECTIVES: In this review paper, the pros and cons of the available pharmacological options for the treatment of uterine fibroids are explored, including oral progestogens, levonorgestrel intra-uterine device, gonadotropin-releasing hormone analogs and progesterone receptor modulators with an emphasis on ulipristal acetate. STUDY DESIGN: The choice of the appropriate therapeutic approach for uterine fibroids depends on several factors, including women's age, parity, childbearing aspirations and wish to preserve fertility, extent and severity of symptoms, size, number and location of myomas, risk of malignancy and proximity to menopause...
September 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28721180/adenomyosis-back-to-the-future
#8
Z Ferraz, N Nogueira-Martins, F Nogueira-Martins
Adenomyosis is a benign invasion of endometrium into the myometrium. It produces a diffusely enlarged uterus and predominantly affects women in the late reproductive age. It has recently been associated with a negative impact on female fertility. Diagnosis is challenging because nonspecific symptoms can be present. However, it is asymptomatic in the majority of women. Medical treatment with GnRH agonist seems to be promising, particularly in subfertile women. A retrospective study was performed (182 patients) by examination of histopathological results with "adenomyosis" between January/2013 and September/2016...
March 2017: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/28664484/the-role-of-three-dimensional-power-doppler-hysterosonography-3-dpds-in-distinguishing-atypical-polypoid-adenomyomas-apas-from-other-intrauterine-tumors-correlation-with-pathologic-findings
#9
Kalmantis Konstantinos, Daskalakis Georgios, Semertzidou Anysia, Rodolakis Alexandros
OBJECTIVE: This study was undertaken to describe the sonographic characteristics of atypical polypoid adenomyomas (APAs) of the uterus and to determine the value of three-dimensional power Doppler hysterosonography (3-DPDS) in distinguishing APA from other polypoid uterine tumors. METHODS: Ninety-five women with a mean age of 37 years (range 28-45) with a suspicious polypoid uterine tumor were referred for preoperative evaluation with 3-DPDS. Sonographic criteria used for the diagnosis of APA were based on a system that consisted of morphological characteristics, histological evaluation and power Doppler imaging...
June 29, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28659202/-polycythaemia-in-a-patient-with-uterus-myomatosus
#10
J P de Boer, G Velders, R Aliredjo, E Scheenjes, T W H Flinsenberg
BACKGROUND: Myomatous erythrocytosis syndrome (MES) is characterised by a combination of polycythaemia, uterus myomatosus and the normalisation of erythrocyte count after hysterectomy. CASE DESCRIPTION: A 58-year-old postmenopausal woman was referred to the gynaecologist with symptoms of vaginal blood loss, increased abdominal circumference and pollakiuria. Physical examination indicated her uterus was enlarged to the size of a 24-week gestation. Endometrial malignancy was excluded and ultrasound showed a myoma...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28599883/uterine-sparing-laparoscopic-resection-of-accessory-cavitated-uterine-masses
#11
Ann Peters, Noah B Rindos, Richard S Guido, Nicole M Donnellan
To demonstrate surgical techniques utilized during uterine-sparing laparoscopic resections of accessory cavitated uterine masses (ACUM) BACKGROUND: ACUM represent a rare uterine entity observed in premenopausal women suffering from dysmenorrhea and recurrent pelvic pain. The diagnosis is made when an isolated extra-cavitated uterine mass is resected from an otherwise normal appearing uterus with unremarkable endometrial lumen and adnexal structures. Pathologic confirmation requires an accessory cavity lined with endometrial epithelium (and corresponding glands and stroma) filled with chocolate-brown fluid...
June 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28597115/psychiatric-outcomes-after-hysterectomy-in-women-with-uterine-myoma-a-population-based-retrospective-cohort-study
#12
Hyo Jung Lee, Seung Ju Kim, Eun-Cheol Park
Controversy regarding psychological or psychiatric outcomes following hysterectomy still exists. The purpose of this study was to investigate the risk of postoperative psychiatric disorders in women with hysterectomy compared to that in women with uterus-conserving surgery for myomas by using population-based data from South Korea. This study was designed as a retrospective cohort study. We analyzed the National Health Insurance Service National Sample Cohort data including all administrative medical claims from 2002 to 2013...
August 2017: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/28586129/psychometric-validation-of-the-chinese-version-of-the-illness-perception-questionnaire-revised-for-women-with-stress-urinary-incontinence
#13
Yijun Fan, Zhaohui Huang, Dazhao Zhang, Jun Chang, Yun Jia, Shuihong He, Bing Wei
AIM: The aim of this study was to examine the reliability and validity of the Illness Perception Questionnaire-Revised (IPQ-R) in patients with stress urinary incontinence (SUI). METHODS: A total of 256 patients with SUI and 76 patients with myoma of the uterus were recruited to complete the Chinese IPQ-R. For the reliability, the key tests included Cronbach's α coefficient and intraclass correlation coefficients. For the validity, the key tests included factor analysis, Spearman's correlation coefficient, and the Student's t-test...
June 6, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28515917/total-laparoscopic-hysterectomy-for-large-uterine-cervical-myoma
#14
Kentaro Nakayama, Mayu Tsukao, Masako Ishikawa, Tomoka Ishibashi, Kohei Nakamura, Kaori Sanuki, Hitomi Yamashita, Ruriko Ono, Toshiko Minamoto, Satoru Kyo
Ureterolysis is a surgical method with a high level of difficulty, which may be necessary when performing total laparoscopic hysterectomy (TLH) for large cervical myoma, despite the benign nature of this tumor. The aim of the present study was to introduce techniques that are commonly applied in malignant tumor surgery in order to safely perform TLH for large cervical myoma. Between 2014 and 2016, TLH was performed at the Shimane University Hospital (Izumo, Japan) in 153 patients with benign tumors, including 25 cases with a large uterus (uterine weight ≥500 g)...
May 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28471130/non-puerperal-uterine-inversion-due-to-submucous-myoma-in-a-woman-a-case-report
#15
Ayse Kirbas, Korkut Daglar, Ozgur Kara, Ayhan Sucak, Turhan Caglar
Uterine leiomyomas are the most common benign tumor of the female reproductive tract. Their incidence during pregnancy is approximately 2 percent and they are associated with some complications such as preterm labor, placental abruption, fetal malpresentation, obstructed labor, cesarean delivery, and postpartum hemorrhage. They may develop anywhere within the muscular wall of the uterus, including submucosal, intramural, or subserosal areas. Some of the submucous myomas may be pedunculated and eventually may protrude through the cervical canal to the vagina...
July 2016: Journal of Experimental Therapeutics & Oncology
https://www.readbyqxmd.com/read/28412850/assessment-of-hysteroscopic-role-in-management-of-women-with-recurrent-pregnancy-loss
#16
M Elsokkary, M Elshourbagy, K Labib, A Mamdouh, Y El-Shahawy, Wael S Nossair, O Abd El Fattah, H Hemeda, S Sallam, Waleed M Khalaf, M Ali
OBJECTIVES: To assess the hysteroscopic value in the management of intrauterine lesion in women with recurrent pregnancy loss. METHODS: This study was done in Ain Shams Maternity Hospital after the approval of the research Ethics Committee, during the period between August 2014 and December 2015 where 200 nonpregnant women with a history of three or more consecutive unexplained first and second trimester miscarriages before 20 weeks were recruited from recurrent miscarriage clinic...
May 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28210025/vascular-lipoleiomyoma-of-the-uterus-an-unusual-case
#17
Vesna Chibisheva, Vesna Antovska, Milka Trajanova, Drage Dabeski, Rubens Jovanovic, Ivana Kijajova
INTRODUCTION: Uterine lipoleiomyomas are a rare type of uterine myomas, which have been seldom diagnosed and are less known and still unusual. Histologically they are composed of smooth muscle cells with multiple fat cells and fibrous tissue. Their pathogenesis is still a stigmata and their preoperative diagnosis is still questionable. CASE REPORT HISTORY: A 39-year old woman presented at the University clinic for obstetrics and gynecology with complaints of a mild low abdominal and pelvic pain, increased frequency of vaginal bleeding and abdominal distension...
December 2016: Medical Archives
https://www.readbyqxmd.com/read/28159054/long-term-sequelae-of-unconfined-morcellation-during-laparoscopic-gynecological-surgery
#18
REVIEW
Aviad Cohen, Togas Tulandi
Although rare, unconfined morcellation of occult sarcoma has been associated with reduced survival rates. Morcellation of uterus and myoma can also lead to iatrogenic endometriosis, parasitic myoma and, albeit rarely, disseminated peritoneal leiomyomatosis. These benign sequelae of morcellation occur more often than malignant dissemination of sarcomatous tissue. Accordingly, confined morcellation should be performed with a minimally invasive technique while eliminating tissue dissemination inside the abdominal cavity...
March 2017: Maturitas
https://www.readbyqxmd.com/read/28089570/use-of-augmented-reality-in-laparoscopic-gynecology-to-visualize-myomas
#19
Nicolas Bourdel, Toby Collins, Daniel Pizarro, Clement Debize, Anne-Sophie Grémeau, Adrien Bartoli, Michel Canis
OBJECTIVE: To report the use of augmented reality (AR) in gynecology. DESIGN: AR is a surgical guidance technology that enables important hidden surface structures to be visualized in endoscopic images. AR has been used for other organs, but never in gynecology and never with a very mobile organ like the uterus. We have developed a new AR approach specifically for uterine surgery and demonstrated its use for myomectomy. SETTING: Tertiary university hospital...
March 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28076829/comparing-the-effect-of-aromatase-inhibitor-letrozole-cabergoline-dostinex-and-letrozole-alone-on-uterine-myoma-regression-a-randomized-clinical-trial
#20
M Sayyah-Melli, M Mobasseri, P M Gharabaghi, E Ouladsahebmadarek, V Rahmani
OBJECTIVE: To evaluate the effect of letrozole in combination with cabergoline and letrozole alone on regression of symptomatic uterine myomas in women of reproductive age. DESIGN: Randomized controlled clinical trial. SETTING: University hospital. PATIENTS: Ninety-one women of reproductive age were enrolled in the study and 88 women were eligible. Eight participants were excluded from the study. INTERVENTIONS: Eighty women of reproductive age with symptomatic myomas >4cm were evaluated in two groups...
March 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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