scholarly journals Myomectomy Revisited: Experiences in a Teaching Hospital

2016 ◽  
Vol 54 (202) ◽  
pp. 79-81
Author(s):  
Shanti Subedi ◽  
Manisha Chhetry ◽  
Sabina Lamichhane
Keyword(s):  
Teaching Hospital ◽  
Reproductive Tract ◽  
College Teaching ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Female Reproductive Tract ◽  
Benign Tumors ◽  
Presenting Symptoms ◽  
Uterine Myomas ◽  
Common Location

Introduction: Uterine myomas are the most common benign tumors of the female reproductive tract with myomectomy being one of the major modalities of the treatment in our set up. The aim of this study was to share the experiences of open myomectomy from a Teaching Hospital.Methods: A observational study was conducted from a records of myomectomy cases in the department of Obstetrics and Gynaecology at Nobel Medical College teaching Hospital from June 2014- May 2016.Results: Total 38 cases of myomectomy were performed during the study period in the women most commong age group being 35-39 years, followed by 30-34. The most common presenting symptoms was abnormal uterine bleeding in 15 (39.47%) followed by mass per abdomen in 10 (26.31%). The most common location of the myoma was intramural followed by subserosal, submucus. Degeneration was also noted in majority of the cases. All the myomectomies were done with Inj Vasopressin injected paracervically except in one case where tourniquet was used. None of the patients had significant post-operative morbidity except fever in the first 24 hours.Conclusions: Abdominal myomectomy is a safe and effective procedure for uterine myomas for infertile women in the past but it should be offered to those desiring for uterine preservation irrespective of age and reproductive status. Keywords: abnormal uterine bleeding; degeneration; myomectomy. | PubMed

scholarly journals Clinico-Pathological Study of Hysterectomy Specimens in Kathmandu Medical College Teaching Hospital

2018 ◽  
Vol 3 (2) ◽  
pp. 423-426
Author(s):  
Sailesh Bahadur Pradhan ◽  
Mamata Sedhain ◽  
Sneh Acharya ◽  
Sailuja Maharjan ◽  
Samikchhya Regmi
Keyword(s):  
Teaching Hospital ◽  
Histopathological Examination ◽  
College Teaching ◽  
Abnormal Uterine Bleeding ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uterine Bleeding ◽  
Cross Sectional ◽  
Medical College ◽  
Chronic Cervicitis

Introduction: Uterus is subjected to many non-neoplastic and neoplastic diseases. Hysterectomy is the commonest gynecological surgery done for the management of the pathologies of the female reproductive system. Histopathological examination of hysterectomy specimens is done routinely which has both diagnostic and therapeutic significance.Objective: To study the common pathologies identified in hysterectomy specimens and to correlate them with the clinical findings.Methodology: A cross sectional study was carried out among all the hysterectomy specimens irrespective of primary lesion sent for histopathological examination from January 2016 to December 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital (KMCTH). Relevant history was taken from the requisition form. Ethical clearance was obtained from the Institutional Review Committee of KMCTH.Results: A total of 198 cases were studied. The most common pathology encountered was leiomyoma (60.0%) followed by adenomyosis (14.0%). Atrophic endometrium was seen in 24.3% cases. Chronic cervicitis was found in most of the cases (96.5%) along with endocervical polyp in 8.1% cases. Leiomyoma was found to be the most common indication for hysterectomy comprising 48.0% followed by abnormal uterine bleeding (24.75%) and utero-vaginal prolapse (18.25%). Hysterectomy was most commonly performed in the age group of 41 - 50 years and total abdominal hysterectomy with bilateral salpingo-oophorectomy was found to be the commonest procedure done comprising 8 0.0%.Conclusion: Leiomyoma was found to be the most common pathology in myometrium and chronic cervicitis in cervix. Abnormal uterine bleeding and vaginal prolapsed were also found to be common. Lesions which can be managed conservatively do need hysterectomy or not, is a matter of great concern. BJHS 2018;3(2)6:423-426.

Case 10.7

2014 ◽  
pp. 490-490
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Reproductive Tract ◽  
Normal Development ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Female Reproductive Tract ◽  
Fallopian Tubes ◽  
Class Iii ◽  
Class V ◽  
Unicornuate Uterus ◽  
Mullerian Ducts

45-year-old woman with abnormal uterine bleeding Axial oblique FSE T2-weighted images (Figure 10.7.1) show a banana-shaped uterus with a single horn. Note also small nabothian cysts in the cervix. Unicornuate uterus Müllerian duct anomalies are not common, but their importance lies in the fact that some of them represent treatable causes of infertility. The female reproductive tract develops primarily from the paired müllerian ducts, which form the fallopian tubes, uterus, cervix, and upper two-thirds of the vagina. Normal development requires completion of organogenesis, fusion, and septal resorption. Failure of organogenesis leads to class I and class II anomalies (agenesis/hypoplasia and unicornuate uterus). Abnormalities of fusion result in bicornuate and didelphic configurations (class III and class VI). Incomplete or absent septal resorption results in a septate (class V) or arcuate (class VI) uterus....

scholarly journals Histopathological Pattern of Endometrial Biopsies in Patients with Abnormal Uterine Bleeding Attending Birat Medical College Teaching Hospital

2020 ◽  
Vol 5 (2) ◽  
pp. 1035-1039
Author(s):  
Neeta Kafle ◽  
Shilpi Shaukin ◽  
Santosh Upadhaya Kafle ◽  
Mrinalini Singh ◽  
Surya Bahadur Parajuli
Keyword(s):  
Teaching Hospital ◽  
Histopathological Examination ◽  
Age Groups ◽  
College Teaching ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Age Group ◽  
Histological Pattern ◽  
Medical College

Introduction: Abnormal uterine bleeding (AUB) is one of the commonest gynaecological problems. Etiology of AUB may be structural and functional and varies according to age group. Histological pattern of endometrial sampling along with clinical and radiological findings remains the diagnostic standard for clinical diagnosis of endometrial pathology which ultimately helps in deciding the management of the patients. Objectives: To determine histopathological pattern of endometrial biopsies in patients with AUB attending Birat Medical College Teaching Hospital. To determine the pattern of menstrual abnormality in patients with AUB in different age groups. Methodology: We conducted a prospective hospital based cross sectional study for a period of one year (1 April 2019 to March 31 2020). Histopathological findings of all endometrial biopsy samples in patients with AUB were examined. Patients were categorized into different age groups and the patterns of menstrual abnormality were also documented. Results: 166 patients presenting with AUB underwent endometrial biopsy. Most of them were of perimenopausal age group (42.77%). Menorrhagia was the most common presenting menstrual abnormality. Histopathological examination predominantly revealed normal cyclical endometrium. Hyperplasia was seen more frequently in patients > 40 years of age. Malignancy was diagnosed in 2.41%, all were adenocarcinoma and was seen in > 50 years age. Conclusion: AUB is a common gynaeco-pathological problem with varied clinical presentation and multiple causes. Functional endometrial changes account for the highest histological pattern. However hyperplasia and malignancy are important cause of AUB in perimenopausal and post menopausal age group's women.

Mechanical Signaling and Extracellular Matrix in Uterine Fibroids

2017 ◽  
Vol 35 (06) ◽  
pp. 487-493 ◽  
Author(s):  
Saima Rafique ◽  
James Segars ◽  
Phyllis Leppert
Keyword(s):  
Gene Expression ◽  
Extracellular Matrix ◽  
Reproductive Tract ◽  
Critical Role ◽  
Uterine Fibroids ◽  
Female Reproductive Tract ◽  
Benign Tumors ◽  
Mechanical Signaling ◽  
Abnormal Cells ◽  
Fibroid Growth

AbstractFibroids (uterine leiomyomas) are the most common benign tumors of the female reproductive tract. Steroid hormones, growth factors, and cytokines have long been implicated in fibroid growth; however, research suggests that changes in the extracellular matrix and mechanical signaling play a critical role in fibroid growth and differentiation. Studies have shown that growth of fibroids is related to the change in the volume and composition of extracellular matrix with increased deposition of abnormal collagen, glycoproteins, laminins, fibronectins, and an increased osmotic stress. These changes generate mechanical stress which is converted to chemical signals in the cells through mechanotransduction and eventually affects gene expression and protein synthesis. Current studies also suggest that mechanical signaling in fibroid cells is abnormal as evidenced by decreased apoptosis of abnormal cells and deposition of a stiff extracellular matrix promoting fibrosis. Understanding and defining these mechanisms could help design new therapies for the treatment of fibroids.

scholarly journals Histopathological Study of Endometrial Biopsy Specimens for Abnormal Uterine Bleeding

2016 ◽  
Vol 4 (2) ◽  
pp. 72
Author(s):  
Archana Tiwari ◽  
Narinder Kaur ◽  
Sushila Jain ◽  
Ramji Rai ◽  
Surendra Kumar Jain
Keyword(s):  
Light Microscopy ◽  
College Teaching ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Histopathological Study ◽  
Medical College ◽  
Biopsy Specimens ◽  
Neoplastic Lesions ◽  
Post Menopausal

Introduction: Endometrial specimen for abnormal uterine bleeding (AUB) is the one of the commonest specimens received in histopathology laboratory. Histopathological characteristics of endometrial tissues, as assessed by light microscopy, remains the diagnostic standard for the management of AUB. The objective of study is to find out the histopathological pattern of endometrium in AUB in the light of clinical details.   Methods: This was a prospective observational study carried out in the department of Pathology, Lumbini Medical College Teaching Hospital for a period of two years from June 2014 to May 2016. Formalin fixed endometrial specimens were processed, paraffin embedded, sectioned at 3-4 µm, stained with hematoxylin and eosin, and studied under light microscopy along with their demographics. Data were collected, entered and analyzed using SPSS version 20.   Results: The study included 100 cases of endometrial biopsy specimens with clinical diagnosis of AUB. Menstrual disturbances was found in wide age range between 17-75 years with the mean age of 45 (SD=13.36) years. Menorrhagia was the commonest (n=60, 60%) clinical presentation. Most (n=85; 85 %) endometrium had non-neoplastic lesions. Among them, normal endometrial patterns were commonest (n=50, 50 %). Neoplastic lesions (n=15, 15%) were distributed in all menstruation status with majority in postmenopause (n=7, 7%) and included malignant cases (n=5, 5%) among others.   Conclusion: Post-menopausal bleeding was common presentation among women with malignant and premalignant disease which was present in 15% of the cases together. Timely evaluation of AUB  by histopathology can be life saving with early tissue diagnosis and management.

Minimally Invasive Approaches to the Surgical Management of Fibroids

2017 ◽  
Vol 35 (06) ◽  
pp. 533-548 ◽  
Author(s):  
Harold Wu ◽  
Karen Wang
Keyword(s):  
Minimally Invasive ◽  
Surgical Management ◽  
Reproductive Tract ◽  
Fluid Management ◽  
Benign Neoplasm ◽  
Abnormal Uterine Bleeding ◽  
Female Reproductive Tract ◽  
Treatment Modalities ◽  
Preoperative Treatment ◽  
Management Interventions

AbstractUterine fibroids, as the most common benign neoplasm of the female reproductive tract, can significantly impact a woman's quality of life through abnormal uterine bleeding, infertility, and bulk symptoms. When medical therapy for symptomatic fibroids fails, surgery is the recommended treatment. While a hysterectomy through laparotomy was historically the first-line surgical approach for fibroids, multiple minimally invasive and uterine-sparing techniques are now available. An evidence-based literature review of the following minimally invasive approaches is detailed in this article: hysteroscopic myomectomy, laparoscopic and robotically assisted myomectomy, laparoscopic and robotically assisted hysterectomy, and ultrasound-guided radiofrequency ablation. For each approach, this review discusses the indications, patient selection, adjunct preoperative treatment modalities, instrumentation, techniques, and pertinent intraoperative considerations such as fluid management, interventions to reduce blood loss, antiadhesion barriers, and tissue extraction. Perioperative benefits, long-term outcomes including recurrence and fertility, and comparisons of outcomes among the various approaches are outlined as well. With continued technological advancements and surgical innovations, minimally invasive techniques will become the mainstay of surgical management for symptomatic fibroids to provide high-quality patient-centered care.

Simvastatin inhibits Wnt/β-catenin pathway in uterine leiomyoma

Endocrinology ◽  
2021 ◽  
Author(s):  
Malak El Sabeh ◽  
Subbroto Kumar Saha ◽  
Sadia Afrin ◽  
Mostafa A Borahay
Keyword(s):  
Uterine Leiomyoma ◽  
Reproductive Tract ◽  
Controlled Trial ◽  
Active Form ◽  
Cell Types ◽  
Female Reproductive Tract ◽  
Benign Tumors ◽  
Therapeutic Effects

Abstract The Wnt/β-catenin pathway is upregulated in uterine leiomyomas, the most common benign tumors in the female reproductive tract. Simvastatin is an anti-hyperlipidemic drug, and previous in vitro and in vivo reports showed it may have therapeutic effects in treating leiomyomas. The objective of this study is to examine the effects of simvastatin on the Wnt/β-catenin signaling pathway in leiomyoma. We treated primary and immortalized human leiomyoma cells with simvastatin and examined its effects using RT-qPCR, Western Blotting, and immunocytochemistry. We also examined the effects using human leiomyoma tissues from an ongoing, randomized controlled trial where women with symptomatic leiomyoma received simvastatin (40mg) or placebo for 3 months prior to their surgery. The results of this study reveal that simvastatin significantly reduced the expression of Wnt4 and its co-receptor LRP5. After simvastatin treatment, levels of total β-catenin and its active form, non-phosphorylated β-catenin, were reduced in both cell types. Additionally, simvastatin reduced the expression of Wnt4 and total β-catenin, as well as non-phosphorylated β-catenin protein expression in response to estrogen and progesterone. Simvastatin also inhibited the expression of c-Myc, a downstream target of the Wnt/β-catenin pathway. The effect of simvastatin on non-phosphorylated-β-catenin, the key regulator of the Wnt/β-catenin pathway, was recapitulated in human leiomyoma tissue. These results suggest that simvastatin may have a beneficial effect on uterine leiomyoma through suppressing the overactive Wnt/β-catenin pathway.

scholarly journals 5-Hydroxymethylcytosine Promotes Proliferation of Human Uterine Leiomyoma: A Biological Link to a New Epigenetic Modification in Benign Tumors

2014 ◽  
Vol 99 (11) ◽  
pp. E2437-E2445 ◽  
Author(s):  
Antonia Navarro ◽  
Ping Yin ◽  
Masanori Ono ◽  
Diana Monsivais ◽  
Molly B. Moravek ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Uterine Leiomyoma ◽  
Reproductive Tract ◽  
Enzyme Inhibitor ◽  
Malignant Tumors ◽  
Epigenetic Modification ◽  
Uterine Fibroids ◽  
Female Reproductive Tract ◽  
Immunofluorescent Staining ◽  
Benign Tumors

Context: Uterine leiomyoma, or fibroids, represent the most common benign tumors of the female reproductive tract. A newly discovered epigenetic modification, 5-hydroxymethylation (5-hmC), and its regulators, the TET (Ten Eleven Translocation) enzymes, were implicated in the pathology of malignant tumors; however, their roles in benign tumors, including uterine fibroids, remain unknown. Objective: To determine the role of 5-hmC and TET proteins in the pathogenesis of leiomyoma using human uterine leiomyoma and normal matched myometrial tissues and primary cells. Design: 5-hmC levels were determined by ELISA and immunofluorescent staining in matched myometrial and leiomyoma tissues. TET expression was analyzed by quantitative RT-PCR and immunoblotting. TET1 or TET3 were silenced or inhibited by small interfering RNA or 2-hydroxyglutarate to study their effects on 5-hmC content and cell proliferation. Results: We demonstrated significantly higher 5-hmC levels in the genomic DNA of leiomyoma tissue compared to normal myometrial tissue. The increase in 5-hmC levels was associated with the up-regulation of TET1 or TET3 mRNA and protein expression in leiomyoma tissue. TET1 or TET3 knockdown significantly reduced 5-hmC levels in leiomyoma cells and decreased cell proliferation. Treatment with 2-hydroxyglutarate, a competitive TET enzyme inhibitor, significantly decreased both 5-hmC content and cell proliferation of leiomyoma cells. Conclusion: An epigenetic imbalance in the 5-hmC content of leiomyoma tissue, caused by up-regulation of the TET1 and TET3 enzymes, might lead to discovery of new therapeutic targets in leiomyoma.

scholarly journals ECTOPIC PREGNANCY : A MAJOR CAUSE OF MATERNAL MORTALITY?

2003 ◽  
Vol 42 (147) ◽  
pp. 151-155
Author(s):  
Rajshree Jha ◽  
M Singh ◽  
A Rana ◽  
A Singh ◽  
S Bastola
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Pelvic Surgery ◽  
Transvaginal Sonography ◽  
Pregnancy Risk ◽  
Abdominal Tenderness ◽  
Presenting Symptoms ◽  
History Of

ABSTRACTSeventyeight cases of ectopic pregnancy were studied retrospectively at Tribhuvan University TeachingHospital during April 1993 - December 1996. The overall incidence of etopic pregnancy was 0.86% livebirths. Grandmultipara were found to be at a low risk for ectopic pregnancy. A history of infertility andprevious pelvic surgery were positive risk factors. The most common presenting symptoms were abdominalpain (90%), history of amenorrhoea (46%), abnormal uterine bleeding (40%). On examination adenexaltenderness (72%), abdominal tenderness (68%), pallor (53%) and cervical excitation (33%) were the mostfrequent findings. Adenexal mass was noted in 22% cases and in 35 % cases the size of the uterus could notbe assessed. Ultrasonography and transvaginal sonography proved to be valuable diagnostic aids. Twomaternal deaths (2.6 %) due to ectopic pregnancy occurred in the hospital during this period.Key Words: Ectopic pregnancy, risk factors, sonography.

Sign in / Sign up

Export Citation Format

Share Document