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At least 127 records · Page 7Linked to original sources
PubMed1988

Adnexal and cul-de-sac abnormalities: transvaginal sonography.

Sixty-seven patients selectively chosen from 354 undergoing conventional transabdominal (TA) sonography for evaluation of a clinically suspected adnexal mass subsequently underwent transvaginal (TV) sonography either because the TA sonograms were technically suboptimal or because it was not possible to characterize with certainty an abnormality identified with TA sonography. TV sonography added diagnostically useful information in 25 of 28 patients with cystic pathologic changes in the adnexa uteri. Eight of 12 patients with tuboovarian abscess and nonspecific adnexal masses visualized with TA sonography had tube-shaped fluid collections characteristic of pyosalpinx identified with TV sonography. TV sonography added diagnostically useful information in all seven patients with diseases of the cul-de-sac (rectouterine fossa) and allowed differentiation of adnexal from primary uterine disease in three patients with TA sonograms on which findings were equivocal. It also expedited the diagnosis of a tubal pregnancy in ten of 14 patients and was useful in the detection of adhesions and perforated intrauterine devices. These results indicate that adjunctive TV sonography can provide important diagnostic information.

Adnexal Diseases↗
PubMed1991

[Evaluation of risk factors of developing underlying and precancerous diseases of the uterine cervix].

The paper analyzes risk factors for underlying and precancerous processes of the cervix uteri in females. The application of a mathematical instrument and computers made it possible to define the most significant risk factors and to evaluate the degree of their impact. The findings may be used in the program test in performing mass prophylactic surveys to identify a group of females who are at a high risk and require a more detailed examination.

Adult↗
PubMed2005

Minilaparotomy in the management of benign gynecologic disease.

BACKGROUND: Considering the enormous advantages of minimally invasive surgery, attempts to explore less invasive trans-abdominal incisions could represent an alternative to laparoscopic gynecologic surgery. The aim of this study was to assess the feasibility and clinical outcome of minilaparotomy in a large series of patients. METHODS: In this retrospective study we describe our 6-year experience on 252 patients undergoing surgery by minilaparotomy for benign adnexal or uterine disease. Surgical treatments included total abdominal hysterectomy, myomectomy, mono or bilateral salpingo-oophorectomy and adnexal surgery. RESULTS: The mean population age and BMI were 39.2 years (+/-13.2 S.D.) and 23.6 (+/-3.31 S.D.), respectively. The mean operative time was 75.4 min (+/-31.8) and the estimated blood loss was never significant except in two cases (0.8%). The mean duration of ileus was 1.58 days (+/-0.6 S.D.) and the mean days until discharge were 3.06 (+/-1.14 S.D.), with a significantly lower duration of recovery in the group of simple adnexal surgery with respect to the others (p = 0.0001). No severe early post-operative morbidity was observed. CONCLUSIONS: The current report describes minilaparotomy as a feasible surgical approach in benign gynecological diseases. The operative time is quite similar or shorter than reported for laparoscopy, laparotomy and vaginal surgery. The estimated blood loss is not significant as well as the duration of the ileus and discharge. Moreover, a prospective randomised study, already ongoing in our department, will better answer the question of whether minilaparotomy could be an alternative to laparoscopic and vaginal surgery.

Adnexal Diseases↗
PubMed2004

Vaginal hysterectomy for patients with moderately enlarged uterus of benign lesions.

OBJECTIVE: To evaluate the possibility of vaginal hysterectomy for patients with moderately enlarged uterus of benign lesions. METHODS: One hundred and seventeen women with benign uterine diseases underwent vaginal hysterectomy. These patients were divided into two groups according to uterine weight. Group I contained 60 patients with uterine enlargement to a weight of 200 to 750 g, and group II contained 57 patients with uterine weight of less than 200 g. Uterine morcellation was performed in some cases. The perioperative data in both groups were analyzed. RESULTS: In group I, 59 cases underwent transvaginal hysterectomy successfully, except 1 case converted to abdominal operation and the uterine morcellation was performed in 21 women. In group II, all patients successfully underwent transvaginal hysterectomy without any assistance of special technique. The mean uterine weight of group I was significantly heavier than that of group II (280.18 +/- 100.40 g vs 146.48 +/- 35.19 g). The mean operating time was significantly longer for group I than that for group II (83.93 +/- 26.26 minutes vs 35.22 +/- 20.55 minutes). There were no significant differences in blood loss and complications between group I and group II. There was no injury of urinary bladder or rectum, and no vaginal vault infection. CONCLUSIONS: Vaginal hysterectomy of moderately enlarged uterus can be safely and effectively performed by experienced operators. In some cases, in order to reduce the uterine volume, uterine morcellation should be used to shorten operative time, reduce the bleeding, and lower the postoperative complications.

Female↗
PubMed1987

The need for Pap tests after hysterectomy for benign disease. Results of a study of black patients.

The questions of whether a Pap test should be done in patients who have undergone hysterectomy for benign uterine disease and, if so, how often were addressed by reviewing the records of 3,008 black women seen in a cancer screening clinic. No vaginal carcinoma was found in the posthysterectomy patients or in the control group with the uterus in place. The absence of carcinoma in the posthysterectomy group suggests that although an annual physical examination is indicated, the time interval between performance of the Pap test may be lengthened.

Adult↗
PubMed1991

Rosai-Dorfman disease of the uterine cervix.

A case of Rosai-Dorfman disease of the uterine cervix is described. The disease is characterized by a mixed chronic inflammatory cell infiltrate in which histiocytic cells predominate. A characteristic feature is the presence within many of the histiocytic cells of engulfed, but undamaged, lymphocytes. Rosai-Dorfman disease is of unknown etiology and pursues a benign course. The disease can occur at a wide variety of extranodal sites, but this appears to be the first reported instance of female genital tract involvement.

Adult↗
PubMedDate not supplied

Immuno-histochemical demonstration of the role of chlamydiaceae in renal, uterine and Salpingeal disease of the koala, and demonstration of chlamydiaceae in novel sites.

Numerous bacteria, including Chlamydophila pecorum and Chlamydophila pneumoniae, are known to occur in diseased sites in koalas. In the present study the significance of such organisms was investigated by demonstrating their distribution in situ, in tissues collected opportunistically from wild koalas. Chlamydiaceae were demonstrated in epithelial cells and macrophages in association with pyogranulomatous pyelonephritis (8/11 kidneys), focal interstitial nephritis (3/21), and active inflammation and fibrosis of the entire upper female reproductive tract (10/10). In one case of pyelonephritis, Gram-positive cocci were also demonstrated in association with Chlamydiaceae and, in another, haematogenous filamentous bacteria appeared to be the sole aetiological agent. Three cases of chlamydial metritis were also superficially co-infected by a mixture of other bacteria. Chlamydiaceae were also demonstrated in pulmonary alveolar macrophages and epithelial cells in association with pneumonitis, and in hepatic and splenic macrophages in one koala. The study illustrated the prominent role of Chlamydiaceae in renal disease and disease of the uterus, uterine tube and ovarian bursa, with implications for pathogenesis and therapy. In addition, macrophages appeared to be a potential site of latent persistence from which systemic spread of infection might occur.

Animal Diseases↗
PubMed2006

Endocrine disrupters and female reproductive health.

There is growing evidence of the impact of estrogenic contaminants in the environment. Studies have shown that male fish in detergent-contaminated water express female characteristics, turtles are sex-reversed by polychlorinated biphenyls (PCBs), male frogs exposed to a common herbicide form multiple ovaries, pseudohermaphroditic offspring are produced by polar bears, and seals in contaminated water have an excess of uterine fibroids. Endocrine-disrupting chemicals (those found in the external environment that can mimic or inhibit endogenous hormones) mostly exhibit estrogenic effects, but a few are anti-estrogenic or anti-androgenic. Many of these compounds are industrial contaminants, such as pesticides and plasticizers, and others are natural phytoestrogens found in plants such as soy and in herbal supplements. Recent work shows that human development can also be feminized by exposure to estrogenic chemicals. Estrogen is the key hormone in the initiation (puberty) and the end (menopause) of reproductive life in women and thus of considerable importance in women's health. The same chemicals that affect wildlife may affect breast growth and lactation, and could have a role in uterine diseases such as fibroids and endometriosis. New studies provide a mechanism of action for estrogenic chemicals and other endocrine disrupters at the molecular level (called epigenetics) that may help explain the long-term effects of endocrine disruption.

Animals↗
PubMed1990

[Contraception and risk factors for the development of diseases of the uterine cervix].

In a group of 350 women operated on account of diseases of the uterine cervix in 1986-1988 risk factors associated with cancerogenesis were evaluated. The author provided evidence of a significant rise of CIN in conjunction with contraception. The rise of number of CIN cannot be differentiated from social factors and sexual behaviour of women which are directly related to the increased risk of cancer of the uterine cervix.

Contraceptives, Oral, Hormonal↗
PubMed2006

Abdominal vs vaginal hysterectomy: a comparative study of the postoperative quality of life and satisfaction.

OBJECTIVE: To compare the short-term results of the quality of life and satisfaction of patients submitted to total abdominal hysterectomy (TAH) and vaginal hysterectomy (VH) for benign uterine disease. METHODS: Women referred for hysterectomy for uterine myoma were randomized to TAH (n=30) or VH (n=30). The exclusion criteria were uterine prolapse, indication associated surgical procedures and uterine size > or =300 cm3. After a month, follow-up questionnaires had a response rate of 100%, and consisted of an interview with application of SF-36 questionnaire (functional capacity, physical aspect and pain) and evaluation of satisfaction rate. RESULTS: There were no differences in the patients' mean age, parity, body mass index, preoperative hemoglobin levels and uterine size between groups. Lower postoperative quality-of-life scores were found in the TAH group when compared to the VH group in functional capacity (P=0.002), physical aspect (P=0.008) and pain (P=0.002). The general satisfaction rate with the surgery was similar in the two groups of patients (P=0.147). However, a higher rate of patients submitted to VH would choose the same therapeutic modality (65.5 vs 90%; P=0.021). CONCLUSIONS: A better postoperative quality of life (functional capacity, physical aspect and pain) and higher satisfaction rate was found in the VH when compared to TAH.

Adult↗
PubMed2005

[Factors considered to choose type of a hysterectomy for benign uterus lesions (excluding prolapsus and obstetrical indications)].

OBJECTIVES: We searched for the factors determining the type of hysterectomy (vaginal, laparoscopy or laparotomy) performed in women with supposedly benign uterine disease. MATERIAL AND METHOD: We conducted a retrospective study of 101 consecutive hysterectomies performed on voluminous uteruses, prolapsus and obstetrical indications excluded. The following factors likely to have influenced the decisions were examined: patient age, nulliparity, menopausal status, history of laparotomy, uterus weight, narrow vagina, nature of uterus lesions, associated unilateral or bilateral annexectomy, complications. RESULTS: The frequencies were: vaginal route 58.4% (average uterine weight 249.4 g, range 93-1149 g), laparoscopic preparation 37.6% (average uterine weight 348 g, range 92-818 g), and laparotomy 4% (average uterine weight 586.2 g, range 112-1216 g). Factors determining type of hysterectomy were uterine weight (and therefore volume) (p < 0.05), nulliparity (p < 0.04), narrow vagina probed by compulsory Schuchardt incision (p < 0.02), associated annexectomy (p < 0.01). No other factors were significantly determinant. The vaginal route appears to be highly preferred. CONCLUSION: Vaginal hysterectomy is clearly the most preferred and practiced. Laparoscopy may be helpful for vaginal hysterectomy and laparotomy is exceptional.

Age Factors↗
PubMed1999

100 total laparoscopic hysterectomies in private practice in Brazil.

STUDY OBJECTIVE: To evaluate of 100 total laparoscopic hysterectomies performed in a private practice. DESIGN: Prospective observational study (Canadian Task Force classification II-2). SETTING: Private hospital. PATIENTS: One hundred women. INTERVENTIONS: Total laparoscopic hysterectomy (TLH). MEASUREMENTS AND MAIN RESULTS: The most common indications for TLH were chronic menorrhagia (uterine myomas), pelvic pain (severe endometriosis), and uterine enlargement. Four of our first 20 procedures were converted to laparotomy in which bipolar was used exclusively. In the others cases the Endo Gia stapler was used in the first step of the procedure (section of broad ligaments) in combination with bipolar coagulation. Mean operating time was 90 minutes (range 45-150 min) and hospital stay was 36 hours (range 18 hrs-2 days). The two intraoperative complications were hemorrhage requiring blood transfusion and a rectal injury; the four postoperative complications were two cases of vesicovaginal fistula, and one each of colonic vaginal fistula and vaginal cuff infection (total complication rate 5%). Ninety-six women returned to work in 2 weeks. CONCLUSION: Total laparoscopic hysterectomy can be performed safely and effectively when the surgical team is sufficiently trained and experienced in managing complications. We believe that it will become standard treatment for benign uterine disease. (J Am Assoc Gynecol Laparosc 6(2):169-171, 1999)

Adult↗
PubMed2004

Malignant mixed Müllerian tumors of the uterus: analysis of patterns of failure, prognostic factors, and treatment outcome.

PURPOSE: To determine the survival outcomes, prognostic factors, and patterns of failure in patients with malignant mixed Müllerian tumor (MMMT) of the uterus. METHODS AND MATERIALS: Between 1954 and 1998, 300 patients with clinical Stage I-III MMMT of the uterus were treated with curative intent at The University of Texas M. D. Anderson Cancer Center. Their hospital records were reviewed to obtain patient and tumor characteristics; details of surgery, radiotherapy (RT), and chemotherapy; and long-term outcome. Surviving patients were followed for a median of 109 months (range 15-138). Survival rates were calculated using the Kaplan-Meier method, with differences assessed by log-rank tests. RESULTS: Of the 300 patients, 113 (38%) were treated with surgery alone, 160 (53%) with surgery plus adjuvant EBRT or ICRT, and 27 (9%) with RT alone. Forty-eight patients received adjuvant chemotherapy. At 5 years, the overall rates of survival and cause-specific survival were 31% and 33%, respectively. Women who were postmenopausal or had a history of prior pelvic RT, pain at presentation, clinical Stage II-III disease, uterine enlargement (>/=12 weeks), or an abnormal Papanicolaou smear finding had a significantly poorer prognosis than the other patients in the series. Of the 273 patients who underwent surgery, those who had positive abdominal washings, uterine length >10 cm, or extrauterine spread of disease to the cervix, adnexa, or peritoneum had a significantly worse prognosis than the other patients. Factors found on multivariate analysis to have an independent adverse influence on cause-specific survival included postmenopausal status (p = 0.0007, relative risk [RR] 3.3), uterine length >10 cm (p = 0.0001, RR 2.2), cervical involvement (p = 0.002, RR 1.8), and peritoneal involvement (p = 0.0001, RR 4.3). At 5 years, the rates of pelvic and distant disease recurrence for the entire group of 300 patients were 38% and 57%, respectively. The most common site of distant recurrence was the peritoneal cavity. Patients treated with pelvic RT had a lower rate of pelvic recurrence than patients treated with surgery alone (28% vs. 48%, p = 0.0002), but the overall survival rates (36% vs. 27%, p = 0.10) and distant metastasis rates (57% vs. 54%, p = 0.96) were not significantly different. However, patients treated with pelvic RT had a longer mean time to any distant relapse (17.3 vs. 7.0 months, p = 0.001) than patients treated with surgery alone. The use of adjuvant chemotherapy did not correlate with the survival rate or rate of distant metastasis. CONCLUSION: Adjuvant pelvic RT decreased the risk of pelvic recurrence and may delay the appearance of distant metastases after hysterectomy for MMMT. However, the survival rates remain poor because of a high rate of distant recurrence. As more effective systemic chemotherapy is developed to control microscopic distant disease, the role of RT in controlling locoregional disease in the pelvis and abdomen may become more important. Future research should consider programs that integrate surgery, RT, and chemotherapy to maximize the probability of cure.

Adult↗