scholarly journals Appendectomy and women’s reproductive outcomes: a review of the literature

2021 ◽  
Author(s):  
Lucia Merlino ◽  
Alessandra Chiné ◽  
Giulia Carletti ◽  
Federica Del Prete ◽  
Massimo Codacci Pisanelli ◽  
...  
Keyword(s):  
Large Population ◽  
Fluid Secretion ◽  
Reproductive Period ◽  
Pelvic Surgery ◽  
Tubal Infertility ◽  
Peritoneal Adhesions ◽  
Relevant Risk Factor ◽  
Perforated Appendix ◽  
Embryo Transport ◽  
Possible Cause

Summary Background The most frequent abdominal surgery performed for benign disease in females of fertile age is appendectomy, which remains among the most common surgeries and is a possible cause of peritoneal adhesions. The fact that appendectomy can cause adhesions may lead one to think that this may be a relevant risk factor for infertility; however, there is no universal agreement regarding the association between appendectomy and fertility. The aim of this review is to evaluate weather appendectomy may have a relevant impact on female fertility. Methods The search was conducted in PubMed and there was no limitation set on the date of publication. All studies regarding populations of female patients who had undergone appendectomy for inflamed appendix, perforated appendix, or negative appendix between childhood and the end of the reproductive period were included. Results Some authors believe that pelvic surgery can cause adhesions which can potentially lead to tubal infertility by causing tubal obstruction or by altering motility of fimbriae, tubal fluid secretion, and embryo transport. On the other hand, the most recent evidence reported that removal of the appendix seems to be associated with an increased pregnancy rate in large population studies. Conclusion Despite the existence of contrasting opinions concerning fertility after appendectomy, the most recent evidence suggests that appendectomy may actually lead to improved fertility and decreased time to pregnancy. Appendectomy seems to be correlated with improved fertility and higher pregnancy rates.

Analysis of efficiency of application of media with hyaluronic acid in cryoprotocols

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. 26-29
Author(s):  
Natalia V. Protopopova ◽  
Elena B. Druzhinina ◽  
Kseniia V. Krylova ◽  
Iuliia V. Mylnikova ◽  
Jan A. Dvoryanov ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Culture Medium ◽  
Genetic Diagnosis ◽  
World Health ◽  
Practical Significance ◽  
Pelvic Surgery ◽  
High Concentration ◽  
Tubal Infertility

According to the World Health Organization, about 2 million new couples experience infertility annually, and their number is growing. An effective way to overcome infertility is assisted reproductive technology (ART). Cryopreservation will rationally solve the issue of preservation and further use of embryos: to delay pregnancy for some time considering womans desire and to prevent ovarian hyperstimulation syndrome. Embryo freezing allows to reduce the rate of repeated ovarian stimulation and perform preimplantation genetic diagnosis. Over the past decades, various cryotransfer options have been proposed to increase ART treatment efficacy, including the use of a culture medium with a high concentration of hyaluronic acid, but there are conflicting data on the use of such a medium in ART programs. Aim. Evaluation of thawed embryo transfers efficacy using the hyaluronic acid-containing culture medium. To achieve the goal, the following tasks were set: to evaluate clinical and medical history data of patients with tubal infertility in cryoprotocols, to analyze the previous cycle of in vitro fertilization and embryological stage, to evaluate the effectiveness of the culture medium with a high content of hyaluronic acid. Materials and methods. A detailed description of the patient sample, inclusion and exclusion criteria, embryological stage, embryo grading, devitrified embryo transfer technique. The article includes 3 tables which present the groups general clinical characteristics, the embryological stage, the rate of pregnancy, depending on the cultivation day. Results. The authors established that in patients with a history of pelvic surgery and sexually transmitted infections, it is advisable to use the culture medium with a high content of hyaluronic acid to transfer the thawed embryo. It was shown that pregnancy rate is 1.5 times higher when transferring devitrified embryos on the 5th day of development with the use of hyaluronic acid-containing culture medium. The conclusion about the pregnancy rate in obese patients is not indisputable, which requires further study. The authors also provide practical recommendations on the use of the culture medium with hyaluronic acid in cryoprotocols. Conclusion. The study allows to optimize the devitrified embryo transfer in patients with tubal infertility using a culture medium with a high content of hyaluronan. This work has undoubted scientific and practical significance.

scholarly journals Spectrum of CT Findings Related to Bowel Adhesions Without Bowel Obstruction: A Comprehensive Imaging Review

2020 ◽  
Vol 10 ◽  
pp. 80
Author(s):  
Dheeraj Reddy Gopireddy ◽  
Erik Soule ◽  
Hina Arif-Tiwari ◽  
Smita Sharma ◽  
Devaraju Kanmaniraja ◽  
...  
Keyword(s):  
Bowel Obstruction ◽  
Surgical Planning ◽  
Early Recognition ◽  
The United States ◽  
Pelvic Surgery ◽  
Computed Tomography Imaging ◽  
Peritoneal Adhesions ◽  
Ct Findings ◽  
Pictorial Review ◽  
Malpractice Claims

Post-operative adhesions can occur following abdominal or pelvic surgery and are a significant cause of morbidity and mortality. Adhesions are an important cause of abdominal complaints, especially chronic abdominal pain, infertility, and bowel obstruction; responsible for an estimated $2.3 billion annual burden in the United States alone. There is a paucity of literature describing CT findings indicative of the presence of adhesions, however, findings suggestive of this entity may be discovered by a discerning eye. Early recognition and diagnosis may be beneficial for reducing consumption of health-care resources related to abdominal complaints. In addition, these findings may impact surgical planning and facilitate recognition of adhesion-related complications, said to be responsible for a significant number of malpractice claims. The following review discusses various CT findings which may indicate the presence of adhesions. These findings may initially be overlooked, but remain valuable as the clinical presentation evolves to become consistent with adhesive disease. Detection of bowel and peritoneal adhesions can be recognized on imaging modalities based on distortion of bowel loops. This pictorial review illustrates the spectrum of findings related to bowel adhesions encountered on computed tomography imaging.

scholarly journals African experience of hysterosalpingography abnormalities tubes management by laparoscopy in infertile women

2019 ◽  
Vol 8 (11) ◽  
pp. 4271
Author(s):  
Mohamed Fanny ◽  
Edele Aka ◽  
Perel Konan ◽  
Luc Olou ◽  
Abdoul K. Koffi ◽  
...  
Keyword(s):  
Pelvic Surgery ◽  
Fallopian Tubes ◽  
Tubal Infertility ◽  
Tubal Patency ◽  
Infertile Women ◽  
African Experience ◽  
Gynecology And Obstetrics ◽  
Therapeutic Procedures ◽  
History Of ◽  
Sub Saharan

Background: Infertility affects about 80 million people worldwide and one in ten couples. The objective of this study was to report our experience of the contribution of laparoscopy in the diagnostic and prognostic approach of fallopian tubes pathology in infertile women in sub-Saharan Africa.Methods: We conducted a retrospective study in the Gynecology and Obstetrics unit of Yopougon Teaching Hospital over a 2-year period (January 1, 2017 to December 31, 2018) which included 49 cases of tubo-peritoneal infertility diagnosed by hysterosalpingography (HSG) then laparoscopy procedure.Results: The average age was 33 years old.  30.6 % were single. 75% had secondary infertility. 59.2% had a medical history of abortion. Pelvic Inflammatory Disease and pelvic surgery accounted 84.2% and 49 respectively. Laparoscopy showed a predominance of distal tubal damage (66.6%) whose 47% hydrosalpinx. Bilateral tubal patency was demonstrated in 77.5% of our patients during laparoscopy procedure. We observed a sensitivity, a specificity, and a concordance laparoscopy / HSG of 63.6%, 80% 63.1% respectively. Laparoscopy also allowed therapeutic procedures such as adhesiolysis or tubal plasty in 22 patients (44.89% of our cases). At the end of laparoscopy procedure, 35 patients (71.42%) were turned towards IVF.Conclusions: Laparoscopy allows an assessment of tubal abnormalities revealed by hysterosalpingography and the fertility prognostic as well as better therapeutic approach in management of tubal infertility.

scholarly journals Dominant Factors Determining Differences of COVID-19 Fatalities Between India and Other Large-Population Regions

2020 ◽  
Author(s):  
Sudhakar Yarlagadda ◽  
Satyaki Kar
Keyword(s):  
European Union ◽  
Large Population ◽  
Herd Immunity ◽  
The Past ◽  
Hot Climate ◽  
Endemic Malaria ◽  
Time Required ◽  
Possible Cause ◽  
Past Summer ◽  
Death Count

We analyze the Covid-19 mortality scenario in India and compare it with those in other large-population regions such as Asia-excluding-China, Africa, European Union, South America, and USA. We compare existing fatality data and offer an interpretation for low fatality based on immunity due to endemic malaria and TB. We identify the hot climate in the past summer as a possible cause for low death count in southern-hemisphere countries without endemic malaria and TB. We also make India-specific observations for easing the lockdown and estimations for the time required to attain herd immunity. Whatever optimism we present should be viewed as a guarded optimism. There should not be room for complacency.

scholarly journals Noxythiolin as a possible cause of peritoneal adhesions.

BMJ ◽  
1977 ◽  
Vol 1 (6072) ◽  
pp. 1355-1355 ◽  
Author(s):  
M A Morris
Keyword(s):  
Peritoneal Adhesions ◽  
Possible Cause

scholarly journals Differentiated approach to the use of the modern surgical technologies in patients with tubal infertility

2013 ◽  
Vol 94 (6) ◽  
pp. 821-825
Author(s):  
N V Yakovleva
Keyword(s):  
Surgical Treatment ◽  
Distal Part ◽  
Reproductive Function ◽  
Pelvic Cavity ◽  
Surgical Trauma ◽  
Tubal Infertility ◽  
Peritoneal Adhesions ◽  
Surgical Interventions ◽  
Surgical Sterilization ◽  
Proximal Occlusion

Aim. To elaborate the differentiated approach to the surgical treatment of the patients with tubal and peritoneal infertility using the endoscopic and microsurgical methods and to evaluate its efficiency. Methods. 1840 female patients with infertility underwent complex clinical and laboratory examination, including endoscopy. 1257 patients underwent surgical treatment. Endo-video-surgical interventions were carried out in 1070 women, microsurgical techniques were applied in 187 patients. Results. The laparoscopic reconstructive plastic surgery was the most effective manipulation in patients with the disease of the distal part of the fallopian tubes and peritoneal adhesions. Treatment results were defined by the severity of distal part of the uterine tubes damage and severity of peritoneal adhesions in the pelvic cavity. The most favorable results of the treatment were noted after salpingo-ovariolysis (success rate 61.4%), by 2.3 times exceeding the pregnancy frequency after salpingoneostomy (26.9%; p 0.001) and by 1.6 times compared to fimbrioplasty (39.2%; p 0.001). In patients with proximal occlusion, results depended on the type of the tubular occlusion. In 69.7% patients with proximal occlusion due to synechiae, small polyps, foreign bodies, hysteroscopic interventions were an effective method of recanalization, allowing to restore the reproductive function in 40.2% patients. The microsurgical method demonstrated the 5.9 fold higher efficiency in patients with fibroid proximal occlusion of the uterine tubes compared to the laparoscopic methods (41.7% vs 7.1%). The microsurgical method was the most effective in patients with true fibrous proximal occlusion after the surgery on uterine tubes for tubular pregnancy and surgical sterilization. Conclusion. The differentiated approach to the surgical treatment of the patients with tubal infertility allowed to use the endo-video-surgical method in 85.1% of cases, improving the treatment’s results due to the decrease the surgical trauma and surgery duration, due to economic and cosmetic effect.

scholarly journals Prevention and treatment of peritoneal adhesions in patients affected by vascular diseases following surgery: a review of the literature

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 106-114 ◽  
Author(s):  
Aldo Rocca ◽  
Giovanni Aprea ◽  
Giuseppe Surfaro ◽  
Maurizio Amato ◽  
Antonio Giuliani ◽  
...  
Keyword(s):  
Adhesion Formation ◽  
Vascular Diseases ◽  
Standard Of Care ◽  
Pelvic Surgery ◽  
Current Evidence ◽  
Peritoneal Adhesions ◽  
Wide Range ◽  
Recovery Times ◽  
Peritoneal Adhesion Formation ◽  
Technological Improvements

AbstractIntra-abdominal adhesions are the most frequently occurring postoperative complication following abdomino-pelvic surgery. Abdominal and pelvic surgery can lead to peritoneal adhesion formation causing infertility, chronic pelvic pain, and intestinal obstruction. Laparoscopy today is considered the gold standard of care in the treatment of several abdominal pathologies as well as in a wide range of vascular diseases. Laparoscopy has several advantages in comparison to open surgery. These include rapid recovery times, shorter hospitalisation, reduced postoperative pain, as well as cosmetic benefits. The technological improvements in this particular surgical field along with the development of modern techniques and the acquisition of specific laparoscopic skills have allowed for its wider utilization in operations with fully intracorporeal anastomoses. Postoperative adhesions are caused by aberrant peritoneal healing and are the leading cause of postoperative bowel obstruction. The use of anti-adherence barriers is currently being advocated for their prevention. The outcome of the investigation showed adhesion formation inhibition without direct detrimental effects on anastomotic healing. Poor anasto-motic healing can provoke adhesions even in the presence of anti-adhesion barriers. This review gives a short overview on the current evidence on the pathophysiology and prevention of peritoneal adhesions.

scholarly journals Woman with surgical reconstruction of anal atresia who realized pregnancy with in vitro fertilisation

2010 ◽  
Vol 67 (3) ◽  
pp. 249-251
Author(s):  
Eliana Garalejic ◽  
Biljana Arsic ◽  
Dragana Bojovic-Jovic ◽  
Milija Veljkovic ◽  
Biljana Macanovic ◽  
...  
Keyword(s):  
Color Doppler ◽  
Reproductive Period ◽  
Surgical Reconstruction ◽  
In Vitro Fertilisation ◽  
Anal Atresia ◽  
Pelvic Anatomy ◽  
Tubal Infertility ◽  
Vitro Fertilization ◽  
Gynecology And Obstetrics

Introduction. Anal atresia is a congenital anomaly, very life threatening and urgent. Surgical treatment of this anomaly consists of colostomy first, and then of anal reconstruction. Case report. We presented a 31-year old female with the surgery treatment of anal atresia in the early childhood. In the reproductive period, due to tubal infertily, the patient was included in the program of in vitro fertilization (IVF), in the Clinic for Gynecology and Obstetrics 'Narodni front', Belgrade. Within this program a long protocol of ovarian stimulation was performed. Ultrasonographic and color Doppler monitoring of the patient was applied by the use of an ultrasonographic apparatus type Siemens Acuson X 150, while any hormonal examinations were performed by an Architect Abbott unit. During the IVF program, the growth of follicules was controlled by the use of ultrasonography, microcirculation of the ovaries and the uterus was marked by a power-pulsating color Doppler, and hormonal examination was performed starting from the day of stimulation up to the day of injecting Pregnyl?. The patient was administered Suprefact? (buserelin) sc from the 21st day of the menstrual cycle, as well as from the 3rd day of the cycle, for totally 11 days. The patient was given 29 ampoules of Gonal F? (recombinant human FSH) 75 IJ im and 15 ampoules of Menopur? (menotrophin) im. Due to a modified pelvic anatomy, the left ovary aspiration was disabled, while the right ovary aspired seven oocytes successfully. Three embryos were inserted in the uterus. The delivery was performed by cesarean section. Conclusion. In the reported patient with a modified pelvic anatomy due to four corrective surgeries of anal atresia, and tubal infertility in the reproductive period, the method of choice for the realization of pregnancy was the IVF procedure. The realized pregnancy and the delivery could be considered highly successful in regard to possible risks.

Ultrastructural Study of Rat Colon Following Psyllium Ingestion

1985 ◽  
Vol 43 ◽  
pp. 580-581
Author(s):  
F.G. Lightfoot ◽  
L.E. Grau ◽  
M.M. Cassidy ◽  
G.R. Tadvalkar ◽  
G.V. Vahouny
Keyword(s):  
Electron Microscopy ◽  
Morphological Changes ◽  
Large Population ◽  
Rat Colon ◽  
Gastrointestinal Disorders ◽  
Luminal Surface ◽  
Fecal Material ◽  
Transmission Electron ◽  
Morphologic Analysis ◽  
Irritable Bowel

Psyllium hydrophillic mucilloid is a natural gelling fiber consumed by a large population of our society. It is used as a bulk-producing laxative and in the treatment of gastrointestinal disorders such as “Irritable Bowel Syndrome”. The literature pertaining to the ultrastructural effects of this agent is sparse.This study documents morphological changes induced by psyllium. Animals fed a diet containing 2% psyllium for four weeks were subsequently sacrificed and processed for scanning and transmission electron microscopy. The colon contained fecal material combined with psyllium which conformed to the contour of the luminal surface. This mixture formed surface replicas of the intestinal mucosa. These replicas and their related colonic sites were processed for morphologic analysis.

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