ABSTRACT
The importance of minimal invasive surgery has increased. Interest in vaginal hysterectomy is rising. Controversy remains regarding the value of conservation of the cervix at hysterectomy. These factors stimulate interest in subtotal vaginal hysterectomy (SVH). SVH is a simple procedure that carries a low risk of morbidity. It can be an option in the treatment of patient with benign conditions of the uterine corpus who desire the retention of the cervix. This desire may arise from concern about possible subsequent bowel, urinary, sexual dysfunction, as well as from other non-clinical issues. We performed SVH in two patients of uterine leiomyoma. Our report includes a brief review of literature.
Subject(s)
Female , Humans , Cervix Uteri , Hysterectomy , Hysterectomy, Vaginal , LeiomyomaABSTRACT
OBJECTIVE: To analyze the change of indications and chromosomal abnormalities according to patient's age and indications in midtrimester genetic amniocentesis. METHODS: This study was reviewed 739 genetic amniocentesis results which were performed at Kwangju Christian Hospital from 1995 to 2004, as prenatal genetic diagnosis for the possibility of chromosomal abnormality of fetus. Age distribution, gestational weeks, indications of amniocentesis and cytogenetic results were the key factors for the analysis. RESULTS: Maternal ages were ranged from 25 to 45, mostly 25~39, Of indications of prenatal genetic amniocentesis, abnormal maternal serum marker was the most common (49.8%), and followed by advanced maternal age (31.1%). The frequency of abnormal karyotypes was 4.6% (34/739). The incidence of abnormal karyotype according to indication had statistical significance in abnormal ultrasonographic finding. CONCLUSION: Among the several indications for prenatal cytogenetic diagnosis, ultrasonographic abnormalities and abnormal maternal serum markers might be important indications. Especially, ultrasonographic abnormalities could be the predictive markers for abnormal fetal karyotypes.
Subject(s)
Female , Humans , Pregnancy , Abnormal Karyotype , Age Distribution , Amniocentesis , Biomarkers , Chromosome Aberrations , Cytogenetics , Diagnosis , Fetus , Incidence , Karyotype , Maternal Age , Pregnancy Trimester, Second , Prenatal DiagnosisABSTRACT
Primary carcinoma of the fallopian tube is an extremely rare and accounts for approximately 0.34-1.8% of all gynecologic malignancies. Preoperative diagnosis was difficult due to nonspecific symptoms and signs. This case of primary fallopian tube adenocarcinoma was confirmed postoperatively on the basis of the pathologic examination. The histology and behavior of fallopian tube cancer are simillar to ovarian cancer, so evaluation and treatment are similar to that of the ovarian cancer. We have experienced a case of primary carcinoma of the fallopian tube and so report with brief review of the literature.
Subject(s)
Female , Adenocarcinoma , Diagnosis , Fallopian Tube Neoplasms , Fallopian Tubes , Ovarian NeoplasmsABSTRACT
Squamous cell carcinoma of the ovary is a very rare malignant tumor originating from malignant transformation of mature cystic teratoma, usually being reported in about 1-3%. It is hard to know the presence of malignant transformation of mature cystic teratoma before operation. So, in case of old age, huge ovarian mass, elevated tumor marker, and operative findings including adhesion, hemorrhage, necrosis and irregular cystic wall, we should suspect malignant transformation. And then we had better do frozen biopsy. Several authors reported the poor prognosis of this malignancy but there is no consensus on optimal therapy because of its rarity. In early stage, curative treatment is possible through only surgical intervention. We experienced a case of squamous cell carcinoma of right ovary developed in a patient with bilateral mature cystic teratomas. We present it with a brief review of literatures.
Subject(s)
Female , Humans , Biopsy , Carcinoma, Squamous Cell , Consensus , Hemorrhage , Necrosis , Ovary , Prognosis , TeratomaABSTRACT
Purpose : To evaluate the short term result of the tension-free vaginal tape (TVT) procedure in conjunction with vaginal hysterectomy in patients with concurrent stress incontinence and gynecological diseases. Materials and Methods: All patients (32 women) underwent the TVT procedure in conjunction with vaginal hysterectomy between June 2001 and April 2003. Preoperative histories, subjective questionnaires of the degree of incontinence, physical examinations, one hour pad tests and full urodynamic testing were evaluated. The postoperative clinical outcomes, patient satisfaction and complications were checked after 3-months. Results: Thirty-two women who met the study criteria were identified. The mean follow-up time, parity, age, operating time and length of hospital stay were 9.2 months, ranging from 3 to 18 months, 2.6, ranging from 1 to 5, 52.5 years, ranging from 40 to 68, 73 minutes, ranging from 55 to 122 minutes and 4.3 days, ranging from 3 to 9 days, respectively. From the questionnaires, 22 patients were found to be mildly incontinent, 7 moderately incontinent and 3 severely incontinent. All patients were cured of gynecological disease. All cases of mild, 5 of moderate and 2 of severe incontinence were cured. The three remaining patients improved. Twenty-eight patients were satisfied after the operation and 1 had intraoperative bladder perforation. Conclusions: The TVT procedure in conjunction with a vaginal hysterectomy for stress incontinence with other gynecologic disease is considered safe and efficacious, although a longer follow-up will be necessary to determine the long term effect.
Subject(s)
Female , Humans , Follow-Up Studies , Genital Diseases, Female , Hysterectomy, Vaginal , Length of Stay , Parity , Patient Satisfaction , Physical Examination , Surveys and Questionnaires , Suburethral Slings , Urinary Bladder , Urinary Incontinence, Stress , UrodynamicsABSTRACT
OBJECTIVE: To investigate the necessity of colposcopically directed biopsy for more accurate detection of cervical neoplasm. METHODS: Cytology and colposcopically directed biopsy were performed in 114 patients and the patients were subsequently underwent conization or hysterectomy from January, 1998 to December, 2001. RESULTS: The complete diagnostic agreement of cytology with permanent biopsy was 57.9% (66 of 114) and the diagnostic agreement within one degree was 80.6% (92 of 114). The complete diagnostic agreement of colposcopically directed biopsy with permanent biopsy was 62.3% (71 of 114) and the diagnostic agreement within one degree was 85.1% (97 of 114). The difference between two tests was statistically significant (p<0.001). CONCLUSION: We concluded that colposcopically directed biopsy can reduce the false negative rate of cytology for screening test of cervical neoplasm. The difference between colposcopically directed biopsy and permanent biopsy was caused by inappropriate resection of the lesion and unskilled physician.
Subject(s)
Humans , Biopsy , Conization , Diagnosis , Hysterectomy , Mass Screening , Uterine Cervical NeoplasmsABSTRACT
OBJECTIVE: To evaluate the effectiveness and the safety of vaginal total hysterectomy. METHODS: We reviewed the medical records of the 110 patients who underwent vaginal total hysterectomy for the indications other than uterine prolapse from August 2001 to September 2002 at our hospital. RESULTS: The average operating time was 48.7 minutes (range from 20 min to 180 min) and the mean uterine weight was 331 gram (range from 60 g to 890 g). The most common indication for hysterectomy was uterine myoma (59%). No serious complications were occurred but conversion to laparotomy was occurred in 1 case. CONCLUSION: Vaginal total hysterectomy would be recommended method for removing uterus even in the absence of prolapse and previous operation history.
Subject(s)
Female , Humans , Hysterectomy , Hysterectomy, Vaginal , Laparotomy , Leiomyoma , Medical Records , Prolapse , Uterine Prolapse , UterusABSTRACT
Intramural pregnancy implanting in the previous cesarean section scar is one of the rarest form of an ectopic pregnancy and probably the most dangerous form because of its risk of rupture and hemorrhage. For its sonographic diagnosis, the gestational sac should be in the anterior wall of uterine isthmic portion, there should be no myometrium between bladder and gestational sac, and it should be verified that uterine cavity and cervix should be isolated from gestational sac. For young patients who wish to maintain their fertility, an earlier diagnosis and more conservative treatment are desirable. We have recently experienced a case of intramural pregnancy implanting in the scar of cesarean section, treated with systemic methotrexate injection. So, we report this case with a brief review of the literature.
Subject(s)
Animals , Female , Humans , Mice , Pregnancy , Cervix Uteri , Cesarean Section , Cicatrix , Diagnosis , Fertility , Gestational Sac , Hemorrhage , Methotrexate , Myometrium , Pregnancy, Ectopic , Rupture , Ultrasonography , Urinary BladderABSTRACT
In the case of pregnancy complicated by intrauterine device, complications such as ectopic pregnancy, septic abortion, preterm delivery are increased significantly. Especially in relation to intrauterine pregnancy, IUD should be removed to prevent complication. But when the tail is missed, therapeutic abortion has been done as an alternative method conventionally. Recently we experienced a case of hysteroscopic removal of IUD complicated by intrauterine pregnancy of 9th week without any harm to the G -sac or embryo. And she delivered healthy girl weighing 2950 gm. So we report this case with the review of articles related.
Subject(s)
Female , Humans , Pregnancy , Abortion, Septic , Abortion, Therapeutic , Embryonic Structures , Intrauterine Devices , Pregnancy, EctopicABSTRACT
Umbilical cord stricture is a very rare cord abnormality that cause intrauterine fetal death. An extreme focal deficiency of Wharton's jelly is suggested as a cause of cord stricture, and was most commonly occurred at the fetal end of umbilical cord. Antenatal detection of umbilical cord stricture is very difficult. We experienced a case of the intrauterine fetal death due to umbilical cord stricture, and we report this case with a brief review of literatures.
Subject(s)
Constriction, Pathologic , Fetal Death , Umbilical Cord , Wharton JellyABSTRACT
Prune-belly syndrome is a rare compound fetal anomaly, characterized by absence or hypoplasia of abdominal wall musculature associated with urinary tract abnormalities and cryptorchidism. The prenatal ultrasound diagnosis was based on the findings of a lower abdominal cystic echo caused by abnormal dilatation of the bladder, upward compression of small intestines and decreased amniotic fluid volume. We experienced a case of Prune-belly syndrome diagnosed by ultrasound in a 12 weeks fetus following to IVF-ET pregnancy. Termination was performed at 12 weeks and autopsy confirmed the distended bladder, absence of abdominal muscles and urethra. So, we reported this case with a brief review of literature.
Subject(s)
Female , Male , Pregnancy , Abdominal Muscles , Abdominal Wall , Amniotic Fluid , Autopsy , Cryptorchidism , Diagnosis , Dilatation , Fetus , Intestine, Small , Prenatal Diagnosis , Prune Belly Syndrome , Ultrasonography , Urethra , Urinary Bladder , Urinary TractABSTRACT
Retroperitoneal Schwannoma is relatively rare and benign tumor originating from Schwann cell. Schwannomas arising in the retroperitoneum are infrequently reported. The majority of Schwannoma is found incidentally and misdiagnosed for other benign conditions both clinically and radiologically. We report a case of a benign retroperitoneal pelvic Schwannoma which was preoperatively misdiagnosed as an ovarian tumor with brief review of literatures.
Subject(s)
NeurilemmomaABSTRACT
Heterotopic pregnancy is defined as simultaneous intrauterine and extrauterine pregnancy. The incidence of heterotopic pregnancy was about 1 to 30,000 pregnancies, but it has been increased. This increased incidence is explained by the rise in PID, pelvic surgery, IUD and assisted reproductive technologies-in vitro fertilization/gamate intrafallopian insemination/intrauterine insemination. Thus careful pelvic examination combined with serial beta-hCG determinations and transvaginal sonography to evaluate the adnexal region are necessary prerequisites for early diagnosis. We report a case of heterotopic pregnancy following in ovulation induction and intrauterine insemination with a brief review of literature.
Subject(s)
Female , Pregnancy , Early Diagnosis , Gynecological Examination , Incidence , Insemination , Ovulation Induction , Ovulation , Pregnancy, Ectopic , Pregnancy, HeterotopicABSTRACT
Ovarian granulosa cell tumor is a uncommon low-grade feminizing malignancy. Its natural history shows slow growth without pain. It often reveals to be very large sized mass when diagnosed, and is confined to the involved ovary in many cases. Complete surgical removal is primary treatment and recurrences thereafter are relatively common. Postoperative adjuvant therapy including reoperation, chemotherapy, radiation therapy or a combination therapy has been used with various degrees of success. We experienced a case of huge ovarian granulosa cell tumor occupying whole abdominal cavity by rapid growth, which is presented with a brief review of corresponding literatures.