scholarly journals Isthmocele, an underecognised cause of secondary infertility and pregnancy outcome after endoscopic repair: a case report

2021 ◽  
Vol 10 (4) ◽  
pp. 1717
Author(s):  
Aradhana K. Dawar ◽  
Akshay K. Nadkarni ◽  
Tuleeka Sethi
Keyword(s):  
Surgical Techniques ◽  
Invasive Procedure ◽  
Minimally Invasive Procedure ◽  
Endoscopic Repair ◽  
Secondary Infertility ◽  
Tissue Healing ◽  
Abnormal Bleeding ◽  
Niche Formation ◽  
Previous Cesarean ◽  
Myometrial Thickness

Isthmocele is a niche at the area of previous cesarean scar. 38 year old lady presented with secondary infertility and decreased ovarian reserve for IVF with previous caesarean 8 years back. Isthmocele confirmed on 3D USG. Hysteroscopic guided laparoscopic repair done after initial failed ET without surgery. Postsurgical observations were increased myometrial thickness, improvement of abnormal bleeding, pain and successful conception and delivery with frozen embryo transfer. Isthmocele is an iatrogenic pathology associated with obstetric and gynecological complications. It’s an under recognised cause of secondary infertility. Etiology could be poor tissue healing or surgical techniques favouring niche formation. It’s imperative to address to its causes during caesarean section to prevent it. Diagnosis is mostly missed. Given the absence of a clearly defined surgical method in literature, choosing the proper approach to treating isthmocele can be arduous. Laparoscopy provides a minimally invasive procedure in women with this defect with secondary infertility and improves the chances of conception.

scholarly journals Pregnancy outcomes after hysteroscopic surgery in women with cesarean scar syndrome

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243421
Author(s):  
Shunichiro Tsuji ◽  
Akimasa Takahashi ◽  
Asuka Higuchi ◽  
Akiyoshi Yamanaka ◽  
Tsukuru Amano ◽  
...  
Keyword(s):  
Abnormal Uterine Bleeding ◽  
Subsequent Pregnancy ◽  
Cesarean Sections ◽  
Secondary Infertility ◽  
Average Birth Weight ◽  
Cesarean Scar ◽  
Hysteroscopic Surgery ◽  
Key Factor ◽  
Previous Cesarean ◽  
Myometrial Thickness

Cesarean scar defect often causes postmenstrual abnormal uterine bleeding, dysmenorrhea, chronic pelvic pain, and infertility, which are collectively known as cesarean scar syndrome (CSS). Several studies have reported that hysteroscopic surgery can restore fertility in women with CSS. The study aimed to identify factors that influence subsequent pregnancy following hysteroscopic surgery. Therefore, we studied 38 women with secondary infertility due to CSS who underwent hysteroscopic surgery at Shiga University of Medical Hospital between July 2014 and July 2019. Our hysteroscopic procedure included inferior edge resection and superficial cauterization of the cesarean scar defect under laparoscopic guidance. Patients were followed up for 3 to 40 months after surgery. Surgery was successful in all cases and no complications were observed. Twenty-seven patients (71%) became pregnant (pregnant group), while 11 (29%) did not (non-pregnant group). Baseline characteristics of age, body mass index, gravidity, parity, previous cesarean section, presence of endometriosis, retroflex uterus, and preoperative residual myometrial thickness were not significantly different between the groups. However, the median residual myometrium thickness was significantly higher after surgery than before surgery in the pregnant group (1.9 [1.1–3.6] vs 4.9 [3.4–6.6] mm, P<0.0001), whereas this difference was not significant in the non-pregnant group. Of those who became pregnant, 85% conceived within 2 years of surgery. Although three pregnancies resulted in abortion and one is ongoing at the time of writing, 23 pregnancies resulted in healthy babies at 35–38 gestational weeks by scheduled cesarean sections with no obstetrical complications due to hysteroscopic surgery. The average birth weight was 3,076 g. Our findings support that hysteroscopic surgery is a safe and effective treatment for secondary infertility due to CSS. The thickness of the residual myometrium may be a key factor that influences subsequent pregnancy in women with CSS.

scholarly journals Definite Ocular Sarcoidosis Using Endobronchial Ultrasonography with Transbronchial Needle Aspiration

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sukhuma Warrasak ◽  
Sawang Saenghirunvattana ◽  
Ataya Euswas ◽  
Santa Methasiri ◽  
Surapon Worapongpaiboon ◽  
...  
Keyword(s):  
Invasive Procedure ◽  
Pulmonary Involvement ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Alternative Procedure ◽  
Minimally Invasive Procedure ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration ◽  
Ocular Sarcoidosis ◽  
Endobronchial Ultrasonography

Purpose. To introduce a minimally invasive procedure, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), to obtain a pathologic evidence of a definite ocular sarcoidosis in a patient who initially presented with presumed ocular sarcoidosis with pulmonary involvement.Methods. An EBUS-TBNA procedure was performed at perihilar lymph nodes, subcarina, and right paratrachea of the patient and specimen obtained was sent for histocytopathological studies.Result. Histocytopathological findings revealed aggregates of epithelioid histiocytes forming a noncaseous granuloma, a hallmark of sarcoidosis.Conclusion. EBUS-TBNA should be considered an alternative procedure to provide cytohistopathology proven diagnosis of definite ocular sarcoidosis.

S34 TENSION-FREE VAGINAL TAPE: ONE OF THE MINIMALLY INVASIVE PROCEDURE IN SUI

2010 ◽  
Vol 9 (6) ◽  
pp. 567
Author(s):  
X. Quni ◽  
I. Haxhiu ◽  
H. Aliu ◽  
N. Baftiu ◽  
M. Toska ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Invasive Procedure ◽  
Minimally Invasive Procedure ◽  
Tension Free ◽  
Tension Free Vaginal Tape

scholarly journals Common operation, uncommon complication. Bleeding from superior haemorrhoidal artery after minimally invasive procedure for hemorrhoids – a case report

2019 ◽  
Vol 39 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Janavikula Sankaran Rajkumar ◽  
Aluru Jayakrishna Reddy ◽  
Ravikumar Radhakrishnan ◽  
Anirudh Rajkumar ◽  
Syed Akbar ◽  
...  
Keyword(s):  
Case Report ◽  
Minimally Invasive ◽  
Invasive Procedure ◽  
Minimally Invasive Procedure ◽  
Common Operation ◽  
Uncommon Complication

scholarly journals Hysteroscopic evaluation in infertility and abnormal uterine bleeding

2018 ◽  
Vol 7 (2) ◽  
pp. 612
Author(s):  
Navneet Kaur ◽  
Ruby Bhatia ◽  
Paramjit Kaur ◽  
Surinder K. Bhopal
Keyword(s):  
Endometrial Hyperplasia ◽  
Uterine Cavity ◽  
Invasive Procedure ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Therapeutic Modality ◽  
Secondary Infertility ◽  
Endometrial Polyps ◽  
Submucous Fibroid

Background: Hysteroscopy an endoscopic procedure for visualization of uterine cavity may be extensively used in both primary and secondary infertility and abnormal uterine bleeding for evaluating intrauterine pathology. The objectives of this study were to visualize and identity intrauterine pathology in both primary and secondary infertility and abnormal uterine bleeding (AUB) by hysteroscopic evaluation and to perform hysteroscopic guided therapeutic procedures like endometrial currettage, polypectomy, adhesiolysis.Methods: Hysteroscopic evaluation of uterine cavity for any intrauterine pathology in AUB and Infertility. Adhesiolysis, polypectomy, endometrial biopsy misplaced copper T removal were carried out under hysteroscopic vision.Results: Intrauterine synechia in 20.51%, Submucous fibroid in 5.13%, bicornuate uterus, endometrial hyperplasia and endometrial polyp were seen in 2.56% patient each were detected in infertility group while 81.95% cases with AUB had abnormal intrauterine pathology commonest being endometrial hyperplasia in 33.33% followed by endometrial polyps in 23.81% cases, submucous fibroid and misplaced copper T in 9.52% each and intrauterine synechia in 4.76% patient. Endometrial biopsy and polypectomy was done in 23.80% each with AUB, misplaced copper T removal in 9.52% and adhesiolysis in 4.76% patient with AUB.Conclusions: Hysteroscopy remains gold standard for evaluating intrauterine lesions in abnormal uterine bleeding and infertility. A safe, simple minimally invasive procedure not only diagnostic but therapeutic modality for adhesiolysis, endometrial biopsy/curettage, polypectomy, misplaced copper T removal under direct vision with minimal complication within reach of every Gynaecologist thereby reducing burden of major surgical intervention.

scholarly journals EMBOLIZATION OF RENAL ANGIOMYOLIPOMA: CASE SERIES

2015 ◽  
Vol 1 (2) ◽  
Author(s):  
Ghania Masood ◽  
Iffat Rehman ◽  
Saquib Khawar ◽  
Khurram A Mufti ◽  
Imran K. Niazi
Keyword(s):  
Minimally Invasive ◽  
Key Words ◽  
Case Series ◽  
Invasive Procedure ◽  
Standard Of Care ◽  
Renal Angiomyolipoma ◽  
Minimally Invasive Procedure ◽  
Benign Lesions ◽  
Current Standard ◽  
Spontaneous Haemorrhage

Renal angiomyolipomas (AML) are benign lesions usually left alone. However, lesions larger than 4 cm carry the risk of spontaneous haemorrhage and need treatment. Angiography and embolisation are the current standard of care particularly in patients with high operative risks. Angio-embolisation is a safe, minimally invasive procedure preserving maximum renal parenchyma, with the added advantage of preventing peri-procedural morbidity. Two cases of AML are presented in this case series. Key words: Angiomyolipoma, embolisation, renal 

Sign in / Sign up

Export Citation Format

Share Document