1
|
Ghaith S, Lewis GK, Craver EC, Li Z, Wasson MN, Burnett TL, Carrubba AR. The association of endosalpingiosis with chronic pelvic pain. Minerva Obstet Gynecol 2024; 76:151-157. [PMID: 36847525 DOI: 10.23736/s2724-606x.23.05241-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Endosalpingiosis is a pathologic diagnosis of ectopic epithelium resembling the fallopian tubes. It has been described with clinical characteristics that are similar to endometriosis. The primary objective is to determine if endosalpingiosis (ES) has a similar association with chronic pelvic pain when compared to endometriosis (EM). METHODS This is a retrospective case-control analysis of patients with a histologic diagnosis of endosalpingiosis or endometriosis at three affiliated academic hospitals between 2000 and 2020. All ES patients were included, and 1:1 matching was attempted to obtain a comparable EM cohort. Demographic and clinical data were obtained, and statistical analysis was performed. RESULTS A total of 967 patients (515 ES and 452 EM) were included. ES patients were significantly older than EM patients (median age 52 vs. 48 years, P<0.001), but other demographic variables were similar. Fewer ES patients had baseline chronic pelvic pain than EM patients (25.3% vs. 47%, P<0.001), and patients with ES were less likely to undergo surgery for the primary indication of pelvic pain (16.1% vs. 35.4%, P<0.001). Pelvic pain as the surgical indication remained lower in the ES group in multivariable analysis (OR=0.49, P<0.001). There were similar rates of persistent postoperative pain between ES and EM groups (10.1% vs. 13.5%, P=0.109). CONCLUSIONS Although endosalpingiosis can be associated with chronic pelvic pain, the incidence of pain is significantly lower than in patients who have endometriosis. These findings suggest that ES is a unique condition that differs from EM. Further research including long-term follow-up and patient-reported outcomes is imperative.
Collapse
Affiliation(s)
- Summer Ghaith
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Gregory K Lewis
- Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, FL, USA
| | - Emily C Craver
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
| | - Zhuo Li
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
| | - Megan N Wasson
- Department of Medical and Surgical Gynecology, Mayo Clinic, Scottsdale, AZ, USA
| | - Tatnai L Burnett
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA
| | - Aakriti R Carrubba
- Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, FL, USA -
| |
Collapse
|
2
|
Geagea V, Echtay L, Salman F, Ghaname W, Ziadeh H. Isolated torsion of the fallopian tube associated with hematosalpinx in a 17-year-old adolescent: A case report. Int J Gynaecol Obstet 2024; 165:382-383. [PMID: 38112290 DOI: 10.1002/ijgo.15289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/20/2023] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Affiliation(s)
- Vanessa Geagea
- Department of Obstetrics and Gynecology, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Leen Echtay
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Firas Salman
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Wadih Ghaname
- Department of Obstetrics and Gynecology, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Hanane Ziadeh
- Department of Obstetrics and Gynecology, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| |
Collapse
|
3
|
Yagur Y, Weitzner O, Shams R, Man-El G, Kadan Y, Daykan Y, Klein Z, Schonman R. Bilateral or unilateral tubo-ovarian abscess: exploring its clinical significance. BMC Womens Health 2023; 23:678. [PMID: 38115034 PMCID: PMC10729436 DOI: 10.1186/s12905-023-02826-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 12/03/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVES To assess the characteristics of patients with unilateral and bilateral tubo-ovarian abscess (TOA). METHODS Women diagnosed with TOA during 2003-2017 were included in this retrospective cohort study. TOA was diagnosed using sonography or computerized tomography and clinical criteria, or by surgical diagnosis. Demographics, sonographic data, clinical treatment, surgical treatment, and post-operative information were retrieved. RESULTS The study cohort included 144 women who met the inclusion criteria, of whom 78 (54.2%) had unilateral TOA and 66 (45.8%) had bilateral TOA. Baseline characteristics were not different between the groups. There was a statistical trend that women with fewer events of previous PID were less likely to have with bilateral TOA (75.3% vs. 64.1%, respectively; p = 0.074). Women diagnosed with bilateral TOA were more likely to undergo surgical treratment for bilateral salpingo-oophorectomy compared to unilateral TOA (61.5% vs. 42.3%, respectively; p = 0.04). There was no difference in maximum TOA size between groups. CONCLUSIONS This study detected a trend toward increased need for surgical treatment in women diagnosed with bilateral TOA. These findings may contribute to determining the optimal medical or surgical treatment, potentially leading to a decrease in the duration of hospitalization, antibiotic exposure, and resistance. However, it is important to acknowledge that the results of the current study are limited, and further research is warranted to validate these potential outcomes.
Collapse
Affiliation(s)
- Yael Yagur
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel affiliated with The School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Omer Weitzner
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel affiliated with The School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rebecca Shams
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel affiliated with The School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gili Man-El
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel affiliated with The School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yfat Kadan
- Department of Gynecology Oncology, Heamek Medical Center, Afula, Israel affiliated with The Ruth and Bruce Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel
| | - Yair Daykan
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel affiliated with The School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Zvi Klein
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel affiliated with The School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Schonman
- Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel affiliated with The School of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
4
|
Tachi E, Yokota Y, Shiota K, Hirata T. Isolated Fallopian Tube Torsion Associated with Tubal Pregnancy. J Obstet Gynaecol Can 2023; 45:102084. [PMID: 36868353 DOI: 10.1016/j.jogc.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 12/24/2022] [Accepted: 12/29/2022] [Indexed: 03/05/2023]
Affiliation(s)
- Emiri Tachi
- Department of Integrated Women's Health, St. Luke's International Hospital
| | - Yuko Yokota
- Department of Integrated Women's Health, St. Luke's International Hospital
| | - Kyoko Shiota
- Department of Integrated Women's Health, St. Luke's International Hospital
| | - Tetsuya Hirata
- Department of Integrated Women's Health, St. Luke's International Hospital.
| |
Collapse
|
5
|
Mayan D, Melton CS, Sanderford VL, Camps JI, Tomlin KV. Surgical Treatment of Bilateral Tubo-Ovarian Abscess in a Pre-Coitarchal Female. Am Surg 2023; 89:6206-6208. [PMID: 35768199 DOI: 10.1177/00031348221112264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Tubo-ovarian abscess (TOA) is a complication of pelvic inflammatory disease that is most commonly seen in sexually active females and seldom in pre-coitarchal adolescents. Initial treatment is generally parenteral antibiotics but often requires more invasive surgical procedures. We present the case of a 12-year-old, non-sexually active adolescent, with bilateral TOA who ultimately underwent a sterilizing bilateral salpingectomy and appendectomy for treatment.
Collapse
Affiliation(s)
- Danel Mayan
- University of South Carolina School of Medicine, Columbia, SC, USA
| | | | | | - Juan I Camps
- Department of Pediatric Surgery, Prisma Health Children's Hospital Midlands, Columbia, SC, USA
| | - Kristl V Tomlin
- Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Prisma Health Midlands, Columbia, SC, USA
| |
Collapse
|
6
|
Meyer R, Meller N, Mohr-Sasson A, Toussia-Cohen S, Machtinger R, Bart Y, Mashiach R, Levin G. Clinical features of isolated Fallopian tube torsion: evidence from a large series. HUM FERTIL 2023; 26:971-977. [PMID: 35114880 DOI: 10.1080/14647273.2022.2034056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 10/14/2021] [Indexed: 11/04/2022]
Abstract
We aimed at studying isolated Fallopian tube torsion (IFTT) in a relatively large cohort of women and to evaluate different features of IFTT in comparison to a large cohort of women with non-IFTT adnexal torsion (NIAT). This was a retrospective cohort study. We included women with surgically confirmed ovarian and/or Fallopian tube torsion between March 2011 and June 2020. Fifty-four cases of IFTT were surgically confirmed during the study period and were compared to 422 surgically confirmed NIAT. The rate of controlled ovarian hyperstimulation treatments, current pregnancy, and vomiting was lower in the IFTT group compared with the NIAT group. Cervical tenderness and vaginal discharge were more common in the IFTT group. Oedematous and enlarged ovaries were less common in the IFTT group. In multivariate regression analysis, the following factors were independently associated with IFTT: (i) vaginal discharge [adjusted odds ratio (aOR) 95% CI 8.16, 1.98-33.55]; (ii) cervical motion tenderness (aOR 95% CI 2.71, 1.01-7.29); (iii) fertility treatments (aOR 95% CI 0.26, 0.70-0.77); (iv) previous abdominal surgery (aOR 95% CI 0.46, 0.22-0.96); (v) vomiting (aOR 95% CI 0.38, 0.19-0.76); and (vi) enlarged ovary (aOR 95% CI 0.34, 0.18-0.65). In conclusion, we have identified factors positively and negatively associated with IFTT in a large cohort of women with adnexal torsion.
Collapse
Affiliation(s)
- Raanan Meyer
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- The Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel
| | - Nir Meller
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Aya Mohr-Sasson
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shlomo Toussia-Cohen
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ronit Machtinger
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yossi Bart
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Roy Mashiach
- Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Ramat-Gan, Israel
- Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gabriel Levin
- Department of Gynecologic Oncology, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| |
Collapse
|
7
|
Türen Demir E, Energin H, Kilic F. Image-guided drainage management of tubo-ovarian abscess and the role of C-reactive protein measurements in monitoring treatment response: a single-center experience. Arch Gynecol Obstet 2023; 308:1321-1326. [PMID: 37389642 DOI: 10.1007/s00404-023-07117-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/11/2023] [Indexed: 07/01/2023]
Abstract
PURPOSE We aimed to compare the results of image-guided drainage in addition to antibiotic therapy (antibiotherapy) with antibiotherapy alone in the treatment of tubo-ovarian abscesses (TOAs) and evaluate C-reactive protein (CRP) levels in predicting the success of antibiotherapy. METHODS This was a retrospective study of 194 patients hospitalized with TOA. Patients were divided into the following two groups: those who underwent image-guided drainage in addition to parenteral antibiotherapy and those who did not undergo image-guided drainage and received antibiotherapy alone. CRP levels on the day of admission (day 0), day 4 of hospitalization (day 4), and day of discharge (last day) were recorded. The percentage of decrease in CRP levels during day 4 and the last day compared with that on day 0 was calculated. RESULTS A total of 106 patients (54.6%) underwent image-guided drainage with antibiotherapy, whereas 88 patients (45.4%) did not undergo drainage and received antibiotherapy alone. At admission, the mean CRP level was 203.4 (± 96.7) mg/L and was similar in both groups. The mean decrease in the CRP level on day 4 compared with that on day 0 was 48.5% and was statistically higher in the group that underwent image-guided drainage. Antibiotherapy failed in 18 patients, and a statistically significant difference was observed between treatment failure and the rate of decrease in the CRP level on day 4 compared with that on day 0. According to the receiver operating characteristic (ROC) analysis, if the CRP level measured on day 4 decreased by < 37.1% compared with that on day 0, the probability of treatment failure would increase (area under the curve = 0.755; 95% confidence interval, 0.668-0.841; sensitivity, 73.6%; specificity, 60%). CONCLUSIONS Image-guided drainage combined with antibiotherapy in the treatment of TOA has high success rates, lower recurrence rates, and lower surgical requirement, and the mean decrease in the CRP level on day 4 can be monitored at treatment follow-up. In patients receiving antibiotherapy alone, if the CRP level on day 4 decreases by < 37.1%, the treatment protocol should be changed.
Collapse
Affiliation(s)
- Emine Türen Demir
- Department of Obstetrics and Gynecology, Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye.
| | - Hasan Energin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye
| | - Fatma Kilic
- Department of Obstetrics and Gynecology, Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye
| |
Collapse
|
8
|
Crosier CJ, Ricca RL. Isolated Fallopian Torsion: A Pediatric Case Series. Am Surg 2023; 89:3917-3919. [PMID: 37204787 DOI: 10.1177/00031348231175118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Isolated fallopian tube torsion is a rare cause of acute abdominal pain in adolescent females. It is known to be a surgical emergency as it may lead to ischemia of the fallopian tube which can result in necrosis, infertility or infection. Presenting symptoms and radiographic findings are vague making diagnosis difficult, often requiring direct visualization in the operating room to make the definitive diagnosis. There has been an increase in this diagnosis at our institution in the previous year prompting compilation of cases and a literature review.
Collapse
Affiliation(s)
| | - Robert L Ricca
- Department of Pediatric Surgery, Prisma Health Upstate, Greenville, SC, USA
| |
Collapse
|
9
|
洪 鹏, 熊 薇, 徐 瑞, 谭 世, 欧阳 运, 傅 璟. [Impact of Endometriosis on the Therapeutic Effect of Hysteroscopic Fallopian Tube Catheterization Combined With Laparoscopy in Infertile Patients With Proximal Tubal Obstruction]. Sichuan Da Xue Xue Bao Yi Xue Ban 2023; 54:1035-1039. [PMID: 37866965 PMCID: PMC10579067 DOI: 10.12182/20230960205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Indexed: 10/24/2023]
Abstract
Objective To investigate the impact of endometriosis on the therapeutic effect of hysteroscopic fallopian tube catheterization combined with laparoscopy in infertile patients with proximal tubal obstruction. Methods We conducted a retrospective analysis of patients who underwent hysteroscopic fallopian tube catheterization combined with laparoscopy for infertility caused by proximal fallopian tube obstruction between January 19, 2016 and March 20, 2020 at the Department of Reproductive Endocrinology, West China Second Hospital, Sichuan University. During the operation, hydrotubation was performed to verify whether there was proximal tubal obstruction. Then, the patients were categorized into an endometriosis group and a non-endometriosis group according to whether their proximal tubal obstruction was combined with endometriosis. The baseline data were balanced by propensity score matching and the rate of successful surgical unblocking of proximal tubal obstruction in infertile patients by hysteroscopic fallopian tube catheterization combined with laparoscopy was calculated. Treating cases lost to follow-up in both groups as non-pregnant cases according to the principle of intention-to-treat analysis, we followed up the pregnancy outcomes after surgery. The primary indicators included overall successful surgical unblocking rate, clinical pregnancy rate, and spontaneous pregnancy rate, while the secondary indicators included live birth rate, miscarriage rate, ectopic pregnancy rate, and the mean time to spontaneous pregnancy after surgery. The primary indicators included overall successful surgical unblocking rate, clinical pregnancy rate, and spontaneous conception rate, while the secondary indicators included live birth rate, miscarriage rate, ectopic pregnancy rate, and the mean time to spontaneous pregnancy after surgery. Results After propensity score matching, 113 cases were included in each of the two groups, with the overall successful surgical unblocking rate being 72.6%. The successful surgical unblocking rate of patients in the endometriosis group was higher than that of the non-endometriosis group, with the difference being statistically significant (78.8% vs. 66.4%, P<0.05). A total of 38 patients were lost after follow-up matching. Postoperative follow-up was performed to date and, through intention-to-treat analysis, the spontaneous conception rate was found to be higher in the endometriosis group than that in the non-endometriosis group (44.2% vs. 30.1%, P<0.05), while the mean time to spontaneous pregnancy after surgery was shorter in the endometriosis group than that in the non-endometriosis group (46 months vs. 53 months, P<0.05). There was no significant difference in clinical pregnancy rate, live birth rate, miscarriage rate, and ectopic pregnancy rate between the endometriosis group and the non-endometriosis group ( P>0.05). Conclusion When infertility caused by proximal tubal obstruction is combined with endometriosis, performing hysteroscopic fallopian tube catheterization combined with laparoscopy contributes to the improvement of reproduction outcomes.
Collapse
Affiliation(s)
- 鹏 洪
- 四川大学华西第二医院 生殖内分泌科 (成都 610041)Department of Reproductive Endocrinology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西临床医院学院 (成都 610041)West China School of Medicine, Sichuan University, Chengdu 610041, China
- 出生缺陷与相关妇儿疾病教育部重点实验室 (成都 610041)Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu 610041, China
- 西藏自治区昌都市人民医院 (昌都 854000)Qamdo People's Hospital of Tibet Autonomous Region, Qamdo 854000, China
| | - 薇 熊
- 四川大学华西第二医院 生殖内分泌科 (成都 610041)Department of Reproductive Endocrinology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西临床医院学院 (成都 610041)West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - 瑞涓 徐
- 四川大学华西第二医院 生殖内分泌科 (成都 610041)Department of Reproductive Endocrinology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西临床医院学院 (成都 610041)West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - 世桥 谭
- 四川大学华西第二医院 生殖内分泌科 (成都 610041)Department of Reproductive Endocrinology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西临床医院学院 (成都 610041)West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - 运薇 欧阳
- 四川大学华西第二医院 生殖内分泌科 (成都 610041)Department of Reproductive Endocrinology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西临床医院学院 (成都 610041)West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - 璟 傅
- 四川大学华西第二医院 生殖内分泌科 (成都 610041)Department of Reproductive Endocrinology, West China Second University Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西临床医院学院 (成都 610041)West China School of Medicine, Sichuan University, Chengdu 610041, China
| |
Collapse
|
10
|
Wang Y. An isolated left sided fallopian tube with gangrenous necrosis in an adolescent. Arch Gynecol Obstet 2023; 308:639-640. [PMID: 35999404 DOI: 10.1007/s00404-022-06749-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/12/2022] [Indexed: 11/02/2022]
Affiliation(s)
- Ying Wang
- Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Longshan Road 120, Yubei District, Chongqing, China.
| |
Collapse
|
11
|
Osada H, Seto M, Nakase K, Ezoe K, Miyauchi O, Fujita H, Miyakawa Y, Nagaishi M, Kato K, Teramoto S, Shozu M. Prevalence of chronic endometritis in patients with infertility due to hydrosalpinx or pelvic peritubal adhesions and effect of laparoscopic surgical correction on pregnancy rates post in vitro fertilization. Eur J Obstet Gynecol Reprod Biol 2023; 284:143-149. [PMID: 36996643 DOI: 10.1016/j.ejogrb.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/19/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVE(S) To assess the prevalence of chronic endometritis (CE) in patients with infertility and hydrosalpinx or peritubal adhesions and to examine the effects of laparoscopic surgical correction (LSC) on CE and pregnancy rates post in vitro fertilization and embryo transfer (IVF-ET). STUDY DESIGN This is a retrospective cohort study at private IVF-ET centers. A total of 438 patients, known to have hydrosalpinx (n = 194) or peritubal adhesions (n = 244), and undergoing IVF treatment between April 1, 2018 and September 30, 2020 were included in the study. Hysterosalpingography, magnetic resonance imaging, and transvaginal ultrasonography were used to diagnose the hydrosalpinx or peritubal adhesions. Laparoscopic examination and surgical correction were performed on patients with CE. IVF-ET was performed after recovery from LSC. RESULTS CE was present in 45.9% of patients (89/194) with hydrosalpinx and 14.3% with peritubal adhesions (35/244). All the 89 patients with CE and hydrosalpinx underwent laparoscopic salpingostomy and/or fimbrioplasty, and 64 (71.9%) further underwent proximal tubal occlusion. All the 35 patients with CE and peritubal adhesions underwent laparoscopic adhesiolysis and/or fimbrioplasty, and 19 (54.3%) further underwent proximal tubal occlusion. CD138 PC levels after LSC decreased to < 5 in 70 of 124 patients (56.5%) in one menstrual cycle and decreased to < 5 in all cases within 6 months. Of the 66 patients who underwent a single blastocyst transfer, 57 delivered (cumulative live birth rate (LBR): 86.3%). The cumulative LBR of patients treated for CE with LSC (86.3%) was significantly different from those given antibiotic therapy (320 patients; 38.4%; p <.0001) and the CD138-negative groups (811; 31.8%; p <.0001). CONCLUSION CE is prevalent in patients with hydrosalpinx and/or peritubal adhesions who present with infertility. LSC improved CE without antibiotic therapy, improving the CP and LBR after IVF-ET.
Collapse
Affiliation(s)
- Hisao Osada
- Natural ART Clinic Nihombashi, Tokyo Nihombashi Tower (8F), 2-7-1 Nihombashi, Chuo-ku, Tokyo 103-6028, Japan.
| | - Michiharu Seto
- Seto Hospital, 8-6 Kanayama-cho, Tokorozawa-shi, Saitama 359-1128, Japan.
| | - Kaori Nakase
- Kato Ladies Clinic, 7-20-3, Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
| | - Kenji Ezoe
- Kato Ladies Clinic, 7-20-3, Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
| | - Osamu Miyauchi
- Natural ART Clinic Nihombashi, Tokyo Nihombashi Tower (8F), 2-7-1 Nihombashi, Chuo-ku, Tokyo 103-6028, Japan.
| | - Hiroshi Fujita
- Kato Ladies Clinic, 7-20-3, Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
| | - Yasuji Miyakawa
- Nihon University Hospital, 1-6, Kanda Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan.
| | - Masaji Nagaishi
- Nihon University Hospital, 1-6, Kanda Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan.
| | - Keiichi Kato
- Kato Ladies Clinic, 7-20-3, Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
| | - Shokichi Teramoto
- Natural ART Clinic Nihombashi, Tokyo Nihombashi Tower (8F), 2-7-1 Nihombashi, Chuo-ku, Tokyo 103-6028, Japan.
| | - Makio Shozu
- Chiba University Postgraduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba Prefecture 260-0876, Japan.
| |
Collapse
|
12
|
Maignien C, Bourdon M, Scarano-Pereira JP, Martinino A, Cheloufi M, Marcellin L, Chapron C, Santulli P. ART Outcomes After Hysteroscopic Proximal Tubal Occlusion Versus Laparoscopic Salpingectomy for Hydrosalpinx Management in Endometriosis Patients. Reprod Sci 2021; 29:427-435. [PMID: 34642914 DOI: 10.1007/s43032-021-00737-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
Abstract
The objective of this paper is to compare assisted reproductive technology (ART) cumulative live birth rates after hysteroscopic proximal tubal occlusion and laparoscopic salpingectomy in endometriosis patients, for management of hydrosalpinx. This is an observational cohort study at a university hospital, including all endometriosis patients with hydrosalpinges undergoing ART, between January 2013 and December 2018. The patients underwent either laparoscopic salpingectomy or hysteroscopic proximal tubal occlusion with Essure® when laparoscopy was not an option (extensive pelvic adhesions at exploratory laparoscopy or a history of multiple abdominal surgeries with frozen pelvis). The diagnosis of endometriosis was based on published imaging criteria using transvaginal sonography (TVUS) and magnetic resonance imaging (MRI). Endometriosis patients with hydrosalpinges diagnosed by hysterosalpingography and/or TVUS and/or MRI were included. The primary outcome was the cumulative live birth rate. A total of 104 patients were included in the study; 74 underwent laparoscopic salpingectomy and 30 underwent proximal tubal occlusion with Essure®. The Essure® group had longer infertility durations (58.9 ± 30.0 months vs. 39.5 ± 19.1 months, p = 0.002) and a higher incidence of associated adenomyosis (76.7% vs. 39.1%, p < 0.001) than the salpingectomy group. The cumulative live birth rate was 56.6% after 44 ART cycles in the Essure® group and 40.5% after 99 ART cycles in the salpingectomy group (p = 0.13). In a population of endometriosis patients undergoing ART, women treated by Essure® for management of hydrosalpinx have similar cumulative live birth rates as women treated by laparoscopic salpingectomy.
Collapse
Affiliation(s)
- Chloé Maignien
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
| | - Mathilde Bourdon
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
- Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Juan Pablo Scarano-Pereira
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
| | - Alessandro Martinino
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
| | - Meryam Cheloufi
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
| | - Louis Marcellin
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
- Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Charles Chapron
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France
- Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Pietro Santulli
- Faculté de Médecine Paris Centre, Faculté de Santé, Université de Paris, 12 Rue de l'École de Médecine, 75006, Paris, France.
- Department of Gynecology Obstetrics II and Reproductive Medicine (Professor Chapron), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 123 Boulevard de Port Royal, 75014, Paris, France.
- Department "Development, Reproduction and Cancer", Cochin Institute, INSERM U1016 (Professor Batteux), 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.
| |
Collapse
|
13
|
de Matos VL, Pessanha I, David DA, Gante I. Isolated torsion of a fallopian tube: an uncommon cause of abdominal pain in an 11-year-old. BMJ Case Rep 2021; 14:e243947. [PMID: 34433530 PMCID: PMC8388290 DOI: 10.1136/bcr-2021-243947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 11/04/2022] Open
Abstract
This report describes a rare case of isolated fallopian tube torsion (IFTT) in a premenarchal 11-year-old girl. The patient presented with subacute abdominal pain, associated with nausea and vomiting. Sonographic findings revealed left tube enlargement with free intraperitoneal fluid. Doppler mapping was not unequivocal. During exploratory laparoscopy, a large pelvic necrotic mass was found to be a twisted left fallopian tube. After detorsion, salpingectomy was performed and the patient recovered promptly, showing no complications 3 months post operation. IFTT should be considered as a differential diagnosis of lower abdominal pain in adolescent girls with normal-appearing ovaries on ultrasound. Conservative management for fertility preservation is the ideal approach. Therefore, avoiding delay in laparoscopy is crucial.
Collapse
Affiliation(s)
- Victória Leones de Matos
- Department of Pediatric Surgery, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Inês Pessanha
- Department of Pediatric Surgery, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Daniela Agostinho David
- Department of gynecology and obstetrics, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| | - Inês Gante
- Department of gynecology and obstetrics, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
| |
Collapse
|
14
|
Hattiangadi R, McEntee K, Dahlman M. Minimally invasive approach to the management of tubo-ovarian abscesses. Curr Opin Obstet Gynecol 2021; 33:249-254. [PMID: 34155166 DOI: 10.1097/gco.0000000000000720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of this publication is to review the most up-to-date literature regarding the pathogenesis, diagnosis and management of tubo-ovarian abscesses. RECENT FINDINGS Prior to the advent of broad-spectrum antibiotics, tubo-ovarian abscesses necessitated total abdominal hysterectomy and bilateral salpingo-oophorectomy. Although it carries a risk of treatment failure, antibiotic therapy enabled fertility-sparing treatment for many women. Recent studies have identified key predictors for antibiotic treatment failure, including age, BMI and abscess diameter. C-reactive protein was also found to be a strong predictor of antibiotic treatment response. Given the growing evidence of treatment failure with antibiotic therapy alone, along with increased availability and access to interventional radiology, image-guided drainage with or without catheter placement, combined with broad-spectrum antibiotics, is now considered first-line therapy. SUMMARY Tubo-ovarian abscess is a diagnostic challenge, as presentation can vary. Inadequate treatment is associated with severe morbidity and mortality. Despite adequate conservative treatment, recurrence risk is high and clinical sequelae can have devastating effects on reproductive health. Recent evidence-based developments, including a risk score system to predict antibiotic failure, serve to provide appropriately directed risk-based care. However, large-scale randomized controlled trials are needed to clarify the most appropriate treatment modalities.
Collapse
Affiliation(s)
- Rohan Hattiangadi
- Virginia Mason Medical Center, Department of Gynecology, Seattle, Washington, USA
| | | | | |
Collapse
|
15
|
Goje O, Markwei M, Kollikonda S, Chavan M, Soper DE. Outcomes of Minimally Invasive Management of Tubo-ovarian Abscess: A Systematic Review. J Minim Invasive Gynecol 2021; 28:556-564. [PMID: 32992023 DOI: 10.1016/j.jmig.2020.09.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/09/2020] [Accepted: 09/19/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare the success rate, complications, and hospital length-of-stay of 3 modalities of minimally invasive management of tubo-ovarian abscesses (TOAs): laparoscopy, ultrasound-guided drainage, and computed tomography-guided drainage. DATA SOURCES Electronic-based search in PubMed, EMBASE, Ovid MEDLINE, Google Scholar, and Cochrane Central Register of Controlled Trials, using the following Medical Subject Heading terms: "minimally invasive surgical procedures," "drainage," "abscess," "tubo-ovarian," "ovarian diseases," and "fallopian tube diseases." METHODS OF STUDY SELECTION Of the 831 articles in the initial results, 10 studies were eligible for inclusion in our systematic review. TABULATION, INTEGRATION, AND RESULTS A total of 975 patients were included in our study; 107 (11%) had laparoscopic drainage procedures, and 406 (42%) had image-guided (ultrasound or computed tomography) drainage of TOAs. Image-guided TOA drainage had higher success rates (90%-100%) than laparoscopic drainage (89%-96%) and the use of antibiotic treatment alone (65%-83%). Patients treated with image-guided drainage had no complications (for up to 6 months of follow-up) and shorter lengths of hospital stay (0-3 days on average) compared with laparoscopic drainage (5-12 days) or conservative management with antibiotics alone (7-9 days). CONCLUSION Although conservative management of TOAs with antibiotics alone remains first-line, our review indicates that better outcomes in the management of TOA were achieved by minimally invasive approach compared with conservative treatment with antibiotics only. Of the minimally invasive techniques, image-guided drainage of TOAs provided the highest success rates, the fewest complications, and the shortest hospital stays compared with laparoscopy. The low magnitude of evidence in the included studies calls for further randomized trials. This systematic review was registered in the International Prospective Register of Systematic Review (register, http://www.crd.york.ac.uk/PROSPERO;CRD 42020170345).
Collapse
Affiliation(s)
- Oluwatosin Goje
- Obstetrics & Gynecology and Women's Health Institute, Cleveland Clinic Foundation (Drs. Goje and Kollikonda).
| | - Metabel Markwei
- Cleveland Clinic Lerner College of Medicine, Case Western Reserve University (Ms. Markwei)
| | - Swapna Kollikonda
- Obstetrics & Gynecology and Women's Health Institute, Cleveland Clinic Foundation (Drs. Goje and Kollikonda)
| | - Monica Chavan
- Case Western Reserve University School of Medicine (Ms. Chavan), Cleveland, Ohio
| | - David E Soper
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina (Dr. Soper)
| |
Collapse
|
16
|
Burla L, Kalaitzopoulos DR, Eberhard M, Samartzis N. [Endosalpingiosis - an Irrelevant Incidental Finding During Laparoscopy?]. Praxis (Bern 1994) 2021; 110:804-811. [PMID: 34702059 DOI: 10.1024/1661-8157/a003728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Endosalpingiosis - an Irrelevant Incidental Finding During Laparoscopy? Abstract. Endosalpingiosis refers to the ectopic presence of tubal epithelium. However, this incidental finding received little attention, although it is the second most common benign peritoneal pathology in women following endometriosis. In contrast to endometriosis, endosalpingiosis shows an increase in prevalence with age beyond the menopause. Furthermore, it does not appear to be chronically inflammatory and, according to research to this date, does not cause chronic pain or infertility. Recent epidemiological and molecular pathological studies show a significantly higher incidence of ovarian and endometrial tumors in women with endosalpingiosis. These correlations have not been conclusively clarified. Generally accepted clinical recommendations for the detection of endosalpingiosis do not yet exist. In order to better understand the disease value of endosalpingiosis and its oncological correlations, this entity should be brought to the attention of surgical gynecology and involved pathology.
Collapse
Affiliation(s)
- Laurin Burla
- Frauenklinik, Kantonsspital Schaffhausen, Schaffhausen
| | | | | | | |
Collapse
|
17
|
Melo P, Georgiou EX, Johnson N, van Voorst SF, Strandell A, Mol BWJ, Becker C, Granne IE. Surgical treatment for tubal disease in women due to undergo in vitro fertilisation. Cochrane Database Syst Rev 2020; 10:CD002125. [PMID: 33091963 PMCID: PMC8094448 DOI: 10.1002/14651858.cd002125.pub4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Tubal disease accounts for 20% of infertility cases. Hydrosalpinx, caused by distal tubal occlusion leading to fluid accumulation in the tube(s), is a particularly severe form of tubal disease negatively affecting the outcomes of assisted reproductive technology (ART). It is thought that tubal surgery may improve the outcome of ART in women with hydrosalpinges. OBJECTIVES To assess the effectiveness and safety of tubal surgery in women with hydrosalpinges prior to undergoing conventional in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). SEARCH METHODS We searched the Cochrane Gynaecology and Fertility (CGF) Group trials register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, DARE, and two trial registers on 8 January 2020, together with reference checking and contact with study authors and experts in the field to identify additional trials. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing surgical treatment versus no surgical treatment, or comparing surgical interventions head-to-head, in women with tubal disease prior to undergoing IVF. DATA COLLECTION AND ANALYSIS We used Cochrane's standard methodological procedures. The primary outcomes were live birth rate (LBR) and surgical complication rate per woman randomised. Secondary outcomes included clinical, multiple and ectopic pregnancy rates, miscarriage rates and mean numbers of oocytes retrieved and of embryos obtained. MAIN RESULTS We included 11 parallel-design RCTs, involving a total of 1386 participants. The included trials compared different types of tubal surgery (salpingectomy, tubal occlusion or transvaginal aspiration of hydrosalpingeal fluid) to no tubal surgery, or individual interventions to one another. We assessed no studies as being at low risk of bias across all domains, with the main limitations being lack of blinding, wide confidence intervals and low event and sample sizes. We used GRADE methodology to rate the quality of the evidence. Apart from one moderate-quality result in one review comparison, the evidence provided by these 11 trials ranged between very low- to low-quality. Salpingectomy versus no tubal surgery No included study reported on LBR for this comparison. We are uncertain of the effect of salpingectomy on surgical complications such as the rate of conversion to laparotomy (Peto odds ratio (OR) 5.80, 95% confidence interval (CI) 0.11 to 303.69; one RCT; n = 204; very low-quality evidence) and pelvic infection (Peto OR 5.80, 95% CI 0.11 to 303.69; one RCT; n = 204; very low-quality evidence). Salpingectomy probably increases clinical pregnancy rate (CPR) versus no surgery (risk ratio (RR) 2.02, 95% CI 1.44 to 2.82; four RCTs; n = 455; I2 = 42.5%; moderate-quality evidence). This suggests that in women with a CPR of approximately 19% without tubal surgery, the rate with salpingectomy lies between 27% and 52%. Proximal tubal occlusion versus no surgery No study reported on LBR and surgical complication rate for this comparison. Tubal occlusion may increase CPR compared to no tubal surgery (RR 3.21, 95% CI 1.72 to 5.99; two RCTs; n = 209; I2 = 0%; low-quality evidence). This suggests that with a CPR of approximately 12% without tubal surgery, the rate with tubal occlusion lies between 21% and 74%. Transvaginal aspiration of hydrosalpingeal fluid versus no surgery No study reported on LBR for this comparison, and there was insufficient evidence to identify a difference in surgical complication rate between groups (Peto OR not estimable; one RCT; n = 176). We are uncertain whether transvaginal aspiration of hydrosalpingeal fluid increases CPR compared to no tubal surgery (RR 1.67, 95% CI 1.10 to 2.55; three RCTs; n = 311; I2 = 0%; very low-quality evidence). Laparoscopic proximal tubal occlusion versus laparoscopic salpingectomy We are uncertain of the effect of laparoscopic proximal tubal occlusion versus laparoscopic salpingectomy on LBR (RR 1.21, 95% CI 0.76 to 1.95; one RCT; n = 165; very low-quality evidence) and CPR (RR 0.81, 95% CI 0.62 to 1.07; three RCTs; n = 347; I2 = 77%; very low-quality evidence). No study reported on surgical complication rate for this comparison. Transvaginal aspiration of hydrosalpingeal fluid versus laparoscopic salpingectomy No study reported on LBR for this comparison, and there was insufficient evidence to identify a difference in surgical complication rate between groups (Peto OR not estimable; one RCT; n = 160). We are uncertain of the effect of transvaginal aspiration of hydrosalpingeal fluid versus laparoscopic salpingectomy on CPR (RR 0.69, 95% CI 0.44 to 1.07; one RCT; n = 160; very low-quality evidence). AUTHORS' CONCLUSIONS We found moderate-quality evidence that salpingectomy prior to ART probably increases the CPR compared to no surgery in women with hydrosalpinges. When comparing tubal occlusion to no intervention, we found that tubal occlusion may increase CPR, although the evidence was of low quality. We found insufficient evidence of any effect on procedure- or pregnancy-related adverse events when comparing tubal surgery to no intervention. Importantly, none of the studies reported on long term fertility outcomes. Further high-quality trials are required to definitely determine the impact of tubal surgery on IVF and pregnancy outcomes of women with hydrosalpinges, particularly for LBR and surgical complications; and to investigate the relative efficacy and safety of the different surgical modalities in the treatment of hydrosalpinges prior to ART.
Collapse
Affiliation(s)
- Pedro Melo
- Buckinghamshire Hospitals NHS Trust, Aylesbury, UK
| | | | - Neil Johnson
- Discipline of Obstetrics and Gynaecology, School of Medicine, Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | | | - Annika Strandell
- Obstetrics and Gynecology, University of Gothenburg, Gothenburg, Sweden
| | - Ben Willem J Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
| | - Christian Becker
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Ingrid E Granne
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| |
Collapse
|
18
|
Abstract
INTRODUCTION The women with hydrosalpinx have lower pregnancy rates in assisted reproductive technology, and only laparoscopic salpingectomy and tubal occlusion has proven to be effective to improve the outcome of in vitro fertilization. The main objective of the present meta-analysis was to assess and compare the ovarian reserve after salpingectomy or proximal tubal occlusion (PTO) in the published literature. MATERIAL AND METHODS We considered all published cohort (retrospective and prospective) and cross-sectional studies as well as randomized controlled trials that investigated changes in serum anti-Müllerian hormone (AMH), follicle-stimulating hormone levels or antral follicle count (AFC) following salpingectomy or PTO. Two investigators (SW, QZ) independently screened the full text of all identified articles to assess relevance to our meta-analysis. RESULTS In total, 648 patients were included in 5 studies. In the analysis of comparative studies. In the analysis of comparative studies, the follicle-stimulating hormone of salpingectomy had no significant difference with that of PTO (WMD 0.46IU/L, 95% CI[-0.14,1.05]). The AMH and AFC of salpingectomy were significantly higher than that of PTO (AFC: WMD -0.80IU/L, 95% CI [-1.46, -0.14]; AMH: WMD -1.01IU/L, 95% CI [-1.28, -0.74]). CONCLUSIONS Salpingectomy did more harm to ovarian reserve than PTO in the short-term. However, the long-term effects on ovarian reserve remains uncertain.
Collapse
|
19
|
Shevach Alon A, Kerner R, Ginath S, Barda G, Bar J, Sagiv R. Clinical Characteristics of Women with Isolated Fallopian Tube Torsion Compared with Adnexal Torsion. Isr Med Assoc J 2019; 21:575-579. [PMID: 31542899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Isolated fallopian tube torsion (IFTT) is a rare gynecological entity and its diagnosis is challenging. OBJECTIVES To compare clinical characteristics, sonographic findings, surgical management, and outcomes of women with surgically verified IFTT compared to those diagnosed with adnexal torsion. METHODS A retrospective case-control study in a university hospital was conducted. Thirty-four women with surgically verified IFTT between March 1991 and June 2017 were compared to 333 women diagnosed with adnexal torsion within the same time period. RESULTS Both groups presented primarily with abdominal pain, which lasted longer prior to admission among the IFTT group (46.8 ± 39.0 vs. 30.0 ± 39.4 hours, P < 0.001). Higher rates of abdominal tenderness with or without peritoneal signs were found in the adnexal torsion group (90.3% vs. 70.6%, P < 0.001). Sonographic findings were similar; however, an increased rate of hydrosalpinx was found among the IFTT group (5.9% vs. 0.0%, P = 0.008). Suspected adnexal torsion was the main surgical indication in only 61.8% of IFTT cases compared with 79.0% in the adnexal torsion group (P = 0.02). Salpingectomy with or without cystectomy was more commonly performed in the IFTT group (35.3% vs. 1.5%, P < 0.001). The leading pathological findings among the IFTT group were hydrosalpinx and paraovarian cysts. CONCLUSIONS The clinical signs and symptoms of IFTT and adnexal torsion are similar. Although sonographic imaging demonstrating a paraovarian cyst or hydrosalpinx may be helpful in diagnosing IFTT, it is rarely done preoperatively.
Collapse
Affiliation(s)
- Ayala Shevach Alon
- Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ram Kerner
- Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shimon Ginath
- Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Giulia Barda
- Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jacob Bar
- Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Sagiv
- Department of Obstetrics and Gynecology, Wolfson Medical Center, Holon, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
20
|
Abstract
This study aims to discuss the operative skills of hysteroscopic tubal embolization and reduce the occurrence of complications.Ninety-four patients were divided into group A and group B. The main surgical technique in group A: when the inner sleeve is sent to the fallopian tube and no longer accessible (but no >3 cm), remove the guide wire and put into the microcoil. But in group B, there are four major surgical techniques. First, the depth at which the guide wire enters the tube was controlled at 2 cm. Second, the inner diameter of the fallopian tube must be explored to determine the type and shape of the coils. Third, saline should be used to separate the catheter. Fourth, it is to control the release speed of the coils. The superiority of the improved operation method was confirmed by comparing the surgical failure rate, incidence of complications, and cost of surgery before and after the procedure.The reoperation rate of group A was 10% (3/30), while that of group B was 2.68% (3/112). The ectopic microcoils rate of group A was 6.67% (2/30), while that of group B was 0.89% (1/112). The microcoil damages rate of group 23.33% (7/30), while that of group B was 8.04% (9/112). All P values were <.01, and the difference was statistically significant.Hysteroscopic tubal embolization is currently a new surgical procedure to block the fallopian tubes and prevent the reverse flow of fluid in the fallopian tubes into the uterine cavity. After we improved surgical techniques, the surgical failure rate, complication rate, and operation cost of fallopian tube embolization were significantly lower than before the improved method was applied. The improved techniques led to a higher success rate.
Collapse
Affiliation(s)
- Hua-Lei Cai
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Guizhou Medical University
| | - Le-Yun Pan
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Shun-Fang Wang
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Yu Tian
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Xiao-Zhu Zheng
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Yan Yang
- Department of Obstetrics and Gynecology, The Affiliated Baiyun Hospital of Guizhou Medical University
| | - Kun Li
- Department of Surgical, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| |
Collapse
|
21
|
Torre A, Thornton J. A Frenchman in England: Ectopic pregnancy, hydrosalpinx, and torsion. Who cares about the tubes? She can have IVF. Or maybe not. J Gynecol Obstet Hum Reprod 2019; 48:291. [PMID: 30639783 DOI: 10.1016/j.jogoh.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 01/08/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Antoine Torre
- Division of Child Health, Obstetrics & Gynaecology, University of Nottingham. Maternity, City Hospital, Hucknall Road, NG5 1PB, Nottingham, United Kingdom.
| | - Jim Thornton
- Division of Child Health, Obstetrics & Gynaecology, University of Nottingham. Maternity, City Hospital, Hucknall Road, NG5 1PB, Nottingham, United Kingdom.
| |
Collapse
|
22
|
Verpalen IM, de Boer J, van den Hoed RD, Schutte JM, Teklenburg G, Vossenkaul R. [Isolated fallopian tubal torsion; rare or overlooked?]. Ned Tijdschr Geneeskd 2018; 162:D2670. [PMID: 30040317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Isolated fallopian tubal torsion (IFTT) is a rare cause of lower abdominal pain. It's difficult to diagnose preoperatively due to non-specific clinical symptoms. Furthermore, IFTT is often not considered in the differential diagnosis. Prompt diagnosis is critical, to prevent progression of symptoms and to maintain fertility; therefore, this article discusses diagnostic pitfalls and reports on key imaging features of IFTT that may facilitate preoperative diagnosis. IFTT should be suspected in a female patient with acute lower abdominal pain and a unilateral pelvic mass close to a normal ipsilateral ovary; there may be a history of prior tubal ligation. Specific imaging findings include the sonographic 'whirlpool sign' and absent flow during colour Doppler ultrasound. CT is often performed when the diagnosis remains unclear, but has no clinical consequences. IFTT requires emergency surgical treatment; detorsion without resection can be considered in women who would like to retain potential future fertility, but salpingectomy is often inevitable due to necrosis.
Collapse
|
23
|
Venturella R, Zullo F, Zupi E, Di Carlo C. Effect of salpingectomy on ovarian response to hyperstimulation during in vitro fertilization: does it really matter? Gynecol Endocrinol 2018; 34:270-271. [PMID: 29254379 DOI: 10.1080/09513590.2017.1417982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Roberta Venturella
- a Unit of Obstetrics and Gynaecology, Department of Experimental and Clinical Medicine , 'Magna Graecia' University , Catanzaro , Italy
| | - Fulvio Zullo
- a Unit of Obstetrics and Gynaecology, Department of Experimental and Clinical Medicine , 'Magna Graecia' University , Catanzaro , Italy
| | - Errico Zupi
- b Department of Biomedicine and Prevention , University of Tor Vergata , Rome , Italy
| | - Costantino Di Carlo
- a Unit of Obstetrics and Gynaecology, Department of Experimental and Clinical Medicine , 'Magna Graecia' University , Catanzaro , Italy
| |
Collapse
|
24
|
Tokmak A, Esercan A, Sarıkaya E. An incidental finding of chronic salpingitis complications: Tubo-uterine fistula. J Exp Ther Oncol 2017; 11:81-83. [PMID: 28976128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 03/27/2015] [Indexed: 06/07/2023]
Abstract
Pelvic inflammatory disease (PID) is an infection of the upper genital tract in women that can include endometritis, parametritis, salpingitis, oophoritis, tubo-ovarian abscess, and peritonitis. The spectrum of the disease ranges from subclinical and asymptomatic infection to severe, lifethreatening illness; squealae include chronic pelvic pain, ectopic pregnancy, and infertility. In this case we report an uncommon complication of pelvic inflammatory disease, a tubo-uterian fistula. Our case was diagnosed by laparoscopy incidentally during assessment of infertility.
Collapse
Affiliation(s)
- Aytekin Tokmak
- Zekai Tahir Burak Women's Health Research and Education Hospital, Department of Obstetrics and Gynecology; Division of Gynecological Endocrinology, Ankara, Turkey
| | - Alev Esercan
- Zekai Tahir Burak Women's Health Research and Education Hospital, Department of Obstetrics and Gynecology; Division of Gynecological Endocrinology, Ankara, Turkey
| | - Esma Sarıkaya
- Zekai Tahir Burak Women's Health Research and Education Hospital, Department of Obstetrics and Gynecology; Division of Gynecological Endocrinology, Ankara, Turkey
| |
Collapse
|
25
|
Abstract
BACKGROUND Surgery remains an acceptable treatment modality for tubal infertility despite the rise in usage of in vitro fertilisation (IVF). Estimated livebirth rates after surgery range from 9% for women with severe tubal disease to 69% for those with mild disease; however, the effectiveness of surgery has not been rigorously evaluated in comparison with other treatments such as IVF and expectant management (no treatment). Livebirth rates have not been adequately assessed in relation to the severity of tubal damage. It is important to determine the effectiveness of surgery against other treatment options in women with tubal infertility because of concerns about adverse outcomes, intraoperative complications and costs associated with tubal surgery, as well as alternative treatments, mainly IVF. OBJECTIVES The aim of this review was to determine the effectiveness and safety of surgery compared with expectant management or IVF in improving the probability of livebirth in the context of tubal infertility (regardless of grade of severity). SEARCH METHODS We searched the following databases in October 2016: the Cochrane Gynaecology and Fertility (CGF) Group trials register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO; as well as clinical trials registries, sources of unpublished literature and reference lists of included trials and related systematic reviews. SELECTION CRITERIA We considered only randomised controlled trials to be eligible for inclusion, with livebirth rate per participant as the primary outcome of interest. DATA COLLECTION AND ANALYSIS We planned that two review authors would independently assess trial eligibility and risk of bias and would extract study data. The primary review outcome was cumulative livebirth rate. Pregnancy rate and adverse outcomes, including miscarriage rate, rate of ectopic pregnancy and rate of procedure-related complications, were secondary outcomes. We planned to combine data to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). We planned to assess statistical heterogeneity using the I2 statistic and to assess the overall quality of evidence for the main comparisons using GRADE methods. MAIN RESULTS We identified no suitable randomised controlled trials. AUTHORS' CONCLUSIONS The effectiveness of tubal surgery relative to expectant management and IVF in terms of livebirth rates for women with tubal infertility remains unknown. Large trials with adequate power are warranted to establish the effectiveness of surgery in these women. Future trials should not only report livebirth rates per patient but should compare adverse effects and costs of treatment over a longer time. Factors that have a major effect on these outcomes, such as fertility treatment, female partner's age, duration of infertility and previous pregnancy history, should be considered. Researchers should report livebirth rates in relation to severity of tubal damage and different techniques used for tubal repair, including microsurgery and laparoscopic methods.
Collapse
Affiliation(s)
- Su Jen Chua
- The University of AdelaideAdelaideAustraliaSA5005
| | - Valentine A Akande
- Directorate of Women's Health, Southmead HospitalObstetrics & GynaecologySouthmead RoadBristolEnglandUKBS10 5NB
| | - Ben Willem J Mol
- The University of AdelaideDiscipline of Obstetrics and Gynaecology, School of Medicine, Robinson Research InstituteLevel 3, Medical School South BuildingFrome RoadAdelaideSouth AustraliaAustraliaSA 5005
| | | |
Collapse
|
26
|
Ottino J, Ricca R. Paratubal Cyst Torsion with Compromise of the Fallopian Tube in an Adolescent Girl. Am Surg 2016; 82:777-778. [PMID: 27670559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Jennifer Ottino
- Department of Pediatric General and Thoracic Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA
| | | |
Collapse
|
27
|
Affiliation(s)
- Chin-Jung Wang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
| | - Justina Go
- Department of Obstetrics and Gynecology, Chinese General Hospital and Medical Center, Manila, Philippines
| | - Yu-Cheng Liu
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| |
Collapse
|
28
|
Abstract
Fallopian tube prolapse is an unusual complication after hysterectomy. Different surgical options have been proposed, including abdominal, vaginal, and combined laparoscopic approaches, with partial or complete salpingectomy. This article presents experience in the management of 7 cases of fallopian tube prolapse with different surgical approaches according to the characteristics of the case. Additionally, 6 cases were reported in the English literature between 1960 and 2006 that required a second procedure after vaginal partial salpingectomy, and the causes of failure were reviewed. It is suggested that the choice between abdominal, vaginal, and combined laparoscopic approach with partial or complete salpingectomy in the management of prolapsed tubes must be decided individually, according to the patient's characteristics and the presenting symptoms. Laparoscopic surgery has a role in cases with dense intraperitoneal adhesions. It safely enables the mobilization of the prolapsed tube, allowing complete removal of the structure and resolution of symptoms.
Collapse
Affiliation(s)
- Keith W K Lo
- Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China.
| | | | | |
Collapse
|
29
|
Hussain K, Masood J. Fallopian Tube Herniation through Left Sided Abdominal Drain Site. J Coll Physicians Surg Pak 2016; 26:S19-S20. [PMID: 27376207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 12/04/2015] [Indexed: 06/06/2023]
Abstract
Intra-abdominal drains have been used since long to prevent intra-abdominal collection, and detect any anastomotic leaks. We report a case of left sided fallopian tube herniation from a left lower abdominal drain site in a 27-year female who underwent caesarian section for breach presentation. Several complications related to drain usage has been described but left sided fallopian tube prolapse through drain site has not been reported in literature.
Collapse
Affiliation(s)
- Khalid Hussain
- Department of Surgery, 01 Mountain Medical Battalion, Bagh, AJK
| | - Jovaria Masood
- Department of Medical Officer, 01 Mountain Medical Battalion, Bagh, AJK
| |
Collapse
|
30
|
Ormasa MCO, Hamouda ESM, Jung J. Isolated Fallopian Tube Torsion With Fimbrial Cyst In A 10 Year-old Girl Diagnosed By Ultrasound: A Case Report. J Radiol Case Rep 2016; 9:29-36. [PMID: 27200174 DOI: 10.3941/jrcr.v9i12.2565] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Torsion of the fallopian tube without the involvement of the ipsilateral ovary is a rare but important cause of acute abdominal pain in women as it is a surgical emergency. Although uncommon, it should be considered as one of the differential diagnosis in female children presenting with acute lower abdominal or pelvic pain. The diagnosis of isolated fallopian tube torsion is difficult pre-operatively and is often made during laparoscopic or surgical exploration because diagnostic features are usually non-specific. In this report, we present a case of isolated fallopian tube torsion with fimbrial cyst in a young female patient diagnosed pre-operatively by ultrasound.
Collapse
Affiliation(s)
| | | | - Jacqueline Jung
- Department of Obstetrics and Gynecology, KK Women's and Children's Hospital, Singapore
| |
Collapse
|
31
|
Gomel V. Reconstructive tubal microsurgery and assisted reproductive technology. Fertil Steril 2016; 105:887-90. [PMID: 26773194 DOI: 10.1016/j.fertnstert.2015.12.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/14/2015] [Accepted: 12/17/2015] [Indexed: 11/18/2022]
Affiliation(s)
- Victor Gomel
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
32
|
Chong LY, Toh HW, Ong CL. Transvaginal Drainage of Pelvic Collections: a 5-year Retrospective Review in a Tertiary Gynaecology Centre. Ann Acad Med Singap 2016; 45:31-34. [PMID: 27118227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- Lun Yin Chong
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore
| | | | | |
Collapse
|
33
|
Fukami T, Tsujioka H, Matsuoka S, Sorano S, Tohyama A, Yamamoto H, Nakamura S, Goto M, Matsuoka R, Eguchi F. Rupture risk factors of fallopian tubal pregnancy. CLIN EXP OBSTET GYN 2016; 43:800-802. [PMID: 29944226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The present authors analyzed patients' backgrounds and pre-surgical findings to clarify the risk factors of rupture of fallopian tubal pregnancy. The surgical findings 113 cases were clearly diagnosed as fallopian tubal pregnancy with or without rupture. Twenty-six cases of fallopian tubal pregnancy were ruptured and 87 cases were not ruptured at the time of operation. The risk factors of fallopian tubal rupture were assessed by Chi-square for independence test and multiple regression analysis. Obesity (BMI over 26), prior birth history, social welfare entitlement, ultrasonography findings of fetal heart movement, and pre-surgical serum beta-hCG level more than 3,000 mIU/ml patient were significantly higher risk in fallopian tubal rupture. Fertility treatment patient were at significantly lower risk for fallopian tubal rupture. Higher beta-hCG levels, especially >3,000 mIU/ml is associated with increased risk of fallopian tubal rupture in ectopic pregnancy.
Collapse
|
34
|
Sola R, Wormer BA, Walters AL, Heniford BT, Schulman AM. National Trends in the Surgical Treatment of Ovarian Torsion in Children: An Analysis of 2041 Pediatric Patients Utilizing the Nationwide Inpatient Sample. Am Surg 2015; 81:844-848. [PMID: 26350658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of this study was to evaluate the national trends in surgical management of ovarian torsion (OT) in children. The Nationwide Inpatient Sample was queried from 1998 to 2011 for females less than 18 years of age with OT. Patients were stratified into three treatment groups: oophorectomy (OO), oophoropexy, or release of torsion (RT) alone. There were 2041 patients with OT, of which 1598 (78%) underwent OO, 126 (6%) oophoropexy, and 317 (15%) RT. RT significantly increased from 1998 to 2011 (9% vs 25%; P < 0.05). At nonteaching hospitals, there were higher rates of OO (89.3% vs 79.5%; P < 0.05) and lower rates of RT (10.7% vs 20.5%; P < 0.05) compared with teaching hospitals. RT was performed at a higher rate in Northeast United States compared with the South (22.7% vs 14.2%; P < 0.05). Girls presenting at nonteaching hospitals and the South had increased odds of undergoing OO compared with those presenting at teaching hospitals and the Northeast (P < 0.05). Although ovarian conservation for OT in children is more often performed in the Northeast United States and at teaching hospitals, this large population-based study demonstrates OO remains the most common surgical management for OT in the United States.
Collapse
Affiliation(s)
- Richard Sola
- Carolinas Medical Center, Charlotte, North Carolina, USA
| | | | | | | | | |
Collapse
|
35
|
Di Benedetto L, Giovanale V, Caserta D. Endometrial tubal metaplasia in a young puerperal woman after breast cancer. Int J Clin Exp Pathol 2015; 8:7610-7613. [PMID: 26261678 PMCID: PMC4526012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 05/28/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Tamoxifen is the usual endocrine (anti-estrogen) therapy for hormone receptor-positive breast cancer in pre and post-menopausal women. Previous studies have suggested an increased prevalence of endometrial diseases after treatment with tamoxifen. CASE PRESENTATION The authors report a case of 38-year-old woman with diagnosis of endometrial polyp and tubal metaplasia, during puerperium and after micropapillary ductal breast cancer surgery, 5 years of tamoxifen treatment, spontaneous pregnancy without complications and full-term vaginal delivery. CONCLUSION Tamoxifen is a safe and reliable treatment of breast cancer, but data suggest an association with endometrial polyps, hyperplasia, metaplasia and carcinoma. One of the most common types of endometrial metaplasia is ciliated tubal metaplasia. It is generally known that endometrial tubal metaplasia is a benign disease. However studies propose endometrial tubal metaplasia to be a potential premalignant endometrial lesion and its association with endometrial hyperplasia and well-differentiated endometrioid carcinoma. We propose close monitoring of patients taking tamoxifen and prompt evaluation of any uterine bleeding or pelvic complaint or abnormal TVUS images.
Collapse
Affiliation(s)
- Luisa Di Benedetto
- Department of Medical and Surgical Sciences and Translational Medicine, "Sapienza", University of Rome, S. Andrea Hospital Rome, Italy
| | - Valentina Giovanale
- Department of Medical and Surgical Sciences and Translational Medicine, "Sapienza", University of Rome, S. Andrea Hospital Rome, Italy
| | - Donatella Caserta
- Department of Medical and Surgical Sciences and Translational Medicine, "Sapienza", University of Rome, S. Andrea Hospital Rome, Italy
| |
Collapse
|
36
|
Xiu JX, Bin LY, Jin WR, Min ZY, Jun L, Hong XK. Preliminary results of tubal surgery with pregnancy outcome. CLIN EXP OBSTET GYN 2015; 42:505-509. [PMID: 26411221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE OF INVESTIGATION To assess the preliminary results of tubal surgery and its effect on pregnancy outcome. MATERIALS AND METHODS The study included 440 patients with unilateral or bilateral tubal disease as the only cause of the infertility. All patients undergoing a laparoscopy for infertility were studied in reproductive surgery centre. The fallopian tube was classified into class I-IV. The studied outcomes were live birth, ectopic pregnancy, and miscarriage. After 12 months, cumulative conception rate was calculated. RESULTS In the 440 patients, 172 patients with mild salpinx abnormality (class I) had a 34% cumulative pregnancy rate, 151 patients with moderate salpinx abnormality (class II) had a 16% cumulative pregnancy rate, and 77 patients with severe salpinx abnormality (class III) had a 10% cumulative pregnancy rate. No intrauterine pregnancies were observed in the severe group of 40 patients (class IV). CONCLUSION Surgical laparoscopy is helpful for class I and II tubal abnormality, while it is not for class III and IV abnormalities.
Collapse
|
37
|
Romano M, Di Giuseppe J, Serri M, Noviello C, Martino A, Cobellis G, Ciavattini A. A possible association between sports and isolated fallopian tube torsion in children and adolescent females. Gynecol Endocrinol 2015; 31:688-92. [PMID: 26291807 DOI: 10.3109/09513590.2015.1056144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Isolated fallopian tube torsion (IFTT) is a rare occurrence characterized by the rotation of the fallopian tube on its own axis, without twisting the ipsilateral ovary. Pre-operative diagnosis is difficult due to the lack of specific clinical symptoms and radiological signs. The etiology is to date unknown and only some pre-disposing factors have been reported. The history, clinical presentation, laboratory findings and surgical treatment of five patients aged 12-16 with IFTT were evaluated. All patients came to be examined for worsening abdominal pain, nausea or vomiting. 75% of them practiced sports involving sudden changes in body position. They all underwent blood tests, ultrasound and Magnetic Resonance and then laparoscopy for the persistence of acute symptoms. Laparoscopic salpingectomy was performed in three patients. Another two needed a conversion to open salpingectomy due to the presence of pelvic adhesions. During the follow-up period, every girl was fine. The cause of IFTT is undetermined. In this series, a close association between IFTT and sports causing rapid body movements was found. The possibility of IFTT should be considered in the differential diagnosis of acute abdominal pain in children or adolescent females, especially if they practice sports.
Collapse
Affiliation(s)
- Mercedes Romano
- a S.O.D. di Chirurgia Pediatrica e delle Specialità Chirurgiche and
| | - Jacopo Di Giuseppe
- b Clinica Ostetrica e Ginecologica, Presidio Ospedaliero di Alta Specializzazione "G. Salesi" - Az. Ospedaliero - Universitaria Ospedali Riuniti di Ancona - Università Politecnica delle Marche , Ancona , Italy
| | - Matteo Serri
- b Clinica Ostetrica e Ginecologica, Presidio Ospedaliero di Alta Specializzazione "G. Salesi" - Az. Ospedaliero - Universitaria Ospedali Riuniti di Ancona - Università Politecnica delle Marche , Ancona , Italy
| | - Carmine Noviello
- a S.O.D. di Chirurgia Pediatrica e delle Specialità Chirurgiche and
| | - Ascanio Martino
- a S.O.D. di Chirurgia Pediatrica e delle Specialità Chirurgiche and
| | | | - Andrea Ciavattini
- b Clinica Ostetrica e Ginecologica, Presidio Ospedaliero di Alta Specializzazione "G. Salesi" - Az. Ospedaliero - Universitaria Ospedali Riuniti di Ancona - Università Politecnica delle Marche , Ancona , Italy
| |
Collapse
|
38
|
Lee DH, Park YK. Isolated fallopian tube torsion during pregnancy: a case report. CLIN EXP OBSTET GYN 2015; 42:681-682. [PMID: 26524824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Isolated fallopian tube torsion is a rare pregnancy-related complication. It is frequently misdiagnosed as acute appendicitis or ovarian torsion owing to the lack of specific symptoms or signs. Here, the authors report a case of a 35-year-old primigravida at 30 weeks and six days of gestation who had presented with right isolated fallopian tube torsion and a history of right oophorectomy. The authors propose that isolated fallopian tube torsion should be included in the list of differential diagnosis when encountered with patients complaining of lower abdominal pain.
Collapse
|
39
|
Aktürk E, Dede M, Yenen MC, Koçyiğit YK, Ergün A. Comparison of nine morphological scoring systems to detect ovarian malignancy. EUR J GYNAECOL ONCOL 2015; 36:304-308. [PMID: 26189258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE OF INVESTIGATION The aim of this study was to prospectively compare the diagnostic performances of nine gray-scale sonographic prediction models to detect ovarian malignancy. MATERIALS AND METHODS Clinical data of 322 women presenting with an adnexal mass were obtained and used in nine scoring systems. For each model a ROC curve demonstrating the capacity of the model to diagnose malignancy was constructed for all cases and for the subgroups of premenopause and postmenopause. The performance of each model was expressed as area under the ROC curve, sensitivity, and specificity. RESULTS The area under the ROC curve, sensitivity, and specificity of these models in the present study varied between 0.737 and 0.929, 70.7% and 87.9%, 60.2% and 80.3%, respectively. CONCLUSIONS This study has revealed the usefulness of morphological scoring systems to correctly discriminate between benign and malignant pelvic masses.
Collapse
|
40
|
Abstract
STUDY OBJECTIVE Tubal factor accounts for 25-30% of cases of female infertility. Laparoscopy "Gold Standard" for tubal evaluation. However, it is known that during the initial infection of the fallopian tube mucosal damage occurs, a condition which plays a decisive role in reproduction. MATERIALS AND METHODS In this prospective randomized study, 468 infertile women with evidence of fallopian tube disease were included. In this, for 256 patients (group 1) after laparoscopic salpingolysis, salpingostomy we performed an additional step operation transcervical falloposcopy tubal dilatation (TFTD). 212 patients (group 2) produced only laparoscopic salpingolysis, salpingostomy. RESULTS As a result, TFTD patency of the fallopian tubes for coaxial catheter was restored in 50 (78%) of 64 tubes with bilateral total occlusion, in 238 (93%) of 254 with partial occlusion of the bilateral, in 14 (58%) of 24 total unilateral occlusion and 26 (92%) of 28 with partial unilateral occlusion. Total number of pregnancies for one year in the first group of patients was 152 (59.3%), in the second 57 (27.1%), of which in the first group 147 -intrauterine pregnancies (57.4%) and in the second - 46 (21.7%). CONCLUSION Falloposcopy surgeon provides good opportunities for the diagnosis and treatment of intralumen lesions. Significant increase in the frequency of uterine pregnancy in the case of an additional step - TFTD during salpingolysis, salpingostomy in patients with tubal factor infertility.
Collapse
Affiliation(s)
- A Kuzmin
- Rostov Scientific Research Institute of Obstetrics and Pediatrics, Ministry of Health of the Russian Federation , Rostov-on-Don , Russia
| | | |
Collapse
|
41
|
Abstract
Fallopian tube torsion is a rare but important cause of acute pelvic pain in young adolescent girls. It is a surgical emergency treated with either detorsion or salpingectomy. The imaging findings can be nonspecific and challenging. However, an accurate early diagnosis is essential for prompt surgical treatment. Our objective was to review whether imaging findings can be specific enough to suggest the diagnosis of tubal torsion prospectively in the appropriate clinical setting. An Institutional Review Board-approved retrospective review of our imaging database from 2005 to 2012 revealed 10 surgically proven cases of fallopian tube torsion. All cases had sonography performed; 5 cases had additional multidetector computed tomography. All 10 patients (9-17 years) presented with acute pelvic pain. Sonographic findings included dilated tubular structures in 6 of 10 cases: adjacent to a normal ipsilateral ovary in 5 of 6 and adjacent to a benign ovarian teratoma in 1. In 4 cases, no dilated tube was identified; 3 of 4 had a cystic mass separate from the ovaries, and 1 had the imaging appearance of a multicystic ovary. Computed tomographic findings in the 5 cases that underwent multidetector computed tomography included a dilated tubular structure in 3 of 5; 2 of 5 had a cystic adnexal mass identified. Although rare, tubal torsion should be considered in female adolescents with acute pelvic pain. Sonography should be the first imaging choice. When a tubular structure or a midline cystic mass associated with a normal ipsilateral ovary is noted, tubal torsion should be considered in the differential diagnosis.
Collapse
Affiliation(s)
- Srikala Narayanan
- Division of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC USA
| | - Anjum Bandarkar
- Division of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC USA
| | - Dorothy I Bulas
- Division of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC USA.
| |
Collapse
|
42
|
Quezada Y, Karram M, Whiteside JL. Case report: diagnosis and management of peritoneovaginal fistula. J Minim Invasive Gynecol 2014; 22:134-6. [PMID: 24910932 DOI: 10.1016/j.jmig.2014.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 05/30/2014] [Accepted: 06/01/2014] [Indexed: 11/18/2022]
Abstract
Fallopian tube vaginal fistula, a form of peritoneovaginal fistula, is an uncommon cause of persistent vaginal leakage after hysterectomy. Fallopian tube vaginal fistula resulting in peritoneal leakage has been reported in conjunction with a prolapsed fimbria. Herein is presented a case of fallopian tube vaginal fistula without a visibly prolapsed tubal fimbria. The patient was a 43-year-old woman with a 6-year history of cyclic vaginal leakage with onset shortly after vaginal hysterectomy. Examination using a vaginal speculum revealed a clear vaginal fluid but no distinct lesion or mass in the vagina, and bimanual examination did not reveal a vesicovaginal or ureterovaginal fistula. Laparoscopic surgical exploration revealed a densely adherent fallopian tube attached to the vaginal cuff, forming a fallopian tube vaginal fistula.
Collapse
Affiliation(s)
- Yarini Quezada
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, The Christ Hospital, Cincinnati, Ohio.
| | - Mickey Karram
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, The Christ Hospital, Cincinnati, Ohio
| | - James L Whiteside
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, The Christ Hospital, Cincinnati, Ohio
| |
Collapse
|
43
|
Hirabayashi M, Imamachi N, Sakakihara M, Saito Y. [Treatment of intrathecal fentanyl-induced itch with pentazocine: a case report]. Masui 2014; 63:696-699. [PMID: 24979869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Pentazocine has activities both of kappa-opioid receptor agonist and weak micro-opioid receptor antagonist. Recent study has suggested that kappa-opioid receptor agonists have antipruritic effects. We experienced a case of pentazocine inhibiting itch evoked by intrathecal fentanyl in a patient with idiopathic pulmonary fibrosis (IPF). A 50-year-old woman with IPF was diagnosed with fallopian tube abscess and which necessitated emergency surgery. We mainly performed regional anesthetic management to prevent acute exacerbation of IPF by tracheal intubation under general anesthesia. About 30 minutes after intrathecal administration of a combination of bupivacaine and fentanyl, she began to complain of itch. Although propofol was given intravenously, pruritus still recurred. Following that, when pentazocine was administered intravenously, pruritus disappeared immediately and then never recurred. Therefore, it is suggested that pentazocine can be useful in reducing pruritus on intrathecal opioid-induced itch. Future studies are necessary to evaluate the efficacy of pentazocine for the treatment and prevention of opioid-induced itch.
Collapse
|
44
|
Ryu KJ, Kim IS, Bae HS, Lee JK, Lee NW, Song JY. Paratubal cancer found at the time of laparoscopic surgery for adnexal torsion: a case report and literature review. EUR J GYNAECOL ONCOL 2014; 35:741-744. [PMID: 25556286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Paratubal cysts are common incidental finding, but malignant paratubal cancers have rare occurrence and have not been sufficiently described and discussed in previous studies. CASE REPORT This report describes a case of a 70-year-old female who underwent emergent laparoscopy for adnexal torsion. A serous cystadenocarcinoma arising in a paratubal cyst and accompanied by tubal torsion was revealed by frozen section and successfully treated with laparoscopic cytoreductive surgery and adjuvant chemotherapy. CONCLUSION This report is the first case of paratubal cancer with bilateral tubal torsion which was diagnosed and treated with laparoscopic surgery, and the third report describing serous cystadenocarcinoma arising in a paratubal cyst. In the laparoscopic surgery for the paratubal cyst clinically presumed as accompanied with tubal torsion, surgeons should not ignore the possibility of malignancy in spite of the rare incidence of paratubal cancers and the preconception that adnexal malignancies are seldom accompanied by tubal torsion.
Collapse
Affiliation(s)
- K J Ryu
- Department of Obstetrics and Gynecology, Korea Universit Medical Center, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
45
|
Fatnassi R, Kaabia O, Laadhari S, Briki R, Dimassi Z, Bibi M, Hidar S, Ben Regaya L, Khairi H. [Interest of laparoscopy in infertile couple with normal hysterosalpingography]. Gynecol Obstet Fertil 2014; 42:20-26. [PMID: 23462340 DOI: 10.1016/j.gyobfe.2012.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Accepted: 09/17/2011] [Indexed: 06/01/2023]
Abstract
OBJECTIVES The diagnostic laparoscopy has long been the key consideration in the export of female infertility. This place is being reconsidered, especially in the case of normal hysterosalpingogrophy (HSG), because of the advent of assisted reproductive technologies which are more efficient, and because of the improvement of medical imaging techniques which are more sensitive and specific. We wanted to clarify the place of the diagnostic laparoscopy in the balance of female infertility in normal HSG. PATIENTS AND METHODS It is a retrospective study on a series of 100 observations of infertile patients with a normal HSG and having a diagnostic laparoscopy in the department of Gynecology and Obstetrics at Farhat Hached hospital in Sousse (Tunisia) from 1st January 1993 to 1st March 2003. RESULTS The mean age was 32.3years; the mean duration of infertility was 70.47months. Laparoscopy revealed pelvic abnormalities in 45% of cases, dominated by disease tubo-adhesions (23%), endometriosis was found in 6% of cases. These anomalies are considered major in 23% of cases and minor in 22% of cases. Conducting a surgical procedure in the same operating time (adhesiolysis, tubal plastic surgery, electrocoagulation of endometriosis implants) could improve the prognosis of fertility. Only 20 patients were followed among the 45 with pelvic abnormalities, seven pregnancies have been completed (35% of cases). DISCUSSION AND CONCLUSION Laparoscopy has improved the prognosis for the fertility of our patients by treating abnormalities involved in infertility. It is estimated that the prognosis can be improved by selecting patients with risk factors for pelvic abnormalities.
Collapse
Affiliation(s)
- R Fatnassi
- Service de gynécologie-obstétrique, hôpital Ibn Jazzar, Kairouan, Tunisie.
| | - O Kaabia
- Centre de maternité, CHU Farhat Hached, Sousse, Tunisie
| | - S Laadhari
- Service de gynécologie-obstétrique, hôpital Ibn Jazzar, Kairouan, Tunisie
| | - R Briki
- Centre de maternité, CHU Farhat Hached, Sousse, Tunisie
| | - Z Dimassi
- Service de gynécologie-obstétrique, hôpital Ibn Jazzar, Kairouan, Tunisie
| | - M Bibi
- Centre de maternité, CHU Farhat Hached, Sousse, Tunisie
| | - S Hidar
- Centre de maternité, CHU Farhat Hached, Sousse, Tunisie
| | - L Ben Regaya
- Centre de maternité, CHU Farhat Hached, Sousse, Tunisie
| | - H Khairi
- Centre de maternité, CHU Farhat Hached, Sousse, Tunisie
| |
Collapse
|
46
|
Salem SA, Peck AC, Salem RD, Sills ES. Can laparoscopic removal of Essure device before embryo transfer correct poor reproductive outcome pattern in IVF? A case report. CLIN EXP OBSTET GYN 2014; 41:219-222. [PMID: 24779258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE This report describes a successful surgical approach to multiple in vitro fertilization (IVF) failures in the setting of hydrosalpinges, which had been previously treated with Essure inserts. MATERIALS AND METHODS A non-smoking 33-year-old Caucasian G2 P0020 (body mass index: BMI = 22) attended for second opinion. Her history was significant for bilateral hydrosalpinges having been noted on hysterosalpingogram two years earlier. This was managed by hysteroscopic placement of Essure inserts bilaterally. One year later, and now with Essure in situ, the patient completed three IVF cycles elsewhere. Her first and third IVF attempts resulted in biochemical pregnancy, while human chorionic gonadotropin (hCG) was negative after the second cycle. Upon presentation at the authors' center and before beginning a fourth IVF cycle, further testing and surgical removal of the Essure devices was recommended. RESULTS Repeat hysteroscopy was unremarkable; laparoscopic bilateral salpingectomy and extirpation of Essure implants was accomplished without difficulty. Following menses, the patient initiated IVF with three embryos transferred. At day 60, a single intrauterine pregnancy was identified with positive cardiac activity (rate > 100/min). Her obstetrical course was uneventful; a healthy 4,195 gram male infant was delivered (breech) by Cesarean at 40 weeks' gestation. CONCLUSION Essure inserts comprise inner fibers of polyethylene terephthalate, a stainless steel coil, and a nickel-titanium coil. The product received FDA approval as a contraceptive in 2002 although its use for hydrosalpinx remains off-label. While successful outcomes with IVF following Essure placement have been reported, this is the first description of pregnancy and delivery from IVF after Essure removal. Essure may be considered for sterilization when laparoscopy is contraindicated, but experience with its use specifically for treating hydrosalpinges before IVF is limited. This observed association between prior poor IVF outcomes and Essure with subsequent delivery after surgical Essure removal is the first of its kind to be reported, and warrants further investigation.
Collapse
|
47
|
Bakacak M, Bakacak Z. Isolated torsion of fallopian tube complicating pregnancy: case report. CLIN EXP OBSTET GYN 2014; 41:362-363. [PMID: 24992798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Isolated fallopian tube torsion is a very uncommon condition in pregnancy. Most of the cases presented were in the third trimester. Only one case was reported in labor. The authors report the second case of the isolated tubal torsion during labor. CASE REPORT A 18-year-old primigravid woman at 37 weeks of gestation was admitted to labor room with painful uterine contraction. Cervix was one-cm dilated and 70% effaced. Her sonographic and laboratory findings were unremarkable. Approximately four hours later the patient reported sudden pain at lower abdomen. The fetal heart rate tracing showed late deceleration. Preoperative diagnosis was considered as ablatio placenta. Isolated torsion of the right fallopian tube was revealed in cesarean delivery. Healthy infant was delivered and right salpingectomy was performed. Postoperative course was uncomplicated. CONCLUSION In case of pain unrelated to uterine contraction during labor may be a sign of fallopian tube torsion which is an uncommon condition complicating pregnancy. In such condition, fallopian tube torsion should be kept in mind since early diagnosis may help to preserve the affected tube during labor.
Collapse
|
48
|
Damiani GR, Landi S, Tartagni M, Bettocchi S, Loverro G, Pellegrino A. Cornual pregnancy after surgical treatment of an incarcerated fallopian tube: a case report. J Reprod Med 2013; 58:550-552. [PMID: 24568053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Incarceration of the fallopian tube is a rare condition. Symptoms are often misleading, making proper diagnosis difficult because of nonspecific clinical presentations. We report a case of cornual pregnancy occurring 7 months after the treatment of an incarcerated fallopian tube. We believe that the abnormal cornual implantation of the gestational sac was due to myometrial reconstruction of the uterine wall. CASE A primigravid woman treated for the incarceration of a fallopian tube was subsequently found to have a cornual pregnancy in a septate uterus. The cornual pregnancy was successfully aborted after laparoscopic myometrial reconstruction, and a metroplasty allowed a subsequent pregnancy. CONCLUSION This hazardous type of ectopic pregnancy can be managed with systemic administration of methotrexate. If the cornual pregnancy is correctly identified at an early stage, this medical management can be attempted and offers the potential advantage of avoiding surgery and increasing the likelihood of preserving fertility.
Collapse
Affiliation(s)
| | - Stefano Landi
- Department of Obstetrics and Gynecology, University of Bari, Policlinico of Bari, Bari, Italy
| | - Massimo Tartagni
- Department of Obstetrics and Gynecology, University of Bari, Policlinico of Bari, Bari, Italy
| | - Stefano Bettocchi
- Department of Obstetrics and Gynecology, University of Bari, Policlinico of Bari, Bari, Italy
| | - Giuseppe Loverro
- Department of Obstetrics and Gynecology, University of Bari, Policlinico of Bari, Bari, Italy
| | - Antonio Pellegrino
- Department of Obstetrics and Gynecology, University of Bari, Policlinico of Bari, Bari, Italy
| |
Collapse
|
49
|
Abstract
Ectopic pregnancy in the interstitial part of the fallopian tube is a rare event, associated with a high rate of complications due to delayed diagnosis. Rupture of such pregnancy often results in catastrophic hemorrhage. Several reports highlighted the role of magnetic resonance imaging in establishing the diagnosis of interstitial pregnancy, but magnetic resonance imaging findings of a ruptured advanced interstitial ectopic pregnancy have not been published before. The authors therefore present characteristic findings on magnetic resonance imaging of a ruptured interstitial ectopic pregnancy which had reached 18 weeks, in a 25-year-old woman who presented with acute abdominal pain.
Collapse
Affiliation(s)
- Ehab S M Hamouda
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore
| | | | - Edwin W H Thia
- Department of Obstetrics and Gynecology, KK Women's and Children's Hospital, Singapore
| | - Chiou L Ong
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore
| |
Collapse
|
50
|
Mabrouk M, Di Donato N, Montanari G, Savelli L, Ferrini G, Seracchioli R. Do women with deep infiltrating endometriosis have more tubal alterations? Objective evaluation of 473 patients. J Reprod Med 2013; 58:417-424. [PMID: 24050031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To evaluate whether deep infiltrating endometriosis (DIE) is associated with tubal alterations. STUDY DESIGN This was a retrospective study. Our study included 335 women with ovarian endometriosis (Group A), 66 women with DIE (Group B), and 72 women presenting with both conditions (Group C). We evaluated tubal morphology and patency during laparoscopic excision of endometriosis. Tubal patency was assessed by tubal dye test. Tubal morphology was determined using the tubal morphology score (TMS), obtained by a total grade of 4 parameters: tubal caliber, course, surface and fimbrial morphology. RESULTS There was no significant difference in the 3 groups regarding the presence of tubal occlusion (p = 0.23). Total TMS was not significantly different in the 3 groups (p = 0.13). A history of surgical treatment for endometriosis was associated with higher rate of tubal occlusion (p < 0.0005) and more severe morphological alterations (p < 0.0005). There was a positive correlation between number of previous surgical interventions and worse TMS (rho = 0.197, p < 0.0005). CONCLUSION Alterations in tubal patency and morphology were not significantly different in patients with DIE as compared to women with ovarian endometriosis. History of surgical interventions for endometriosis was related with the presence of tubal alterations.
Collapse
Affiliation(s)
- Mohamed Mabrouk
- Minimally Invasive Gynecology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti, 13, 40138 Bologna, Italy
| | | | | | | | | | | |
Collapse
|