scholarly journals Ultrasound assessment of the uterine wall after hysteroscopic myomectomy of submucous uterine fibroids

2020 ◽  
Vol 19 (4) ◽  
pp. 5-21
Author(s):  
I.А. Esipova ◽  
◽  
L.M. Kappusheva ◽  
V.G. Breusenko ◽  
D.M. Lyafisheva ◽  
...  
Keyword(s):  
Uterine Fibroid ◽  
Surgical Navigation ◽  
Uterine Fibroids ◽  
Intraoperative Ultrasound ◽  
Precise Determination ◽  
The State ◽  
Reproductive Age ◽  
New Technique ◽  
Hysteroscopic Myomectomy ◽  
A New Technique

Objective. To study the state of the myometrium and the endometrium after hysteroscopic myomectomy of uterine fibroid using 2D/3D transvaginal echography in patients of reproductive age. Patients and methods. We examined 90 patients of reproductive age with submucous uterine fibroid, who underwent 117 one-, two- or three-step hysteroscopic resections performed with a new technique of transcervical myomectomy. 3D transvaginal echography was performed in all patients with target assessment of the fibroid type and the intended resection site, and also with subsequent assessment of its changes. Results. A new technique of fibroid resection with rigid loops was elaborated. New options for noninvasive 3D-US in preoperative diagnosis of uterine fibroids have been determined. Owing to 3D-US, the state of the endometrium, myometrium at the «resection site» were studied for the first time. Indications for one-, two- and tree-step resections have been specified. Conclusion. 3D transvaginal echography at the stage of planning hysteroscopic myomectomy allows not only a more precise determination of the fibroid type, assessment of its location and size, but also prediction of the length of operative intervention, the likelihood of multi-step resection and a risk of developing postoperative complications, as well as recommendation of other surgical treatments. Intraoperative ultrasound surgical navigation was introduced, which in combination with an appropriate resection technique permits to enhance the safety of surgical procedure. Depending on the echographic image of the endometrium and myometrium at the «resection site», specific recommendations have been formulated on management of the postoperative period that can permit to prevent the formation of synechiae and to determine precise terms of possible pregnancy occurrence. Key words: infertility, hysteroscopic myomectomy, resection site, uterine fibroid, reproductive age, submucosal fibroid, ultrasound examination, 3D-US

scholarly journals Intrauterine Adhesions following Conservative Treatment of Uterine Fibroids

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Pietro Gambadauro ◽  
Johannes Gudmundsson ◽  
Rafael Torrejón
Keyword(s):  
Conservative Treatment ◽  
Current Knowledge ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Surgical Trauma ◽  
Tumor Removal ◽  
Intrauterine Adhesions ◽  
Hysteroscopic Myomectomy ◽  
Uterine Arteries ◽  
Diagnostic Pitfalls

Uterine fibroids are common in women of reproductive age and various conservative treatments are available. In order to achieve a successful conservative treatment of fibroids, functional integrity of the uterus is as important as tumor removal or symptoms relief. In this context, intrauterine adhesions must be recognized as a possible complication of conservative management of uterine fibroids, but diagnostic pitfalls might justify an underestimation of their incidence. Hysteroscopic myomectomy can cause adhesions as a result of surgical trauma to the endometrium. The average reported incidence is around 10% at second-look hysteroscopy, but it is higher in certain conditions, such as the case of multiple, apposing fibroids. Transmural myomectomies also have the potential for adhesion, especially when combined with uterine ischemia. Uterine arteries embolization also carries a risk of intracavitary adhesions. Prevention strategies including bipolar resection, barrier gel or postoperative estradiol, might be useful, but stronger evidence is needed. In view of current knowledge, we would recommend a prevention strategy based on a combination of surgical trauma minimization and identification of high-risk cases. Early hysteroscopic diagnosis and lysis possibly represents the best means of secondary prevention and treatment of postoperative intrauterine adhesions.

scholarly journals «Картина и рама». На основе материалов выставки Государственной Третьяковской Галереи

2019 ◽  
Author(s):  
Svetlana Soloveva
Keyword(s):  
The State ◽  
New Technique ◽  
National Characteristics ◽  
A New Technique

This report is based on the collection of the State Tretyakov Gallery, and it concerns interaction between pictures and frames. Sometimes frames contain texts on their own plane. Texts affect the perception of the image, amplifying viewer’s emotions. Quoting texts on frames is not a new technique but in Russia of the second half of the ХIХ century it acquires national characteristics. This report deals with two groups of examples: pictures and frames created by the state order and those made according to the author's idea. Presented examples show the importance and inseparability of the ‘union’ of frames with the paintings. The report underlines the importance of conservation and restoration of author's frames in order to keep the ability of paintings and frames to dialogue.

scholarly journals Concept of Granthi with reference to uterine fibroid: An Ayurveda review

2021 ◽  
Vol 9 (02) ◽  
Author(s):  
Jaya Umate ◽  
Soudamini Chaudhari
Keyword(s):  
Life Span ◽  
Uterine Fibroid ◽  
Uterine Fibroids ◽  
Modern Science ◽  
Reproductive Age ◽  
Significant Morbidity ◽  
Reproductive Life ◽  
Reproductive Life Span ◽  
Gynecological Disease ◽  
Reproductive Age Group

Uterine fibroids are the commonest benign tumor of the uterus and also the commonest benign solid tumor in the female. It can cause significant morbidity in women of a reproductive life span. The exact cause of uterine fibroid is unknown. Prevalence of uterine fibroid 5 -20 % of women in the reproductive age group. It can cause significant morbidity in women of a reproductive life span. Not all fibroids cause symptoms. 50% of women are asymptomatic. Fibroids mainly cause symptoms like menorrhagia, dysmenorrhea and cause pressure symptoms on adjacent viscera i. e. bladder, uterus, rectum which affects the everyday activities of women. In Ayurveda all gynecological disease explained under the term yonivyapad. It can be explained as the anatomical and functional abnormalities of the female reproductive system. In Ayurveda granthi can be correlated with the uterine fibroid. In modern science uterine fibroid treats medically, surgically. But it is challenging to establish a satisfactory conservatory medical treatment to date. so in Ayurveda the main purpose is the management of granthi by samprapti vighatan by use of medicine.

A New Technique of Hysteroscopic Myomectomy with Enucleation in Toto

2003 ◽  
Vol 10 (2) ◽  
pp. 263-270 ◽  
Author(s):  
Pietro Litta ◽  
Corina Vasile ◽  
Federica Merlin ◽  
Chiara Pozzan ◽  
Giuseppe Sacco ◽  
...  
Keyword(s):  
New Technique ◽  
Hysteroscopic Myomectomy ◽  
A New Technique

scholarly journals Aberrant expression and regulation of NR2F2 and CTNNB1 in uterine fibroids

Reproduction ◽  
2013 ◽  
Vol 146 (2) ◽  
pp. 91-102 ◽  
Author(s):  
Marina Zaitseva ◽  
Sarah J Holdsworth-Carson ◽  
Luke Waldrip ◽  
Julia Nevzorova ◽  
Luciano Martelotto ◽  
...  
Keyword(s):  
Uterine Fibroid ◽  
Molecular Mechanisms ◽  
Primary Cultures ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Causal Role ◽  
Aberrant Expression ◽  
Regulatory Pathways ◽  
Shh Pathway ◽  
Common Benign Tumour

Uterine fibroids are the most common benign tumour afflicting women of reproductive age. Despite the large healthcare burden caused by fibroids, there is only limited understanding of the molecular mechanisms that drive fibroid pathophysiology. Although a large number of genes are differentially expressed in fibroids compared with myometrium, it is likely that most of these differences are a consequence of the fibroid presence and are not causal. The aim of this study was to investigate the expression and regulation of NR2F2 and CTNNB1 based on their potential causal role in uterine fibroid pathophysiology. We used real-time quantitative RT-PCR, western blotting and immunohistochemistry to describe the expression of NR2F2 and CTNNB1 in matched human uterine fibroid and myometrial tissues. Primary myometrial and fibroid smooth muscle cell cultures were treated with progesterone and/or retinoic acid (RA) and sonic hedgehog (SHH) conditioned media to investigate regulatory pathways for these proteins. We showed that NR2F2 and CTNNB1 are aberrantly expressed in fibroid tissue compared with matched myometrium, with strong blood vessel-specific localisation. Although the SHH pathway was shown to be active in myometrial and fibroid primary cultures, it did not regulateNR2F2orCTNNB1mRNA expression. However, progesterone and RA combined regulatedNR2F2mRNA, but notCTNNB1, in myometrial but not fibroid primary cultures. In conclusion, we demonstrate aberrant expression and regulation of NR2F2 and CTNNB1 in uterine fibroids compared with normal myometrium, consistent with the hypothesis that these factors may play a causal role uterine fibroid development.

Transcervical Intralesional Vasopressin Injection in Hysteroscopic Myomectomy—Description of a New Technique

2013 ◽  
Vol 23 (3) ◽  
pp. 258-262 ◽  
Author(s):  
Alyssa S.W. Wong ◽  
Eva C.W. Cheung ◽  
Kit-Tong Leung ◽  
Sik-Wing Yeung ◽  
Tak-Yeung Leung ◽  
...  
Keyword(s):  
New Technique ◽  
Hysteroscopic Myomectomy ◽  
A New Technique
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