The study of patients-reported functional changes and satisfaction after total abdominal hysterectomy / 대한산부인과학회지

OBJECTIVE: Our purpose was to investigate women's perception and satisfaction before and after hysterectomy comparing urinary, lower gastrointestinal, and sexual function. METHODS: It was a prospective study of 89 women ages 31-65 years undergoing total abdominal hysterectomy for nonmalignant conditions. These women were interviewed before surgery and 1, 3 and 6 months later. Patients-reported symptoms of urinary, lower gastrointestinal, and sexual function and woman's satisfaction of hysterectomy were assessed. Only P< or =0.001 was considered statistically significant. RESULTS: The most common reason of patients for hysterectomy was abnormal uterine bleeding. Secondary complication after hysterectomy was negligible. Hysterectomy has got lead to the improvements in pelvic/abdominal pain, gastrointestinal symptoms, and urinary symptoms. The frequency of orgasm was reduced, but other sexual variables were not changed significantly. The level of satisfaction after hysterectomy was very high. CONCLUSION: Abdominal hysterectomy for benign conditions improves urinary and lower gastrointestinal function with no consistent changes in sexual function. Hysterectomy gives patients high degree of satisfaction as well as marked improvement of quality of life.

Vaginal Removal of the Pedunculated Submucous Myoma: Twisting-off Method / 대한산부인과학회잡지

OBJECTIVE: To evaluate the efficacy of the twisting-off method in transvaginal removal of the pedunculated submucous myoma. METHODS: After paracervical block and vaginal dressing with Povidone iodine, the myoma was grasped at its widest diameter and twisted to avulse it from its attatchment. Several kinds of grasping instruments, ie. kelley clamp, tenaculum, ring forcep, was used. If there was bleeding from its detachment site, vaginal gauze or tampon was inserted for bleeding control. RESULTS: The procedure was perfomed successfully on all 33 patients (100%). In most patients, bleeding was scanty in amount. But in one patient, emergency hysterectomy was performed because of massive uterine bleeding. The myoma varied greatly in size. Largest volume was 62.24 cm3, and mean volume was 13.79 cm3. Pathology revealed classic leiomyomas in most cases. Some showed endocervical polyp or endometrial polyp. Follow up examination was done, and its mean interval was eighteen weeks and no patient was recurred. CONCLUSION: The transvaginal removal of pedunculated submucous myoma utilizing grasping instruments may be an effective and safe procedure and the complication is minimal. Twisting-off method was may be a safe alternative to abdominal myomectomy and hysterectomy. Reproductive capacity can be preserved, also.

A Study on the Translocation of Human Chromosome / 대한주산의학회잡지

OBJECTIVE: The aim of this study was to evaluate the relation between the chromosomal translocation and the outcome of pregnancy. METHODS: Between 1989 and 2001, 26 translocation carriers have been detected in our center and Jin Obstetrics and Gynecology Clinic. The subjects consisted of 26 couples that included 14 reciprocal translocation carriers and 12 Robertsonian translocation carriers. The balanced translocation carriers were analyzed retrospectively. RESULTS: The most frequent indication for parental chromosomal examination was repeated abortions or fetal death(57.7%). In contrast to couples with reciprocal translocations, a high excess of female over male carriers was found in the group of Robertsonian translocations. The rates of miscarriages (68.0%) in prior pregnancies were significantly higher than the birth rates of morphologically normal newborns(16.0%). Prenatal chromosomal examination in subsequent pregnancies revealed that 24.0% of the fetuses showed normal karyotypes, 56.0% of the fetuses showed balanced translocations and 20.0% of the fetuses showed a chromosomal imbalance. The unbalanced karyotypes consisted of three trisomies, one partial trisomy and one duplication. There was no case of partial monosomy in this study. CONCLUSIONS: The risk of unbalanced chromosome abnormalities was greater in our study than the empirically known risk. Prenatal examination is always indicated in carriers of any type of translocation.