Showing posts with label surgical procedure. Show all posts
Showing posts with label surgical procedure. Show all posts
Monday, April 07, 2014
Saturday, March 22, 2014
New Guideline: Management of Women With Endometriosis
ESHRE Guideline: Management of Women With Endometriosis
Dunselman GA, Vermeulen N, Becker C, et al
Hum Reprod. 2014;29:400-412
Hum Reprod. 2014;29:400-412
Background
Endometriosis can be diagnosed when endometrial tissue is found in extrauterine locations. It is found in 10%-15% of the general population and in up to one third of the infertile population.[1] There are various theories that attempt to explain its etiology. Some cases can be explained by retrograde menstruation, but metaplasia, hormonal, inflammatory processes, and abnormal cytokine function also seem to play a role.[2]
A wide variety of symptoms may accompany endometriosis. Some women are asymptomatic, whereas others are affected by dysmenorrhea, menorrhagia, dyspareunia, chronic pelvic pain, and urinary and gastrointestinal symptoms. The symptoms typically recur in a cyclic fashion, and an exacerbation can occur around menstruation.
The diagnosis can be suspected on the basis of symptoms but is established when histologic confirmation of endometrial glands and stroma is made from a tissue biopsy sample obtained from an extrauterine location.
Read the rest here: http://www.medscape.com/viewarticle/822100
Sunday, March 16, 2014
Transvaginal hydrolaparoscopy. as diagnostic tool Endometriosis Adhesions
JSLS. 2012 Jul-Sep;16(3):461-5. doi: 10.4293/108680812X13462882736295.
Transvaginal hydrolaparoscopy.
Abstract
Transvaginal hydrolaparoscopy (THL) is being performed regularly in Europe and China, but rarely in the United States. The reasons may be physicians' unfamiliarity with the procedure and their uneasiness over potential rectal puncturing due to the proximity of the rectum to the vaginal trocar insertion site. THL has the advantage over hysterosalpingography (HSG) in that it allows for direct visualization of the tubal mucosa in addition to determining tubal patency. THL has advantages over traditional laparoscopy in that it does not require an abdominal incision and has the capability of being conducted in an outpatient office setting with local anesthesia. Studies have shown that THL has comparable accuracy to laparoscopy with 96.1% concordance between THL and laparoscopic findings. THL may be combined with chromopertubation and salpingoscopy. In addition to diagnostic purposes, THL may be used for operative intervention including adhesiolysis, endometriosis ablation, and ovarian drilling. Studies from France and China report the occurrence of rectal injury from 0% to1%. Despite the advantages of THL and low reports of rectal injury, THL has not gained popularity in the United States. The purpose of this article is to familiarize gynecologists in the United States with THL.
- PMID:
- 23318074
- [PubMed - indexed for MEDLINE]
- PMCID:
- PMC3535799
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