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At least 145 records · Page 8Linked to original sources
PubMed1993

[Respective diagnostic importance of hysterography and hysteroscopy in common uterine pathology].

In order to evaluate the diagnostic effectiveness of hysteroscopy and hysterography in common uterine diseases. 175 cases of hysterectomy were reviewed. The preoperative diagnosis obtained by these two examination methods was compared with the pathologist's report. Statistical analysis showed a 97.3% sensitivity for hysterography (specificity 28.5%). The sensitivity of hysteroscopy was 89% and its specificity 50%. The results varied according to the pathology observed. The best results for myomas were obtained with hysterography, and those for localized disorders (hyperplasia, polyps, etc.) with hysteroscopy.

Biopsy↗
PubMed1982

Uretero-neocystostomy in the treatment of postoperative uretero-vaginal fistula.

Nine patients with unilateral uretero-vaginal fistula afer hysterectomy were seen over a 9-year period. In 5 patients radical pelvic surgery combined with radiotherapy had been carried out because of carcinoma of the cervix. In one patient the fistula developed following total hysterectomy 18 years after radiotherapy because of a cervical carcinoma. In 3 patients hysterectomy had been performed for benign disease, uterine fibroids or fibroids combined with endometriosis. In one patient the fistula was successfully treated with an indwelling ureteral catheter for 7 days. In the other 8 patients uretero-neocystostomy was successful as regards vaginal urine leakage; following this procedure one kidney was lost in the follow-up period. It is concluded that in patients with uretero-vaginal fistula, uretero-neocystostomy can be performed with satisfactory results even when the patient has been treated for a cervical carcinoma by radiotherapy and radical surgery.

Adult↗
PubMedDate not supplied

Serum levels of soluble receptors for tumor necrosis factor (p55 and p75 sTNFr) in endometrial cancer.

The pretreatment serum levels of the soluble receptors for tumor necrosis factor (p55 and p75 sTNFr) were retrospectively measured in 38 patients with endometrial cancer and 55 patients with benign uterine diseases as controls. Serum p55 and p75 sTNFr levels were significantly higher in patients with endometrial cancer (median = 2.4 ng/ml, range = 1.4-6.8 ng/ml, and median = 7.1 ng/ml, range = 2.5-19.5 ng/ml, respectively) than in controls (median = 1.7 ng/ml, range = 0.5-4.0 ng/ml, p < 0.0001, and median = 5.2 ng/ml, range = 2.6-21.9 ng/ml, p = 0.03, respectively). In the former, serum p55 and p75 sTNFr values correlated with the extent of disease (stage III-IV versus I-II: p = 0.04 and p = 0.03, respectively). Among the 23 patients with stage I endometrial cancer who underwent initial surgery, the preoperative serum levels of both receptors correlated with the histologic grade and myometrial invasion but not with the clinical outcome. In conclusion, a stage-dependent release of the soluble receptors for TNF into the bloodstream occurs in patients with endometrial cancer.

Adult↗
PubMed1996

The feasibility of vaginal hysterectomy.

OBJECTIVE: To assess the feasibility of vaginal hysterectomy for benign uterine disease and to assess how frequently laparoscopic assistance is necessary. METHODS: A prospective series of 806 hysterectomies for benign disease of the uterus without prolapse which were performed in our institution from 1 March 1991 to 28 February 1994 is discussed. The report is an evaluation of a planned approach for hysterectomy. Vaginal hysterectomy was performed whenever possible-laparoscopic hysterectomy was indicated for adnexal pathology, known or anticipated significant pelvic adhesions and for a narrow vaginal access with a moderately enlarged uterus-abdominal hysterectomy was chosen when both laparoscopic and vaginal surgery were judged to be impossible. RESULTS: Vaginal hysterectomy was performed in 80.6% of patients. Laparoscopic assistance was needed in 9.4% of cases. The need for laparotomy was reduced to 10% with an acceptable pre- or postoperative complications rate.

Feasibility Studies↗
PubMed2003

Myometrial hyperplasia in pediatric, adolescent, and young adult uteri.

OBJECTIVES: To evaluate if myometrial hyperplasia is a congenital variation in myometrial differentiation, or an acquired structural disorder of the myometrium, this study evaluated whether myometrial hyperplasia was present in uteri of children, adolescents, and young adults. METHODS: We studied 19 pediatric/young adult uteri in cases with no clinical history of uterine disease. Random photomicrographs at 100x, taken at 1, 5, and 10 mm beneath the endometrium, were assessed for increased cellularity and nucleus/cell ratio, as compared to normal myometrium in the outer third of the same uterus. RESULTS: Myometrial hyperplasia was generally absent in prepubertal uteri, first appeared in adolescent uteri just beneath the endometrium, and was found at 5 mm depth only after age 18. It decreased with depth beneath the endometrium (P<0.05). CONCLUSIONS: Myometrial hyperplasia is not a congenital anatomic variation in myometrial differentiation, but rather an age-related acquired structural variation. Its relationship to common adolescent symptoms of dysmenorrhea and anovulatory bleeding remains unknown and unexplored.

Adolescent↗
PubMed1984

Lack of efficacy of prehysterectomy curettage as a diagnostic procedure.

From January 1, 1972, until December 31, 1980, 181 patients who underwent hysterectomy for benign disease at the Newton-Wellesley Hospital had uterine curettage performed immediately prior to the procedure. Of five endometrial carcinomas subsequently demonstrated in the hysterectomy specimens, only one had been discovered via the curettage. Even in this one case, the planned hysterectomy was not postponed or altered. Prehysterectomy curettage in patients without symptoms of uterine disease is a low-yield, inaccurate, time-consuming procedure which has little or no effect on intra-operative management and which should be replaced by preoperative endometrial evaluation by either office sampling techniques or formal curettage.

Curettage↗
PubMed1977

Exogenous estrogens and endometrial carcinoma: review and comments for the clinician.

It is justifiable to have reservations about the significance of the data available at this time on a possible increase in the risk of a patient's developing endometrial cancer if estrogen replacement therapy has been prescribed for her. Hopefully, additional studies currently being conducted will help to clarify the issue further. In the meantime, clinicians need guidelines on the use of estrogen replacement therapy. Estrogen is indicated in the premenopausal woman who has had surgical or radiation castration for treatment of disease. Menopausal women with severe vasomotor instability or atrophic vaginitis should also be considered for estrogen replacement therapy. In the latter situation, topical administration may be adequate. Contraindications to estrogen replacement include undiagnosed vaginal bleeding, breast cancer history of thromboembolic disease, liver disease, uterine leiomyomata, hypertension, diabetes, migraine headaches or gall bladder disease. In patients for whom estrogens are contraindicated, atrophic vaginitis can be treated with local estrogens and vasomotor symptoms with sedatives such as phenobarbital and belladonna. Before estrogen treatment is begun, a medical history and physical examination that look for possible contraindications are required. Obviously, any woman with abnormal uterine bleeding in the menopausal age group requires a procedure that provides tissue for histopathologic examination. Although postmenopausal women taking estrogen may have uterine bleeding related to the hormone, such bleeding cannot be assumed to be due to the therapy and always requires evaluation. The lowest dose effective in controlling a patient's symptoms should be administered, preferably in cyclic fashion. Whether the addition of a progestational compound at cyclic intervals has a beneficial effect on the endometrium is a matter of conjecture at this time. Requirement for continuing therapy should be reevaluated at least on an annual basis and preferably more often. In conclusion, a quote from Graber and Barber is appropriate: "The entire picture of routine postmenopausal estrogen therapy is in a state of complete confusion. We must proceed with circumspection and caution. We need less passion, fewer hypotheses, and more facts."

Estrogens↗
PubMed1996

Expression of estrogen receptor variants in normal and neoplastic human uterus.

Estrogen receptor variants lacking internal exons and representing dominant positive and negative activity may be involved in the initiation and/or progression of endocrine dependent tumors. To assess the role of estrogen receptor in uterine disease, we have analyzed both normal and neoplastic uterine samples for the presence of variant estrogen receptors using the sensitive technique of RT-PCR and direct automated DNA sequencing of the amplified products. Our analysis was conducted to determine the presence of spliced variants lacking exons 3 through exon 8. We demonstrate that both the normal and neoplastic human uterus contains a number of spliced variants of the estrogen receptor that co-exist with the wild type receptor. Variants lacking exons 4, 5 and 7 but not exons 3 and 6 were detected. Also, a novel partial deletion in exon 8 was detected in both the normal and neoplastic tissues, although a total deletion of this exon was not observed. In addition another region of exon 8 deletion was found to be present in one tumor tissue which also contained an insertion within this region, however, other tumors did not contain this variant. In addition, double exon deletion variants were observed lacking exons 3 and 4, exons 4 and 5, and exon 7 with part of exon 8. Although our data represents a limited number of samples it suggests that splicing of the estrogen receptor message occurs in the normal physiological setting. There does not appear to be any association between the presence or absence of spliced variants of estrogen receptor and uterine tumor formation at the mRNA level.

Adenocarcinoma↗
PubMed1980

[Genital prolapse and ureteropelvic distension].

In the last 110 cases of genital prolapse examined, IVU formed part of the prior urological investigation. 14 cases of ureteropelvic distension were thus discovered (13.6% of cases). In ten cases the prolapse was sufficiently largee as to exterioris the uterus or bring it to of the vulva. In 13 cases out of 15 a larg cystocoele was visible at the vulva with a full bladder. The precise urological consequences of these prolapses was greater than had been expected: 13 cases of incomplete vesical retention, 4 of unilateral ureteropelvic distension and 10 bilateral, including 3 only symmetrical. Bilateral high distension was in general associated with a large cystocoele. Severe renal insufficiency was seen in only one case, and 5 moderate elevations in blood urea, in 5 cases. The mechanism of such ureteropelvicalyceal distension is not clear, but the prolapse is directly responsible, since mechanical (insertion of a pessary) or surgical reduction of the prolapse restores the upper excretory tract to normal. Renal function recovered all the more rapidly when the prolapse had been present for a shorter time.

Aged↗
PubMed1995

[Vesical flexion and vaginal prolapse of sows as an obstetrical problem].

The evaluation of 523 clinically supervised parturitions of swine from the last ten years showed that vesical flexion and vaginal prolapse as a complex range together (with 9.4%) on place three of the causes of dystocia. There were 16 cases of vesical flexion (= 3.1% of dystocia) and 33 cases of vaginal prolapse (= 6.3% of dystocia). Both groups showed a lot of mutualities. For example most cases in both groups were shortly before the third parturition. 50% of vesical flexions and 78.8% of vaginal prolapses appeared within one week before parturition concerning the third pregnancy in 25 and 27.3% of the cases. Both kinds of illness often were accompanied by a further dislocation of rectal tissue. This concerned 31.2% of the patients with vesical flexion and 21.2% of those with vaginal prolapse. The patients in 81.2% of vesical flexions and in 72.7% of vaginal prolapses were not taken to the clinic before dislocation of tissue appeared stationary. To make sure the diagnosis "vesical flexion" and to differentiate it from vaginal prolapse several methods are available. The most important one is catheterization of the bladder. This was done in 56.2% of the cases for diagnostical as well as for therapeutical reasons. To avoid relapses the foley-catheter had to be left in the bladder for maximal 19 days and for 6 days on an average. The vaginal prolapse after reposition was treated in 60.6% of the cases by a vaginal fastening. This was done to 75% of these patients according to Bühner.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

The relationship between the prevalence of uterine lesions and the use of medroxyprogesterone acetate for canine population control.

The prevalence of uterine disease was established during desexing of 175 bitches in the Torres Strait and Cape York, 42 of which had been treated with injectable medroxyprogesterone acetate (MPA) for oestrus postponement. The prevalence of uterine lesions was 45% for treated bitches, 5% for untreated bitches, and 14.9% for the sample population. A highly significant relationship (P < 0.01) between MPA treatment and uterine lesions was established. A significant association (P < 0.05) between age (> 2 years old) and uterine lesions was found, most likely attributable to a significantly higher proportion (P < 0.01) of MPA-treated bitches in the older population. There was no significant difference in the effect of MPA on the prevalence of uterine lesions between older and younger bitches. There was no effect of parity on the prevalence of uterine lesions.

Animals↗
PubMed2004

Omentalization of a nonresectable uterine stump abscess in a dog.

One month after ovariohysterectomy, a 2-year-old spayed female Golden Retriever was evaluated because of an extensive uterine stump abscess. Clinical signs included intermittent vomiting, signs of depression, lethargy, and pollakiuria. The dog underwent abdominal surgery; the greatly enlarged uterine stump was tightly adhered to the dorsal surface of the bladder, encompassing the distal portions of the ureters and the bladder's neurovascular supply. En bloc resection of the uterine stump was not considered an acceptable treatment option because of the risk of surgical damage to and subsequent devitalization of the bladder or ureters, urinary incontinence, or urinary tract obstruction. Therefore, the diseased uterine tissue that extended cranial to the bladder was resected, and the remaining abscess cavity was lavaged and packed with omentum. The dog recovered fully from the procedure. The omentum is an effective physiologic drain; its extensive vascular and lymphatic networks absorb fluid and actively promote elimination of infection. Omentalization appears to be an option for surgical management of nonresectable uterine stump abscesses in dogs.

Abdominal Abscess↗