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Asher Shushan

Publications and source records attributed to Asher Shushan.

7 recordsLinked to original sources
PubMed2003

Severe menorrhagia due to factor VII deficiency successfully treated by thermal balloon endometrial ablation.

Factor VII deficiency, a rare inherited bleeding disorder, is often complicated by menorrhagia leading to severe anemia. These women are treated by repeated blood product transfusions, various hormone preparations, and repeated endometrial curettage. Despite the high risks involved, women with refractory disease were usually advised to undergo hysterectomy. A 36-year-old patient was known to suffer from factor VII deficiency and common variable immune deficiency, and had a long history of worsening menorrhagia. As various medical therapies failed to improve her menorrhagia, and she often required curettage and blood transfusions, we offered her more definitive treatment with thermal balloon endometrial ablation. The procedure was uneventful, and during 24 months of follow-up the patient has had several events of spotting but no heavy periods. It is suggested that thermal balloon endometrial ablation is a suitable minimally invasive therapeutic option for menorrhagia in women with factor VII deficiency.

Adult↗
PubMed2003

Focused ultrasound treatment of uterine fibroid tumors: safety and feasibility of a noninvasive thermoablative technique.

OBJECTIVE: The purpose of this study was to determine the safety and efficacy of focused ultrasound surgery with magnetic resonance imaging guidance for the noninvasive treatment of uterine leiomyomas. STUDY DESIGN: Fifty-five women with clinically significant uterine leiomyomas were treated. Pain and complications were assessed prospectively, and posttreatment magnetic resonance imaging was used to measure the treatment effects. Patients in three of the five centers underwent planned hysterectomy after treatment, which provided pathologic correlation of treatment. RESULTS: Seventy-six percent of the enrolled patients completed the full treatment session. All treatments were conducted in an outpatient setting with minimal discomfort for subjects and no major complications. Pathologic examination of the uterus confirmed that magnetic resonance imaging guidance provides the safe and accurate delivery of effective levels of thermal energy with a 3-fold increase in volume of histologically documented necrosis, compared with treatment volume (6.6 +/- 0.8 vs 18.4 +/- 3.9 mL, P <.005). CONCLUSION: Magnetic resonance imaging-guided focused ultrasound surgery appears to be a well-tolerated treatment for uterine leiomyomas.

Adult↗
PubMed2003

Septate uterus with cervical duplication: rethinking the development of müllerian anomalies.

We present a case of a septate uterus with duplication of the cervix and a vaginal septum, which challenges the embryologic concept of unidirectional caudad to cephalad müllerian ducts fusion. This unique case is, to the best of our knowledge, the seventh reported case of this müllerian anomaly. It challenges the classic theory of unidirectional caudad to cephalad fusion of the müllerian ducts, and might be additional evidence to support the hypothesis suggested by Musset et al. Accurate diagnosis and reports of such cases are important not only for the benefit of treatment, but to reflect the true incidence of this anomaly, and consolidate the embryologic concept.

Adult↗
PubMed2002

Hysteroscopic treatment of intrauterine lesions in premenopausal and postmenopausal women.

STUDY OBJECTIVE: To compare the safety and efficacy of hysteroscopic surgery in the management of intrauterine lesions in premenopausal and postmenopausal women and, in particular, to investigate whether glycine absorption is different between these populations. DESIGN: Comparative study (Canadian Task Force classification II-2). SETTING: Tertiary care university hospital. PATIENTS: Thirty postmenopausal and 78 premenopausal women with intrauterine polyps or myomas. INTERVENTION: Hysteroscopic myomectomy or polypectomy. MEASUREMENTS AND MAIN RESULTS: One hundred eight procedures were completed successfully by hysteroscopy; in two cases myomectomy was completed in a second operation for a deeply embedded myoma. No major complications occurred in either group. Median operating time, mean glycine absorption, and median postoperative hospital stay were not significantly different between groups. During mean follow-up of 15 months (range 1-39 mo), four women underwent hysterectomy (1 for endometrial cancer, 1 for complex hyperplasia with atypia, 2 for pelvic pain and menorrhagia). CONCLUSION: Hysteroscopic surgery is an effective and safe therapeutic option for intrauterine lesions regardless of a woman's menopausal status.

Adult↗
PubMed2002

Investigation of the infertile couple: hysteroscopy with endometrial biopsy is the gold standard investigation for abnormal uterine bleeding.

During the last decade hysteroscopy has become the tool of choice for the evaluation of the endometrial cavity, including for assessment of abnormal uterine bleeding (AUB). Many clinicians would consider that, in most patients, the combination of transvaginal sonography and out-patient endometrial biopsy with diagnostic hysteroscopy could replace the need for dilation and curettage. Hysteroscopy was reported to have sensitivity, specificity, negative predictive value and positive predictive value of 94.2, 88.8, 96.3 and 83.1% respectively, in predicting normal or abnormal endometrial histopathology. The highest accuracy of hysteroscopy was in diagnosing endometrial polyps, whereas the worst result was in estimating hyperplasia. Therefore, since the incidence of focal lesions in patients with AUB is high, it seems that the most beneficial approach is to proceed with hysteroscopy complemented by endometrial biopsy early in the assessment of AUB. Nevertheless, the usage of distension media to flush the uterine cavity raises the concern that when the endometrium harbours pathology, there is the potential risk of retrograde dissemination of malignant cells into the peritoneal cavity. The clinical significance of the dissemination of endometrial cells during hysteroscopy is still undetermined.

Female↗