dimensional ultrasound evaluation of the uterine cavity before and after myomectomy in cases of multiple fibroids

The aim of this work was to evaluate the role of three - dimensional [3D] transvaginal ultrasonography [TVS] of the uterine body and cavity in cases of multiple myomas going to do myomectomy and its impact on the integrity of the cavity after myomectomy. The present study was carried on 42 patients with multiple fibroids planned for myomectomy. They were divided into two groups; 16 patients [group I] were examined before and within three months after myomectomy by transabdominal, conventional 2D and 3D TVS in multiplanar mode at the coronal view. 26 patients [group 2] who did myomectomies within three months were examined by 3D ultrasound only after the operation. In both groups, the uterus was evaluated for size, shape of the cavity, presence of intrauterine adhesions and any submucous myomas or polyps. The results of the present study showed that the two groups were comparable as regards the age, gravidity, parity and number of myomas diagnosed preoperatively [p>0.05]. Intraoperatively, fibroids were pure interstitial in 75% of patients in group [1] and 80.77% of patients in group [2], however, fibroids were combined submucous and interstitial in 25% and 19.23% of patients in group 1 and 2 respectively with insignificant difference between both groups [P > 0.05]. The uterine cavity was opened in 31.25% and 15.38% of patients of group 1 and 2 with significant difference between the two groups, [p<0.05]. Postoperatively, 3D TVS revealed normal uterine cavity in all patients of group 1 [100%] and in 88.5% of patients in group 2 with insignificant differences between the two groups, p> 0.05. Three patients in group 2 [11.5%] showed abnormal coronal view in multiplanar mode of 3D scan. Two patients showed intrauterine adhesions with cavity distortion in one of them. One patient showed missed submucous fibroid. Preoperative evaluation of the uterine cavity with 3D TVS in patients planed for myomectomy allows better identification of the position of the uterine fibroids, thus, providing surgeons with guidelines for easy removal of the fibroids and avoid distortion of the uterine cavity when it is opened. Also, postoperative 3D evaluation allows early postoperative diagnosis and management of operative complications and insures an intact uterine cavity for subsequent spontaneous pregnancy or pregnancy following assisted reproductive technology [ART]

Correlation of ultrasound evaluation and pathological diagnosis of endometrial cancer

The present study wad done to correlate between clinical diagnosis, sonographic assessment of tumor spread and histological and surgical findings in 10 women undergoing hysterectomy for endometrial carcinoma. Out of 10 cases, 6 patients [60%] were of age group 40-52 years, and [30%] were of group above 66 years. About 90% of patients were nullipara or primipara and only 10% were multiparous, thees patients were under hormone replacement therapy [H. R. T]. Six patients out of ten [60%] were hypertensive and 30% of cases were diabetic. Liver affection was present in two patients age group 65-70 years, thus 20% of patients developed cancer endometrium due to detfect in hormone metabolism by the affected liver and accumulation of estrogn [T. V. S]. Transvaginal sonography had successful accuracy [80%] in diagnosing staging of endometrial carcinoma. Only 20% had been overestimated due to alterated uterine cavity and intracvitary lesion or disturbed uterine thickness by myomata. However, T. V. S. was 100% accurate in early cases of cancer endometrium and correlate well with the pathologic findings

Importancia del Doppler testicular en la detección subclínica del varicocele / Significance of testicular Doppler in subclinical detection of varicocele

Se estudiaron 110 pacientes infértiles masculinos, los cuales fueron sometidos a riguroso examen físico general y de genitales, a los que además se les realizó el Doppler testicular a fin de precisar la presencia de varicocele subclínico. Al examen físico, 50 pacientes (45,5 %) presentaron varicocele, y se encontró predominio de localización en el lado izquierdo en 45 pacientes (90,0 %); mientras que con el Doppler testicular el número de pacientes afectados se elevó a 77 (70,0 %); de ellos, 27 (45,0 %) presentaron varicocele grado I (subclínico) dentro de éstos, 18 tenían varicocele unilateral y 9 varicocele bilateral. Con estos resultados se demuestra la alta sensibilidad de este proceder diagnóstico para la detección de esta enfermedad en estado subclínico