Laparoscopic combined with hysteroscopic repair or operative hysteroscopy in the treatment of symptomatic cesarean-induced diverticulum

Objective: The postmenstrual bleeding with cesarean-induced diverticulum is a bothersome symptom and can be confused with other abnormal-uterine bleeding disease. The aim of the present study was to evaluate the efficacy and safety of laparoscopic combined with hysteroscopic repair vs operative hysteroscopy in treatment of symptomatic cesarean-induced diverticulum. Methods: Eighty-two women with cesarean-induced diverticulum who underwent either laparoscopic combined with hysteroscopic repair or operative hysteroscopy between January 2012 and September 2015 were retrospectively included in the study. We evaluated the menstrual duration before and after the surgery, the width, length and depth of the niche, operating time, blood loss, complications, and postoperative pregnancy status. Results: 62.2% (51/82) patients started to have postmenstrual bleeding immediately when they gained regular menstruation after their cesarean section. The laparoscopic group has longer operative time and greater blood loss (p<0.001). Both groups have a significant improvement in their menstruation duration ( p< 0.001). The patients in the laparoscopic repair group had a greater improvement in bringing the uterine bleeding into normal menstruation duration (P=0.046) and the same in pregnancy rate (P=0.505). The interval between operation and pregnancy in laparoscopic combined with hysteroscopic group was much longer than the hysteroscopic group (27 vs 10 months, p<0.001). Conclusion: the laparoscopic repair exhibited a better efficiency in bringing the uterine bleeding into normal menstruation duration and in improving the pregnancy rate However, there was not a clear absolute advantage for one of the two type of surgeries. Thus, patients with post-cesarean section diverticulum (PCSD) should choose with caution the type of surgery, considering the residual myometrial thickness (RMT), the age, the desire for further fertility and ovarian reserve capacity.

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Transvaginal ultrasonography sonohysterography and operative hysteroscopy for the evaluation of abnormal uterine bleeding

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1080/j.1600-0412.2001.800706.x ◽

2001 ◽

Vol 80 (7) ◽

pp. 616-622 ◽

Cited By ~ 33

Author(s):

Elisabeth Krampl ◽

Tom Bourne ◽

Heidi Hurlen-Solbakken ◽

Olav Istre

Keyword(s):

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Transvaginal Ultrasonography ◽

Operative Hysteroscopy

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Effects of operative hysteroscopy with anti-adhesive solution in the patients who have abnormal uterine bleeding or intrauterine lesions

Open Journal of Obstetrics and Gynecology ◽

10.4236/ojog.2013.33060 ◽

2013 ◽

Vol 03 (03) ◽

pp. 327-330

Author(s):

Tae-Hee Kim ◽

Hae-Hyeog Lee ◽

Soo-Ho Chung ◽

Junsik Park

Keyword(s):

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Operative Hysteroscopy

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Comparative Study of Desogestrel- Containing Oral Contraceptive and Levonorgestrel- Containing Oral Contraceptive in Dysfunctional Uterine Bleeding

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i4.3210 ◽

2020 ◽

Vol 11 (4) ◽

pp. 5678-5684

Author(s):

Swathi Suresh ◽

Mariya Els Johny ◽

Kiruba Shankari ◽

Ahamed Irshath U ◽

Yokesh M ◽

...

Keyword(s):

Weight Gain ◽

Oral Contraceptive ◽

Side Effects ◽

Menstrual Cycle ◽

Blood Loss ◽

Ethinyl Estradiol ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Dysfunctional Uterine Bleeding ◽

Group D

Dysfunctional uterine bleeding is a type of abnormal uterine bleeding where vaginal bleeding occurs outside of the menstrual cycle in the absence of any known pelvic pathology. Dysfunctional uterine bleeding can be treated safely with hormone therapy. Combined oral contraceptives help in increased menstrual cycle regularity and decreased blood loss. In this study, a reliable drug for the dysfunctional uterine bleeding with maximum effectiveness and minimal side effects were assessed. This study was conducted on 120 cases of dysfunctional uterine bleeding. Patients who were diagnosed with dysfunctional uterine bleeding were randomly assigned into two groups. Group D and group L included patients who were given Ethinyl estradiol 0.02mg + desogestrel 0.15mg and Ethinyl estradiol 0.03mg + levonorgestrel 0.15mg respectively for the four consecutive 28- day cycles. Menstrual blood loss was assessed using the pictorial blood assessment chart (PBAC) score on 2nd and 4th months of recruitment. Side effects such as weight gain, acne and headache were assessed in both groups. This study shows 56.68% reduction in mean PBAC score in 2 months in desogestrel group whereas only 44.96% reduction in levonorgestrel group and 79.87% reduction in mean PBAC score in desogestrel group in 4 months whereas only 74.46% reduction in levonorgestrel group. Side effects like weight gain, acne and headache were more prominent in the levonorgestrel group than desogestrel group. Desogestrel containing combined oral contraceptive can be a useful and safe treatment for dysfunctional uterine bleeding.

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A Literary Review of AsrigdarainAyurvedw.s.r. to Menometrorrhagia

International Research Journal of Ayurveda & Yoga ◽

10.47223/irjay.2021.41115 ◽

2021 ◽

Vol 04 (11) ◽

pp. 97-99

Author(s):

Sonu Kumari ◽

Mahesh Dixit ◽

Narendra Kumar Meena

Keyword(s):

Menstrual Cycle ◽

Blood Loss ◽

Abnormal Uterine Bleeding ◽

Causative Factor ◽

Uterine Bleeding ◽

Massive Blood Loss ◽

Result Management

In PrasutitantraOPD, Menometrorrhagia is the most common gynaecological illness. It is a symptom that can be detected in the majority of gynecological issues. The irregular, massive blood loss per vaginum is a symptom of abnormal uterine bleeding. Bleeding in excess of regular amounts and for a longer period of time during the menstrual cycle. Abnormal uterine bleeding is known as Asrigdara in Ayurvedic samhitas, which implies pradirana(extreme excretion) of raja (menses) per vaginum. The causative factor or Dosa In Asrigdarais Vayu, and the vitiated Dhatu Or Dusya is Rakta(blood), or blood is also vitiated. Because the qualities of rakta and pittaare so similar, vitiating Raktawould aggravate pitta as well. As a result, management should be centered on the usage of medications with Kashaya Rasa and Pittashamak Guna.Due to its Stambhanafeature, Kashaya rasais mostly used to treat bleeding symptoms.There is loss of Rakta Dhatu, so we use the drugs and diet that increases Rakta Dhatu.Management mainly based on the principle of Raktastambhakaand Raktavardhaka.

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Treatment of C-section diverticula with hysteroscopic resection in women without childbearing intention: a retrospective cohort study

10.21203/rs.2.14905/v1 ◽

2019 ◽

Author(s):

Hui Shi ◽

Jingyan He ◽

Yunhe Gao ◽

Shuang Qin ◽

Jiaying Fan ◽

...

Keyword(s):

Cohort Study ◽

Cesarean Section ◽

Pelvic Pain ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Chronic Pelvic Pain ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Timing Of Surgery ◽

Hysteroscopic Resection

Abstract Background: Diverticulum, one of the long-term squelae of cesarean section, can cause abnormal uterine bleeding, dysmenorrhea and chronic pelvic pain. Hysteroscopic resection of diverticula is thought to reduce abnormal uterine bleeding and chronic pelvic pain. In this study, we aim to describe the improvement after hysteroscopic resection of cesarean section diverticula hysteroscopic resection of cesarean section diverticula (CSD) in women without childbearing intention, and to explore the variables associated with poor prognosis.Methods: A retrospective cohort study of women aged 25-48 with CSD diagnosis by transvaginal ultrasonography (TVS) and hysteroscopy that were enrolled at Guangzhou Women and Children’s Medical Center between June 2017 and December 2018. A total of 124 women met the inclusion criteria and all patients had undergone hysteroscopic resection and accepted a follow-up interview at the 3rd and 6th months postoperatively to record symptom improvement.Result: The mean of intraoperative blood loss and operative time of hysteroscopic resection were (12.94±12.63) ml and (33.63±6.87) min in 124 patients. Overall observed improvement rates of CSD symptom were 47.2% and 65.6% in the first 3 and 6 months, respectively. Multivariable logistic regression models revealed that timing of surgery <14 days was a good prognostic factor associated with both 3-month improvement (OR, 16.59; 95% CI, 2.62-104.90; P=0.003) and 6-month improvement (OR, 15.51; 95%CI, 1.63-148.00; P=0.02); Patients with numbers of cesarean section(CS) ≥2 had a lower rate of improvement after 6 months of CSD repair surgery compared with patients who underwent one CS(OR, 8.29; 95%CI, 1.05-65.75; P=0.04).Conclusions: A hysteroscopic repair might be an appropriate method for CSD in women who no childbearing intentions. The timing of surgery and the number of CS seems to be factors influencing the postoperative improvement of CSD.

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Abnormal uterine bleeding: we diagnose and choose treatment

GYNECOLOGY ◽

10.26442/2079-5696_2018.4.4-8 ◽

2018 ◽

Vol 20 (4) ◽

pp. 4-8

Author(s):

G E Chernuha ◽

L M Ilina ◽

I A Ivanov

Keyword(s):

Quality Of Life ◽

Iron Deficiency ◽

Blood Loss ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Deficiency Anemia ◽

Estradiol Valerate ◽

Basic Principles ◽

International Data

Abnormal uterine bleeding (AUB) is one of the most common frequent reasons for contacting a gynecologist and conducting intrauterine interventions. AUB causes iron deficiency anemia and a decrease quality of life of women, which in turn is the reason of their social and clinical significance. Based on the analysis of literature and international data recommendations, the review outlines the basic principles of AUB diagnosis, non-hormonal and hormone therapy Advantages of continuous regimen for the administration of progestogens, in particular the LNG-IUS, and COCs containing estradiol valerate, to reduce menstrual flow blood loss are presented in the article. The need for a differentiated approach of choosing the therapy based on age, causes of bleeding, and balance benefits and risks of medicines.

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