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At least 595 records · Page 33Linked to original sources
PubMed1992

[Ovarian remnant syndrome. A case report of a malignancy].

We operated on a patient who had already had total abdominal hysterectomy with bilateral salpingo-oophorectomy who developed a pelvic mass. The Pouch of Douglas was filled with a friable cystic mass of which the anatomo-pathological diagnosis was of a borderline serous cyst adenoma that probably was ovarian in origin. The case is interesting because of the radiopathological hypotheses that are brought up and by the various ways of treatment that have been suggested.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1952

Culdoscopy.

Cul-de-sac puncture for introduction of a culdoscope is easily made with the patient in the knee-chest position. With the use of the instrument, the pelvic organs can be viewed clearly. Culdoscopic examination of 45 patients was carried out. In all cases in which laparotomy was done after the examination, the culdoscopic observations and diagnosis were confirmed. In no case in which tubal pregnancy was present, was the diagnosis missed in culdoscopic examination. Patients were only slightly uncomfortable after the examination. There was no evidence of pelvic peritonitis in any patient, and no pregnant patient aborted as a result of the procedure.

Culdoscopes↗
PubMed1992

Percutaneous catheter drainage of tubo-ovarian abscesses.

We present the successful treatment of tubo-ovarian abscesses in three young patients by continuous percutaneous drainage, inserted under the guidance of real-time ultrasonography using only local anesthesia. Each patient had been diagnosed laparoscopically as suffering from acute pelvic inflammatory disease, but had formed abscesses despite extensive broad-spectrum antibiotic therapy. One case involved a complication of the ovum pick-up procedure; the woman had tubo-ovarian abscesses with infected hematomas. Because the abscesses were localized anteriorly in the lower abdomen and did not reach the pouch of Douglas, they could not be drained through a posterior colpotomy. Ultrasound guidance allowed us to drain all the areas of the multioculated abscesses. We suggest that percutaneous abscess drainage be the initial treatment of choice for tubo-ovarian abscesses before laparotomy is considered.

Abscess↗
PubMedDate not supplied

[Extrauterine endometriosis: three new cases].

Extragonadal endometriosis is rarely diagnosed preoperatively due the variety of its localizations. Presentation to general surgeons may be atypical and pose diagnostic difficulties. The Authors report three cases surgically treated between 2000-2003. The Authors stress the peculiarity of one of these cases with endometrial tissue involvement of the intestinal mucosa. They also discuss about various aetiological hypothesis, symptomatology, differential diagnosis and need for multidisciplinary treatment.

Abdominal Pain↗
PubMed1992

Role of gonadotrophin-releasing hormone agonists in the treatment of external genital endometriosis: review of 77 cases.

Peritoneal and ovarian endometriosis are anatomically highly polymorphous and can give rise to pain and sterility. Endometriosis can be recognized and evaluated by means of laparoscopy and an appropriate therapeutic strategy determined. Surgical laparoscopy using lasers (CO2, KTP and argon) produces excellent results. More than 80% of cases can be treated by coelioscopy, bearing in mind that severe endometriosis can require classic surgery and remains difficult to perform. However, one basic idea should not be forgotten, ie, that endometriosis is a progressive disease. Restoration of anatomic pelvic integrity (with free pouch of Douglas, mobility of appendages and functional ovaries) is the only guarantee of good fertility, achievable by interruption of progression of the disease. Following therapeutic trials with danazol, norsteroidal progestagens, gonadotrophin-releasing hormone agonists have opened up wide perspectives for use and we use them in combination with coeliac surgery. Our experience has paralleled that of Donnez and Bruhat, with almost identical results.

Combined Modality Therapy↗
PubMed2004

[Study on combined transvaginal hydrolaparoscopy and hysteroscopy in patients with infertility].

OBJECTIVE: To evaluate the advantages of combined transvaginal hydrolaparoscopy (THL) and hysteroscopy in patients with infertility. METHODS: Twenty-three primary infertile patients (primary group) and 23 secondary infertile patients (secondary group) were received THL (using a 3-mm scope with a 0 degrees lens) and hysteroscopy. The fallopian tube patency, pelvic pathology, operative time, discharge time, healing time of vaginal wound, success rate of insertion into the pouch of Douglas and intra- and postoperative complications were observed. RESULTS: Primary group had more tube patency cases (P < 0.05) and fewer pelvic adhesion cases (P < 0.05) when compared with secondary group. Only 15.2% patients needed conventional laparoscopy postoperatively. The time of THL, overall time of operation, discharge time, and healing time of vaginal wound were respectively (10.5 +/- 1.7) min, (32.2 +/- 4.6) min, (87.3 +/- 12.5) min, and (4.5 +/- 0.5) days. No complications occurred. CONCLUSIONS: THL is accurate, minimally invasive, safe, economical, and does not require hospitalization. It could serve as a first-line procedure in early stages of infertility investigation when combined with hysteroscopy.

Adult↗
PubMed1992

Role of Chlamydia trachomatis in pelvic inflammatory disease.

Endocervical swabs and peritoneal aspirate from the pouch of Douglas (POD) were taken in 50 women with pelvic inflammatory disease (PID) and in 50 controls for the detection of C. trachomatis antigen (Chlamydiazyme). C. trachomatis antigen was detected from endocervix in 8 per cent patients and 2 per cent controls (P greater than 0.05), while from the POD it was detected in 44 per cent patients and in none of the control women (P less than 0.005). There was a higher detection rate of C. trachomatis antigen from the POD in women with chronic PID (50%) as compared to acute PID (28.5%; P greater than 0.05). Culdocentesis was found to be a simple and reliable OPD procedure for obtaining material for C. trachomatis antigen detection.

Adult↗
PubMed1992

Abdominal sacral colpopexy in 163 women with posthysterectomy vaginal vault prolapse and enterocele. Evolution of operative techniques.

Abdominal sacral colpopexy with retroperitoneal interposition of a suspensory hammock between a prolapsed vaginal vault and the anterior surface of the sacrum was performed on 163 women for correction of vaginal vault prolapse during 18 consecutive years, from 1972 through 1989. Hysterectomy had previously been performed on 160 of the patients, 2 patients had congenital absence of the uterus, and 1 patient underwent vaginal hysterectomy at the time of the sacral colpopexy. The patients had been followed for 9 months to 18 years at this writing, with a median follow-up of 33 months. An additional 25 patients underwent successful sacral colpopexy since the end of the study period, but those data are not included here. Modifications of surgical techniques have evolved from our experience.

Adolescent↗
PubMed1992

[Endosonographic diagnosis of metastatic tumors in the recto-uterine or recto-vesical space by transrectal scan].

A 6-year experience of transrectal ultrasonography (TRUS) in 75 patients with advanced gastrointestinal cancers was reviewed regarding the diagnostic yield of metastatic extrarectal tumors. A diagnostic capability of TRUS (a sensitivity of 82.9%, a specificity of 97.5% and an accuracy of 90.7%) was statistically superior to that of digital rectal examination (a sensitivity of 62.9%, a specificity of 75% and an accuracy of 69.3%). However, TRUS could hardly correctly diagnose a miliary type of extrarectal tumors in contrast to nodular and thickened types. TRUS also had an advantage over conventional ultrasonography in detecting a small amount of ascites with a sensitivity of 75%, a specificity of 93% and an accuracy of 86.6%. Patients with positive signs of extrarectal tumors or ascites on TRUS survived significantly shorter than those with negative signs. TRUS renders a convenient means in the objective diagnosis of peritoneal carcinomatosis, and predicts patient's prognosis.

Adult↗
PubMed2005

Recurrent ectopic pregnancy following ipsilateral partial salpingectomy.

An unusual case of a second ipsilateral ectopic pregnancy following a partial (proximal) salpingectomy for ectopic gestation is presented in a 32-year-old woman with a history of secondary infertility. This occurred in the distal remnant of the left fallopian tube. It is postulated that the pregnancy was conceived following migration of spermatozoa or the fertilised egg from the endometrial cavity to the distal remnant of the left fallopian tube or by passage of spermatozoa through the intact right fallopian tube and the pouch of Douglas. Consequent to the maintenance of a high index of suspicion of ectopic pregnancy, there was early diagnosis and expedient surgical intervention on both occasions.

Adult↗