جستجوی مقالات مرتبط با کلیدواژه « Uterine myomectomy » در نشریات گروه « پزشکی »

We report a 33 years multipara pregnant woman who presented with vaginal bleeding due to intramural myoma and preeclampsia. After cesarean section, the myoma changed to the peduncle type and entered the internal space from the inner thickness of the uterus. This infrequent phenomenon made it easier to operate and remove the myoma within a few hours after the cesarean section. Finally, the mother and baby were discharged from the hospital safely after a few days.

Myoma is the most common benign monoclonal neoplasm of the uterus with increased frequency during reproductive years of women.

A twenty two year old female presented with abdomen lump, dysmenorrhoea, and heavy menstrual bleeding. Multiple myomas were diagnosed based on clinical and radiological findings. Abdominal myomectomy was performed and 75 myomas were enucleated followed by reconstruction of uterus. The second case was a 28 year old married woman presented with heavy menstrual bleeding and dysmenorrhoea. Ultrasound reported single posterior wall myoma of 86.35.8 cm in size. Laparoscopic myomectomy was performed. At follow-up visit, both cases were completely free of any symptoms.

Myomectomy is a feasible and safe option and a uterine preserving surgery even in the presence of multiple myomas. Setting appropriate criteria in selecting patients for abdominal myomectomy rather than MIS is essential to avoid conversion and associated morbidity.

Tricuspid valve myxomas are very uncommon tumors that could be found after the occurrence of pulmonary thromboembolism, symptomatic tricuspid obstruction, and right-sided heart failure.  Herein, we describe a 42-year-old woman evaluated for an abdominal mass. In preoperative consultation, a tricuspid valve mass was detected in echocardiography. She underwent the removal of a benign uterine myoma and a myxoma of the tricuspid valve. Tricuspid valve myxomas constitute a scarce diagnosis. They could be asymptomatic, occurring in unusual locations and in association with benign tumors in other organs. Our patient was asymptomatic, underscoring the significance of the early diagnosis of this type of tumor to prevent further catastrophic events.

The aim was to assess the effect of vasopressin in reducing the time of surgery, amount of bleeding, and fluid deficit during hysteroscopic myomectomy of submucosal myoma from 2016 to 2018.

This study was conducted as a prospective, randomized, single‑blinded clinical trial on the premenopausal women ranged from 18 to 62 years’ old. A number of 80 patients were randomly assigned to each arm of the study according to random consecutive numbers. The control group (n = 40) of patients underwent conventional hysteroscopic myomectomy without vasopressin and the case group (n = 40) underwent hysteroscopic myomectomy with the injection of diluted vasopressin. Measured outcomes were time for myomectomy, fluid deficit, inflow volume, visual clarity, and postoperation hemoglobin level.

The mean time of myomectomy was 38.1 and 77.38 min in vasopressin and control groups, respectively (P < 0.001). The mean inflow volume was 2800 and 4100 in vasopressin and control groups, respectively (P = 0.029). The visual clarity score was 8.5 and 6.5 in the vasopressin and control groups, respectively (P < 0.001).

The injection of vasopressin during hysteroscopic myomectomy is effective in the management of fluid deficit, time of surgery, and improvement of visual clarity.

This study aimed to compare the effectiveness of a single preoperative dose of misoprostol with intraoperative oxytocin infusion in abdominal myomectomies.
Patients undergoing abdominal myomectomies were divided into 2 groups. An hour before the operation, women in the misoprostol group (n = 35) received a single dose of vaginal misoprostol (400 μg); those in the oxytocin group (n = 35) received oxytocin (intravenous infusion of normal saline solution [30 units in 1000 mL] during myomectomy).
Blood loss, operation time, and need for blood transfusion were significantly reduced in the group administered with vaginal misoprostol. No difference was observed between patients in term of the period of hospitalization and complications. The results of oxytocin in abdominal myomectomy showed no significant difference.
Administration of a single preoperative dose of misoprostol could be a simple and reliable method for reducing intraoperative blood loss and need for postoperative blood transfusion in abdominal myomectomies.

Leiomyomata is the most frequent gynecological neoplasm. One of the major complications of myomectomy is intrauterine adhesion (synechiae).

To evaluate and compare the rate and severity of synechiae formation after myomectomy by laparotomy and laparoscopy.

In this non-randomized interventional trial, hysteroscopy was performed in all married fertile women who had undergone myomectomy (type 3-6 interamural and subserosal fibroids) via laparotomy and laparoscopy in Tehran’s Arash Hospital from 2010 to 2013. Three months after the operation, the occurrence rate and severity of intrauterine synechiae, and its relationship with type, number and location of myomas were investigated and compared in both groups.

Forty patients (19 laparoscopy and 21 laparotomy cases) were studied. Both groups were similar regarding the size, type (subserosal or intramural), number and location of myoma. The occurrence rate of synechiae in the laparoscopy and laparotomy group was 21% and 19%, respectively; showing no significant difference (p=0.99). Among all patients, no significant relationship was found between the endometrial opening (p=0.92), location (p=0.14) and type of myoma (p=0.08) with the occurrence rate of synechiae. However, a significant relationship was observed between myoma’s size (p=0.01) and the location of the largest myoma with the occurrence of synechiae (p=0.02).

With favorable suturing methods, the outcome of intrauterine synechiae formation after myomectomy, either performed by laparotomy or laparoscopy, is similar. In all cases of myomectomy in reproductive-aged women, postoperative hysteroscopy is highly recommended to better screen intrauterine synechiae.

HOXA11 and HOXA10 are expressed in endometrium throughout the menstrual cycle and show a dramatic increase during the mid-luteal phase at the time of implantation. The expression of these genes is decreased in women with myomas. To determine whether myomectomy would reverse HOXA11 and HOXA10 expression, we evaluated the transcript levels of these genes in the endometria of patients before and after myomectomy. Expression of HOXA11 and HOXA10 were examined prospectively during the midluteal phase in endometrium obtained from infertile women (n=12) with myoma before and three months after myomectomy. Endometrial HOXA11 and HOXA10 expression were evaluated using quantitative real-time reverse transcriptase-polymerase chain reaction (RT-PCR). Endometrial HOXA11 and HOXA10 mRNAs expression levels (normalized to 18SrRNA) were increased insignificantly in endometrium of patients after myomectomy (p=0.7 and p=0.15 respectively). The results suggest that the alteration in expression pattern of these genes could not account for some aspects of fertility after myomectomy.