Biomedical subjects
Publications and source records attributed to B McLucas.
A patent urachal sinus, as well as other urachal anomalies, may complicate laparoscopy. Perforation of such a sinus occurred during laparoscopy. Laparotomy or repeat laparoscopy may be necessary to excise the urachal anomaly.
Endometrial ablation for control of menorrhagia is a safe, effective alternative to hysterectomy in selected patients. Endometrial ablation with a resectoscope equipped with a roller ball electrode was used on 12 patients. The technique appears to be as effective as Nd:YAG laser endometrial ablation and offers gynecologists the advantages of speed, low cost and safety when compared to the laser approach.
Leiomyoma of the bladder is an unusual cause of persistent bladder or pelvic pain. Traditional modalities may enable the clinical to suspect the diagnosis, which should be confirmed by transurethral biopsy. Except in rare circumstances, the treatment of choice is a suprapubic abdominal approach for removal of the bladder tumor.
PURPOSE: To evaluate the potential usefulness of transcatheter uterine artery embolization as a treatment for fibroid-related vaginal bleeding and pelvic pain refractory to hormonal therapy and myomectomy. MATERIALS AND METHODS: Eleven patients (aged 27-55 years; mean, 44.2 years; none desiring future pregnancy) with refractory vaginal bleeding and/or chronic pelvic pain related to uterine leiomyomata underwent uterine artery embolization with use of polyvinyl alcohol (PVA) particles. Clinical improvement was assessed by detailed questionnaire at 2-9 months (mean, 5.8 months) after the procedure. Sonographic measurements of the uterus and dominant masses were obtained before and at 2 months after the procedure. RESULTS: All 11 patients underwent technically successful embolization. Eight of nine women who completed the follow-up questionnaire reported noticeable symptomatic improvement, including three women with complete resolution of symptoms. One woman (the only patient undergoing unilateral embolization) exhibited no clinical response. Another patient developed endometritis and pyometra 3 weeks after the procedure, necessitating hysterectomy. Large reductions in uterine volume (average, 40%) and dominant fibroid size (average, 60%-65%) were sonographically demonstrated. CONCLUSION: Uterine artery embolization represents a promising new method of treating fibroid-related menorrhagia and pelvic pain. Further investigation will be required to assess clinical response and durability, identify appropriate candidates, and define the optimal angiographic technique and PVA particle size.
Hysteroscopic treatment of 30 patients suffering from menorrhagia or post-partum complications was accomplished using an electrosurgical polyp snare. Using this method, 18 polyps and 12 myomas were successfully removed in less than twenty minutes without complications. Local anaesthesia was used in 12 patients. Three patients have presented with recurrence of menorrhagia, with a minimum of six months follow-up. Benefits of this technique compared to uterine resectoscopy include shorter operative time, decreased risk of fluid overload, and less risk of uterine perforation. The snare is difficult to use and a learning curve exists. Higher currents than that used for resection are required.