Mohamed Siraj Shahulhameed, Bernard Su Min Chern, Ann M Wright
{"title":"Role of Hysteroscopy in the Management of Uterine Vascular Malformations with a Focus on Enhanced Myometrial Vascularity - A Review of Diagnosis and Treatment with the Suggested Algorithm.","authors":"Mohamed Siraj Shahulhameed, Bernard Su Min Chern, Ann M Wright","doi":"10.4103/gmit.gmit_29_24","DOIUrl":"10.4103/gmit.gmit_29_24","url":null,"abstract":"<p><p>Postpregnancy bleeding is common after failed pregnancy, termination of pregnancy, and postnatally after both vaginal and cesarean delivery. Pelvic ultrasound (US) is usually the initial imaging modality of choice to ascertain the cause when the bleeding is heavy or prolonged. When used in combination with Doppler studies, US can help differentiate retained products of conception (RPOC) from rarer uterine vascular malformations (UVM), including true arterial vascular malformations and areas of enhanced endometrial vascularity (EMV), which may themselves be associated with any RPOC present. While the management of RPOC is well established and has evolved from an almost universal surgical approach to increasingly more medical or expectant alternatives, clinical decisions over the management of a concurrent UVM are less clear and treatment options need to be individualized depending on features of the lesion and the clinical situation with hysteroscopy featured as an important modality, especially when dealing with EMV's. In this review, we discuss the role of hysteroscopy in the treatment of enhanced myometrial vascularity with and without associated RPOC and propose a management algorithm.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"13 4","pages":"209-214"},"PeriodicalIF":1.4,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laparoscopic Posterior Pelvic Exenteration with Radical Vulvectomy for Intestinal-type Vulvar Adenocarcinoma.","authors":"Takashi Natsume, Mayumi Kobayashi-Kato, Yasuhito Tanase, Masaya Uno, Hiroshi Yoshida, Konosuke Moritani, Yukihide Kanemitsu, Mitsuya Ishikawa","doi":"10.4103/gmit.gmit_103_23","DOIUrl":"10.4103/gmit.gmit_103_23","url":null,"abstract":"<p><p>Vulvar intestinal adenocarcinoma is a rare malignancy. The most significant predictor of advanced vulvar cancer is achieving complete resection, although determining the optimal treatment for this rare histologic type remains uncertain. We report the case of a 63-year-old woman with a primary vulvar tumor suspected of having rectal invasion and inguinal lymph node metastases based on preoperative magnetic resonance imaging and computed tomography scans. To achieve complete resection of stage IIIC intestinal-type vulvar adenocarcinoma, we performed a laparoscopic posterior pelvic exenteration (PPE) and radical vulvectomy, along with bilateral inguinal lymph node dissection. This case report highlights the use of a novel hybrid procedure that combines laparoscopic PPE with radical vulvectomy and bilateral inguinal lymph node dissection for vulvar adenocarcinoma of the intestinal type. Laparoscopic PPE can be considered a minimally invasive approach for vulvar tumor when complete resection is achievable with an appropriate safety margin.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"13 2","pages":"126-129"},"PeriodicalIF":1.4,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jhanice Paredes, Kuan-Gen Huang, Chyi-Long Lee, Gillian Patrick Gonzalez, Mary Evangeline Mercado, Zin Mar Lay
{"title":"A Novel Technique of Laparoscopic Transabdominal Cerclage after a Mersilene Tape Erosion in a Prior Laparoscopic Radical Trachelectomy and Transvaginal Cerclage Patient.","authors":"Jhanice Paredes, Kuan-Gen Huang, Chyi-Long Lee, Gillian Patrick Gonzalez, Mary Evangeline Mercado, Zin Mar Lay","doi":"10.4103/gmit.gmit_108_23","DOIUrl":"10.4103/gmit.gmit_108_23","url":null,"abstract":"<p><p>A case of a 32-year-old patient who presented with vaginal bleeding 2 years after undergoing laparoscopic radical trachelectomy and vaginal cerclage was noted to have Mersilene tape erosion. Subsequent management includes the removal of displaced Mersilene tape and a repeat cerclage through a new technique of laparoscopic abdominal cerclage to avoid repeat tape erosion. The novel technique of laparoscopic abdominal cerclage to lower the incidence of preterm delivery among pregnant patients who underwent laparoscopic radical trachelectomy for early-stage cervical cancer is described.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"13 2","pages":"123-125"},"PeriodicalIF":1.4,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Era of 4K Three-dimensional Imaging is Coming.","authors":"Mary Evangeline Villa Mercado, Chyi-Long Lee","doi":"10.4103/GMIT.GMIT_4_24","DOIUrl":"10.4103/GMIT.GMIT_4_24","url":null,"abstract":"","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"13 2","pages":"69-70"},"PeriodicalIF":1.4,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hwa Sook Moon, Bo Sun Joo, Sang Gap Kim, Kyung Il Nam, Ja Seong Koo
{"title":"Where Microsurgical Tubal Reanastomosis Stands in the <i>In vitro</i> Fertilization Era.","authors":"Hwa Sook Moon, Bo Sun Joo, Sang Gap Kim, Kyung Il Nam, Ja Seong Koo","doi":"10.4103/gmit.gmit_43_23","DOIUrl":"10.4103/gmit.gmit_43_23","url":null,"abstract":"<p><p>Among various options of contraception, bilateral tubal ligation (BTL) remains the most frequently used method for women worldwide even at present. However, up to 30% of those who undergo BTL eventually change their minds and wish to conceive again for a variety of reasons, such as a change in marital status or simply wanting more children. In this case, we can either approach it surgically with tubal re-anastomosis (TA) or by <i>in vitro</i> fertilization (IVF)-embryo transfer. Despite the many advantages of TA which lead the American Society of Reproductive Medicine Committee Opinion to recommend it as the primary choice of treatment in posttubal ligation infertility in 2012, IVF is widely being chosen as the first-line treatment nowadays. This study will review the efficacy of TA in various aspects, including pregnancy rate, cost-effectiveness, feasibility, and accessibility, based on review of the literature and our experience. Through this study, we intend to provide a basis for gynecologists to consider TA as the first option in women who wish to conceive again after BTL in this day and age of IVF.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"13 2","pages":"71-78"},"PeriodicalIF":1.4,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comment on \"Evaluation of the success of hysteroscopic uterine septum resection\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.4103/gmit.gmit_134_23","DOIUrl":"10.4103/gmit.gmit_134_23","url":null,"abstract":"","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"13 2","pages":"134"},"PeriodicalIF":1.4,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laparoscopic Excision of Cesarean Scar Ectopic Pregnancy: An Optimum Management Option.","authors":"Kavita Khoiwal, Deepika Sheoran, Ramya Mishra, Akanksha Deshwali, Jaya Chaturvedi","doi":"10.4103/gmit.gmit_83_23","DOIUrl":"10.4103/gmit.gmit_83_23","url":null,"abstract":"<p><p>Cesarean scar ectopic pregnancy is a leading cause of life-threatening complications in the first trimester. It poses a diagnostic and management challenge; if not diagnosed and adequately treated in early pregnancy, it may lead to considerable maternal morbidity and mortality. We report a case series of cesarean scar ectopic pregnancies managed successfully by laparoscopy. Laparoscopic excision is the gold standard management approach for cesarean scar ectopic pregnancy.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"13 2","pages":"119-122"},"PeriodicalIF":1.4,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hysteroscopic Uterine Septum Resection: Is it a Successful Treatment for Infertile Patients?","authors":"Sule Atalay Mert","doi":"10.4103/gmit.gmit_143_23","DOIUrl":"10.4103/gmit.gmit_143_23","url":null,"abstract":"","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"13 2","pages":"135-136"},"PeriodicalIF":1.4,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hiroyuki Yazawa, Riho Yazawa, Ryo Matsuoka, Miki Ohara
{"title":"Surgical Outcomes and Trends in Incidence of Ectopic Pregnancy.","authors":"Hiroyuki Yazawa, Riho Yazawa, Ryo Matsuoka, Miki Ohara","doi":"10.4103/gmit.gmit_53_23","DOIUrl":"10.4103/gmit.gmit_53_23","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to evaluate the surgical results for ectopic pregnancy (EP) treated at Fukushima Red Cross Hospital for over a 20-year period from 2002 to 2021.</p><p><strong>Materials and methods: </strong>We evaluated the incidence, surgical procedures, site of implantation, amount of hemoperitoneum, and the proportion of cases with risk factors of EP.</p><p><strong>Results: </strong>Two hundred and fifty-nine cases of EP were treated surgically. The incidence of EP seemed to be gradually decreasing in recent years. By pregnancy site, 235 (90.7%) of EPs were tubal pregnancies (TPs), 13 in interstitial pregnancies (IPs), 7 in ovarian pregnancies, and 4 in peritoneal pregnancies. For IPs, human chorionic gonadotropin (hCG) levels were statistically higher than with TP and intraperitoneal bleeding was less than with other EP sites. Thirty-nine patients (15.0%) were with massive hemoperitoneum (>500 mL), and laparoscopic surgery was performed in all patients with massive hemoperitoneum except in two patients. The proportion of cases with risk factors for EP such as <i>Chlamydia trachomatis</i> infection or history of smoking was 5.4% and 40.6%, respectively. Epidemiological research shows that the number of patients with chlamydia infection, rates of smokers, or the occurrence of EP with assisted reproductive technology has been decreasing in recent years in Japan.</p><p><strong>Conclusion: </strong>Appropriate surgical intervention should be selected while considering such as facility capabilities, context, and surgeon skill, especially in critical cases, such as cases involving massive hemoperitoneum and hemorrhagic shock. The recent presumed decrease in the occurrence of EP may partly be associated with the decrease in the occurrence of risk factors.</p>","PeriodicalId":45272,"journal":{"name":"Gynecology and Minimally Invasive Therapy-GMIT","volume":"13 2","pages":"111-118"},"PeriodicalIF":1.4,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}