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At least 19 recordsLinked to original sources
PubMed1993

[Hematometra in patients with cervical cancer--its CT presentation and clinical significance].

Cervical cancer is the most common gynecologic malignancy in Chinese. Clinical staging has been traditionally used in cervical cancer, according to international Federation of Gynecology and Obstetrics (FIGO) staging classification. Computed tomography was an adjunctive modality for detecting paraaortic lymph nodes in preoperative evaluation. But CT has failed to accurately define the extent of parametrial and vaginal invasion. Here, an attempt has been made to define indirect clues alerting to invasive cervical cancer. Hematometra can be seen in CT as a dilated uterine cavity with retention of significant fluid. The incidence of hematometra was 5% (5/101) in control group, and 26% (22/84) in cervical cancer. Hematometra cannot be more specific for cervical cancer, with an accuracy of 64%, sensitivity of 82% and specificity of 61%. Hematometra was found to have a statistically high relationship with high cancer staging and uterine invasion. The Chi-square values were 14.8 (P < 0.005) in high cancer staging, and 19.8 in uterine invasion. The accuracy of hematometra was 65% in high cancer staging, and 74% in uterine invasion. Hematometra was more common in postmenopause women, with accuracy elevated to 80% for uterine invasion. This is probably related to senile atrophy or endophytic growth of the cervix into the uterus as well as to hormone replacement. These were five false positive instances of hematometra, all unrelated to cervical cancer. They presented with marked fluid and a solid mass in the uterine cavity, and included endometrial adenocarcinoma, uterine myoma and leiomyosarcoma. None of cervical cancer showed a solid mass in a dilated uterine cavity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2005

Hematometra in a patient with Cornelia De Lange syndrome.

BACKGROUND: Hematometra is usually the result of developmental anomalies or may be secondary to cervical obstruction. Abnormal uterine contractile function (atony) would be an uncommon cause of hematometra. CASE: An 18-year-old female with Cornelia De Lange syndrome and abdominal pain was found to have a hematometra on ultrasound examination. On pelvic examination, her cervical canal was patent and was easily dilated, but the hematometra did not drain until suprapubic pressure was applied. Two weeks postoperatively, pelvic magnetic resonance imaging showed a markedly thinned uterine myometrium and a recurrent hematometra, prompting the decision to perform a hysterectomy. CONCLUSION: Hematometra in a patient with Cornelia De Lange syndrome may be the result of abnormal uterine contractile function.

Abdominal Pain↗
PubMed2006

Use of office hysteroscopy to empty a very large hematometra in a young virgin patient with mosaic Turner's syndrome.

OBJECTIVE: To describe the successful management of a hematometra using a 5-mm continuous flow operative office hysteroscope. DESIGN: Case report. SETTING: University of Naples "Federico II." PATIENT(S): A 13-year-old virgin patient affected by mosaic Turner's syndrome (45 X; 46 XX) was referred to the emergency room of the Department of Obstetrics and Gynecology after an episode of severe pelvic pain with metrorrhagia. A large hematometra was detected by transabdominal ultrasound scanning. INTERVENTION(S): Vaginoscopic hysteroscopy performed in outpatient setting. MAIN OUTCOME MEASURE(S): Complete resolution of the hematometra and related clinical symptoms. RESULT(S): Vaginoscopic approach avoided general anesthesia and preserved the integrity of her hymen. A chocolate-like fluid started to spill out from the uterine cavity as soon as the tip of hysteroscope passed through the internal uterine ostium. A transabdominal ultrasound performed 2 days later showed resolution of the hematometra. Success of the procedure was confirmed by the resolution of all clinical symptoms. CONCLUSION(S): In selected cases, with intact outflow tract, outpatient vaginoscopic hysteroscopy might represent the therapeutic technique of choice in case of hematometra, even in the case of virgin patients.

Adolescent↗
PubMed2002

Frequency of symptomatic cornual hematometra and postablation tubal sterilization syndrome after total rollerball endometrial ablation: a 10-year follow-up.

OBJECTIVE: This study was undertaken to determine the frequency of symptomatic cornual hematometra and postablation tubal sterilization syndrome after total rollerball endometrial ablation and to describe methods for diagnosis, treatment, and prevention. STUDY DESIGN: Retrospective cases of 50 consecutive patients who received total rollerball endometrial ablation for dysfunctional uterine bleeding were followed up for 10 years. RESULTS: Symptomatic cornual hematometra or postablation tubal sterilization syndrome was diagnosed by ultrasound scanning and/or magnetic resonance imaging in 5 of 50 patients (10%) who had a total endometrial ablation. Two patients had cornual hematometra, and 3 patients had postablation tubal sterilization syndrome 4 months to 90 months after rollerball ablation. Subsequent gonadotropin-releasing hormone agonist treatment or hysteroscopic decompression of the hematometra was only partially successful, and recurrence of symptoms necessitated hysterectomy with salpingectomy. CONCLUSION: Uterine contracture, which obstructs bleeding from persistent cornual endometrium and leads to symptomatic cornual hematometra or postablation tubal sterilization syndrome, is not uncommon after total rollerball endometrial ablation, with an incidence of 10% in our series. Satisfactory treatment requires hysterectomy with salpingectomy, but modifications such as partial endometrial ablation can prevent these complications.

Catheter Ablation↗
PubMedDate not supplied

Endometrial carcinoma presenting as hematometra mimicking a large pelvic cyst.

Large pelvic cysts are commonly seen in gynecologic practice; their heterogeneous origin is reflected in their pleomorphic clinical features. We report the case of a 64-year-old multiparous postmenopausal woman with an unusual manifestation of endometrial adenocarcinoma that presented as hematometra mimicking a large pelvic cyst. In this case, hematometra was well demonstrated by transabdominal sonography, but transvaginal sonography allowed better visualization of the endometrial lining and suggested the correct diagnosis of endometrial cancer. Abnormal vaginal bleeding or hematometra in postmenopausal women should lead to assessment of the endometrial mucosa. Transvaginal sonography can be used to visualize neoplastic lesions in the endometrium when hematometra is detected through transabdominal sonography.

Adenocarcinoma↗
PubMed1999

Resectoscopic treatment of uterus didelphys with unilateral imperforate vagina complicated by hematocolpos and hematometra: case report.

OBJECTIVE: To describe a technique for treating hematocolpos and hematometra in patients with uterus didelphys and unilateral imperforate vagina involving the use of resectoscopy under ultrasonographic control. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 13-year-old girl with uterus didelphys with unilateral hematometra, hematocolpos, and ipsilateral renal agenesis. The girl complained of severe abdominal pain, which appeared with each of her menses. INTERVENTION(S): The intervention was performed by a vaginoscopic approach to preserve the integrity of the hymen. The first incision on the vaginal wall was performed in correspondence with the hematocolpos under continuous ultrasonographic guidance with the use of a straight resectoscopic loop. Resection of the vaginal septum was continued with the use of an angled resectoscopic loop until almost complete excision of the septum was achieved. MAIN OUTCOME MEASURE(S): Clinical, echographic, and vaginoscopic findings before the operation and 2 and 6 months after the operation. RESULT(S): The surgical procedure was easy to perform. Almost complete excision of the septum was achieved with just a few passages of the resectoscope. Complete drainage of both the hematocolpos and the hematometra was confirmed by ultrasonography. The postoperative period was completely uneventful. Clinical and vaginoscopic evaluations 6 months after the operation confirmed the integrity of the hymen, the complete resolution of clinical symptoms, and the persistence of a large communication between the two vaginas. CONCLUSION(S): Resectoscopic excision under ultrasonographic guidance of the vaginal septum in a girl with uterus didelphys with unilateral hematometra and hematocolpos was effective and easy to perform, and it fully respected the integrity of the reproductive system.

Adolescent↗
PubMed1996

Transvaginal sonography in the evaluation of hematometra. A report of two cases.

BACKGROUND: Transabdominal sonography is useful in the diagnosis of hematometra but may not provide information as to its cause. CASES: Two cases of postmenopausal bleeding were evaluated using both transabdominal and transvaginal sonography. Transabdominal sonography detected the presence of hematometra; transvaginal sonography detected the neoplastic lesions responsible for the hematometra. CONCLUSION: Transvaginal sonography is important in the evaluation of hematometra because it affords clear visualization of the endometrial cavity.

Adenocarcinoma↗
PubMed1997

Hematometra after radiotherapy for cervical carcinoma.

The development of a hematometra after radiotherapy for cervical carcinoma is often related to recurrent disease. We present two cases in which a hematometra developed during the use of estrogen replacement therapy. This development was related to regained endometrial activity in combination with fibrosis and obliteration of the upper vagina and/or cervix. In one patient a dilatation and curettage could be performed; in the other a hysterectomy was necessary in order to exclude recurrent disease. These two cases show once more that endometrium can regain its proliferative activity after radiotherapy for cervical cancer. Estrogen replacement therapy in these patients should include the use of a progestagen agent in order to avoid continuous unopposed endometrial stimulation. In the absence of progesterone withdrawal bleeding the uterine cavity should be routinely examined for the development of a hematometra.

Carcinoma, Squamous Cell↗
PubMed2001

Hematometra after thermal balloon endometrial ablation in a patient with cervical incompetence.

BACKGROUND: Thermal balloon endometrial ablation is a relatively safe nonsurgical treatment for menorrhagia. Hematometra follows this procedure in <3 % of patients, but risk factors for this complication are unclear. CASE: A woman with a history of cervical incompetence during pregnancy later developed cervical occlusion and hematometra after thermal balloon endometrial ablation. Cervical occlusion did not recur after cervical dilatation and temporary placement of a catheter as a stent. CONCLUSION: The normal resistance of the internal cervical os may be an important factor in avoiding thermal damage to the cervix during thermal balloon endometrial ablation. This case suggests that a history of cervical incompetence may be a clinical indicator of decreased cervical resistance.

Adult↗
PubMed1993

Hematometra associated with estrogen replacement therapy.

We have described two cases of hematometra occurring after initiation of estrogen replacement therapy. In both cases, cervical stenosis had developed during a prolonged period of hypoestrogenism. After initiation of sequential estrogen/progestin therapy, the stenosis prevented menstrual flow, and sonography revealed an asymptomatic hematometra in both cases. Based on these cases, we recommend doing a baseline evaluation of cervical patency before initiating estrogen replacement therapy in women who have been menopausal for a substantial length of time.

Aged↗
PubMed1993

Hematometra as a cause of lumbar radiculopathy. A case report.

Low-back pain combined with a positive straight leg raising test (Lasègue's sign) is uncommon in children and adolescents. Reproductive tract (Mullerian) anomalies causing an accumulation of menstrual blood in the vagina, uterus, and fallopian tubes represent an unusual extraspinal cause of low-back pain. The accumulation of blood in these cavities is termed hematocolpos, hematometra, and hematosalpinx. Amenorrhea with cyclic lower abdominal pain and a presenting pelvic mass are the usual presenting features. In the current report, we describe a case of an adolescent with low-back pain, positive straight leg raising test, and signs of L5 radiculopathy that were attributable to hematometra secondary to congenital partial absence of a vagina. This appears to be the first report of this type of presentation.

Child↗
PubMed2004

Heterotopic pregnancy in a natural conception cycle presenting as hematometra.

BACKGROUND: Heterotopic pregnancy is a rare event in natural conception cycles. Diagnosis of heterotopic pregnancy requires a high index of suspicion. Described herein is a reported case of a heterotopic pregnancy presenting as hematometra. CASE: A young, multiparous woman, with her last menstrual period 6 weeks before presentation, complained of a dark reddish-brown vaginal discharge and progressive left lower-quadrant discomfort during early pregnancy following a natural conception cycle. An intrauterine mass was observed, and subsequently a heterotopic pregnancy complicated by hematometra was diagnosed with the help of transvaginal ultrasonography and 3-dimensional power Doppler ultrasound angiography. CONCLUSION: Women with intrauterine fluid accumulation during pregnancy may be at risk for coexistent ectopic pregnancy. High resolution transvaginal color Doppler sonography may be useful to identify a heterotopic pregnancy preoperatively.

Adult↗
PubMed2006

Didelphic uterus and obstructed hemivagina: recurrent hematometra in spite of appropriate classic surgical treatment.

We report the case of a young girl with uterus didelphys, obstructed vagina and ipsilateral renal agenesis treated by diagnostic laparoscopy and resection of the vaginal septum by a vaginal approach in order to drain the distended uterus. Despite classic surgery, the myometrium on the treated side never recovered its normal function, with subsequent persistence of recurrent hematometra. Laparoscopic subtotal hemihysterectomy had to be performed to avoid retention of hematometra and secondary pelvic inflammatory disease.

Abnormalities, Multiple↗
PubMedDate not supplied

Hematometra secondary to anticoagulant rodenticide toxicity.

An adult, intact female Australian shepherd presented for frank vaginal bleeding of unknown duration. The only coagulation profile abnormality upon presentation was mild prolongation of the partial thromboplastin time (PTT). The uterus was removed at surgery and contained a large amount of coagulated blood. Clotting profiles were markedly abnormal 48 hours postoperatively. Serum analysis was positive for brodifacoum, an anticoagulant rodenticide. Preoperative coagulation was most likely normalized by vitamin K1 therapy administered prior to presentation. The only manifestation of anticoagulant rodenticide was hematometra. Rodenticide intoxication should be considered in the differential diagnosis list of hematometra or metrorrhagia.

4-Hydroxycoumarins↗
PubMed2001

[Hematometra & Listeria monocytogenes].

The hematometra is a nosological entity that may not always be attributed to an embryonic defect of the paramesonefros; cervical-vaginal infections such as etiological possibilities due to Listeria monocytogenes (Lm), cervix malignant neoplasias, iatrogenias due to endometrial ablation with Lasser, traumatic bloody uterine curetage and because of cervical cryocoagulation or electrocoagulation are also mentioned. The case to be reported is from a woman in reproductive stage, who is 32 years old, and had menarca at the age of 13, starting her sexual life at 31, not using any method to control her fertility. When having an eight-week amenorrhea after 8 months of marriage, she visited the doctor for assumed pregnancy, within the prenatal analysis a pelvic echographic study was requested, finding out images that we concluded as hematometra, having been drained and demonstrated the presence of LM by anti-Lm antibodies, being administered Azitromicina and Espiramicina.

Adult↗
PubMed1988

[Clinical and ultrasonic diagnosis of hematometra following curettage].

By hands of a case report we describe our diagnostic management in a patient suffering from hematometra 3 months after legal abortion. Sonography plays an important role in such cases to detect and explain the symptoms "metrorrhagy and uterine cramps monthly connected with small inflammatory signs". For curing we did a probing of the uterine cavity to eliminate the residual blood coagulas. 3 months after curing the hematometra the patient was clinically and sonographically without bodily ailments. Hypotheses about etiology and treatment of this rare condition are reviewed.

Adult↗
PubMed1994

Hematometra-A Complication of Endometrial Ablation/Resection

Hematometra is an uncommon complication of endometrial ablation/resection. Twenty-four patients with hematometra have been treated. Patients having endometrial ablation can be warned of this problem so that they can be dealt with rapidly either by ultrasound guided puncture and drainage, hysteroscopy with fluid medium or, as in one case, vaginal hysterectomy.

Journal Article↗