ISSN:1077-2847    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

ObjectivesTo outline the anatomical variations of malformations of the uterine cavity and to discuss the clinical management of cervical agenesis and dysgenesis.DesignPatients who were treated for cervical malformations during a 55-year interval are reviewed and followed prospectively. The diagnosis of cervical agenesis or dysgenesis is assigned at the time of exploratory laparotomy.SettingHospital based tertiary care reproductive endocrine-infertility units.Main Outcome MeasuresAll surgical findings were carefully reviewed to determine the anatomical characteristics of the malformed cervix. When cervical reconstruction was performed, the patient was followed to determine the need for reoperation or if the patient achieved a pregnancy.ResultsPatients were found to lack a cervix (cervical agenesis) or to have one of three variants of cervical dysgenesis. Patients with cervical dysgenesis were characterized as having 1) an intact cervical body with obstruction of the cervical os, 2) a cervical body consisting of a fibrous band, or 3) cervical fragmentation. One patient conceived after reconstruction. Reoperation was less likely to occur among women who had an obstructed endocervical canal but an otherwise normal cervical body.ConclusionsThere are two basic types of anatomic congenital cervical malformations, the second of which may be considered as three distinct variations. The weight of the international clinical experience suggests that women with cervical agenesis or fragmentation should receive hysterectomy, whereas women with cervical dysgenesis may benefit from a reconstruction operation.

ISSN:1077-2847    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

ObjectiveTo report our experience with routine cystoscopy after the intravenous administration of indigo carmine dye to demonstrate ureteral patency at the end of benign gynecologic surgical cases.Materials and MethodsA retrospective chart review was performed on all cases of ureteral injury occurring on the benign gynecology service at Grady Memorial Hospital between January 1,1990 and May 31,1994.ResultsUnilateral ureteral injuries were identified in seven patients. Five of the seven injuries were previously unsuspected and initially identified by routine cystoscopy at the end of the procedure: four with vaginal hysterectomy and posterior culdoplasty with or without colpor-rhaphy, and one with abdominal hysterectomy. All of these injuries were promptly repaired. No patients with bilateral ureteral patency demonstrated by cystoscopy were later found to have a ureteral injury.ConclusionThe routine administration of intravenous indigo carmine dye followed by cystoscopy to demonstrate ureteral patency at the end of gynecologic surgery is a useful method for the early diagnosis and repair of unsuspected ureteral injuries.

ISSN:1077-2847    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

BackgroundThe infrequent syndrome of didelphic uterus, double vagina, unilateral vaginal obstruction with hematocolpos, and ipsilateral renal agenesis can be associated with pelvic and abdominal endometriosis presumably through the mechanism of menstrual blood reflux. The use of various techniques to diagnose the syndrome and the observation of the natural history of associated endometriosis in a case of severe disease are reported.CasesThree cases of this disorder are reported. The patients were adolescent girls with recent onset of symptoms of different intensities. Individual diagnostic imaging techniques were not equally helpful in all three patients. The presence of endometriosis ranged from no clinically identifiable to Stage IV disease. A simple surgical technique was used to relieve the obstruction and simultaneous laparoscopy facilitated the procedure.ConclusionDidelphic uterus, double vagina, unilateral vaginal obstruction with hematocolpos, and ipsilateral renal agenesis may have somewhat diverse manifestations. Although single diagnostic techniques may be misleading, a combination of diagnostic methods often proves efficacious. Surgery is generally easy and devoid of complications. Endometriosis, when present, may not need specific treatment. The long-term outcome is excellent.

ISSN:1077-2847    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1077-2847    

出版商:OVID    

年代:1995

数据来源: OVID