Vaginal myomectomy is superior to abdominal myomectomy in treatment effect and postoperative recovery

Uterine leiomyomatosis is one of the most common benign pelvic tumors diagnosed in women aged 25-44 years. Clinically, it is manifested by vaginal bleeding, pelvic pain, infertility, digestive and urinary symptoms. The diagnosis of uterine fibroids requires careful clinical and paraclinical evaluation. Based on these data, the therapeutic decision is conducted in most cases. The treatment of uterine leiomyomatosis involves several procedures, such as: total abdominal hystectomy, total vaginal hystectomy, abdominal myomectomy, vaginal, laparoscopic or hysteroscopic myomectomy. Hysteroscopic myomectomy is currently the preferred procedure for submucosal fibroids. It has multiple advantages: shorter recovery time, reduced pain related to movements, shorter duration procedure and fewer risks. The procedure has few contraindications. The most common complication is recurrence. The treatment of choice for prolapsed pedunculated submucous leiomyoma is vaginal myomectomy. As described, the procedure has multiple advantages and generally has a low recurrence rate.

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Myomectomy by vaginal route

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0402018m ◽

2004 ◽

Vol 132 (1-2) ◽

pp. 18-21 ◽

Cited By ~ 1

Author(s):

Zagorka Milovanovic ◽

Dusan Stanojevic

Keyword(s):

Operating Time ◽

Surgical Techniques ◽

Posterior Wall ◽

Postoperative Recovery ◽

Surgical Instruments ◽

Prospective Clinical Study ◽

Vaginal Route ◽

Operative Blood Loss ◽

Operative Trauma ◽

Vaginal Myomectomy

In recent years, the development of new surgical techniques in uterus myoma treatment have reduced operative trauma significantly. Our objective was to present operative technique-vaginal myomectomy, making a prospective clinical study where we have evaluated the operative and postoperative period after intentive diagnosis. The result of our study shows the feasibility of myomectomy by entering the peritoneum through the posterior vaginal fornix, using traditional and cheap surgical instruments and thus avoiding the trauma of laparatomy, minimal operative blood loss, reduced operating time and postoperative recovery. In our opinion, vaginal myomectomy could be useful for the treatment of selected cases with fundal or posterior wall uterine myomas.

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Myomectomy by vaginal route

Acta chirurgica iugoslavica ◽

10.2298/aci0601083z ◽

2006 ◽

Vol 53 (1) ◽

pp. 83-86

Author(s):

M. Zamurovic ◽

D. Stanojevic ◽

P. Srbinovic ◽

M. Cerovic ◽

M. Stanojevic

Keyword(s):

Cost Benefit ◽

Posterior Wall ◽

Postoperative Recovery ◽

Control Group ◽

Intraoperative Blood Loss ◽

Vaginal Route ◽

Postoperative Course ◽

Abdominal Myomectomy ◽

Health Authorities ◽

Type Of Surgery

Myomectomy by vaginal route is the least invasive of all methods for myoma removal. Compared to classical, abdominal myomectomy, it has numerous advantages, especially in cases of fundal and posterior wall myomas, but still it is relatively rarely performed. This study provides an analysis of operative and postoperative course of patients subjected to myomectomy by vaginal route in the period from 01/01/2003 to 01/11/2005 as well as the corresponding control group of patients which had undergone classical, abdominal myomectomy. The study points out to significance and advantages of application of surgical technique for removal of myoma through the posterior wall of the vagina as opposed to classical, abdominal myomectomy. Transvaginal myomectomy eliminates trauma of laparotomy, intraoperative blood loss is reduced, postoperative complications are down to minimum, postoperative recovery is shorter, and so is the number of days spent in hospital. Thus, by performing this type of surgery, a positive cost-benefit effect is obtained not only for the patient but for health authorities as well.

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Clinical Diagnosis of Endometrial Polyps Using Multioperator Algorithm Combined with Hysteroscopy

Scientific Programming ◽

10.1155/2021/6254873 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Dongfang Han ◽

Dajun Wang ◽

Ba Sangzeren ◽

Xiaomei Li

Keyword(s):

Treatment Effect ◽

Clinical Symptoms ◽

High Sensitivity ◽

Recovery Process ◽

Postoperative Recovery ◽

Diagnostic Methods ◽

Surgical Trauma ◽

Endometrial Polyps ◽

Hysteroscopic Surgery ◽

Sensitivity Specificity

Exploring the effects of uterine imaging and hysteroscopy of endometrial polyps, this article has chosen the treatment effect of 50 cases of intrauterine polyps to observe hysteroscopy. The results showed that the diagnosis and sensitivity, specificity, positive, negative, and consistency were passed through various diagnostic methods ( P < 0.05 ). The diagnostic sensitivity of antidiagnosis combination and series combination was 90.0%, 64.0%, 96.0%, 92.0%, 80.0%, 80.0%, 88.0%, and 92.0%, parallel diagnosis with high sensitivity, significantly higher than simple diagnosis ( P < 0.05 ). Therefore, in the clinical treatment of endometrial polyps, hysteroscopic surgery is a safe and effective treatment, which can remove endometrial quality, improve the clinical symptoms of patients, and reduce the interference and postoperative recovery process of surgical trauma.

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The Effect of Partly Missing Covariates on Statistical Power in Randomized Controlled Trials With Discrete-Time Survival Endpoints

Methodology ◽

10.1027/1614-2241/a000121 ◽

2017 ◽

Vol 13 (2) ◽

pp. 41-60

Author(s):

Shahab Jolani ◽

Maryam Safarkhani

Keyword(s):

Randomized Controlled Trials ◽

Discrete Time ◽

Treatment Effect ◽

Survival Data ◽

Controlled Trials ◽

Missing Covariates ◽

Indicator Method ◽

Imputation Methods ◽

Randomized Controlled ◽

Baseline Covariates

Abstract. In randomized controlled trials (RCTs), a common strategy to increase power to detect a treatment effect is adjustment for baseline covariates. However, adjustment with partly missing covariates, where complete cases are only used, is inefficient. We consider different alternatives in trials with discrete-time survival data, where subjects are measured in discrete-time intervals while they may experience an event at any point in time. The results of a Monte Carlo simulation study, as well as a case study of randomized trials in smokers with attention deficit hyperactivity disorder (ADHD), indicated that single and multiple imputation methods outperform the other methods and increase precision in estimating the treatment effect. Missing indicator method, which uses a dummy variable in the statistical model to indicate whether the value for that variable is missing and sets the same value to all missing values, is comparable to imputation methods. Nevertheless, the power level to detect the treatment effect based on missing indicator method is marginally lower than the imputation methods, particularly when the missingness depends on the outcome. In conclusion, it appears that imputation of partly missing (baseline) covariates should be preferred in the analysis of discrete-time survival data.

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NIDA CTN Treatment Effect and Assessment Measures Task Force Recommendations

PsycEXTRA Dataset ◽

10.1037/e632372012-001 ◽

2012 ◽

Author(s):

John G. Gardin

Keyword(s):

Treatment Effect ◽

Task Force ◽

Assessment Measures

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Using Discount Rate to Predict Treatment Effect and Relapse

PsycEXTRA Dataset ◽

10.1037/e707752007-001 ◽

2007 ◽

Author(s):

Yun Zhang ◽

Min Yu ◽

Xinyue Zhou ◽

Jingjing Lin ◽

Yi Ni

Keyword(s):

Discount Rate ◽

Treatment Effect

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Endovenous procedures in varicose veins

Phlebologie ◽

10.1055/s-0037-1622235 ◽

2008 ◽

Vol 37 (05) ◽

pp. 229-236

Author(s):

N. Cayne ◽

G. Jacobowitz ◽

P. Lamparello ◽

T. Maldonado ◽

C. Rockman ◽

...

Keyword(s):

Varicose Veins ◽

Treatment Options ◽

Postoperative Recovery ◽

Comparable Efficacy ◽

Intense Pulse Light ◽

Efficacy And Safety ◽

Endovenous Laser Ablation ◽

The Past ◽

Early Evidence ◽

Endovenous Treatment

SummaryOver the past ten years endoveous treatment options for varicose veins have evovled considerably, offering clinicians a multitude of options to meet the needs of their patients. The endothermal ablation procedures have moved to the forefront as the choice modality for treating truncal reflux. Both radiofrequency ablation and endovenous laser ablation are widely accepted and interchangeable, showing comparable efficacy and safety. Although numerous endovenous laser wavelengths exist, the data indicates that the differences do not affect the efficacy or postoperative recovery of the procedure. The endovenous laser innovation that has shown early evidence of improved patient outcome is the jacket-tip fiber. The versatility of sclerotherapy makes it a critical component in the endovenous treatment of varicosities. Although not approved by the Food and Drug Administration (USA), the use of a foamed sclerosing agent is the fastest growing segment of sclerotherapy and an important treatment modality in the future of varicose vein treatment. Cutaneous lasers and intense pulse light devices contribute a crucial element, enabling clinicians to treat minute veins that may be impossible to treat with other therapies.

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