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Results for “Fallopian Tube Diseases”

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PubMed1999

Ruptured tuboovarian abscess in late pregnancy. A case report.

BACKGROUND: Tuboovarian abscess is an unusual obstetric complication that causes maternal and fetal morbidity and mortality. CASE: A woman, G1, P0, with a 32-week pregnancy presented with abdominal pain. Physical examination on admission revealed fever and unremarkable abdominal signs. Eleven hours after admission, signs of peritonitis became prominent, necessitating emergency laparotomy. Surgical findings included an 8-cm, right, ruptured tuboovarian abscess with massive purulent contamination of the abdominal cavity. Cesarean hysterectomy with bilateral salpingo-oophorectomy was performed. Neither the newborn nor the mother had postoperative complications. CONCLUSION: Since there are discrepancies in the incidences of tuboovarian abscess in pregnant and nonpregnant groups, the pathogenesis of tuboovarian abscess may be different in the two populations. In pregnancy, diagnosis and management are also more difficult than in the nonpregnant state. Clinical data may not reveal the diagnosis until surgery is mandatory. Because most pregnant women with tuboovarian abscesses are young, conservative surgery should be attempted if the pathology is limited to only one side of the adnexa and further reproduction is desired.

Abdominal Pain↗
PubMed1999

Laparoscopic surgery of the fallopian tubes and ovaries.

Operative laparoscopy can be used for many surgical procedures on the fallopian tube and ovary. These include: (1) tubal sterilization; (2) salpingectomy and salpingostomy for tubal pregnancy; (3) fimbrioplasty, salpingoneostomy, and linear salpingostomy for tubal obstruction and infertility; (4) microsurgical tubal reanastomosis for reversal of tubal sterilization; (5) oophorectomy, cystectomy, cyst drainage and fulguration, and excision of ovarian tumors; (6) wedge resection and ovarian drilling for polycystic ovaries; and (7) fulguration and laser vaporization for endometriosis. Many of these procedures are conservative and involve reconstruction of the tube and ovaries to preserve fertility. Microsurgical techniques are incorporated into such fertility sparing or enhancing procedures. Comparison of similar surgical procedures on the tube and ovaries indicates better or similar surgical outcome when done through the laparoscope rather than laparotomy; less blood loss, faster recovery, and cheaper cost are the hallmarks when the procedure is done by laparoscopy. With further improvement and expansion in laparoscopy equipment, it can be expected that more surgical procedures on the adnexa can be undertaken safely and effectively.

Fallopian Tube Diseases↗
PubMed1992

[Infiltrating tubo-ovarian abscess in IUD-associated actinomycosis].

We report on a case of a 55-year old patient with a great adnexal tumour (10 x 5 x 8 cm), on the left side with infiltration of the bladder and the pelvis with recurring urinary retention in the kidney. Histological examination revealed an intrauterine device-associated actinomycosis. Following a 6-month high dose penicillin therapy, the abdominal hysterectomy with adnexectomy and partial resection of the bladder with new implantation of the ureter (Boari) was performed. The postoperative period was uneventful, the urogram normal.

Abscess↗
PubMed1988

Up-to-date surgical management of tubal infertility due to inflammations of the pelvis.

A total of 87 refertilization operations in the distal tubal segment are reported. Tubal obstructions developed following inflammations of the pelvis. Hysterosalpingography and laparoscopy were used to learn about the patients' anatomy and these served as bases for assessing the changes of pregnancy following recanalization. The interventions were made by applying up-to-date microtechnical methods and instruments. Among the causes of tubal infertility, the interruption of the first pregnancy showed a marked prevalence. The 20 pregnancies that ensued correspond to a success rate of 23%. Mature deliveries occurred in 17 cases. A considerable proportion of the pregnancies occurred within a year of the operation. The effectiveness is mainly influenced by adhesions in the pelvis and the characteristics of the distal tubal segment. The surgical solution is worth attempting when the expected chances are over 20%.

Adult↗
PubMed1994

Frequency of proximal tubal obstruction in patients undergoing infertility evaluation.

Fallopian tube recanalization is a technique for treatment of proximal tubal obstruction caused by debris. The true frequency of infertile women for whom this treatment is suitable is not well known. In this study all hysterosalpingograms (HSGs) performed over a 3-year period (1986-88) were reviewed. The HSGs were performed as part of an infertility evaluation program in 494 women, with a mean duration of infertility of 2.4 years. Bilateral proximal tubal obstruction was found in 3% and unilateral proximal obstruction in 2% of the cases. In women examined in the first 2 years (1986-87) (n = 328), the birth frequency after HSG was 25%. When HSG was performed with optimal technique the number of patients who were suitable for Fallopian tube recanalization was low.

Adult↗
PubMed2003

Rapid reaccumulation of hydrometra after drainage at embryo transfer in patients with hydrosalpinx.

OBJECTIVE: To report the occurrence and management of hydrometra at the time of scheduled embryo transfer in two patients who underwent drainage of hydrosalpinges at oocyte retrieval. DESIGN: Case report. University IVF clinic. PATIENT(S): Two patients with hydrosalpinges visible on ultrasonography who deferred tubal surgery. Although no fluid was seen at the time of oocyte retrieval, hydrometra was noticed and drained before planned embryo transfer (ET). MAIN OUTCOME MEASURE(S): Reoccurrence of hydrometra after drainage. RESULT(S): Rapid reaccumulation of hydrometra despite drainage was seen in both patients, one of whom had reoccurrence in 1 hour. Embryo transfer was deferred until after tubal surgery, and all embryos were cryopreserved. CONCLUSION(S): In patients with hydrosalpinges, ultrasonography before ET is useful to detect newly developed hydrometra. Aspiration of the uterine fluid is unlikely to help because of rapid reaccumulation of hydrometra. Cryopreservation of the embryos for future transfer after the hydrosalpinx is removed or ligated is recommended.

Body Fluids↗
PubMed1995

Intestinal obstruction and bilateral ureteral injuries after laparoscopic oophorectomy in a patient with severe endometriosis.

The overall frequency of ureteral injury during laparoscopic adnexectomy for endometriosis is unknown, and intestinal obstruction after laparoscopy is rare. Our patient had two postoperative complications: small bowel obstruction and bilateral ureteral injuries discovered 2 and 39 days, respectively, after outpatient laparoscopic adhesiolysis and bilateral salpingo-oophorectomy for severe endometriosis. Pelvic examination and vaginal sonography revealed a large unilocular cystic mass. Laparoscopy showed a fixed large endometrioma firmly attached to pelvic peritoneum and intestines in the pelvic cavity, and significant adhesions in the upper part of a midline incision from prior abdominal hysterectomy. These midabdominal adhesions were not released. The patient underwent laparoscopic bilateral adnexectomy as an outpatient. Two days later she was admitted with small bowel obstruction. Thirty-nine days later, diagnostic evaluation revealed urinary ascites with right ureteral stricture at the uterine artery level, and complete ligation and resection of the left ureter at the pelvic brim near the infundibulopelvic ligament stump. She underwent left ureteral implantation with psoas hitch and right ureterolysis. Follow-up cystogram and intravenous pyelography at 6 and 20 weeks revealed complete recovery. In cases of severe endometriosis with significant ureteral and intestinal involvement, laparotomy may have to be considered.

Adult↗
PubMed2006

Saline sonohysterosalpingographic findings in infertile Nigerian women.

This paper describes the findings in the first 100 women who underwent saline sonohysterosalpingography (SHG) at two privately owned health facilities in Enugu, South East Nigeria. This was a prospective study of the first 100 consecutive women presenting with infertility to the authors at Mbanefo Hospital and Hansa Clinics, both in Enugu, South-East geopolitical zone of Nigeria from 1 May 2005 to 20 January 2006. Saline sonohysterosalpingography was carried out in the standard way in these women. The findings were analysed using simple percentages and means +/- SD. The procedure was completed in 98 women, while in two others it was not possible to cannulate the uterine cavity. A total of 61 of the women had normal uterine musculature, 37 had interstitial fibroids and two had sonographic features of adenomyosis. Regarding the endometrial cavity, 93 women had a normal endometrium, four had a submucosal fibroid, one had intrauterine adhesions, while the endometrial cavity could not be assessed in two women who could not be cannulated. No case of submucosal polyp or uterine septa or other congenital uterine anomalies was seen. As assessed sonologically, 77 of the study subjects had bilateral patent tubes, while five had unilateral tubal patency. In one woman, there was uncertainty about tubal patency or blockage; in two women, the tubes could not be assessed because of non-cannulation of the uterine cavity and in 15 women, both tubes were blocked. A total of 74 women had normal ovaries; 15 had polycystic ovaries; five had atrophic ovaries consistent with ovarian failure and six women had ovarian cysts. In 18 women, the findings at sonosalpingography (SSG) were confirmed at laparoscopy in 11 women or laparotomy (two women) or by the fact that the patients became pregnant (five women). In 15 (83.3%) of these 18 women, the findings at SSG and laparotomy/laparoscopy or of the woman becoming pregnant were compatible. SSG is a useful screening test for assessing endometrial, tubal and ovarian factors in infertile Nigerian women, thereby obviating the need for laparoscopy and hysteroscopy in the majority of cases.

Adult↗
PubMed1991

Laparoscopic adnexectomy.

We are now performing laparoscopic adnexectomy in selected cases of benign pathology of the adnexa. This report is presented to show that even fairly large tumors may be removed by this technique. It involves 30 cases of tumors having a diameter more than 4 cm that were operated on over a period of 12 months. Cystectomies and cystotomies were not included in this study. Patients were excluded if there was any suspicion of malignancy. Indications for laparoscopy were functional and organic cysts, tubo-ovarian abscesses, and adnex torsions due to large hydrosalpinx. No complications have been encountered during the laparoscopic operation or during the follow-up period of 6-18 months.

Abscess↗
PubMed1998

[Endoscopic diagnosis of mechanic sterility].

An attempt has been made to classify mechanical tubal obliteration (proximal, distal, external obliteration). The material consisted of 798 laparoscopic procedures done in order to find the cause of female infertility. Tubal obliteration in females with secondary infertility are often associated with foci of endometriosis genitalis.

Adult↗
PubMed1982

Tubal surgery.

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Fallopian Tube Diseases↗
PubMed1994

[Hysteroscopic evaluation of the uterine tubal opening].

The hysteroscopic evaluation of uterine openings in 23 sterile women was described. The attention was paid to morphological features of obliterated uterine openings. The hysteroscopic examination of structural changes located in uterine openings seems to be a reliable method for evaluation of potency of oviducts. This procedure may help in choosing the proper way of therapy--microsurgery or IVF.

Adult↗