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Sample records for uterine myoma endometrial

  1. Vaginal myoma expulsion after NovaSure endometrial ablation.

    Science.gov (United States)

    van Riemsdijk, V M J; Graziosi, G C M; Veersema, S; Bongers, M Y

    2009-01-01

    A 46-year old multiparous woman visited a 1-stop clinic for abnormal uterine bleeding. There was a small submucosal type 2 myoma of 2 cm in her normal sized uterus. We treated her using Novasure endometrial ablation. One year later the patient suffered from sudden excessive vaginal bleeding and collapse. A myoma of 4 cm was being expelled from the uterus. PMID:19573829

  2. Uterine myoma and adenomyosis: sonographic findings and differentiation

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    Lee, Yeong Hwan; Yun, Kwang Myeong; Kim, Ok Dong; Chung, Duck Soo [College of Medicine, Taegu Catholic Hospital, Taegu (Korea, Republic of)

    1990-07-15

    Uterine myoma and adenomyosis are the two most likely diagnoses in women with hypermenorrhea, dysmenorrhea, and an enlarged uterus, but it is often not possible to make a distinction between them preoperatively. But their treatments can differ : myoma can be treated through myomectomy whereas adenomyosis require hysterectomy. In order to establish the characteristic and differential findings of myoma and adenomyosis sonographically, sonographic findings of 125 cases of pathologically proven myoma and adenomyosis were reviewed retrospectively. Histologic diagnosis were myoma in 94 patients and adenomyosis in 31 patients. The results were as follows : 1. The common sonographic findings of uterine myoma were globular enlargement or bulging contour of uterus 77.8%, loss of central endometrial echoes 66.0%, and homogeneous decreased internal echoes 35.1% or heterogeneous internal echoes 44.7%. 2. The common sonographic findings of adenomyosis were diffuse enlargement without contour change 80.6%, homogeneous hypoechoic or isoechoic internal textures 96.8%, preserved central endometrial echoes 80.6%, and thickening of posterior uterine wall 64.5%. 3. Adenomyosis was highly suggested if the uterus showed diffuse enlargement without contour change or visible nodule, homogeneous hypoechoic textures, and especially thickened posterior wall with anteriorly displaced central endometrial echoes. 4. Adenomyosis could be excluded if the patient was under 30 or above 50 years old, and especially had no previous obstetric history.

  3. Uterine myoma and adenomyosis: sonographic findings and differentiation

    International Nuclear Information System (INIS)

    Uterine myoma and adenomyosis are the two most likely diagnoses in women with hypermenorrhea, dysmenorrhea, and an enlarged uterus, but it is often not possible to make a distinction between them preoperatively. But their treatments can differ : myoma can be treated through myomectomy whereas adenomyosis require hysterectomy. In order to establish the characteristic and differential findings of myoma and adenomyosis sonographically, sonographic findings of 125 cases of pathologically proven myoma and adenomyosis were reviewed retrospectively. Histologic diagnosis were myoma in 94 patients and adenomyosis in 31 patients. The results were as follows : 1. The common sonographic findings of uterine myoma were globular enlargement or bulging contour of uterus 77.8%, loss of central endometrial echoes 66.0%, and homogeneous decreased internal echoes 35.1% or heterogeneous internal echoes 44.7%. 2. The common sonographic findings of adenomyosis were diffuse enlargement without contour change 80.6%, homogeneous hypoechoic or isoechoic internal textures 96.8%, preserved central endometrial echoes 80.6%, and thickening of posterior uterine wall 64.5%. 3. Adenomyosis was highly suggested if the uterus showed diffuse enlargement without contour change or visible nodule, homogeneous hypoechoic textures, and especially thickened posterior wall with anteriorly displaced central endometrial echoes. 4. Adenomyosis could be excluded if the patient was under 30 or above 50 years old, anent was under 30 or above 50 years old, and especially had no previous obstetric history

  4. Lipid peroxidation and antioxidant status in blood of patients with uterine myoma, endometrial polypus, hyperplastic and malignant endometrium

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    SNEZANA, PEJIC; JELENA, KASAPOVIC; ANA, TODOROVIC; VESNA, STOJILJKOVIC; SNEZANA B, PAJOVIC.

    Full Text Available Oxidative stress is considered to be involved in pathogenesis of many disorders of the female genital tract. In this study, we explored the lipid peroxidation levels and antioxidant enzyme activities in women diagnosed with different forms of uterine diseases in order to evaluate the extent of oxida [...] tive stress in blood of such patients. Blood samples of healthy subjects and gynecological patients were collected and subjected to assays for superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and lipid hydroperoxides. The results show that alterations of measured parameters vary with the enzyme type and diagnosis. However, both reduction in antioxidants and elevation of lipid peroxidation were observed in general. Lipid hydroperoxides level was negatively correlated to superoxide dismutase and glutathione peroxidase activities, as well as positively correlated to catalase activity. In addition, the lipid hydroperoxides/ glutathione peroxidase ratio was found to be increased, according to the type of uterine disease. The obtained results show that perturbation of antioxidant status is more pronounced in blood of patients with premalignant (hyperplastic) and malignant (adenocarcinoma) lesions, compared to those with benign uterine changes such as polypus and myoma

  5. Uterine artery embolization as a treatment option for uterine myomas.

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    Marshburn, Paul B; Matthews, Michelle L; Hurst, Bradley S

    2006-03-01

    Information is still being collected on the long-term clinical responses and appropriate patient selection for UAE. Prospective RCTs have not been performed to compare the clinical results from UAE with more conventional therapies for symptomatic uterine leiomyomata. At least three attempts at conducting such RCTs have been unsuccessful because of poor patient accrual that related to differing patient expectation and desires, clinical bias, insurance coverage, and the tendency that patients who have exhausted other treatment options may be disposed more favorably to less invasive treatments. Other comparative studies have serious limitations. For example, the retrospective study that compared outcomes after abdominal myomectomy with UAE suggested that patients who received UAE were more likely to require further invasive treatment by 3 years than were recipients of myomectomy. Lack of randomization introduced a selection bias because women in the group that underwent UAEwere older and were more likely to have had previous surgeries. A prospective study of "contemporaneous cohorts," which excluded patients who had sub-mucosal and pedunculated subserosal myomas, sought to compare quality of life measures and adverse events in patients who underwent UAE or hysterectomy. The investigators concluded that both treatments resulted in marked improvement in symptoms and quality of life scores, but complications were higher in the group that underwent hysterectomy over 1 year. In this study,however, a greater proportion of patients who underwent hysterectomy had improved pelvic pain scores. Furthermore, hysterectomy eliminates uterine bleeding and the risk for recurrence of myomas. Despite the lack of controlled studies that compared UAE with conventional surgery, and despite limited extended outcome data, UAE has gained rapid acceptance, primarily because the procedure preserves the uterus, is less invasive, and has less short-term morbidity than do most surgical options. The cost of UAE varies by region, but is comparable to the charges for hysterectomy and is less expensive than abdominal myomectomy. The evaluation before UAE may entail additional fees for diagnostic testing, such as MRI, to assess the uterine size and screen for adenomyosis. Other centers have recommended pretreatment ultrasonography, laparoscopy, hysteroscopy, endometrial biopsy, and biopsy of large fibroids to evaluate sarcoma. Generally,after UAE the recovery time and time lost from work are less; however, the potential need for subsequent surgery may be greater when compared with abdominal myomectomy. Any center that offers UAE should adhere to published clinical guidelines,maintain ongoing assessment of quality improvements measures, and observe strict criteria for obtaining procedural privileges. After McLucas advocated that gynecologists learn the skill to perform UAE for managing symptomatic myomas, the Society of Interventional Radiology responded with a precautionary commentary on the level of technical proficiency that is necessary to maintain optimum results from UAE. The complexity of pelvic arterial anatomy, the skill that is required to master modern coaxial microcatheters, and the hazards of significant patient radiation exposure were cited as reasons why sound training and demonstration of expertise be obtained before clinicians are credentialed to perform UAE.A collaboration between the gynecologist and the interventional radiologist is necessary to optimize the safety and efficacy of UAE. The primary candidates for this procedure include women who have symptomatic uterine fibroids who no longer desire fertility, but wish to avoid surgery or are poor surgical risks. The gynecologist is likely to be the primary initial consultant to patients who present with complaints of symptomatic myomas. Therefore, they must be familiar with the indications, exclusions, outcome expectations, and complications of UAE in their particular center. When hysterectomy is the only option, UAE should be considered. Appropriate diagnostic testing should ai

  6. Selective artery embolization for treatment of uterine myoma

    International Nuclear Information System (INIS)

    Objective: To assess the clinical effects of selective embolization of uterine arteries in the treatment of uterine myomata. Methods: 15 cases with symptomatic uterine myomata were treated by Seldinger's selective uterine arteries embolization. After a percutaneous femoral arterial puncture, an artery catheter was selectively inserted into bilateral uterine arteries. The insertion silk of fragments and gel form were introduced through catheter to occlude the blood supply of myoma. Results: Arteriography showed that most uterine myomata were supplied by bilateral uterine arteries. When both uterine arteries were embolized, the blood supply of uterine myoma could be occluded. With a mean follow-up of 6 months the menorrhagia and menstrual cycles returned to normal and, pain resolved. Conclusions: Selective uterine artery embolization is a new method for treatment of uterine myomata with less trauma

  7. Current and emerging treatments for uterine myoma – an update

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    Duhan, Nirmala

    2011-01-01

    Uterine myomas, the most common benign, solid, pelvic tumors in women, occur in 20%–40% of women in their reproductive years and form the most common indication for hysterectomy. Various factors affect the choice of the best treatment modality for a given patient. Asymptomatic myomas may be managed by reassurance and careful follow up. Medical therapy should be tried as a first line of treatment for symptomatic myomas, while surgical treatment should be reserved only for appropriate indicatio...

  8. MRI evaluation for conservative treatment in endometriosis and uterine myoma

    International Nuclear Information System (INIS)

    Eighteen patients with endometriosis or uterine myoma underwent MRI before and after conservative treatment with Danazol (400 mg/day) or Buserelin (900 ?g/day to examine pathological changes. Of 8 patients with endometrial chocolate cyst, 7 patients were given Dazazol for 3 to 7 months, in whom high signal intensity indicative of mass tended to decrease after chemotherapy especially on T2-weighted images. In addition, the area of cyst was reduced by 31% to 100%. In the remaining one patient receiving Buserelin for 8 months, the reduction rate of cyst was 31%. Ten patients with adenomyosis were classified into the group given Danazol for 5 to 15 months (n=4) and the group given Buserelin for 3 to 8 months (n=6). Low intensity area was decreased by 9% to 25% in the Danazol group and by 20% to 69% in the Buserelin group. Uterine area was reduced by 10% to 32% in the Danazol group and by 4.5% to 51% in the Buserelin group. MRI was helpful in the management of these diseases during conservative treatment. (N.K.)

  9. Current and emerging treatments for uterine myoma – an update

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    Duhan N

    2011-08-01

    Full Text Available Nirmala DuhanPt Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IndiaAbstract: Uterine myomas, the most common benign, solid, pelvic tumors in women, occur in 20%–40% of women in their reproductive years and form the most common indication for hysterectomy. Various factors affect the choice of the best treatment modality for a given patient. Asymptomatic myomas may be managed by reassurance and careful follow up. Medical therapy should be tried as a first line of treatment for symptomatic myomas, while surgical treatment should be reserved only for appropriate indications. Hysterectomy has its place in myoma management in its definitiveness. However, myomectomy, rather than hysterectomy, should be performed when subsequent childbearing is a consideration. Preoperative gonadotropin-releasing hormone analog treatment before myomectomy decreases the size and vascularity of the myoma but may render the capsule more fibrous and difficult to resect. Uterine artery embolization is an effective standard alternative for women with large symptomatic myomas who are poor surgical risks or wish to avoid major surgery. Its effects on future fertility need further evaluation in larger studies. Serial follow-up without surgery for growth and/or development of symptoms is advisable for asymptomatic women, particularly those approaching menopause. The present article is incorporated with multiple clear clinical photographs and simplified elaboration of the available management options for these tumors of uterine smooth muscle to facilitate clear understanding.Keywords: myomectomy, uterine artery embolization, pelvic tumor, hysterectomy, GnRH, leiomyoma

  10. Uterine myomas in pregnancy, childbirth and puerperium

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    Spari? Radmila

    2014-01-01

    Full Text Available Fibroids are the most common benign tumors of the genital organs of women in reproductive age. Achieving reproductive function later in life, with more frequent use of assisted reproductive technologies, leads to an increased number of pregnancies complicated with fibroids. Their size may change during pregnancy, but the changes are mostly individual. Most fibroids stop growing or decline during the puerperium. The effect of fibroids on pregnancy depends on their number, size and location. The mechanisms bringing about perinatal complications are not fully understood. Fibroids during pregnancy can cause many perinatal complications, such as bleeding in pregnancy, miscarriage, pain due to red degeneration, malpresentation, preterm labor, premature rupture of membranes, placental abruption and obstruction of delivery and are associated with higher incidence of cesarean section, operative vaginal delivery, uterine atony and postpartum hemorrhage. Postpartum hysterectomy in these women is also more likely than in general population. Postpartum infections are more common in patients with fibroids, and myomas may also cause retained placenta. The most common cause of neonatal morbidity is prematurity, due to pregnancy ending in an earlier gestational age. Monitoring of pregnancies complicated with fibroids is essentially indistinguishable from monitoring normal pregnancies. Therapy includes only bed rest and observation, symptomatic therapy in case of pain and intensive fetal surveillance, and surgery in the acute situations.

  11. Current and emerging treatments for uterine myoma – an update

    OpenAIRE

    Duhan N

    2011-01-01

    Nirmala DuhanPt Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IndiaAbstract: Uterine myomas, the most common benign, solid, pelvic tumors in women, occur in 20%–40% of women in their reproductive years and form the most common indication for hysterectomy. Various factors affect the choice of the best treatment modality for a given patient. Asymptomatic myomas may be managed by reassurance and careful follow up. Medical therapy should be tried as ...

  12. A mathematical model of the growth of uterine myomas.

    Science.gov (United States)

    Chen, C Y; Ward, J P

    2014-12-01

    Uterine myomas or fibroids are common, benign smooth muscle tumours that can grow to 10  cm or more in diameter and are routinely removed surgically. They are typically slow- growing, well-vascularised, spherical tumours that, on a macro-scale, are a structurally uniform, hard elastic material. We present a multi-phase mathematical model of a fully vascularised myoma growing within a surrounding elastic tissue. Adopting a continuum approach, the model assumes the conservation of mass and momentum of four phases, namely cells/collagen, extracellular fluid, arterial and venous phases. The cell/collagen phase is treated as a poro-elastic material, based on a linear stress-strain relationship, and Darcy's law is applied to describe flow in the extracellular fluid and the two vascular phases. The supply of extracellular fluid is dependent on the capillary flow rate and mean capillary pressure expressed in terms of the arterial and venous pressures. Cell growth and division is limited to the myoma domain and dependent on the local stress in the material. The resulting model consists of a system of nonlinear partial differential equations with two moving boundaries. Numerical solutions of the model successfully reproduce qualitatively the clinically observed three-phase "fast-slow-fast" growth profile that is typical for myomas. The results suggest that this growth profile requires stress-induced resistance to growth by the surrounding tissue and a switch-like cell growth response to stress. Analysis of large-time solutions reveal that while there is a functioning vasculature throughout the myoma, exponential growth results, otherwise power-law growth is predicted. An extensive survey of the effect of parameters on model solutions is also presented, and in particular, the enhanced growth caused by factors such as oestrogen is predicted by the model. PMID:25466579

  13. Deep venous thrombosis due to massive compression by uterine myoma

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    Aleksandra Brucka

    2010-10-01

    Full Text Available A 42-year-old woman, gravida 3, para 3 was admitted to hospital because of painful oedema of her right lower extremity. Initial physical examination revealed a gross, firm tumour filling the entire peritoneal cavity. Doppler ultrasound scan revealed a thrombus in the right common iliac vein, extending to the right femur and popliteal veins, and partially into the calf deep vein. Computed tomography confirmed the existence of an abdominal tumour probably deriving from the genital organs and the presence of a thrombus in the said veins.The patient underwent hysterectomy where a myomatous uterine was removed. She was put on subcutaneous enoxaparine and compressive therapy of the lower extremities. Such symptoms as pain and oedema receded. Control Doppler scan showed fibrinolysis, partial organization of the thrombus and final vein recanalisation. After exclusion of other risk factors of deep vein thrombosis apart from stasis, we conclude that the described pathology was the effect of compression of regional pelvic structures by a uterine myoma.

  14. Non-puerperal uterine inversion due to submucous myoma in a young woman: a case report

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    Perquin Denise

    2010-01-01

    Full Text Available Abstract Introduction Inversion of the uterus is an uncommon complication of the puerperium and it is an even rarer complication of the non-puerperal period. A submucous myoma is mostly the cause of the non-puerperal inversion but diagnosis can be difficult. In young women, non-puerperal uterine inversion is likely associated with a malignancy. Case presentation A 19-year-old nulliparous woman presented with abnormal vaginal bleeding, dysmenorrhoea, and a large mass protruding from her cervix. The mass was interpreted as a prolapsed pedunculated submucosal myoma. After extirpation of the mass by clamping and twisting its pedicle, a laparotomy was required under suspicion of a uterine rupture. The diagnosis was confirmed and the patient's uterus could be preserved. Pathological examination revealed a submucous myoma. The uterine inversion happened when the uterus retracted to expel the submucous myoma with fundal attachment. By extirpating the stalk the fundus was also resected, causing a uterine rupture. Conclusion We report a case of non-puerperal uterine inversion associated with a benign submucous myoma. Non-puerperal uterine inversion is very uncommon in women of reproductive age and is usually caused by a malignant tumour. However, uterine-sparing surgery should be attempted in young women until the final pathology is known.

  15. Evaluation on the safety of transcatheter uterine artery embolization for uterine myoma

    International Nuclear Information System (INIS)

    Objective: To observe complications of transcatheter uterine artery embolization (TUAE) for uterine fibroids and to evaluate its long-term safety. Methods: One hundred and ninety-eight women with uterine fibroids were treated by TUAE. The bilateral TUAE were performed using lipiodol-pingyangmycineemulsion (LPE) and gelatin sponge particles in 186 women. Among them, 138 patients were followed up for 1 to 3 year and complications were observed. Results: Complications included ecchymosis and ulceration on buttock (n=1); ulcer of labia minora (n=1); urinary retention (n=12); urinary tract infection (n=1); expelling of necrotic fibroids via vagina (n=5); secondary infection of chocolate cyst of ovary (n=1); increasing in endometrial thickness and calcification (n=1) and amenorrhea (n=2). Conclusion: TUAE is a treatment with long-term safety, while severe complications or sequelae may occur to a few patients, so strict indication should be insisted in patient selection. (authors)

  16. Changes of serum levels of prolactin (PRL), testosterone (T) and estriol (E2) in patients with uterine myoma and endometriocarcinoma

    International Nuclear Information System (INIS)

    Objective: To study the relationship between the serum levels of PRL, T, E2 and development of uterine myoma/endometriocarcinoma. Methods: Serum PRL, T and E2 levels were determined with CLIA in 30 patients with uterine myoma, 28 patients with endometriocarcinoma and 38 controls. Results: (1) Serum levels of PRL and T in both the patient groups were significantly higher than those in controls (P2 levels in both patient groups were not significantly different from those in controls (P>0.01), (3) The serum PRL levels were lowest in the controls and highest in patients with endometriocarcinoma while levels in patients with uterine myoma were intermediate. Conclusion: With the development of uterine myoma/endometriocarcinoma the serum PRL and T levels increased significantly. (authors)

  17. Actual management and its problem for uterine myoma using transcervical needle biopsy

    International Nuclear Information System (INIS)

    Recent clinical introductions of gonadotropin releasing hormore (GnRH) agonists and uterine artery embolization have meant that the patients with uterine myoma, who might have previously undergone surgery, are now often managed conservatively. In both of the above situations, there is an important common clinical problem; that is distinguishing uterine sarcomas from benign leiomyomas. However, clinical differential diagnosis between uterine sarcomas and benign leiomyomas is difficult even with magnetic resonance imaging (MRI). The most reliable preoperative diagnostic method is a biopsy of the tumor. We have evaluated the accuracy and the practical problem of needle biopsy for uterine myoma-like tumors, a procedure that has been infrequently performed. Transcervical needle biopsy was performed in 694 patients with uterine myoma-like tumors. The biopsy specimens were classified into 5 groups for degree of malignancy according to the histopathological criteria proposed by Bell et al. Immunohistochemical analysis (49 cases) using Ki67 (MIB1), P53 and hTERT, and telomerase activity measured using TRAP (62 cases) were also evaluated for differential diagnosis. Histopathological evaluation of surgical specimens and clinical outcome of 2 years of follow-up were used as the reference standards. Among 694 patients, 11 had uterine sarcomas. Six cases, judged as Group V, were diagnosed as 'sarcoma' by needle biopsy alone. No sarcoma cases were included in those patients with Gros were included in those patients with Group I, II, and III. The cutoff level combining the highest sensitivity and specificity with respect to distinguishing uterine leiomyosarcoma from uterine leiomyoma was obtained was Group VI; sensitivity, specificity, positive, and negative predictive values were 100%, 98.9%, 69%, and 100.0%, respectively. Of the 3 immunohistochemical analyses, the evaluation using Ki67 showed the highest accuracy. At cutoff values of 20 units, telomerase activity in needle biopsy sample showed the highest accuracy; sensitivity and specificity were 85% and 100%, respectively. Transcervical needle biopsy using histopathological grouping is a reliable diagnostic test for differential diagnosis between uterine sarcomas and leiomyomas. This diagnostic method, combined with MRI screening, could support the conservative management for patients with uterine myoma more safely. (author)

  18. Non-puerperal uterine inversion due to submucous myoma in a young woman: a case report

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    Perquin Denise; de Vries Marjolijn

    2010-01-01

    Abstract Introduction Inversion of the uterus is an uncommon complication of the puerperium and it is an even rarer complication of the non-puerperal period. A submucous myoma is mostly the cause of the non-puerperal inversion but diagnosis can be difficult. In young women, non-puerperal uterine inversion is likely associated with a malignancy. Case presentation A 19-year-old nulliparous woman presented with abnormal vaginal bleeding, dysmenorrhoea, and a large mass protruding from her cervix...

  19. REPRESENTATION OF DIFFERENT LYMPHOCYTES' POPULATIONS IN PERIPHERAL BLOOD OF PATIENTS WITH UTERINE MYOMA

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    Ye. E. Zueva

    2014-07-01

    Full Text Available Abstract. Uterine myoma is one of the most widespread gynecological pathology among reproductive women older than 30 years. It is known, that often progress of this pathology is associated with genetic and endocrinologic factors. The immune system is not evident still. The aim of this study was to analyze the state of patient's immune system using flow cytometry assessment of different subpopulations of lymphocytes in peripheral blood. We have examined 46 patients with simple and proliferating forms of the myoma, with different variants of clinical symptoms. Absolute and relative content of different subpopulations of lymphocytes was not differed from normal population's standard. Significant differences of B-lymphocytes and natural killers content were observed between groups with simple and proliferating forms of disease. It was shown that metrorrhagia is associated with high level of T-lymphocytes and T-killers. It was noted that decreasing of B-lymphocytes content took place in cases with large number of uterine nodes. Obtained data are not sufficient for complete understanding of the role of immune system in pathogenesis of this disease, but they confirm that using of immunomodulating therapy is expedient for complex treatment of uterine myoma.

  20. Diagnostic value of saline contrast sonohysterography comparing with hysteroscopy for detecting endometrial abnormalities in women with abnormal uterine bleeding

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    Farzaneh Goharzad

    2011-01-01

    Full Text Available Background: Abnormal uterine bleeding is a common presentation of uterine abnormalities among premenopausal and postmenopausal women.Objective: To evaluate and compare the diagnostic accuracy of saline contrast sonohysterography and hysteroscopy for detecting the cause of abnormal uterine bleeding.Materials and Methods: A total of 65 women with abnormal uterine bleeding were enrolled in this study. A prior saline contrast sonohysetrography followed by a hysteroscopy was performed in all cases. Sensitivity, specificity, positive and negative predictive value and test accuracy were calculated.Results: As the most common abnormality, SCSH showed hyperplasia in 19 patients while hysteroscopy diagnosed polyp in 15 cases. A sensitivity of 73.3%, 71.4% and 90.9% were reported for polyp, hyperplasia and submucous myoma respectively whereas the specificity was calculated 96% for polyps, 82.3% for hyperplasia and 90.7% for submucous myoma.Conclusion: Comparing with hysteroscopy, sonohysterography showed a high sensitivity and specificity for detecting submucous myoma but not for endometrial polyp and endometrial hyperplasia

  1. Comparison of the effect of gonadotropin-releasing hormone analog (Diphereline) and Cabergoline (Dostinex) treatment on uterine myoma regression.

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    Sayyah Melli; Laya Farzadi; Madarek, Elaheh O. S.

    2007-01-01

    OBJECTIVES To investigate the effect of cabergoline (Dostinex, a dopamine agonist) on the myoma growth compared to Diphereline (a gonadotropin-releasing hormone agonist). METHODS This study took place in the Department of Obstetrics and Gynecology of Tabriz University of Medical Sciences, Tabriz, Iran from July 2004 to December 2005. Fifty women with uterine myoma, who met the criteria of the study thoroughly, were randomly allocated into 2 equal groups to take either Diphereline or ...

  2. State and development of uterine myoma embolization in Germany; Stand und Entwicklung der Uterusmyomembolisation in Deutschland

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    Jakobs, T.F.; Helmberger, T.K.; Reiser, M.F. [Institut fuer Klinische Radiologie, Klinikum der Universitaet Muenchen - Grosshadern (Germany)

    2003-08-01

    To evaluate the current situation and implementation of embolization of uterine leiomyomas into the treatment concept in women with symptomatic uterine leiomyomas in Germany. A questionnaire addressing the clinical background of uterine myomas, recommended treatment concepts, preclinical evaluation, technical approach and complications was sent to 164 departments of gynecology and radiology in Germany. 33 radiological departments and 19 gynecological departments submitted a completed questionnaire. Only 7 departments of radiology reported to have own experience with embolization of uterine leiomyomas, while only 2 departments of gynecology considered embolization as an alternative treatment option in patients with symptomatic leiomyomas. 18/33 radiological departments offer this treatment option but get no patient referrals. Agreement was found concerning the indications for treatment, preclinical evaluation by ultrasound and MRI, preferable location of treatable fibroids, technical approach and pain management. The embolization of uterine leiomyomas in patients with symptomatic myomas is regardless of the well documented high efficacy and low complication rate not yet an established treatment option in Germany. Interventional radiologists and gynecologists have to evaluate the indications for the embolization of uterine leiomyomas together before the procedure is advised to the patient, because it seems mandatory to add this procedure to the standard armamentarium of treatment options in uterine myomas. (orig.) [German] Ziel dieser Arbeit war es, Stand, Entwicklung und Implementierung der Embolisationstherapie von Uterusmyomen (UME) in das Behandlungskonzept von Patientinnen mit symptomatischen Uterusmyomen in Deutschland zu evaluieren. Ein Fragebogen zum Thema der Embolisation von Uterusmyomen wurde an 164 Abteilungen fuer Gynaekologie und Radiologie im gesamten Bundesgebiet versandt. Erfragt wurden Informationen zur klinischen Symptomatik, mit der sich die Patientinnen vorstellen, zu den empfohlenen Behandlungsstrategien, zur Interventionsvorbereitung, zur technischen Durchfuehrung und zu den Komplikationen der UME. Von den angeschriebenen Abteilungen antworteten 33 radiologische und 19 gynaekologische Abteilungen. Nur 7 Abteilungen fuer Radiologie berichteten ueber eigene Erfahrungen bei der Durchfuehrung der UME, waehrend nur 2 gynaekologische Abteilungen die UME in das Repertoire moeglicher Therapieoptionen fuer Patientinnen mit symptomatischen Uterusmyomen aufnehmen. Insgesamt bieten 18 radiologische Abteilungen die UME an, koennen jedoch nicht alle ueber eine Zuweisung zur Therapie berichten. Bezueglich der Diagnosesicherung mit Ultraschall und MRT, der Indikationsstellung, der bevorzugten Lokalisation der Myome, des technischen Vorgehens und des Schmerzmanagements herrschte abteilungsuebergreifend hohe Uebereinstimmung. Die UME zur Behandlung von Patientinnen mit symptomatischen Uterusmyomen hat sich trotz der weltweit dokumentierten Behandlungserfolge und niedriger Komplikationsrate in Deutschland bisher nicht etablieren koennen. Gynaekologen und interventionelle Radiologen muessen gemeinsam die Indikation zur UME stellen, um der UME einen Stellenwert als Alternative zur klassischen chirurgischen Therapie zu verschaffen. (orig.)

  3. Pharmacotherapeutic effects of kuei-chih-fu-ling-wan (keishi-bukuryo-gan) on human uterine myomas.

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    Sakamoto, S; Yoshino, H; Shirahata, Y; Shimodairo, K; Okamoto, R

    1992-01-01

    Kuei-chih-fu-ling-wan (Keishi-bukuryo-gan; KBG), a traditional Chinese herbal remedy contains five components: bark of Cinnamomum cassia Bl. (Lauraceae), root of Paeonia lactiflora Pall. (Paeoniaceae), seed of Prunus persica Batsch. or P. persiba Batsch.var.davidiana Maxim. (Rosaceae), carpophores of Poria cocos Wolf. (Polyporaceae), and root bark of Paeonia suffruticosa Andr. (Paeoniaceae). This prescription has been frequently used in the treatment of gynecological disorders such as hypermenorrhea, dysmenorrhea and sterility. We previously reported that KBG might act as a LH-RH antagonist and a weak anti-estrogen on the uterine DNA synthesis in immature rats. In the present study, we investigated the effects of KBG on 110 premenopausal patients with uterine myomas. Clinical symptoms of hypermenorrhea and dysmenorrhea were improved in more than 90% of the cases with shrinking of uterine myomas in roughly 60% of the cases. PMID:1471615

  4. Presentación de un caso de mioma uterino gigante / Report of a case of giant uterine myoma

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    María del Carmen, Leal Soliguera.

    2008-12-01

    Full Text Available Se presenta el caso de una paciente de 30 años de edad, que acudió a la consulta de ginecología en enero de 1999, refiriendo que su abdomen estaba muy grande y pensaba en un embarazo. Al examinarla se encontró un tumor abdominal que clínicamente impresionó: un mioma uterino, que después se corroboró [...] por la práctica de una ultrasonografía e histerosalpingografía. Abstract in english The case of a 30-year-old female patient that was seen at the gynecologist's office in 1999 because her abdomen was very big and she thought she was pregnant is presented. On examining her, it was found an abdominal tumor that was clinically impressive: a uterine myoma that was later confirmed by ul [...] trasonography and histerosalpingography.

  5. Presentación de un caso de mioma uterino gigante Report of a case of giant uterine myoma

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    María del Carmen Leal Soliguera

    2008-12-01

    Full Text Available Se presenta el caso de una paciente de 30 años de edad, que acudió a la consulta de ginecología en enero de 1999, refiriendo que su abdomen estaba muy grande y pensaba en un embarazo. Al examinarla se encontró un tumor abdominal que clínicamente impresionó: un mioma uterino, que después se corroboró por la práctica de una ultrasonografía e histerosalpingografía.The case of a 30-year-old female patient that was seen at the gynecologist's office in 1999 because her abdomen was very big and she thought she was pregnant is presented. On examining her, it was found an abdominal tumor that was clinically impressive: a uterine myoma that was later confirmed by ultrasonography and histerosalpingography.

  6. Diagnóstico ecográfico de mioma uterino en mujeres con síntomas ginecológicos Ultrasound diagnosis of uterine myoma in women with gynecological symptoms

    Directory of Open Access Journals (Sweden)

    Katia Ramírez Fajardo

    2012-09-01

    Full Text Available Se realizó un estudio descriptivo y transversal de 76 pacientes atendidas en el Departamento de Ultrasonido del Hospital "Carlos Manuel de Céspedes" de Bayamo, Granma, desde junio de 2011 hasta enero de 2012, con vistas a describir las características ecográficas del mioma uterino en mujeres con síntomas ginecológicos. Entre las variables analizadas figuraron: edad, color de la piel, hallazgos ecográficos y correspondencia entre el diagnostico presuntivo y el ecográfico. En la serie prevalecieron las diagnosticadas con mioma uterino, el grupo etario de 15-45 años y las féminas de piel negra. Asimismo, predominaron los miomas múltiples y de localización intramural. Las complicaciones que primaron fueron la degeneración quística y las calcificaciones. No hubo total correspondencia entre las indicaciones médicas presuntivas de miomas y el diagnóstico ecográfico definitivo.A descriptive and cross-sectional study was conducted in 76 patients attended in the Ultrasound Department of "Carlos Manuel de Céspedes" Hospital in Bayamo, Granma, from June 2011 to January 2012, in order to describe the sonographic characteristics of the uterine myoma in women with gynecological symptoms. Among the analyzed variables were age, race, sonographic findings and correspondence between the presumptive and sonographic diagnosis. Those diagnosed with uterine myoma, age group of 15-45 years and black women prevailed in the series. Also, multiple myomas and those of intramural location prevailed. Cystic degeneration and calcifications were the prevailing complications. There was not total correspondence between the presumptive medical indications of myomas and the final ultrasound diagnosis.

  7. Diagnóstico ecográfico de mioma uterino en mujeres con síntomas ginecológicos / Ultrasound diagnosis of uterine myoma in women with gynecological symptoms

    Scientific Electronic Library Online (English)

    Katia, Ramírez Fajardo; Grisell, Torres Alfes; Yuleydis K, Frutos Ramírez.

    2012-09-01

    Full Text Available Se realizó un estudio descriptivo y transversal de 76 pacientes atendidas en el Departamento de Ultrasonido del Hospital "Carlos Manuel de Céspedes" de Bayamo, Granma, desde junio de 2011 hasta enero de 2012, con vistas a describir las características ecográficas del mioma uterino en mujeres con sín [...] tomas ginecológicos. Entre las variables analizadas figuraron: edad, color de la piel, hallazgos ecográficos y correspondencia entre el diagnostico presuntivo y el ecográfico. En la serie prevalecieron las diagnosticadas con mioma uterino, el grupo etario de 15-45 años y las féminas de piel negra. Asimismo, predominaron los miomas múltiples y de localización intramural. Las complicaciones que primaron fueron la degeneración quística y las calcificaciones. No hubo total correspondencia entre las indicaciones médicas presuntivas de miomas y el diagnóstico ecográfico definitivo. Abstract in english A descriptive and cross-sectional study was conducted in 76 patients attended in the Ultrasound Department of "Carlos Manuel de Céspedes" Hospital in Bayamo, Granma, from June 2011 to January 2012, in order to describe the sonographic characteristics of the uterine myoma in women with gynecological [...] symptoms. Among the analyzed variables were age, race, sonographic findings and correspondence between the presumptive and sonographic diagnosis. Those diagnosed with uterine myoma, age group of 15-45 years and black women prevailed in the series. Also, multiple myomas and those of intramural location prevailed. Cystic degeneration and calcifications were the prevailing complications. There was not total correspondence between the presumptive medical indications of myomas and the final ultrasound diagnosis.

  8. Focused ultrasound for treatment of uterine myoma: From experimental model to clinical practice

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    Terzi? Milan

    2008-01-01

    Full Text Available It is well known that focused ultrasound has a biologic effect on tissue. High intensity focused ultrasound (HIFU on a small target area raises the temperature of the tissue enough to denaturate proteins and cause irreversible cell damage. The tight focus of the ultrasound energy allows delivery of the intended dose to a very precise location. The resulting coagulation necrosis is relatively painless. The application of this method in the human clinical setting has required pilot studies on an animal model. Although the treatment had a high success rate, there was a significant percentage of complications, mainly attributed to the technical drawbacks of the procedure. Therefore, this method has been modified for use in humans, and the HIFU is now guided, monitored and controlled by magnetic resonance imaging (MRI. In October 2004, Food and Drug Adiministration (FDA approved MRI guided focused ultrasound treatment of uterine fibroids in humans. Since then, successful treatment of uterine myomas by HIFU has been performed in thousands of women.

  9. Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU) in Treatment of Symptomatic Uterine Myomas

    OpenAIRE

    Filipowska, Justyna; ?ozin?ski, Tomasz

    2014-01-01

    Magnetic Resonance-guided High-Intensity Focused Ultrasound (MR-HIFU) is a noninvasive technique for ablation therapy for uterine myomas, where focused ultrasound energy beam generates localized high temperature in the selected area and coagulates chosen tissue, leaving the skin and tissues in between unharmed. Magnetic resonance imaging enables accurate targeting for HIFU as well as temperature monitoring during treatment. MR guidance with 3D anatomical imaging provides reference data for tr...

  10. Correlations between nonperfused ratio immediately after MRgFUS and color flow Doppler around uterine myomas

    Science.gov (United States)

    Funaki, Kaoru; Fukunishi, Hidenobu

    2010-03-01

    Objective: To examine the relationship between color flow Doppler indices and MRgFUS ablation effect. Materials and Methods: This study includes forty-seven myoma patients who underwent magnetic resonance-guided focused ultrasound surgery (MRgFUS). Single myoma was treated in 27 patients, and two or more myomas were treated at once in 20 patients. All patients were assessed color flow Doppler of peri-myoma artery just before MRgFUS procedure. Peak velocity, pulsatility index (PI), resistant index (RI) were measured. Treated area ratio was defined as nonperfused ratio of each ablated myoma immediately after MRgFUS. The treated area ratio is considered as an assumed ablation area, and the relationship between color flow Doppler indices and treated area ratio were examined respectively. We have already reported that high-intensity myomas (type-3) on pretreatment T2-weighted MR imaging are less effectively treated by MRgFUS than low- (type-1) and intermediate- (type-2) intensity myomas, therefore, as of today, we ceased to treat type-3 myomas. We also compared the color flow Doppler indices based on myoma type. Results: This study included 19 type-1 patients and 28 type-2 patients. Peak velocity, PI and RI were almost the same regardless of the myoma type. In cases where multiple myomas were targeted, we investigated only the largest myoma; the treated myoma volumes were 248.9±196.5 cm3 (mean±standard deviation) and treated area ratios were 59.8±18.0%. Mild correlation between RI and treated area ratio was observed (r = 0.30), however no relations were found for peak velocity and PI. Conclusion: The peripheral artery color flow Doppler of myoma correlates with NPR immediately after MRgFUS. Abundant blood flow is one of the predictive factors of poor ablation after MRgFUS.

  11. Study of endometrial pathology in abnormal uterine bleeding

    OpenAIRE

    Jignasha Parmar; Deepak Desai

    2013-01-01

    Background: Abnormal uterine bleeding (AUB) is the commonest presenting symptom in gynaecology outpatient department. Endometrial sampling could be effectively used as a first diagnostic step in AUB, although at times, its interpretation could be quite challenging to the practicing obstetrician. This study was done to evaluate histopathology of endometrium for identifying endometrial causes of AUB. We observed the incidence of various pathology in different age groups presenting with abnormal...

  12. Management of dysfunctional uterine bleeding based on endometrial thickness

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    Ozgul Muneyyirci-Delale

    2010-09-01

    Full Text Available Ozgul Muneyyirci-Delale1,2, Anuja Gupta1,2, Cynthia Abraham1, Ashadeep Chandrareddy1, Charles H Bowers Jr2, Jed B Cutler2Departments of Obstetrics and Gynecology, 1SUNY Downstate Medical Center, 2Kings County Hospital Center, Brooklyn, New York, USAObjective: To manage patients with dysfunctional uterine bleeding (DUB according to endometrial thickness.Methods: A retrospective chart review of 49 patients who reported 8 or more days of bleeding was performed. They were then divided into three groups based on endometrial thickness (mm: less than 6, 6–11, and greater than 11. These three groups were treated with combined oral contraceptive pills (OCP, conjugated estrogen plus progesterone and megestrol respectively. Patients given megestrol also underwent endometrial biopsy before treatment. Patients recorded the degree of bleeding each day for one month after starting treatment.Results: Mean endometrial thickness in the combined OCPs, conjugated estrogen plus progesterone and megestrol groups were 4, 8 and 14 mm, respectively. Combined OCPs decreased bleeding from 46 to 8 days (P < 0.05, n = 8. Conjugated estrogen plus progesterone decreased the number of days of bleeding from a mean of 41 to 9 (P < 0.01, n = 16. Megestrol decreased bleeding from 54 to 3 days (P < 0.001, n = 25. 52% of patients given megestrol had endometrial hyperplasia.Conclusion: These results support the effectiveness of treating patients with DUB according to endometrial thickness.Keywords: DUB, abnormal uterine bleeding, endometrium, hyperplasia, megestrol acetate

  13. Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU) in Treatment of Symptomatic Uterine Myomas

    Science.gov (United States)

    Filipowska, Justyna; ?ozi?ski, Tomasz

    2014-01-01

    Summary Magnetic Resonance-guided High-Intensity Focused Ultrasound (MR-HIFU) is a noninvasive technique for ablation therapy for uterine myomas, where focused ultrasound energy beam generates localized high temperature in the selected area and coagulates chosen tissue, leaving the skin and tissues in between unharmed. Magnetic resonance imaging enables accurate targeting for HIFU as well as temperature monitoring during treatment. MR guidance with 3D anatomical imaging provides reference data for treatment planning, while real-time temperature monitoring aids in controlling ablation process. This review provides basic information regarding methodology, clinical indications for this kind of treatment, expected outcome and patient management during MR-HIFU procedure. The aim of this work is to introduce a new, noninvasive treatment method for uterine leiomyomas and to present a comparison with other currently used methods. PMID:25469176

  14. Management of dysfunctional uterine bleeding based on endometrial thickness

    OpenAIRE

    Ozgul Muneyyirci-Delale; Anuja Gupta; Cynthia Abraham; et al, ...

    2010-01-01

    Ozgul Muneyyirci-Delale1,2, Anuja Gupta1,2, Cynthia Abraham1, Ashadeep Chandrareddy1, Charles H Bowers Jr2, Jed B Cutler2Departments of Obstetrics and Gynecology, 1SUNY Downstate Medical Center, 2Kings County Hospital Center, Brooklyn, New York, USAObjective: To manage patients with dysfunctional uterine bleeding (DUB) according to endometrial thickness.Methods: A retrospective chart review of 49 patients who reported 8 or more days of bleeding was performed. They were then divided into three...

  15. Semi-Quantitative Analysis of Endometrial HOXA10 and BTEB1 Mrna Expressions in the Implantation Window of Patients With Endometriosis and Myoma

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    Alizadeh Z

    2012-01-01

    Full Text Available Background: The techniques used in assisted reproductive technologies have progressed considerably, but many embryos do not implant after transfer upon the use of these techniques. One of the causes of infertility is repeated implantation failure due to decreased endometrial receptivity. Furthermore, in clinical conditions such as endometriosis and myoma, implantation decreases after embryo transfer. In this case-control study the expression patterns of HOXA-10 and BTEB1 mRNAs were evaluated at the time of implantation in patients with myoma and endometriosis.Methods : In this study performed in Hamadan University of Medical Sciences during 1389, the cases included 16 patients with endometriosis and myoma (8 in each group and the control group consisted of 8 fertile women. Endometrial sampling was performed at mid-secretory phase. Later, the expression patterns of HOXA-10 and BTEB1 mRNAs were evaluated using a semi-quantitative RT-PCR method. Results : The optimal PCR cycles determined were 30, 32 and 26 for HOXA10, BTEB1 and ?-actin, respectively. Endometrial HOXA-10 and BTEB1 mRNA expression levels (normalized to ß-actin expression at the time of implantation were significantly decreased in the endometrium of infertile patients with endometriosis compared with that of healthy fertile controls (P<0.05. A similar pattern was seen in patients with myomas for both HOXA10 and BTEB1 genes, (P<0.05. Conclusion: It seems that lower expression of HOXA-10 and BTEB1 mRNAs in the implantation window of endometrium that increase normally, could account for some aspects of infertility in patients with endometriosis and myoma.

  16. Quiste gigante de ovario y mioma uterino. Presentación de un caso Giant ovarian cyst and uterine myoma. A case report

    Directory of Open Access Journals (Sweden)

    Carlos Antonio Sánchez Portela

    2012-10-01

    Full Text Available Se presenta un caso de quiste gigante del ovario, en una paciente de 30 años de edad, que fue atendida por el Servicio de Ginecología del Hospital Provincial de Inhambane, en el año 2010, por un aumento de tamaño en el abdomen. Se realizaron los estudios clínicos y ultrasonográficos. Se confirmó a través de una laparotomía exploradora una tumoración quística gigante del ovario con dimensiones extraordinarias y un mioma uterino, lo que es poco frecuente en la actualidad. En el estudio anatomopatológico se comprobó el diagnóstico de cistoadenoma seroso del ovario.A 30-year old patient presenting a giant ovarian cyst was attended at Gynecology service in the Provincial Hospital of Inhambane in 2010, the patient complained of abdominal distension. Clinical and ultrasonographic studies were completed. An exploratory laparotomy confirmed a giant ovarian cyst having odd dimensions and uterine myoma, not frequently found in present times. Pathological studies proved a serous cystadenoma of the ovary.

  17. Quiste gigante de ovario y mioma uterino. Presentación de un caso / Giant ovarian cyst and uterine myoma. A case report

    Scientific Electronic Library Online (English)

    Carlos Antonio, Sánchez Portela; Adonis, García Valladares; Carmen Juana, Sánchez Portela.

    2012-10-01

    Full Text Available Se presenta un caso de quiste gigante del ovario, en una paciente de 30 años de edad, que fue atendida por el Servicio de Ginecología del Hospital Provincial de Inhambane, en el año 2010, por un aumento de tamaño en el abdomen. Se realizaron los estudios clínicos y ultrasonográficos. Se confirmó a t [...] ravés de una laparotomía exploradora una tumoración quística gigante del ovario con dimensiones extraordinarias y un mioma uterino, lo que es poco frecuente en la actualidad. En el estudio anatomopatológico se comprobó el diagnóstico de cistoadenoma seroso del ovario. Abstract in english A 30-year old patient presenting a giant ovarian cyst was attended at Gynecology service in the Provincial Hospital of Inhambane in 2010, the patient complained of abdominal distension. Clinical and ultrasonographic studies were completed. An exploratory laparotomy confirmed a giant ovarian cyst hav [...] ing odd dimensions and uterine myoma, not frequently found in present times. Pathological studies proved a serous cystadenoma of the ovary.

  18. Study of endometrial tissue in dysfunctional uterine bleeding.

    Science.gov (United States)

    Kayastha, S

    2013-03-01

    Dysfunctional uterine bleeding (DUB) is defined as heavy and or irregular menstruation in the absence of recognizable pelvic pathology, pregnancy or general bleeding disorder. Hyperplastic endometrium is abnormal histology finding found in DUB. Out of three type of hyperplasia, atypical type is associated with co-existent ca endometrium and the chance of progression to ca endometrium is very high. Thus this study was conducted to see the incidence of hyperplasia of endometrium in cases of DUB and to see the risk factors for endometrial hyperplasia. It was a prospective study carried out in span of two years (2010 JULY- 2013 Jan) in Nepal Medical College and Teaching Hospital. Hundred cases DUB who under went D&C or hysterectomy were included to study the age range, the relation of parity, patient symptom, contraceptive method and medical disease with the type of endometrial histology. It was found that DUB was common in perimenopusal age (49%) and the incidence increase with the increase of parity. Abnormal endometrial finding (hyperplasia) was found in 31% of the cases. Atypical and complex hyperplasia were associated with irregular menstruation and one third of the hyperplastic patient had hypertension (32.26%). Thus perimenopausal age, irregular menstruation and hypertension are risk factors for hyperplasia. So it is mandatory to do endometrial sampling in cases of perimenopausal age with irregular menstruation withor without hypertension. PMID:24592789

  19. Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding

    OpenAIRE

    Fakhar Shazia; Saeed Gulshan; Khan Amir; Alam Ali

    2008-01-01

    Background and Objectives: We compared endometrial sampling by pipelle endometrial curette with Conventional dilatation and curettage (D&C) in patients with abnormal uterine bleeding. Methods: Endometrial sampling with pipelle curette was performed on 100 patients followed by formal D&C. Samples were labeled as A and B, respectively, and sent to a histopathologist who was blinded as to the method of sampling. The histopathology reports of both samples were compared, taking D&C as the gold ...

  20. Alcoolização de miomas uterinos: uma nova estratégia terapêutica / Ethanol sclerotherapy for uterine myomas: A new therapeutic strategy

    Scientific Electronic Library Online (English)

    Lucilo, Ávila; Mirela, Ávila; Fernando, Gurgel; Melania, Amorim.

    Full Text Available O estudo avaliou a segurança, eficácia e resultados da técnica de alcoolização para tratamento da miomatose uterina. Analisou-se uma série de 20 pacientes (idade variando entre 20 e 40 anos) submetidas a alcoolização para tratamento de miomatose uterina sintomática. O procedimento foi realizado sob [...] anestesia geral, guiado por ultra-sonografia transvaginal. Realizou-se seguimento clínico e ultra-sonográfico (ultra-sonografia transvaginal e doppler colorido) com um e seis meses depois do tratamento. Analisaram-se os parâmetros: frequência de sintomas, mapa vascular (doppler) e tamanho da tumoração. Utilizaram-se os testes do qui-quadrado e Mann-Whitney. Significância p Abstract in english The aim of this study was to evaluate the safety, efficacy and outcome of ethanol sclerotherapy for uterine myomata. This is a series of 20 patients (aged 20 to 40 years) with symptomatic uterine myomata submitted to ethanol sclerotherapy. The procedure was performed under sedation and guided by tra [...] nsvaginal ultrasound. The patients were followed clinically and ultrasonically (transvaginal sonography and color Doppler evaluation) one month and six months after treatment. The frequency of symptoms, intratumoral color flow mapping and tumoral size were analyzed. Chi-square and Mann-Whitney tests were used at a 5% level of significance. Postprocedure complications were not observed. A significant relief of dysmenorrhea was observed with one and six months and the frequency of pelvic pain and menorrhagia was significantly reduced with six months. A significant reduction of tumoral size was observed, from 89,4 cm3 (inicial volume) to 73,5 cm3 e 69,9 cm3 (one and six months, respectively). The frequency of intratumoral high blood flow was 80% before and 15% and 20% one and six months after the procedure (p=0,0001). It can be concluded that these preliminary results indicate that transvaginal ultrasound-guided ethanol sclerotherapy can be an effective treatment for uterine myomas when conservative management is preferable. Patient satisfaction was high and the procedure might become an accepted option for the treatment of uterine myomata.

  1. Uterine artery embolization for the treatment of symptomatic myomas in Brazilian women / Embolização da artéria uterina para o tratamento de miomas sintomáticos em mulheres brasileiras

    Scientific Electronic Library Online (English)

    Maurício, Sena-Martins; Cecilia Maria, Roteli-Martins; Valdir, Tadini; Gustavo Antonio de, Souza; Nestor, Kisilevzky; Felipe, Lazar Junior.

    Full Text Available CONTEXTO: Miomas uterinos são tumores benignos que ocorrem na idade reprodutiva das mulheres com uma freqüência que varia entre 20% a 25%. Quando presentes os sintomas, estes se caracterizam por aumento do fluxo menstrual, dor e sinais de compressão. Têm sido propostas novas formas de tratamento, de [...] stacando-se a embolização das artérias uterinas. OBJETIVO: Avaliar os efeitos do tratamento com embolização das artérias uterinas em mulheres portadoras de miomas sintomáticos e os volumes uterino e do mioma dominante, antes e após 12 semanas após o procedimento. TIPO DE ESTUDO: Ensaio clínico aberto. LOCAL: Hospital Leonor Mendes de Barros, São Paulo, Brasil. PARTICIPANTES: 32 mulheres com diagnóstico de mioma sintomático, único ou múltiplo, do corpo uterino, atendidas no Ambulatório de Ginecologia do Hospital Leonor Mendes de Barros, entre maio de 2000 e setembro de 2001. VARIÁVEIS ESTUDADAS: As mulheres foram submetidas a exame ginecológico seguido de ultra-sonografia abdominal, pélvica e endovaginal, repetidos 12 semanas após o procedimento. A embolização da artéria uterina com PVA (partículas de álcool polivinil de 355 a 700 µ) foi realizada através da cateterização da artéria femoral direita em 30 mulheres e, em duas mulheres, a cateterização foi bilateral. RESULTADOS: A média do volume uterino de 32 mulheres antes da embolização foi 455 cm³ e a média do volume do mioma dominante foi de 150 cm³ antes da embolização. Após 12 semanas de embolização, média do volume uterino e do mioma dominante foram 256 cm³ e 91 cm³ respectivamente. A redução dos volumes uterino e do mioma dominante foi estatisticamente significativa (p Abstract in english CONTEXT: Uterine myomas are benign tumors that mostly occur in women of reproductive age at a frequency ranging from 20 to 25%. The symptoms are increased menstrual flow, pain and compressive signs. New treatments have been proposed and uterine artery embolization is one of them. OBJECTIVE: To evalu [...] ate the effects of treatment by embolization of the uterine artery, in women with symptomatic myomas. Uterine and dominant myoma volumes and the major symptoms were evaluated before treatment and 12 weeks later. TYPE OF STUDY: Open clinical trial. SETTING: A tertiary-care women's hospital. PARTICIPANTS: The study was conducted on 32 women with symptomatic single or multiple myomas of the uterine body, seen at the outpatient unit from May 2000 to September 2001. MAIN MEASUREMENTS: The patients were submitted to gynecological examination and abdominal and endovaginal pelvic ultrasonography, and the examinations were repeated 12 weeks after the first procedure. Uterine artery embolization using PVA (polyvinyl alcohol) particles of 355-700 µ was performed by catheterization of the right femoral artery in 30 women and by bilateral catheterization in two. RESULTS: Before embolization, the mean uterine volume of the 32 women was 455 cm³ and the mean volume of the dominant myoma was 150 cm³. Twelve weeks after embolization, the mean uterine volume was 256 cm³ and the mean volume of the dominant myoma was 91 cm³, with p

  2. [Radiographic changes of the breast in presence of uterine myoma (author's transl)].

    Science.gov (United States)

    Brezina, K; Hernuss, P

    1975-01-01

    211 female patients with proved uterus myomatosus have been mammographed. With more than 50% chronic mastopathies could be identified; i.e. twice as much than with non-selected radiographically examined patients. The pattern showed fibrocytic changes as well as fibroplastic ones, fibrous involutions and--especially frequently--cystic degenerations. Fibrocytic degeneration occurred mostly with women who had already given birth and lactated. In glandular-cystic hyperplasias of the endometrium, mastophathies occurred twice as often than in hysteromyomas with normal mucose. An at least relative hyperoestrinism is made responsible for the myoma, but especially for the mucosa hyperplasia. Therefore, the same hormonal situation has to be responsible for the a.m., mainly fibrotic changes of the mammary gland. Of course no characteristic effect of the oestrogens can be derived from this, as it certainly is connected with the development of the total hormonal situation of the female. According to various investigators, most forms of chronic mastopathy bear a higher risk of carcinomas. For this reason, all structural transformations which appear one-sided in radiological case control (course observation) have to be considered cases of risk. PMID:1135398

  3. An incidentally found inflamed uterine myoma Causing low abdominal pain, using TC-99m-tektrotyd single photon emission computed tomography-CT hybrid imaging

    International Nuclear Information System (INIS)

    We report the case of a 50-year-old woman presented with a history of right hemicolectomy due to an ileocecal neuroendocrine tumor and left breast metastasis. Owing to a slightly elevated chromogranin A-level and lower abdominal pain, single photon emission computed tomography-computer tomography (SPECT-CT) was performed. There were no signs of recurrence on the SPECT-CT scan, but the patient was incidentally found to have an inflamed intramural myoma. We believe that the slightly elevated chromogranin A-level was caused by the hypertension that the patient presented. In the clinical context, this is a report of an inflamed uterine myoma seen as a false positive result detected by TC-99m-Tc-EDDA/HYNIC-Tyr3-Octreotide (Tektrotyd) SPECT-CT hybrid imaging.

  4. An incidentally found inflamed uterine myoma Causing low abdominal pain, using TC-99m-tektrotyd single photon emission computed tomography-CT hybrid imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zandieh, Shahin; Schuetz, Matthias; Bernt, Reinhard; Zwerina, Jochen; Haller, Joerg [Hanusch-Hospital, Teaching Hospital of Medical University of Vienna, Vienna (Australia)

    2013-10-15

    We report the case of a 50-year-old woman presented with a history of right hemicolectomy due to an ileocecal neuroendocrine tumor and left breast metastasis. Owing to a slightly elevated chromogranin A-level and lower abdominal pain, single photon emission computed tomography-computer tomography (SPECT-CT) was performed. There were no signs of recurrence on the SPECT-CT scan, but the patient was incidentally found to have an inflamed intramural myoma. We believe that the slightly elevated chromogranin A-level was caused by the hypertension that the patient presented. In the clinical context, this is a report of an inflamed uterine myoma seen as a false positive result detected by TC-99m-Tc-EDDA/HYNIC-Tyr3-Octreotide (Tektrotyd) SPECT-CT hybrid imaging.

  5. Mifepristone versus placebo to treat uterine myoma: a double-blind, randomized clinical trial

    OpenAIRE

    Jl, Esteve Carbonell; Acosta R; Perez Y; Rodriguez B; Seigler I; Sanchez C; Tomasi G

    2013-01-01

    Josep Lluis Carbonell Esteve,1 Rita Acosta,2 Yasmirian Pérez,2 Barbara Rodriguez,2 Isabel Seigler,2 Carlos Sanchez,2 Giuseppe Tomasi3 1Mediterránea Médica Clinic, Valencia, Spain; 2Eusebio Hernández Gynecology and Obstetrics Teaching Hospital, Havana, Cuba; 3University of The Basque Country, Bilbao, Spain Objective: To evaluate the efficacy, safety, and quality of life of 5 mg mifepristone per day compared with a placebo in treating uterine fibroids. Design: Random...

  6. Mifepristone versus placebo to treat uterine myoma: a double-blind, randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Esteve Carbonell JL

    2013-06-01

    Full Text Available Josep Lluis Carbonell Esteve,1 Rita Acosta,2 Yasmirian Pérez,2 Barbara Rodriguez,2 Isabel Seigler,2 Carlos Sanchez,2 Giuseppe Tomasi3 1Mediterránea Médica Clinic, Valencia, Spain; 2Eusebio Hernández Gynecology and Obstetrics Teaching Hospital, Havana, Cuba; 3University of The Basque Country, Bilbao, Spain Objective: To evaluate the efficacy, safety, and quality of life of 5 mg mifepristone per day compared with a placebo in treating uterine fibroids. Design: Randomized, double-blind clinical study. Location: Eusebio Hernández Gynecology and Obstetrics Teaching Hospital, Havana, Cuba. Subjects: One hundred twenty-four subjects with symptomatic uterine fibroids. Treatment: One daily capsule of 5 mg mifepristone or a mifepristone placebo over 3 months. Variables in evaluating safety: Changes in fibroid and uterine volumes, changes in symptom prevalence and intensity, and changes in quality of life. Results: Three months into treatment, fibroid volume was reduced by 28.5% in the mifepristone group with an increase of 1.8% in the placebo group (P = 0.031. There were significant differences between the groups with respect to pelvic pain prevalence (P = 0.006, pelvic pressure (P = 0.027, rectal pain (P = 0.013, hypermenorrhea (P < 0.001, and metrorrhagia (P = 0.002 at the end of treatment. Amenorrhea was 93.1% and 4.3% in the mifepristone and placebo groups, respectively (P < 0.001. Treatment side effects were significantly greater in the mifepristone group. Estradiol levels did not differ significantly between the placebo and mifepristone groups at the end of treatment. Improvement in quality of life was significantly greater in the categories of "symptoms" (P = 0.004 and "activity" (P = 0.045 in the mifepristone group. Conclusion: The 5 mg dosage of mifepristone presented significantly superior efficacy compared to the placebo. Keywords: mifepristone, leiomyoma, fibroid, antiprogestins

  7. Presentación de una paciente con mioma gigante del útero / Report of a Patient with Giant Uterine Myoma

    Scientific Electronic Library Online (English)

    Jorge Luís, Hiralda Martínez.

    2013-09-01

    Full Text Available Se presentó una paciente de 32 años de edad, de la raza negra, con historia obstétrica de dos abortos espontáneos en el primer trimestre del embarazo, nulípara, que acudió a la Consulta de Ginecología en enero de 2010 en el Hospital de Kabgayi, Rwanda, África, y refirió aumento de volumen del abdome [...] n y además, constipación, tenesmo vesical y sangrados abundantes, que le causaban anemia severa. Después del interrogatorio y examen físico se encontró una tumoración gigante de la cavidad abdominal que ocupaba todo el hemiabdomen inferior y sobrepasaba la cicatriz umbilical que parecía ser un mioma uterino, diagnóstico que se corroboró posteriormente con la ultrasonografía abdominal. Se decidió tratamiento quirúrgico con histerectomía total, y se obtuvo una pieza correspondiente a un mioma uterino con un peso de 4,7 kg. Abstract in english A 32- year- old patient of black race, with obstetrical history of two spontaneous abortions in the first trimester of pregnancy, nullipara, who was attended at Gynecology Service in January 2010, Kabgayi Hospital in Rwanda, Africa. The patient´s abdomen increased and the clinical manifestations wer [...] e constipation, vesiacal tenesmus and profuse bleeding that caused severe anemia. After the patient’s interview application and the physical examination was done a giant tumor of the abdominal cavity was found that filled the lower abdomen and surpassed the umbilicus that clinically impressed: a uterine myoma that was later confirmed by abdominal ultrasonography. Surgical treatment was performed with total hysterectomy, and showed a giant tumor of 4.7 kg

  8. Clinicopathological Spectrum of Endometrial Changes in Peri-menopausal and Post-menopausal Abnormal Uterine Bleeding: A 2 Years Study

    OpenAIRE

    Damle, Rajshri P.; Dravid, N. V.; Suryawanshi, Kishor H.; Gadre, Arundhati S.; Bagale, Priya S.; Ahire, Neelam

    2013-01-01

    Background: Abnormal uterine bleeding is the Common presenting complaint in Gynaecology Outpatient Department in all age groups. It is due to the anovulatory cycles which are commonly seen in adolescent and peri-menopausal women. Abnormal uterine bleeding is caused by wide variety of organic or non-organic causes. Histopathological examination of endometrial sample remains the gold standard for diagnosis of endometrial pathology.

  9. Decidualized Human Endometrial Stromal Cells Mediate Hemostasis, Angiogenesis, and Abnormal Uterine Bleeding

    OpenAIRE

    Lockwood, Charles J.; Krikun, Graciela; Hickey, Martha; Huang, S. Joseph; Schatz, Frederick

    2009-01-01

    Factor VII binds trans-membrane tissue factor to initiate hemostasis by forming thrombin. Tissue factor expression is enhanced in decidualized human endometrial stromal cells during the luteal phase. Long-term progestin only contraceptives elicit: 1) abnormal uterine bleeding from fragile vessels at focal bleeding sites, 2) paradoxically high tissue factor expression at bleeding sites; 3) reduced endometrial blood flow promoting local hypoxia and enhancing reactive oxygen species levels; and ...

  10. Parasitic myoma after supracervical laparoscopic histerectomy

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    Maurício Paulo Angelo Mieli

    2013-06-01

    Full Text Available Parasitic myoma is a condition defined as a myoma of extrauterine nourishing. It may occur spontaneously or as a consequence of surgical iatrogeny, after myomectomy or videolaparoscopic supracervical hysterectomy, due to remaining residues of uterine tissue fragments in the pelvic cavity after morcellation. The authors describe two cases in which the patients were submitted to videolaparoscopic supracervical hysterectomy and uterine body removal through morcellation. The sites of development of the parasitic myomas were next to the cervix stump in Case 1, and next to the right round ligament in Case 2. These parasitic myomas were removed by videolaparoscopy. After myomectomies or videolaparoscopic supracervical hysterectomies followed by uterine fragments removal from the pelvic cavity through morcellation, meticulous searching for residues or fragments of uterine tissue is mandatory to prevent the occurrence of parasitic myomas.

  11. Prevalence and characteristics of endometrial polyps in patients with abnormal uterine bleeding

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    ?or?evi? Biljana

    2008-01-01

    Full Text Available Background/Aim. The prevalence of endometrial polyps (EPs in the general female population is about 24%. Abnormal uterine bleeding is frequently the presenting symptom of EPs. The aim of this study was to determine the prevalence and characteristics of EPs in patients with abnormal uterine bleeding. Methods. The prevalence and characteristics of EPs were investigated in 961 patients with abnormal uterine bleeding who underwent dilatation and curettage between January and December 2006. Regarding histopathological features of EPs (presence of atypical hyperplasia or endometrial carcinoma, patients were divided into two groups: group A - patients who had EPs and EPs with hyperplasia without atypia (n = 204 and group B - patients who had EPs with atypical hyperplasia and EPs with carcinoma (n = 7. Results. In 211 (21.94% patients EPs were found with abnormal uterine bleeding. Histopathologically, there were 175 (82.94% EPs, 29 (13.74% EPs with hyperplasia without atypia, 5 (2.37% EPs with atypical hyperplasia, and 2 (0.95% EPs with endometrial carcinoma. Contrary to the patients with EPs and EPs with hyperplasia without atypia (group A, patients who had EPs with atypical hyperplasia and EPs with carcinoma (group B were older (p < 0.05, and more commonly postmenopausal (p < 0.05 and with hypertension (p < 0.05, all of statistical significance. Conclusion. The prevalence of endometrial polyps in patients with abnormal uterine bleeding according to our data was 21.95%. Atypical hyperplasia and endometrial carcinoma were rarely confined to a polyp. Older age, postmenopausal period and hypertension may increase the risk of premalignant and malignant changes in endometrial polyps.

  12. A study of differential diagnosis of uterine endometrial pathologies with MR imaging in postmenopausal women

    International Nuclear Information System (INIS)

    In postmenopausal women, the usefulness of the thickness and the organic changes of the endometrium obtained in MRI were investigated in the diagnosis of uterine cancer. A total of 129 study subjects were selected from the postmenopausal women, consisting of 72 cases of control group (C-group) having no endometrial hyperplasia or uterine cancer, 12 cases of endometrial hyperplasia group (EH-group) and 45 cases of uterine body cancer group (Ca-group), which were confirmed by histological diagnosis during the period from 1996 to 2001. Women with submucous myomata or endometrial polyp were excluded form the subjects. With the T2-weighted MRI, the thickness and heterogeneity of the endometrium (evaluated by comparisons with heterogeneity in the signal of bladder content), and the intensity of endometrial signal (classified by rating ''high'', ''intermediate'' or ''low'' in comparison with intracystic signal intensity) were comparatively examined. To determine cut-off values for differentiation of disease-free from EH, and for that of EH from cancer, analyses with receiver-operating characteristic (ROC) curve were performed. The endometrial thickness (mm, M±SD) in the Ca-group (24.6±17.2) was significantly greater than that in the C-group (3.0±1.2) or EH-group (6.9±5.3). ROC curve analyses revealed cut-off value for differentiating EH from disease-free was 4 mm, and that for EH from cancer was 10 mm. The, endometrial thickness in the EH-group tended to increase comparehe EH-group tended to increase compared to that in the C-group, while there were no significant differences in endometrial heterogeneity and signal intensity between these groups. In the Ca-group, there were significantly more cases (77.8%) showing endometrial heterogeneity compared to those in the C-group (0%) or EH-group (9.3%). The percentage of the cases showing a ''low'' endometrial signal intensity was found to be significantly higher in the Ca-group (48.9%) compared to those in the C-group (0%) or EH-group (0%), and the same was observed in any clinical stage in the Ca-group. The endometrial thickness in the Ca-group was examined at different clinical stages, showing an increasing trend with the progress of clinical stage, while significant differences in the endometrial heterogeneity and signal intensity between the Ca-group and C- or EH-group were observed from an early period of clinical stage. The present study revealed that there are qualitative and quantitative differences in MRI findings of endometrium and/or myometrium between in patients with uterine cancer and in those with endometrial hyperplasia or with uterine pathologies other than endometrial cancer. This suggests the usefulness of MRI for the differential diagnosis of endometrial disorders. Endometrium thickness over 10 mm, heterogeneity in endometrial signal intensity, and ''low'' signal intensity of endometrial tissue in T2 weighted MRI would be useful criteria for screening diagnosis of endometrial cancer in postmenopausal women. (authors)

  13. Comparison of Office Hysteroscopy, Transvaginal Ultrasonography and Endometrial Biopsy in Evaluation of Abnormal Uterine Bleeding

    OpenAIRE

    Pal, Lubna; Lapensee, L.; Toth, T. L.; Isaacson, K. B.

    1997-01-01

    This is a prospective, observational study that utilizes hysteroscopy as the “gold standard” for evaluation of transvaginal ultrasound and endometrial biopsy in the detection of intrauterine pathology. The sensitivity and specificity for detecting focal intrauterine lesions are examined in order to suggest the most cost-effective approach in patients with abnormal uterine bleeding.

  14. Comparison of an Additional Transdermal Fentanyl Patch Compared to Intravenous NSAID and Opioid Analgesics within 24 Hours of an Uterine Artery Embolization for Myoma and Adenomyosis

    International Nuclear Information System (INIS)

    To evaluate the effectiveness of an additional transdermal fentanyl patch compared to intravenous analgesics in pain control during the 24-hour period following uterine artery embolization (UAE) for myoma and adenomyosis. Between September 2009 and August 2010, 42 patients underwent UAE for myoma or adenomyosis. Of these, 21 received an intravenous opioid (pethidine) and a nonsteroidal anti-inflammatory drug (group A), and 21 received an additional transdermal fentanyl patch (group B). Pain perception levels were established verbally on a 0-10 scale during the 24-hour period following UAE. Differences in pain trends, mean dose of intravenous pethidine, and adverse effects were compared between the two groups. Pain perception was most severe at 6 hours after UAE and the mean pain level of group B at that time was 6.3 ± 0.7, which was significantly lower than that of group A, 8.2 ± 0.7 (p0.05), and no evidence of respiratory distress was demonstrated. The addition of a transdermal fentanyl patch to intravenous analgesics is effective in reducing post-embolization pain during the 24-hour period after UAE.

  15. Validation of endometrial curettage in abnormal uterine bleeding in a teaching institute of central India: A prospective study

    OpenAIRE

    Smita S Patne, Manik S. Sirpurkar

    2013-01-01

    Abnormal uterine bleeding (AUB) is one of the common reasons for female patients to consult a gynecologist. AUB include bleeding from structural causes like polyps, endometrial hyperplasia, chronic endometritis, proliferative endometrium, fibroids, carcinoma and pregnancy related complication and dysfunctional uterine bleeding. Methods: A prospective study done in one year duration among 210 patients of 20-70 years age group. A tissue sample is taken after endometrial curettage and examined ...

  16. ASSESSMENT OF ENDOMETRIAL-SUBENDOMETRIAL BLOOD FLOW DETECTED BY COLOR DOPPLER SONOGRAPHY AND UTERINE RECEPTIVITY IN INFERTILE WOMEN

    OpenAIRE

    Aghahoseini, M.; Tuba, K.; Marsousi, V.; Aleyasin, A.

    2008-01-01

    "nndometrial vasculature has been shown to play an important role in the early endometrial response to the implanting blastocyst, and vascular changes may contribute to uterine receptivity. The aim of this study was to investigate the role of endometrial and subendometrial vascularity and thickness in uterine receptivity in infertile women treated with assisted reproductive technologies (ART). A total of 175 women were recruited from our ART program from June 2005 to May 2006. In the fir...

  17. Study of the Impact of Uterine Artery Embolization (UAE) on Endometrial Microvessel Density (MVD) and Angiogenesis

    International Nuclear Information System (INIS)

    PurposeTo investigate the influence of uterine artery embolization (UAE) on endometrial microvessel density (MVD) and angiogenesis.MethodsSixty female guinea pigs were divided into two groups, the control group (n = 15) and the UAE treatment group (n = 45). In the UAE group, tris–acryl gelatin microspheres were used to generate embolization. Animals were further divided into three subgroups, A1, A2, and A3 (n = 15 for each subgroup), with uterine specimens collected at 7–15, 16–30, and 31–45 days after UAE, respectively. Immunostaining for factor VIII and CD105 was performed to identify total endometrial MVD (MVDFVIII) and CD105-positive angiogenesis (MVDCD105) at the indicated time points after UAE.ResultsQuantitative analysis revealed that MVDFVIII significantly decreased in the A1 (11.40 ± 2.76, p CD105-positive angiogenesis in the A1 group (9.33 ± 2.37, p CD105 value returned to normal in the A3 group (8.07 ± 1.97).ConclusionUAE caused a temporal decrease in endometrial MVD that reversed over time as a result of the increase of CD105-positive angiogenesis. Although the UAE-induced reduction of endomenduced reduction of endometrial MVD was reversible, its long-term effect on endometrial receptivity still needs further study

  18. The effect of progesterone on uterine fluid ph &endometrial nhe-1 protein expression in rats

    Directory of Open Access Journals (Sweden)

    Salleh Naguib

    2011-01-01

    Full Text Available A precise regulation of the uterine fluid volume and pH is essential for a successful embryo implantation. Progesterone has been reported to participate in uterine fluid volume regulation during this period, however its effect on the uterine fluid pH is unknown. As endometrial fluid absorption has been proposed to occur secondary to sodium (Na+ absorption under progesterone mediated effect, we therefore hy-pothesize that there may be a concomitant changes in fluid volume and pH if sodium-hydrogen exchanger (NHE, a protein responsible for both luminal Na+ absorption and H+ extrusion is involved. In view of these, our study aimed to investigate the possibility that progesterone affect the uterine fluid pH and endometrial NHE expression. Ovariectomised female Sprague- Dawley (SD rats were treated with peanut oil (vehicle, oestradiol-3-benzoate and progesterone for three consecutive days. On the fourth day, in-vivo uterine perfusions were performed on anaesthetized rats. The collected perfusate were analyzed for the changes in pH. The effect of amiloride, a non-specific Na+-channel blocker on the pH was investigated. The expression of uterine NHE-1 protein was detected by Western blotting and immunohistochemistry. Our findings indicate that the fluid pH is the lowest in progesterone-treated group and amiloride ad-ministration significantly increased the pH in the same treatment group (p < 0.05. NHE-1 proteins were significantly expressed in the progesterone-treated group. In conclusion, progesterone induces a reduction of the uterine fluid pH and is amiloride-sensitive. The up-regulation of NHE-1 under a common proge-sterone effect may explain the role of this ex-changer in regulating the uterine fluid pH.

  19. Superoxide dismutase and lipid hydroperoxides in blood and endometrial tissue of patients with benign, hyperplastic and malignant endometrium

    OpenAIRE

    Snežana Peji?; Ana Todorovi?; Vesna Stojiljkovi?; Dragana Cvetkovi?; Nenad Lu?i?; Ratko M. Radoji?i?; Zorica S. Sai?i?; Snežana B. Pajovic

    2008-01-01

    Epidemiological and experimental data point to involvement of oxygen derived radicals in the pathogenesis of gynecological disorders, as well as in cancer development. The objective of the present study was to examine changes in activities and levels of copper/zinc superoxide dismutase (CuZnSOD) and lipid hydroperoxides (LOOH) in blood and endometrial tissue of patients diagnosed with uterine myoma, endometrial polypus, hyperplasia simplex, hyperplasia complex and adenocarcinoma endometrii. T...

  20. Correlation of endometrial thickness, cycle day and histopathology in women with abnormal uterine bleeding.

    OpenAIRE

    Vlasta Vaclavinkova; Machado, Lovina S.; Mariam Mathew; Alia Al-Hassani

    2005-01-01

    OBJECTIVES To correlate the endometrial thickness measured by transvaginal sonography (TVS), cycle day and menstrual status with histopathology in women with abnormal uterine bleeding and to evaluate the accuracy of transvaginal sonography in detecting intrauterine abnormalities as compared to hysteroscopy. METHODS This prospective study was conducted in the Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital between January 1998 and July 2002. Transvaginal son...

  1. Inhibitory effects of uterine endometrial carcinogenesis in Donryu rats by tamoxifen.

    Science.gov (United States)

    Yoshida, M; Kudoh, K; Katsuda, S; Takahashi, M; Ando, J; Maekawa, A

    1998-12-11

    The effects of tamoxifen (TAM) on uterine carcinogenesis were investigated in female Donryu rats. The effects were initiated by a single intrauterine treatment with N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) at a dose of 20 mg/kg body weight via the vagina at 10 weeks of age. TAM tubes (cholesterol tubes containing 50% TAM) were implanted into the backs of the rats for 13 months (full TAM group) or for the second-half of this period (half TAM group). In the control group treated with ENNG alone, various proliferative lesions were induced in the uterine endometrium and the incidence of endometrial adenocarcinomas was about 30%. In contrast, the uteri in both TAM-treated groups showed severe atrophy and the incidences of uterine proliferative lesions were limited to a few endometrial hyperplasias in the half TAM group. Most of the vaginas in both TAM-treated groups showed mucification, while cornification was common in the vaginal epithelium of controls. The ovaries demonstrated similar atrophy with cystic follicles and no corpora lutea in all groups. Other estrogen responsive endocrine organs, such as the pituitaries and adrenals, were small in the TAM-treated groups. Serum estrogen levels in the TAM-treated groups were lower than in the control group but progesterone levels did not differ. These results indicated that TAM acts as an anti-estrogen on the adult rat uterus, inhibiting the development of endometrial adenocarcinomas initiated by ENNG. PMID:10381129

  2. Diagnostic Value of Endometrial Sampling with Pipelle Suction Curettage for Identifying Endometrial Lesions in Patients with Abnormal Uterine Bleeding

    Directory of Open Access Journals (Sweden)

    F Behnamfar

    2004-06-01

    Full Text Available Background: While determining the cause of abnormal uterine bleeding, sampling from the endometrium is necessary. Considering that pipelle suction curettage can be performed on an out patient basis and does not require hospitalization, using anesthesia and cervical dilatation, we performed this study. The aim of this study was to compare the diagnostic value of dilatation and curettage (D&C with pipelle suction curettage. Methods: This study was quasiexperimental on 200 pre and postmenopausal patients with abnormal uterine bleeding who refered to Shabihkhani hospital in Kashan, Iran. Endometrial sampling was performed in all patients with two methods namely pipelle and D&C. A pathologist examined the samples each having a predetermined code. Results: The mean age of subjects was 46.2 ±6.2 years, minimum age was 35 years and the maximum was 70 years. The various pathological lab findings were proliferative endometrium, secretory endometrium, athrophic, decidua, cystic and adenomatous hyperplasia. The reports were the same in two methods except for 2 cases where they were different: secretory endometrium with D&C but cystic hyperplasia in pipelle method. Conclusions: The result of our study shows the comparability of obtaining endometrial sample by pipelle with D&C. Due to comfort and convenience of patients in pipelle methode especially in the office setting which does not need anesthesia, pipelle method can easily be employed instead of D&C. Keywords: Pipelle Suction Curette, Dilatation and Curettage, Premenopause, Postmenopause.

  3. Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding

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    Fakhar Shazia

    2008-01-01

    Full Text Available Background and Objectives: We compared endometrial sampling by pipelle endometrial curette with Conventional dilatation and curettage (D&C in patients with abnormal uterine bleeding. Methods: Endometrial sampling with pipelle curette was performed on 100 patients followed by formal D&C. Samples were labeled as A and B, respectively, and sent to a histopathologist who was blinded as to the method of sampling. The histopathology reports of both samples were compared, taking D&C as the gold standard. Results: An adequate sample was obtained in 98% of cases by pipelle and in 100% of cases by D&C. Pipelle had a sensitivity, specificity, positive predictive value and negative predictive value of 100% for diagnosing endometrial carcinoma, hyperplasia and secretory endometrium. Pipelle also had high diagnostic sensitivity, specificity and negative predictive value (100%, 98% and 100%, respectively for hyperplasia with atypia, and low sensitivity (57% and positive predictive value (57%, but high specificity (97% and negative predictive value (97% for endometritis. Similarly, for proliferative endometrium, the pipelle technique had values of 94% and 93% for sensitivity and specificity, respectively. Both samples labeled as inadequate for histology by pipelle were polyps on the D&C report. Difficult endotracheal intubation was encountered in two cases of D&C. No other complications of the procedure were observed. Conclusion: The pipelle is a safe device for getting an adequate endometrial sample for histology, with a high sensitivity and specificity for detection of hyperplasia and malignancy.

  4. Study of the Impact of Uterine Artery Embolization (UAE) on Endometrial Microvessel Density (MVD) and Angiogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Tan Guosheng; Xiang Xianhong; Guo Wenbo; Zhang Bing; Chen Wei; Yang Jianyong, E-mail: kerisgz@126.com [The First Affiliated Hospital of Sun Yat-sen University, Department of Interventional Radiology (China)

    2013-08-01

    PurposeTo investigate the influence of uterine artery embolization (UAE) on endometrial microvessel density (MVD) and angiogenesis.MethodsSixty female guinea pigs were divided into two groups, the control group (n = 15) and the UAE treatment group (n = 45). In the UAE group, tris-acryl gelatin microspheres were used to generate embolization. Animals were further divided into three subgroups, A1, A2, and A3 (n = 15 for each subgroup), with uterine specimens collected at 7-15, 16-30, and 31-45 days after UAE, respectively. Immunostaining for factor VIII and CD105 was performed to identify total endometrial MVD (MVD{sub FVIII}) and CD105-positive angiogenesis (MVD{sub CD105}) at the indicated time points after UAE.ResultsQuantitative analysis revealed that MVD{sub FVIII} significantly decreased in the A1 (11.40 {+-} 2.76, p < 0.05) and A2 (15.37 {+-} 3.06, p < 0.05) groups compared to the control group (19.40 {+-} 2.50), and was restored to normal in the A3 group (18.77 {+-} 2.69). UAE caused a temporal up-regulation of MVD{sub CD105}-positive angiogenesis in the A1 group (9.33 {+-} 2.37, p < 0.05) and the A2 group (11.63 {+-} 1.56, p < 0.05) compared to the control group (7.12 {+-} 1.67), and the MVD{sub CD105} value returned to normal in the A3 group (8.07 {+-} 1.97).ConclusionUAE caused a temporal decrease in endometrial MVD that reversed over time as a result of the increase of CD105-positive angiogenesis. Although the UAE-induced reduction of endometrial MVD was reversible, its long-term effect on endometrial receptivity still needs further study.

  5. Current approaches to the treatment of endometrial hyperplasia in women with uterine leiomyoma

    Directory of Open Access Journals (Sweden)

    Potapov V.A.

    2014-09-01

    Full Text Available The study involved 155 women, of which 30 healthy women were in the control group. 125 women with uterine leiomyomas and endometrial hyperplasia constituted the main groups. In all women with uterine leiomyoma myomectomy was performed. Further treatment included randomized study of a new regimen of GnRH agonists together with COCs after myomectomy using comparison techniques: monotherapy with a-GnRH, progestins (dydrogesterone or COCs. The treatment using different medication regimens of endometrial hyperplasia after myomectomy convincingly demonstrated significantly greater efficacy of GnRH-a and COCs com¬bination in reducing frequency of symptoms of these diseases, volume of menstrual blood loss and improvement quality of life through the entire observation period. Greater efficacy of COCs and a-GnRH combination, to our opinion, is associated with a greater degree of suppression of cell proliferation and angiogenesis as a result of local (COCs, and systemic effects (a-GnRH.Thus, the proposed method of adjuvant therapy after myomectomy for women with associated endometrial hyperplasia has significant clinical benefits with minimal impact on bone mineral density and other menopausal signs caused by a-GnRH monotherapy.

  6. Atypical Polypoid Adenomyoma (APAM of the Uterine: Relationship with Endometrial Cancer

    Directory of Open Access Journals (Sweden)

    Iori Kisu

    2011-10-01

    Full Text Available Atypical polypoid adenomyoma (APAM is a rare polypoid tumor that generally occurs in women of reproductive age who have abnormal genital bleeding. The tumor was reported as a new disease concept by Mazur in 1981. Pathologically, APAM consist of irregularly proliferated endometrial gland cells and interlacing bundles of smooth muscle cells within the stroma, and have a similar form to adenocarcinoma, adenofibroma, adenosarcoma, and carcinosarcoma. Therefore, differential diagnosis is required in many cases. APAM is pathologically classified as a benign lesion and clinically has a comparatively favorable outcome. However, treatment and follow-up observation should be performed carefully because recurrence and residual lesions occur in many patients after conservative treatment. Concomitant development of endometrial adenocarcinoma also occurs in many cases and it is difficult to differentiate this disease from APAM. Thus, diagnosis of APAM should be made carefully, particularly since the number of cases of endometrial adenocarcinoma has increased in recent years. Furthermore, APAM tends to develop during a woman’s reproductive years, and fertility sparing treatment should be considered. Here, we review the clinicopathological characteristics of APAM, including the difficulty of diagnosis as a benign or malignant uterine tumor, and we examine the relationship between APAM and endometrial cancer.

  7. Dasatinib, Paclitaxel, and Carboplatin in Treating Patients With Stage III-IV or Recurrent Endometrial Cancer

    Science.gov (United States)

    2015-04-09

    Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Clear Cell Adenocarcinoma; Endometrial Mucinous Adenocarcinoma; Endometrial Serous Adenocarcinoma; Endometrial Undifferentiated Carcinoma; Endometrioid Adenocarcinoma; Recurrent Uterine Corpus Carcinoma; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer; Uterine Carcinosarcoma

  8. Impacto da embolização arterial do leiomioma uterino no volume uterino, diâmetro do mioma dominante e na função ovariana Impact of the myoma arterial embolization by uterine volume, diameter myoma greater and in the ovarian function

    Directory of Open Access Journals (Sweden)

    André Bernardo

    2011-08-01

    Full Text Available RESUMO OBJETIVO: Avaliar o impacto da embolização arterial de miomas (EAM sobre o volume uterino (VU, na função ovariana. MÉTODOS: Trinta pacientes com leiomioma se submeteram à EAM. Foram realizados exames de USPTV e FSH antes e três meses após a EAM. Foram analisados o VU em cm³, o diâmetro do mioma dominante (DMD em cm e o FSH em UI/mL, expressos por média desvio padrão (DP e submetidos a análise estatística pelo teste não paramétrico de Mann-Whitney. RESULTADOS: Foram incluidos na análise 29 casos. A média do VU pré-EAM foi 402,4 165,9 cm³, DMD pré-EAM 5,9 2,1 cm. O VU pós-EAM foi 258,9 118,6 cm³, DMD pós-EAM foi 4,6 1,8 cm. A média da dosagem de FSH pré-EAM foi 4,9 3,5 UI/mL e pós-EAM foi 5,5 4,7 UI/mL com p=0,5. Houve redução de 35% do VU, de 22% no DMD e a EAM não alterou significativamente os valores de FSH após três meses. CONCLUSÃO: O procedimento diminui significativamente o VU e DMD e, não há aumento significativo dos níveis séricos de FSH, não havendo, portanto, alterações na função ovariana.PURPOSE: To evaluate the impact of uterine artery embolization (UAE on uterine volume (UV, greater myoma diameter (GMD and ovarian function three months after the procedure, by transvaginal pelvic ultrasonography (TVPUS and by the determination of follicle-stimulating hormone (FSH. METHODS: Thirty patients with leiomyomas were submitted to UAE. TVPUS and FSH determination were performed before and three months after UAE. UV was determined in cm³, GMD in cm and FSH in IU/mL. Data are reported as as mean standard deviation (SD and were analyzed statistically by the nonparametric Mann-Whitney test. RESULTS: Twenty-nine patients were analyzed. Before UAE, mean UV was 402.4 165.9 cm³ and GMD was 5.9 2.1 cm. After UAE, mean UV was 258.9 118.6 cm³ and GMD was 4.6 1.8 cm. Mean FSH concentration was 4.9 3.5 IU/mL before UAE and 5.5 4.7 IU/mL after UAE, with p=0.5. There was a 35% reduction of UV and a 22% reduction of GMD, with no changes in FSH values after three months. CONCLUSION: The procedure significantly reduced UV and GMD but did not cause a significant increase in FSH levels, thus causing no changes in ovarian function.

  9. Impacto da embolização arterial do leiomioma uterino no volume uterino, diâmetro do mioma dominante e na função ovariana / Impact of the myoma arterial embolization by uterine volume, diameter myoma greater and in the ovarian function

    Scientific Electronic Library Online (English)

    André, Bernardo; Mariano Tamura Vieira, Gomes; Rodrigo Aquino, Castro; Manoel João Batista Castello, Girão; Claudio Emilio, Bonduki; Claudio Atsushi, Yokoyama.

    2011-08-01

    Full Text Available RESUMO OBJETIVO: Avaliar o impacto da embolização arterial de miomas (EAM) sobre o volume uterino (VU), na função ovariana. MÉTODOS: Trinta pacientes com leiomioma se submeteram à EAM. Foram realizados exames de USPTV e FSH antes e três meses após a EAM. Foram analisados o VU em cm³, o diâmetro do m [...] ioma dominante (DMD) em cm e o FSH em UI/mL, expressos por média desvio padrão (DP) e submetidos a análise estatística pelo teste não paramétrico de Mann-Whitney. RESULTADOS: Foram incluidos na análise 29 casos. A média do VU pré-EAM foi 402,4 165,9 cm³, DMD pré-EAM 5,9 2,1 cm. O VU pós-EAM foi 258,9 118,6 cm³, DMD pós-EAM foi 4,6 1,8 cm. A média da dosagem de FSH pré-EAM foi 4,9 3,5 UI/mL e pós-EAM foi 5,5 4,7 UI/mL com p=0,5. Houve redução de 35% do VU, de 22% no DMD e a EAM não alterou significativamente os valores de FSH após três meses. CONCLUSÃO: O procedimento diminui significativamente o VU e DMD e, não há aumento significativo dos níveis séricos de FSH, não havendo, portanto, alterações na função ovariana. Abstract in english PURPOSE: To evaluate the impact of uterine artery embolization (UAE) on uterine volume (UV), greater myoma diameter (GMD) and ovarian function three months after the procedure, by transvaginal pelvic ultrasonography (TVPUS) and by the determination of follicle-stimulating hormone (FSH). METHODS: Thi [...] rty patients with leiomyomas were submitted to UAE. TVPUS and FSH determination were performed before and three months after UAE. UV was determined in cm³, GMD in cm and FSH in IU/mL. Data are reported as as mean standard deviation (SD) and were analyzed statistically by the nonparametric Mann-Whitney test. RESULTS: Twenty-nine patients were analyzed. Before UAE, mean UV was 402.4 165.9 cm³ and GMD was 5.9 2.1 cm. After UAE, mean UV was 258.9 118.6 cm³ and GMD was 4.6 1.8 cm. Mean FSH concentration was 4.9 3.5 IU/mL before UAE and 5.5 4.7 IU/mL after UAE, with p=0.5. There was a 35% reduction of UV and a 22% reduction of GMD, with no changes in FSH values after three months. CONCLUSION: The procedure significantly reduced UV and GMD but did not cause a significant increase in FSH levels, thus causing no changes in ovarian function.

  10. Exploring the effects of Chinese medicine in improving uterine endometrial blood flow for increasing the successful rate of in vitro fertilization and embryo transfer

    OpenAIRE

    Jia Guo

    2011-01-01

    Endometrial blood flow is directly related to endometrial receptivity thereby affecting in vitro fertilization and embryo transfer (IVF-ET) outcomes. In recent years a growing number of studies have shown that traditional Chinese medicine (TCM) can play a role to improve endometrial blood flow and embryo transfer. Studies have confirmed that formulas based on reinforcing kidney and activating blood can promote the formation of uterine endometrial blood vessels by adjusting expressions of a va...

  11. Radiation Therapy With or Without Cisplatin in Treating Patients With Recurrent Endometrial Cancer

    Science.gov (United States)

    2015-03-17

    Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Clear Cell Adenocarcinoma; Endometrial Endometrioid Adenocarcinoma, Variant With Squamous Differentiation; Endometrial Serous Adenocarcinoma; Recurrent Uterine Corpus Carcinoma

  12. A STUDY OF DYSFUNCTIONAL UTERINE BLEEDING: CLINICAL FACTORS AND ENDOMETRIAL HISTOLOGY

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    Seena KB

    2015-03-01

    Full Text Available Present study reports the (A Clinical factors associated with DUB including 1 Incidence in different age groups. 2 Influence of parity in DUB. 3 Pattern of bleeding seen in DUB. 4 Influence of tubectomy, recent delivery and IUCD insertion on the incidence of DUB. 5 Association of DUB with medical diseases like diabetes and hypertension and (B Identify the histopathology of endometrial curettage in cases of DUB.The study is of prospective (observational type. All patients of adolescent age group, reproductive and perimenopausal age group with history suggestive of dysfunctional uterine bleeding registered as inpatient and outpatient during the period August 1, 2010 to July 31, 2011 were studied. A total of 143 cases were selected. DUB forms about 10% of admissions in Government Medical College Hospital, Thrissur. Out of 156 cases, 143 cases were finally taken for the study. The commonest endometrial abnormality was proliferative endometrium. Anovulatory bleeding constituted 70% and ovulatory bleeding 30%. Uterine curettage is an important tool as depending on the functional status of the endometrium, treatment can be planned.

  13. Strain-differences in proliferative activity of uterine endometrial cells in Donryu and Fischer 344 rats.

    Science.gov (United States)

    Ando-Lu, J; Sasahara, K; Nishiyama, K; Takano, S; Takahashi, M; Yoshida, M; Maekawa, A

    1998-06-01

    Strain differences in proliferative activities of uterine endometrial cells were sequentially investigated in Donryu and Fischer 344 (F344) rats until 52 weeks of age. At 13 and 26 weeks of age, when all rats showed a normal estrous cycle, histological findings for the endometrium at each estrous stage were similar in both strains. Mitoses of epithelial cells were frequently observed during the proestrous and metestrous stages, and especially in the latter, but were very few in the estrous stage. The bromodeoxyuridine(BrdU)-labeling indices coincided with the histological findings, the results indicating a peak of cell proliferative activity in the metestrous stage. In Donryu rats, estrous cycle abnormalities increased age-dependently after 26 weeks of age, and almost all animals showed persistent estrus at 52 weeks of age. At 39 and 52 weeks of age, the rats showing persistent estrus displayed similar vaginal smears and histological findings to those of younger rats in the estrous stage, but the BrdU-labeling indices of epithelial cells were age-dependently increased. In contrast, vaginal smear of F344 rats indicated a normal estrous cycle at all ages, with no changes in BrdU-labeling being observed. Previously, we reported that the Donryu rat is a high incidence strain in terms of spontaneous development of endometrial adenocarcinomas, this being related to an age-dependent hormonal imbalance, characterized in particular by an increased estrogen/progesterone ratio. The F344 rat in contrast is a low incidence strain. The present results thus indicate that a constant high-level of proliferative activity of epithelial cells may play an important role, together with an age-related hormonal imbalance, in the spontaneous development of endometrial carcinomas in Donryu rats. PMID:9681648

  14. Effect of pregnancy on endometrial sex steroid receptors and on prostaglandin F2? release after uterine biopsy in heifers

    International Nuclear Information System (INIS)

    The effect of pregnancy on oestrogen receptor (ER) and progesterone receptor (PR) endometrial expression in heifers was studied. Holstein heifers were not inseminated (controls, n = 8) or inseminated (n = 21). Endometrial biopsies were taken at Day 17 h from the uterine horn ipsilateral to the corpus luteum. Hourly samples were taken on the day of the biopsy in 12 animals (controls = 4 and inseminated = 8) to analyze 15-ketodihydro-PGF2? (PGFM) and progesterone concentrations. Pregnancy determined by ultrasonography diagnosed 6 pregnant cows. The uterine biopsy increased PGFM concentrations, which remained high for 2 to 4 hours, followed by a transient decrease in progesterone concentrations, but the procedure neither provoked luteolysis nor blocked pregnancy. PGFM concentrations were higher in cyclic than in pregnant cows. No differences in PR mRNA expression were observed among groups, but ER mRNA in pregnant heifers tended to be lower than controls, suggesting that this pathway is implicated in maintenance of pregnancy. (author)

  15. How should painful cystic degeneration of myomas be managed during pregnancy? a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Hae-Hyeog Lee

    2011-01-01

    Full Text Available Background: Uterine myomas are common pelvic masses during pregnancy. The pain and rapid growth of myomas are among the most common complications during pregnancy. We evaluate management of painful cystic degeneration of myomas during pregnancy.Case: A 27-year-old primigravida had a pelvic mass. We have managed a case in which the diagnosis of cystic degeneration of uterine myomas could not be easily differentiated from an ovarian torsion or carcinoma. Differentiation between degenerative pain of the myoma and an ovarian malignancy or torsion was necessary. A complete aspiration of the cystic changes of the uterine myoma was performed without performing a myomectomy.Conclusion: We report a good result of aspiration of a cystic uterine myoma during pregnancy with a review of the literature published for twenty years since 1 January 1988

  16. Hysteroscopic endometrial resection: efficacy and factors for failure

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    Geraldo Rodrigues de Lima

    2008-09-01

    Full Text Available Objective: To evaluate the effectiveness of hysteroscopic endometrial ablation in women with abnormal benign uterine bleeding resistant to clinical treatment, and to identify factors potentially related to its failure. Methods: Ninety patients with abnormal benign uterine bleeding were retrospectively evaluated. They were submitted to endometrial ablation between January 2000 and August 2003. Their mean age was 44.3 years and their average parity was 2.3 childbirths. All patients had been given gonadotrophin-releasing hormone analogues prior to surgery, to make the procedure easier. Rresults: After surgery, amenorrhea occurred in 20% of cases, hypomenorrhea in 30%, and eumenorrhea in 32.2%. In 17.8% of patients, the procedure failed. No intra or postoperative complications occurred. There was no statistically significant difference between the patients in which the ablation failed and those in which it was successful regarding mean age (p = 0.557, parity (p = 0.891, presence of intramural myoma (p= 0.29, submucosal myoma (p = 0.68 or endometrial polyps (p = 0.76. A significant difference between the two groups was observed with regard to the uterine size median (7  cm in the successful group and 9 cm in the failure group, p  = 0.008. A statistically significant difference was also found in follow-up time: 13 months in the first group and nine months in the second group (p = 0.001. Cconclusions: Endometrial ablation is a good treatment method for abnormal uterine bleeding of benign etiology. Special attention must be paid to patients with increased uterine size, since failure is more frequent in these cases.

  17. A Comparison of Endometrial Biopsy, Transvaginal Ultrasonography and Dilation and Curettage in Diagnosis of Abnormal Uterine Bleeding

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    M. Dadyar

    2006-07-01

    Full Text Available Background: Abnormal uterine bleeding (AUB is a common presenting symptom indicative of abnormal menstrual bleeding patterns that may occur in anovulatory or ovulatory women.There are different ways to diagnose AUB, all requiring much time and energy. The purpose of this study was to evaluate and compare the value of endometrial biopsy, transvaginal ultrasonography with dilation and curettage (D&C which is the current gold standard procedure. Methods: A prospective-descriptive study was conducted on fifty patients referred to our center for refractory abnormal uterine bleeding who were candidates for hysterectomy. All patients underwent endometrial biopsy and transvaginal ultrasonography , followed by D&C as a Gold standard procedure in operating room just before surgery. Results: Mean age of patients was 46.62 years. Transvaginal utrasonography offered a sensitivity of 70% and specificity of 68% demonstrating the lowest numbers compared to D&C. Endometrial biopsy had a sensitivity of 70% and specificity of 75% that was better than sonography alone. Conclusion: D&C was the most useful and valuable procedure and addition of endometrial biopsy with transvaginal ultrasonography will not be of high value in diagnosis.

  18. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    International Nuclear Information System (INIS)

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found o concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass from endometrial cancer clinically presenting as cervical myoma is rare. This case suggests that poorly differentiated endometrial cancer may extend into the cervix, presenting as cervical myoma, and the possibility of a metastatic mass should be considered in the differential diagnosis when dealing with cervical myoma

  19. ASSESSMENT OF ENDOMETRIAL-SUBENDOMETRIAL BLOOD FLOW DETECTED BY COLOR DOPPLER SONOGRAPHY AND UTERINE RECEPTIVITY IN INFERTILE WOMEN

    Directory of Open Access Journals (Sweden)

    M Aghahoseini

    2008-12-01

    Full Text Available "nndometrial vasculature has been shown to play an important role in the early endometrial response to the implanting blastocyst, and vascular changes may contribute to uterine receptivity. The aim of this study was to investigate the role of endometrial and subendometrial vascularity and thickness in uterine receptivity in infertile women treated with assisted reproductive technologies (ART. A total of 175 women were recruited from our ART program from June 2005 to May 2006. In the first stage, down regulation was done using GnRH-a and then ovarian hyperstimulation was initiated with human menopausal gonadotrophin and in vitro fertilization (IVF procedures were performed. Then, the endometrial-subendometrial blood flow distribution pattern was determined by color Doppler ultrasonography and its characteristics were compared between pregnant (n = 56 and non-pregnant (n = 119 women.  Zones 1, 2 and 3 of vascular penetration were found in 15.4%, 22.3%, and 62.3% of patients, respectively. The number of implanted embryos was 62 and implantation rate was 11.61%. There was no significant association between implantation rate and endometrial thickness or zone of vascular penetration. Among all women, fertility occurred in 56 (32.2% women. Zone 1 of vascular penetration was found in 10.71% and 10.08% (P = 0.898, zone 2 in 16.07% and 13.44% (P = 0.643, and zone 3 in 41.07% and 41.17% (P = 0.989 of pregnant and non-pregnant groups, respectively. Endometrial-subendometrial blood flow (according the findings of Doppler ultrasonography in women undergoing ART could not predict endometrial receptivity and IVF outcome.

  20. Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Seok Nam [Kwandong Univ. College of Medicine, Seoul (Korea, Republic of)

    2012-09-15

    A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass from endometrial cancer clinically presenting as cervical myoma is rare. This case suggests that poorly differentiated endometrial cancer may extend into the cervix, presenting as cervical myoma, and the possibility of a metastatic mass should be considered in the differential diagnosis when dealing with cervical myoma.

  1. A Clinical and Pathologic Comparison Between Stage-Matched Endometrial Intraepithelial Carcinoma and Uterine Serous Carcinoma

    Science.gov (United States)

    Hou, June Y.; McAndrew, Thomas C.; Goldberg, Gary L.; Whitney, Kathleen; Shahabi, Shohreh

    2014-01-01

    Endometrial intraepithelial carcinoma (EIC) is a rare pathologic variant of uterine serous carcinoma (USC). Our aim is to distinguish patterns of clinic–pathologic outcomes in patients with EIC and USC for disease limited to the endometrium (stage 1A) as well as with distant metastasis (stage 4B). Surgically staged patients were retrospectively identified and relevant variables were extracted and compared. Kaplan-Meier was used to generate the survival data. More USC (n = 29) exhibited lymphovascular invasion (stage 4, P = .01) and expressed higher levels of estrogen receptor-? than EIC (P = .0009 and .063 for stages 1 and 4, respectively). The survival is comparable, with 1 recurrence in each group for stage 1A disease. For stage 4 EIC and USC, the progression-free survival (14 vs10 months) and overall survival (19 vs 20 months) are similar to what is previously published. In conclusion, EIC, whether limited to the endometrium, or widely metastatic, imparts similar outcomes and should be treated comparably with stage-matched USC. PMID:24023030

  2. Treatment of Uterine Myoma with 2.5 or 5?mg Mifepristone Daily during 3 Months with 9 Months Posttreatment Followup: Randomized Clinical Trial

    OpenAIRE

    Carbonell, Josep Lluis; Acosta, Rita; Pe?rez, Yasmirian; Garce?s, Roberto; Sa?nchez, Carlos; Tomasi, Giuseppe

    2013-01-01

    Objectives. To evaluate the efficacy, safety, and quality of life by using 2.5 and mifepristone 5?mg daily doses to treat uterine fibroids over 3 months with a 9-month followup period. Design. Randomized clinical trial. Place. “Eusebio Hernández” Hospital, Havana, Cuba. Subjects. 220 women with symptomatic uterine fibroids. Treatment. One-half (2.5?mg) or one-whole 5?mg mifepristone tablet. Variables to Evaluate Efficacy. Changes in fibroid and uterine volumes, in symptomatic preva...

  3. The Occurrence of Fetal Microchimeric Cells in Endometrial Tissues Is a Very Common Phenomenon in Benign Uterine Disorders, and the Lower Prevalence of Fetal Microchimerism Is Associated with Better Uterine Cancer Prognoses

    OpenAIRE

    Hromadnikova, Ilona; Kotlabova, Katerina; Pirkova, Petra; Libalova, Pavla; Vernerova, Zdenka; Svoboda, Bohuslav; Kucera, Eduard

    2014-01-01

    This is the first study carried out to describe the role of fetal microchimerism (FM) in the pathogenesis of uterine cancer. The prevalence and concentration of male fetal microchimeric cells (FMCs) were examined in endometrial tissues in relation to subtypes of uterine cancer, and the histological grade and stage of the tumor. FM occurrence was analyzed in relation to risk factors, including hypertension, obesity, type 2 diabetes, dyslipidemia, age at cancer diagnosis, and patient pregnancy ...

  4. Comparison of the effect of gonadotropin-releasing hormone agonist and dopamine receptor agonist on uterine myoma growth. Histologic, sonographic, and intra-operative changes.

    OpenAIRE

    Manizheh Sayyah-Melli; Sepideh Tehrani-Gadim; Ali Dastranj-Tabrizi; Fatemeh Gatrehsamani; Ghojazadeh Morteza; Elaheh Ouladesahebmadarek; Laya Farzadi; Maryamalsadat Kazemi-Shishvan

    2009-01-01

    OBJECTIVES To investigate the effect of 2 medications; Diphereline and Cabergoline, on uterine leiomyoma growth, and its histologic, sonographic, and intra-operative changes. METHODS In an effort to treat large uterine leiomyoma in symptomatic patients in the Gynecology Clinics of the Alzahra Teaching Hospital of Tabriz University of Medical Sciences, Tabriz, Iran, from September 2007 to November 2008, 60 candidates randomized to receive Diphereline 3.75 mg, 4 times every 28 days (gr...

  5. Microscopic endometrial perivascular epithelioid cell nodules: a case report with the earliest presentation of a uterine perivascular epithelioid cell tumor

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    Fang Chia-Lang

    2012-09-01

    Full Text Available Abstract Perivascular epithelioid cell (PEC tumors (PEComas are a family of related mesenchymal tumors composed of PECs which co-express melanocytic and smooth muscle markers. Although their distinctive histologic, immunohistochemical, ultrastructural, and genetic features have been clearly demonstrated, their histogenesis and normal counterpart remain largely unknown. Precursor lesions of PEComas have rarely been reported. We herein describe a tuberous sclerosis patient with microscopic PEC nodules in the endometrium of adenomyosis, pelvic endometriosis, an ovarian endometriotic cyst, and the endometrium of the uterine cavity. The nodules showed a mixture of spindle-shaped and epithelioid cells concentrically arranged around small arteries. The cells exhibited uniform nuclei, light eosinophilic cytoplasm, and immunoreactivity with HMB-45 and CD10. Some nodules revealed continuity with a PEComa in the myometrium. These findings support microscopic endometrial PEC nodules possibly being precursor lesions of uterine PEComas. The wide distribution of the nodules in the pelvis may be related to the multicentricity of PEComas in tuberous sclerosis patients. Owing to the immunoreactivity with CD10, microscopic endometrial PEC nodules may be misinterpreted as endothelial stromal cells unless melanocytic markers are stained. To the best of our knowledge, this is a case with the earliest manifestation of PEC lesions occurring in the endometrium. Virtual Slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9658280017862643

  6. Absence of CD9 reduces endometrial VEGF secretion and impairs uterine repair after parturition

    OpenAIRE

    Natsuko Kawano; Kenji Miyado; Noriko Yoshii; Seiya Kanai; Hidekazu Saito; Mami Miyado; Noboru Inagaki; Yasushi Odawara; Toshio Hamatani; Akihiro Umezawa

    2014-01-01

    In mammals, uterine epithelium is remodeled cyclically throughout adult life for pregnancy. Despite the expression of CD9 in the uterine epithelium, its role in maternal reproduction is unclear. Here, we addressed this issue by examining uterine secretions collected from patients undergoing fertility treatment and fertilization-competent Cd9?/? mice expressing CD9-GFP in their eggs (Cd9?/?TG). CD9 in uterine secretions was observed as extracellular matrix-like feature, and its amount ...

  7. The Effects of Nitric Oxide Donors on Uterine Artery and Sub-endometrial Blood Flow in Patients with Unexplained Recurrent Abortion

    Science.gov (United States)

    Abdel-Razik, Mohamed; El-Berry, Seham; Mostafa, Ahmed

    2014-01-01

    Background Nitric oxide plays a major role in increasing uterine blood flow during the luteal phase and early pregnancy. This study was done to compare uterine artery and sub-endometrial blood flow indices during the luteal phase between patients with unexplained recurrent abortion and fertile women and also to evaluate the effects of nitric oxide donors on blood flow indices in the abortion group. Methods The study included a control group of 30 primiparae who had normal vaginal delivery and no history of abortion and an abortion group of 30 nulliparous women with history of two or more unexplained recurrent abortions. Transvaginal three-dimensional pulsed color Doppler ultrasound was done on days 21-23 of the cycle to measure uterine artery resistance and pulsation indices and the subendometrial vascular, flow and vascular-flow indices. Isosorbide mononitrate 20 mg tablet was administered vaginally in the abortion group and blood flow indices were measured again after two hours. The Student t-test and the paired t-test were used for analysis of results and a p-value of ?0.05 was considered significant. Results Patients with unexplained recurrent abortion had significantly higher uterine artery resistance and pulsation indices and lower sub-endometrial vascular, flow and vascular-flow index (p < 0.01-0.0001). Isosorbide mononitrite significantly decreased uterine artery and increased sub-endometrial blood flow indices (p < 0.001). Conclusion Uterine artery and sub-endometrial blood flow decreased during the luteal phase in patients with unexplained recurrent abortion. Nitric oxide donors increased blood flow and may be of a therapeutic value. PMID:25202671

  8. Diagnostic Value of Endometrial Sampling with Pipelle Suction Curettage for Identifying Endometrial Lesions in Patients with Abnormal Uterine Bleeding

    OpenAIRE

    Behnamfar, F.; Khamehchian, T.; Mazoochi, T.; Fahiminejad, T.

    2004-01-01

    Background: While determining the cause of abnormal uterine bleeding, sampling from the endometrium is necessary. Considering that pipelle suction curettage can be performed on an out patient basis and does not require hospitalization, using anesthesia and cervical dilatation, we performed this study. The aim of this study was to compare the diagnostic value of dilatation and curettage (D&C) with pipelle suction curettage. Methods: This study was quasiexperimental on 200 pre and postmenop...

  9. Treatment of Uterine Myoma with 2.5 or 5?mg Mifepristone Daily during 3 Months with 9 Months Posttreatment Followup: Randomized Clinical Trial.

    Science.gov (United States)

    Carbonell, Josep Lluis; Acosta, Rita; Pérez, Yasmirian; Garcés, Roberto; Sánchez, Carlos; Tomasi, Giuseppe

    2013-01-01

    Objectives. To evaluate the efficacy, safety, and quality of life by using 2.5 and mifepristone 5?mg daily doses to treat uterine fibroids over 3 months with a 9-month followup period. Design. Randomized clinical trial. Place. "Eusebio Hernández" Hospital, Havana, Cuba. Subjects. 220 women with symptomatic uterine fibroids. Treatment. One-half (2.5?mg) or one-whole 5?mg mifepristone tablet. Variables to Evaluate Efficacy. Changes in fibroid and uterine volumes, in symptomatic prevalence and intensity, and in quality of life. Results. After 3-month treatment, fibroid volume decreased by 27.9% (CI 95% 20-35) and 45.5% (CI 95% 37-62), in the 2.5 and 5?mg groups, respectively, P = 0.003. There was no difference in the prevalence of symptoms at the end of treatment, unlike after 6- and 9-month followup when there was a difference. Amenorrhea was significantly higher in the 5?mg group, P = 0.001. There were no significant differences in mifepristone side effects between the groups. Both groups displayed a similar improvement in quality of life. Conclusions. The 2.5?mg dosage resulted in a lesser reduction in fibroid size but a similar improvement in quality of life when compared to the 5?mg dose. This trial is registered with ClinicalTrials.gov NCT01786226. PMID:23984082

  10. Uterine Cancer

    Science.gov (United States)

    ... is pregnant. There are different types of uterine cancer. The most common type starts in the endometrium, the lining of the uterus. This type of cancer is sometimes called endometrial cancer. The symptoms of ...

  11. Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies

    Directory of Open Access Journals (Sweden)

    Suna Kabil Kucur

    2013-01-01

    Full Text Available ive: To investigate the diagnostic value of blood flow measurements in spiral artery by transvaginal color Doppler sonography (CDS in predicting endometrial pathologies.Methods: Ninety-seven patients presenting with abnormal uterine bleeding and requiring endometrial assessment were included in this prospective observational study. Endometrial thickness, structure and echogenicity were recorded. Pulsatility index (PI and resistive index (RI of the spiral artery were measured by transvaginal CDS. Endometrial sampling was performed for all subjects. Sonographic and hystopathologic findings were compared.Results: The histopathological diagnoses were as follows; 39 cases (40.2% endometrial polyp, 9 cases (9.3% endometrial hyperplasia, 10 cases (10.3 submucous myoma, 7 cases (7.2% endometrium cancer, and 32 cases (33% nonspecific findings. The spiral artery PI in endometrium cancer group was highly significantly lower than other groups (p<0.01. The spiral artery RI was also significantly lower in the patients with malignant histology (p<0.05. Conclusion: Endometrial pathologies are associated significantly with endometrial spiral artery Doppler changes.Key words: Spiral artery, Doppler ultrasonography, endometrium

  12. Genistein Disrupts Glucocorticoid Receptor Signaling in Human Uterine Endometrial Ishikawa Cells

    OpenAIRE

    Whirledge, Shannon; Senbanjo, Linda T.; Cidlowski, John A.

    2014-01-01

    Background: The link between environmental estrogen exposure and defects in the female reproductive tract is well established. The phytoestrogen genistein is able to modulate uterine estrogen receptor (ER) activity, and dietary exposure is associated with uterine pathologies. Regulation of stress and immune functions by the glucocorticoid receptor (GR) is also an integral part of maintaining reproductive tract function; disruption of GR signaling by genistein may also have a role in the adver...

  13. Comparison of levonorgestrel-releasing intrauterine device with oral progestins in heavy menstrual bleeding (HMB) cases with uterine leiomyoma (LNG-IUD and oral progestin usage in myoma uteri)

    OpenAIRE

    Tosun, Ayse Kavasoglu; Tosun, Ismet; Suer, Necdet

    2014-01-01

    Objective: To compare the effectiveness and acceptability of LNG-IUD with oral progesterone (norethisterone acetate; NETA) in achieving a reduction in volume of the myomas, hemoglobin levels, satisfaction of the women.

  14. Vascular endothelial growth factor-D over-expressing tumor cells induce differential effects on uterine vasculature in a mouse model of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Stacker Steven A

    2010-07-01

    Full Text Available Abstract Background It has been hypothesised that increased VEGF-D expression may be an independent prognostic factor for endometrial cancer progression and lymph node metastasis; however, the mechanism by which VEGF-D may promote disease progression in women with endometrial cancer has not been investigated. Our aim was to describe the distribution of lymphatic vessels in mouse uterus and to examine the effect of VEGF-D over-expression on these vessels in a model of endometrial cancer. We hypothesised that VEGF-D over-expression would stimulate growth of new lymphatic vessels into the endometrium, thereby contributing to cancer progression. Methods We initially described the distribution of lymphatic vessels (Lyve-1, podoplanin, VEGFR-3 and VEGF-D expression in the mouse uterus during the estrous cycle, early pregnancy and in response to estradiol-17beta and progesterone using immunohistochemistry. We also examined the effects of VEGF-D over-expression on uterine vasculature by inoculating uterine horns in NOD SCID mice with control or VEGF-D-expressing 293EBNA tumor cells. Results Lymphatic vessels positive for the lymphatic endothelial cell markers Lyve-1, podoplanin and VEGFR-3 profiles were largely restricted to the connective tissue between the myometrial circular and longitudinal muscle layers; very few lymphatic vessel profiles were observed in the endometrium. VEGF-D immunostaining was present in all uterine compartments (epithelium, stroma, myometrium, although expression was generally low. VEGF-D immunoexpression was slightly but significantly higher in estrus relative to diestrus; and in estradiol-17beta treated mice relative to vehicle or progesterone treated mice. The presence of VEGF-D over-expressing tumor cells did not induce endometrial lymphangiogenesis, although changes were observed in existing vessel profiles. For myometrial lymphatic and endometrial blood vessels, the percentage of profiles containing proliferating endothelial cells, and the cross sectional area of vessel profiles were significantly increased in response to VEGF-D in comparison to control tumor cells. In contrast, no significant changes were noted in myometrial blood vessels. In addition, examples of invading cells or tumor emboli were observed in mice receiving VEGF-D expressing 293EBNA cells. Conclusions These results illustrate that VEGF-D over-expression has differential effects on the uterine vasculature. These effects may facilitate VEGF-D's ability to promote endometrial cancer metastasis and disease progression.

  15. Role of diagnostic hysteroscopy in abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Swati Singh

    2014-06-01

    Full Text Available Background: The objective of the study was to correlate hysteroscopic findings with histopathological findings in women with abnormal uterine bleeding and to study the accuracy of hysteroscopy in abnormal uterine bleeding. Methods: Settings: tertiary care hospital. Study design: prospective study. A prospective study was carried out in the Department of Obstetrics and Gynaecology at MMIMSR, Mullana, Ambala, from May 2011 to September 2013. 100 cases were selected for this study from patients who were admitted with history of abnormal uterine bleeding. Hysteroscopic examination was done in all patients post-menstrually, whenever possible, except in those cases where menstrual cycles were grossly irregular or patients came with continuous bleeding per vaginum. The patients then underwent dilatation and curettage and curettings was sent for histopathological examination. The correlation between findings on hysteroscopy and histopathological examination was done. Results: On hysteroscopy, 48% of the patients had either proliferative or secretory picture which was grouped as normal. The rest 52% of patients had some abnormality. Hyperplasia was the most common finding which was seen in 26% patients. The other findings included endometrial polyp 8%, myoma or myomatous polyp 7%, atrophic endometrium 4%, endometrial carcinoma, misplaced IUCD, and synechiae comprising 2% each and tubercular endometritis 1%. Conclusions: Hysteroscopy has a high sensitivity i.e. it can supplement and enhance the accuracy of tissue diagnosis. So, hysteroscopically directed biopsy would be an ideal procedure in abnormal uterine bleeding wherever facilities are available. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 544-551

  16. TWEAK Appears as a Modulator of Endometrial IL-18 Related Cytotoxic Activity of Uterine Natural Killers

    OpenAIRE

    Petitbarat, M.; Rahmati, M.; Sérazin, V.; Dubanchet, S; Morvan, C.; Wainer, R; de Mazancourt, P.; Chaouat, G.; Foidart, Jean-Michel; Munaut, Carine; Lédée, N.

    2011-01-01

    BACKGROUND: TWEAK (Tumor necrosis factor like WEAK inducer of apoptosis) is highly expressed by different immune cells and triggers multiple cellular responses, including control of angiogenesis. Our objective was to investigate its role in the human endometrium during the implantation window, using an ex-vivo endometrial microhistoculture model. Indeed, previous results suggested that basic TWEAK expression influences the IL-18 related uNK recruitment and local cytotoxicity. METHODOLOGY/...

  17. Chromohysteroscopy—A new technique for endometrial biopsy in Abnormal Uterine Bleeding (AUB)

    OpenAIRE

    Bharti Singh; Nisha Singh

    2013-01-01

    Objective: To evaluate the role of chromohysteroscopy in improving diagnostic accuracy of endometrial biopsy in cases of AUB. Design: Cross sectional interventional study. Materials and Methods: This study was conducted on 60 women with AUB in Dept. of Obst. & Gyne at King George Medical University, Lucknow over a period of one year. All cases underwent diagnostic hysteroscopy followed by chromohysteroscopy using 2% methylene blue dye. Hysteroscopic guided biopsy was taken from stained and u...

  18. Mioma uterino gigante / Giant myoma uteri

    Scientific Electronic Library Online (English)

    Gimel, Sosa Martín; Luis Raúl, Gutiérrez Gaytán; Adonis, Crespo Galán.

    2011-12-01

    Full Text Available El útero es un órgano del aparato ginecológico, sitio de muchas afecciones benignas y malignas. Las primeras, más frecuentes, y dentro de ellas está el mioma o fibroma uterino. Entre la tercera y quinta décadas de la vida es el tiempo en el que aparece mayormente esta afección en la mujer. Los sínto [...] mas son variables, en consecuencia de la localización del mioma (submucoso, intramural o subseroso). El crecimiento del útero es variable, puede ir desde pequeñas tumoraciones hasta grandes masas intraabdominales, que se hacen visibles y llegan a palparse en el mesogastrio. Sus complicaciones son las que la hacen acreedoras de tratamiento quirúrgico. Un gran crecimiento del útero a consecuencia de un mioma puede llegar a convertirlo en un mioma gigante. Se presenta esta paciente con el objetivo de alertar al médico que se encuentre ante la sospecha de un tumor gigante intraabdominal. Abstract in english Uterus is an organ of the gynecological tract, site of many of them benign and malignant affections. The first ones, more frequent, and including the myoma or uterine fibroma. Between the third and the fifth decades of life is the time in which this affection is more frequent in the woman. Symptoms [...] are variables, as a result of the myoma location (submucous, intramural or subserous). The uterus growth is variable, may go from small tumors until large more evident intra-abdominal masses and to be enough palpable in the mesogastrium. Its complications are the reason for the surgical treatment. A significant growth of uterus caused by a myoma may become it in a giant myoma. The case of this patient is the objective to alert to physician facing the suspicion of a intra-abdominal giant tumor.

  19. Mioma uterino gigante Giant myoma uteri

    Directory of Open Access Journals (Sweden)

    Gimel Sosa Martín

    2011-12-01

    Full Text Available El útero es un órgano del aparato ginecológico, sitio de muchas afecciones benignas y malignas. Las primeras, más frecuentes, y dentro de ellas está el mioma o fibroma uterino. Entre la tercera y quinta décadas de la vida es el tiempo en el que aparece mayormente esta afección en la mujer. Los síntomas son variables, en consecuencia de la localización del mioma (submucoso, intramural o subseroso. El crecimiento del útero es variable, puede ir desde pequeñas tumoraciones hasta grandes masas intraabdominales, que se hacen visibles y llegan a palparse en el mesogastrio. Sus complicaciones son las que la hacen acreedoras de tratamiento quirúrgico. Un gran crecimiento del útero a consecuencia de un mioma puede llegar a convertirlo en un mioma gigante. Se presenta esta paciente con el objetivo de alertar al médico que se encuentre ante la sospecha de un tumor gigante intraabdominal.Uterus is an organ of the gynecological tract, site of many of them benign and malignant affections. The first ones, more frequent, and including the myoma or uterine fibroma. Between the third and the fifth decades of life is the time in which this affection is more frequent in the woman. Symptoms are variables, as a result of the myoma location (submucous, intramural or subserous. The uterus growth is variable, may go from small tumors until large more evident intra-abdominal masses and to be enough palpable in the mesogastrium. Its complications are the reason for the surgical treatment. A significant growth of uterus caused by a myoma may become it in a giant myoma. The case of this patient is the objective to alert to physician facing the suspicion of a intra-abdominal giant tumor.

  20. Abnormal uterine bleeding: an evaluation endometrial biopsy, vaginal ultrasound and outpatient hysteroscopy.

    OpenAIRE

    Hunter, D. C.; Mcclure, N.

    2001-01-01

    Abnormal uterine bleeding is a common gynaecological symptom. Whilst most patients have benign disease, thorough investigation is necessary, particularly in the peri- and post-menopausal woman. Hysteroscopy with directed biopsy of suspicious lesions is the gold standard investigation but it is invasive and is not offered in all units as an outpatient procedure. Ultrasound and outpatient biopsy techniques may allow patients to be triaged to select those who require formal evaluation by hystero...

  1. Office hysteroscopy, transvaginal ultrasound and endometrial histology: a comparison in infertile patients

    Directory of Open Access Journals (Sweden)

    Devleta Bali?

    2011-05-01

    Full Text Available Objective. To evaluate accuracy of transvaginal sonography (TVS and hysteroscopy in detection of intrauterine pathology in infertile women. Subjects and methods. This retrospective study was conducted in 56 infertile women with abnormal transvaginal ultrasound findings of the uterine cavity which was performed during the midfollicular phase as a part of routine infertility workup. Hysteroscopy was performed between 6th and 10th day of cycle. Results. The mean age of the subjects was 31.9±4.0. The most frequent ultrasound finding was endometrial polyp in 34 (60.7% patients, septate uterus in 8 (14.3% patients, submucosal myoma in 7 (12.5% patients, endometrial hyperplasia in 5 (8.9% patients and Syndroma Ascherman in 2 (3.6% patients. Hysteroscopy confirmed 20 (35.7% polyps, the same number of myomas, septate uterus and Syndroma Ascherman as detected by ultrasound, (7 (12.5%, 8 (14.3% and 2 (3.6%, respectively and 19 (33.9% endometrial hyperplasia. In 46 women with histological excamination, the sensitivity of TVS and hysteroscopy in the diagnosis of endometrial polyps were identical - 100%, while the specificity was higher in hysteroscopy than in TVS (92.3% versus 56.4%, p<0.001. The sensitivity of TVS in the diagnosis of endometrial hyperplasia was higher than that of hysteroscopy (86.4% versus 22.7%, p<0.001, while specificity was identical, of 100%. Accordance between hysteroscopy and histology was good (k=0.79, between ultrasound and histology was moderete (k=0.59. Conclusion. Hysteroscopy appeared to be more reliable in diagnosis than TVS. The use of a high frequency ultrasound probe leads us to a lack of diagnostic clarity between endometrial polyps and hyperplasia.

  2. Induction of endometrial adenocarcinomas by a single intra-uterine administration of N-ethyl-N'-nitro-N-nitrosoguanidine to aged Donryu rats showing spontaneously persistent estrus.

    Science.gov (United States)

    Takahashi, M; Ando-Lu, J; Yoshida, M; Iijima, T; Ishihara, R; Imai, S; Kitamura, T; Suzuki, K; Nishiyama, K; Nishimura, S

    1995-08-16

    Induction of endometrial adenocarcinomas by a single intra-uterine administration of N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) to aged rats was examined. Donryu rats showing spontaneously persistent estrus were given a single intra-uterine administration of ENNG (20 mg/kg) at 10 months (44 weeks) of age. At the termination of the experiment (week 34 after the ENNG-treatment), 22% and 13% incidences of endometrial adenocarcinomas were observed in the experimental and control groups, respectively, the difference being without significance. No variation was found in the endocrine environment between experimental and non carcinogen-treated control animals throughout the experimental period. These results show that ENNG-treatment alone is not sufficient in aged rats for high induction of endometrial carcinomas. Comparison of the data with those from our previous studies, in which ENNG was given at a young age (10 weeks of age), indicates that young rats may be more sensitive than their old counterparts. PMID:7656249

  3. Impact of myomas on the results of transcervical resection of the endometrium

    DEFF Research Database (Denmark)

    Christoffersen, Christian P. V.; Kahr, Henriette StrØm

    2014-01-01

    STUDY OBJECTIVE: To investigate long-term hysterectomy rates after transcervical resection of the endometrium (TCRE) performed by experienced surgeons in the presence and absence of intracavitary myomas. DESIGN: Multicenter case-control study (Canadian Task Force classification II-2). PATIENTS: The study group comprised 456 women with myomas who met the inclusion criteria, and of these, 82 (17.98%) later underwent hysterectomy. The control group comprised 1438 women without myomas, and of these, 284 (19.75%) later underwent hysterectomy. METHODS: From 2001 to 2004, standardized results were extracted from Hyskobase on the basis of a total of 1894 women aged 23 to 59 years. The women were identified as having or not having myomas, and data from both groups were statistically analyzed. Detailed information on myoma size and intramural involvement (type 0, 1, and 2) was collected. MEASUREMENTS AND MAIN RESULTS: After TCRE, women with type 2 myomas, compared with those with type 0 myomas, were found to have asignificantly higher risk of undergoing hysterectomy (p = .04), and women, including controls, with myomas >3.6 cm in greatest diameter were found to have a significantly higher risk of undergoing hysterectomy than were those with smaller myomas (p = .01). There was no statistically significant difference in risk of hysterectomy between type 0 and type 1 myomas or between type 1 and type 2 myomas. When hysterectomy rates between the myoma and control groups were compared, there was an increased risk of hysterectomy in the control group (p = .008). Multiple-step multivariate regression analysis of uterine and procedural characteristics of TCRE demonstrated that factors that were positive predictors of hysterectomy within 66 months after resection were younger age, inaccessible uterine corners, enlarged uterus, and pretreatment using gonadotropin-releasing hormone agonists. CONCLUSION: When performing TCRE in women with intracavitary myomas, the chance of treatment success is worsened if they are of type 2 ortheir diameter is >3.5 cm. In addition, younger age increases the risk of hysterectomy and the need for pretreatment with gonadotropin-releasing hormone agonists, or if the uterus is enlarged or the uterine corners are difficult to access during the procedure.

  4. Transient Occlusion of Uterine Arteries in Laparoscopic Uterine Surgery

    Science.gov (United States)

    Kwon, Yong-Soon; Roh, Hyun Jin; Ahn, Jun Woo; Lee, Sang-Hun

    2015-01-01

    Background and Objectives: This study was conducted to determine the feasibility and effectiveness of transient occlusion of the uterine arteries (TOUA) during laparoscopic surgery for benign uterine tumors, with preservation of fertility. Methods: Patients with uterine myoma or adenomyoma underwent laparoscopic uterine surgery, with or without TOUA, performed by a single surgeon (Y.-S.K.). Surgical outcomes included operative time; occurrence of intraoperative injury of blood vessels, nerves, and pelvic organs; and intraoperative blood loss. Results: Of the 168 surgical patients included in this study, 144 were enrolled consecutively during the study period, and 24 had undergone adenomectomy before the study period. A total of 104 women (70 with myoma; 34 with adenomyoma) seeking uterine preservation underwent laparoscopic surgery with TOUA for benign uterine tumors. Sixty-four women (40 with myoma; 24 with adenomyoma) underwent surgery without TOUA. The mean total surgical time of the TOUA groups was 74.85 minutes for uterine myoma and 84.09 minutes for uterine adenomyoma. The mean estimated blood loss during laparoscopic myomectomy and adenomyomectomy was less in the TOUA groups than in the non-TOUA groups (109 vs. 203.4 mL in myomectomy, P < .05; 148.1 vs. 158.9 mL in adenomyomectomy; P < .05). Time to perform TOUA was 13.9 minutes in laparoscopic myomectomy and 7.33 minutes in laparoscopic adenomyomectomy. The hospital stay of the TOUA groups was 3.32 days for uterine myoma and 3.82 days for uterine adenomyoma. No intraoperative conversion to laparotomy was necessary, and no major complications occurred during any of the procedures. Conclusion: Laparoscopic uterine surgery with TOUA could be a safe and effective surgical method for women with symptomatic benign uterine tumors who wish to preserve fertility. PMID:25848179

  5. High-yield induction of uterine endometrial adenocarcinomas in Donryu rats by a single intra-uterine administration of N-ethyl-N'-nitro-N-nitrosoguanidine via the vagina.

    Science.gov (United States)

    Ando-Lu, J; Takahashi, M; Imai, S; Ishihara, R; Kitamura, T; Iijima, T; Takano, S; Nishiyama, K; Suzuki, K; Maekawa, A

    1994-08-01

    A total of 130 female Donryu rats (10-week-old) were divided into two groups; 80 animals in the experimental group were given a single intra-uterine administration of 20 mg/kg N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) dissolved in polyethylene glycol (PEG) via the vagina without laparotomy, and 50 animals in the control group received PEG alone in the same manner. Small numbers of animals in both groups were killed at 3, 6, 9 and 12 months after ENNG treatment for sequential histological and endocrinological examination, and at 12.5 experimental months (15 months of age) all survivors were killed. At the termination, endometrial adenocarcinomas were present in 49% of the experimental group, compared to 0% in the control group. Severe endometrial hyperplasias were also found only in the experimental group and sequential histological examination showed first appearance of hyperplasia at 6 months and adenocarcinoma at 9 months. No tumors other than uterine carcinomas were induced by ENNG and the carcinogen treatment did not affect the endocrine environment of rats, persistent estrus appearing at 6 months after the start and increasing with age in both groups. The estradiol-17 beta:progesterone (E:P) ratio was also increased after 6 months, with further elevation at 12 months to about 8 times higher than the level at 6 months. These results indicate that an increased E:P ratio might act as a promoter of development of endometrial proliferative lesions initiated by ENNG in this rat strain. The study indicates that the present simple method using Donryu rats provides a good animal model for endometrial adenocarcinoma development in women. PMID:7928623

  6. Impact of soluble HLA-G levels and endometrial NK cells in uterine flushing samples from primary and secondary unexplained infertile women.

    Science.gov (United States)

    Rizzo, Roberta; Lo Monte, Giuseppe; Bortolotti, Daria; Graziano, Angela; Gentili, Valentina; Di Luca, Dario; Marci, Roberto

    2015-01-01

    The aim of this research was to determine the levels of human leukocyte antigen G (HLA-G) and endometrial Natural Killer ((e)NK) cell percentages in uterine flushing samples from primary and secondary infertile women. sHLA-G levels were lower in the uterine flushing samples from primary infertile women in comparison with women with secondary infertility. Lower CD56+KIR2DL4+ (e)NK cell percentages were detected in primary infertile women compared with secondary infertile women. This is the first study demonstrating that primary and secondary unexplained infertilities are characterized by different basal sHLA-G levels and CD56+KIR2DL4+ (e)NK cell percentages. PMID:25764161

  7. Impact of Soluble HLA-G Levels and Endometrial NK Cells in Uterine Flushing Samples from Primary and Secondary Unexplained Infertile Women

    Directory of Open Access Journals (Sweden)

    Roberta Rizzo

    2015-03-01

    Full Text Available The aim of this research was to determine the levels of human leukocyte antigen G (HLA-G and endometrial Natural Killer ((eNK cell percentages in uterine flushing samples from primary and secondary infertile women. sHLA-G levels were lower in the uterine flushing samples from primary infertile women in comparison with women with secondary infertility. Lower CD56+KIR2DL4+ (eNK cell percentages were detected in primary infertile women compared with secondary infertile women. This is the first study demonstrating that primary and secondary unexplained infertilities are characterized by different basal sHLA-G levels and CD56+KIR2DL4+ (eNK cell percentages.

  8. Diagnostic value of saline contrast sonohysterography comparing with hysteroscopy for detecting endometrial abnormalities in women with abnormal uterine bleeding

    OpenAIRE

    Farzaneh Goharzad; Razieh Dehghani Firouzabadi; Mohammad Ali Karimzadeh

    2011-01-01

    Background: Abnormal uterine bleeding is a common presentation of uterine abnormalities among premenopausal and postmenopausal women.Objective: To evaluate and compare the diagnostic accuracy of saline contrast sonohysterography and hysteroscopy for detecting the cause of abnormal uterine bleeding.Materials and Methods: A total of 65 women with abnormal uterine bleeding were enrolled in this study. A prior saline contrast sonohysetrography followed by a hysteroscopy was performed in all cases...

  9. Endometrial Imaging

    Directory of Open Access Journals (Sweden)

    Khadijeh Bakhtavar

    2009-01-01

    Full Text Available   "nAbnormal uterine bleeding, whether in peri menopausal or postmenopausal patients, is an important clinical concern and results in much medical intervention. When bleeding occurs in women over 40 years of age as well as any postmenopausal women, endometrial assessment is mandatory. In the past and present, many clinicians prefer to begin such assessment with blind endometrial sampling. However, when an ultrasound-based approach to such patients is present, a thin distinct endometrial echo excludes significant pathology, assuming it is performed at an appropriate time if the patient is, in fact, cycling. When a thin distinct endometrial echo is not visualized (inadequate visualization or presence of thickened echo then saline infusion sonohysterography can help to triage patients to no anatomic pathology, globally thickened anatomic pathology that may then be evaluated with blind endometrial sampling, and focal abnormalities that must be evaluated under direct vision. Such an ultrasound-based approach will not only help to exclude endometrial carcinoma, but also to identify the source of any bleeding for better clinical management. MRI has no role as a screening technique for endometrial carcinoma however the accuracy of MRI in differentiating non invasive from invasive carcinoma is high.   

  10. Initiating and promoting effects of concurrent oral administration of ethylenethiourea and sodium nitrite on uterine endometrial adenocarcinoma development in Donryu rats.

    Science.gov (United States)

    Nishiyama, K; Ando-Lu, J; Nishimura, S; Takahashi, M; Yoshida, M; Sasahara, K; Miyajima, K; Maekawa, A

    1998-01-01

    The effects of oral administration of ethylenethiourea (ETU) and sodium nitrite on endometrial adenocarcinoma development was investigated in female Donryu rats. At 10 week of age, groups 1 and 3 received a single dose of polyethylene glycol (PEG) into the uterine cavity, while groups 2 and 4 were given N-ethyl-N-nitrosourea (ENU) (15 mg/kg) solution, dissolved in PEG, in the same manner. ETU (80 mg/kg) and sodium nitrite (56 mg/kg) dissolved in distilled water were orally given to animals in groups 3 and 4 once a week from 11 to 51 weeks of age. Groups 1 and 2 received the vehicle alone. At termination (52 weeks of age), endometrial adenocarcinomas were observed in 29, 13 and 57% of rats in groups 2, 3 and 4, respectively, but not in group 1. Persistent estrus appeared earlier in groups 3 and 4 than in group 1. In groups 3 and 4, hyperplastic and neoplastic lesions of the digestive tract, especially the forestomach, were also observed. The results indicate that N-nitroso ETU formed in the stomach by concurrent oral administration of ETU and sodium nitrite, itself induces endometrial adenocarcinomas by its mutagenic action, as well as promoting their development after ENU-initiation, presumably by influencing the hormonal balance. PMID:9706485

  11. Is there a role for a brachytherapy vaginal cuff boost in the adjuvant management of patients with uterine-confined endometrial cancer?

    International Nuclear Information System (INIS)

    Purpose/Objective: Many patients who have uterine-confined endometrial cancer with prognostic factors predictive of recurrence are treated with adjuvant pelvic radiation. The addition of a brachytherapy vaginal cuff boost is controversial. Materials and Methods: Between 1983 and 1993, 270 patients received adjuvant postoperative pelvic irradiation following hysterectomy for Stage I or II endometrial cancer. Group A includes 173 patients who received external beam irradiation alone (EBRT), while group B includes 97 patients who received EBRT with a vaginal brachytherapy application. The median dose of EBRT was 45 Gy. Vaginal brachytherapy consisted of a low dose rate ovoid or cylinder in 41 patients, a high dose rate cylinder in 54 patients, and a radioactive gold seed implant in two patients. The median follow-up time was 64 months. The two groups were compared in terms of age, histologic grade, favorable versus unfavorable histology, capillary space invasion, depth of myometrial invasion, and pathologic stage. Results: Chi-square analysis revealed that the only difference between the two groups was the presence of more Stage II patients in group B (38% versus 14%). No difference was detected for 5 year pelvic control and disease-free survival rates between groups A and B. Conclusion: There is no suggestion that the addition of a vaginal cuff brachytherapy boost to pelvic radiation is beneficial for pelvic control or disease-free survival for patients with Stage I or ree survival for patients with Stage I or II endometrial cancer. Prospective randomized trials designed to study external irradiation alone versus external beam treatment plus vaginal brachytherapy are unlikely to show a positive result. Because EBRT provides excellent pelvic control, protocol development for uterine-confined corpus cancer should focus on identifying patients at risk for recurrence as well as other means of augmenting EBRT (e.g. addition of chemotherapy) in order to improve disease free survival in those subgroups

  12. Papel da Histerossonografia no Estudo da Cavidade Uterina em Pacientes com Sangramento Uterino Anormal / Role of Sonohysterography in the Evaluation of the Uterine Cavity in Patients with Abnormal Uterine Bleeding

    Scientific Electronic Library Online (English)

    Angélica Lemos Debs, Diniz; Elmar Gonzaga, Gonçalves.

    2000-06-01

    Full Text Available Objetivo: determinar o papel da histerossonografia na avaliação das anormalidades da cavidade uterina, em pacientes com sangramento uterino anormal, selecionadas previamente pela ultra-sonografia transvaginal. Métodos: foram selecionadas 48 pacientes na menacme e pós-menopausa, portadoras de sangram [...] ento uterino anormal e anormalidades da cavidade uterina, diagnosticadas inicialmente pela ultra-sonografia transvaginal. Todas as pacientes se submeteram à histerossonografia e, posteriormente, aos métodos "padrão ouro", a histeroscopia e/ou histerectomia. As histerossonografias foram avaliadas por dois diferentes médicos e os diagnósticos confrontados. Resultados: a histerossonografia mostrou ter alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina. Na presença de pólipo a sensibilidade e a especificidade do método foram, respectivamente, de 100 e 97%, seguido do mioma submucoso cuja sensibilidade e especificidade foram, respectivamente, de 83 e 100%. Já na hiperplasia endometrial e no endométrio normal a sensibilidade e especificidade foram de 100%. Diagnosticamos 33 casos de pólipos, 13 casos de miomas submucosos, quatro casos de hiperplasia endometrial e três casos normais na análise dos métodos "padrão ouro". Houve alta correlação entre os diagnósticos dados pelos dois examinadores. Conclusões: a histerossonografia mostrou ser um exame reprodutível, com alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina em pacientes com sangramento uterino anormal. Abstract in english Purpose: to determine the role of sonohysterography in the evaluation of abnormalities in the uterine cavity in patients presenting abnormal uterine bleeding, who had previously been selected by transvaginal ultrasonography. Methods: forty-eight patients presenting abnormal uterine bleeding and chan [...] ges in the uterine cavity seen by transvaginal ultrasonography were selected, and they were in the menacme or postmenopause period. All patients underwent a sonohysterography, and later a hysteroscopy and/or a hysterectomy. The sonohysterographies were evaluated by two different physicians, and the diagnoses were compared. Results: the sonohysterography method showed high sensitivity and specificity for the diagnosis of benign pathologies in the uterine cavity. First, in the presence of polyps the sensitivity and specificity rates were 100 and 97%, respectively, second, in the presence of submucous myoma, they were 83 and 100%, and finally, concerning endometrial hyperplasia and normal endometrium, they were 100%. We diagnosed thirty-three cases of polyps, thirteen cases of submucous myoma, four cases of endometrial hyperplasia and three normal cases. The correlation between the diagnoses provided by the two physicians was high. Conclusions: sonohysterography is a safe and fast method which is very well tolerated by the patient, and has low levels of complications. Its high sensitivity and specificity allow this method to be used for routine diagnosis concerning benign pathologies in the uterine cavity of patients presenting abnormal uterine bleeding.

  13. Papel da Histerossonografia no Estudo da Cavidade Uterina em Pacientes com Sangramento Uterino Anormal Role of Sonohysterography in the Evaluation of the Uterine Cavity in Patients with Abnormal Uterine Bleeding

    Directory of Open Access Journals (Sweden)

    Angélica Lemos Debs Diniz

    2000-06-01

    Full Text Available Objetivo: determinar o papel da histerossonografia na avaliação das anormalidades da cavidade uterina, em pacientes com sangramento uterino anormal, selecionadas previamente pela ultra-sonografia transvaginal. Métodos: foram selecionadas 48 pacientes na menacme e pós-menopausa, portadoras de sangramento uterino anormal e anormalidades da cavidade uterina, diagnosticadas inicialmente pela ultra-sonografia transvaginal. Todas as pacientes se submeteram à histerossonografia e, posteriormente, aos métodos "padrão ouro", a histeroscopia e/ou histerectomia. As histerossonografias foram avaliadas por dois diferentes médicos e os diagnósticos confrontados. Resultados: a histerossonografia mostrou ter alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina. Na presença de pólipo a sensibilidade e a especificidade do método foram, respectivamente, de 100 e 97%, seguido do mioma submucoso cuja sensibilidade e especificidade foram, respectivamente, de 83 e 100%. Já na hiperplasia endometrial e no endométrio normal a sensibilidade e especificidade foram de 100%. Diagnosticamos 33 casos de pólipos, 13 casos de miomas submucosos, quatro casos de hiperplasia endometrial e três casos normais na análise dos métodos "padrão ouro". Houve alta correlação entre os diagnósticos dados pelos dois examinadores. Conclusões: a histerossonografia mostrou ser um exame reprodutível, com alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina em pacientes com sangramento uterino anormal.Purpose: to determine the role of sonohysterography in the evaluation of abnormalities in the uterine cavity in patients presenting abnormal uterine bleeding, who had previously been selected by transvaginal ultrasonography. Methods: forty-eight patients presenting abnormal uterine bleeding and changes in the uterine cavity seen by transvaginal ultrasonography were selected, and they were in the menacme or postmenopause period. All patients underwent a sonohysterography, and later a hysteroscopy and/or a hysterectomy. The sonohysterographies were evaluated by two different physicians, and the diagnoses were compared. Results: the sonohysterography method showed high sensitivity and specificity for the diagnosis of benign pathologies in the uterine cavity. First, in the presence of polyps the sensitivity and specificity rates were 100 and 97%, respectively, second, in the presence of submucous myoma, they were 83 and 100%, and finally, concerning endometrial hyperplasia and normal endometrium, they were 100%. We diagnosed thirty-three cases of polyps, thirteen cases of submucous myoma, four cases of endometrial hyperplasia and three normal cases. The correlation between the diagnoses provided by the two physicians was high. Conclusions: sonohysterography is a safe and fast method which is very well tolerated by the patient, and has low levels of complications. Its high sensitivity and specificity allow this method to be used for routine diagnosis concerning benign pathologies in the uterine cavity of patients presenting abnormal uterine bleeding.

  14. Subserous Uterine Leiomyoma

    OpenAIRE

    Rusda, Muhammad; Adrian

    2010-01-01

    Uterine fibroids are the most common pelvic tumor. The growth of a fibroid seems to depend on the hormone estrogen. As long as a woman with fibroids is menstruating, the fibroids will probably continue to grow, usually slowly. Management of uterine myomas may involve one of the following approaches or a combination thereof: expectant management, medical management. A case of subserous leiomyoma in a 20-year old, virgin is hereby presented. She underwent myomectomy for a preoperative adnexal m...

  15. Carboplatin and Paclitaxel With or Without Cisplatin and Radiation Therapy in Treating Patients With Stage I, Stage II, Stage III, or Stage IVA Endometrial Cancer

    Science.gov (United States)

    2014-12-23

    Endometrial Clear Cell Adenocarcinoma; Endometrial Serous Adenocarcinoma; Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer

  16. Induction of endometrial adenocarcinomas in persistent estrous Donryu rats by a single intra-uterine administration of N-ethyl-N'-nitro-N-nitrosoguanidine.

    Science.gov (United States)

    Takahashi, M; Ando-Lu, J; Iijima, T; Ishihara, R; Imai, S; Kitamura, T; Wakabayashi, K; Maekawa, A

    1994-01-01

    Induction of endometrial adenocarcinomas in persistent estrous Donryu rats by a single intra-uterine administration of N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) was examined. Female Donryu rats were divided into four groups at 7 weeks of age. Rats in Croup 1 were controls under a 12-h light/12-h dark regimen while Groups 2-4 were persistent estrous animals maintained under 24-h light conditions. At 10 weeks of age, rats in Group 1 and 2 were given a single intra-uterine administration of polyethylene glycol(PEG), and those in Groups 3 and 4 received ENNG(20 mg/kg body weight), dissolved in PEG, in the same manner. Group 4 rats also received an s.c. 17 beta-estradiol(E2) implant one week thereafter. At the termination of the experiment (week 42 after the ENNG-treatment), all surviving rats were killed and the development of uterine proliferative lesions assessed. All groups demonstrated hyperplasias, the incidence and severity being higher in ENNG-treated animals. The incidence of uterine adenocarcinomas in Group 2(2/20, 10%) was slightly higher than that in Group 1(0/16, 0%), although this difference was not significant. In Groups 3(7/19, 37%) and 4(6/20, 30%) statistically significant induction of adenocarcinomas was noted, two lesions in the latter case being very large with prominent invasion of tumor cells into the perimetrium. At 10 and 25 weeks after ENNG-treatment, the E2-progesterone(E2:P) ratios in Groups 2, 3 and 4 were significantly higher than in Group 1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7772735

  17. Role of MR in diagnosis of uterine leiomyoma

    International Nuclear Information System (INIS)

    Uterine myoma is the most common benign uterine neoplasm, and associated with numerous gynecologic and obsteric complication. Preoperative acurrate analysis of the number, location and type of the myoma is important, especially in reproductive women. We analyze the MR findings of uterine myoma for evaluation of the role of MR in diagnosis of uterine myoma. We analyze MR findings of 76 myomas in 40 patients, and 34 myomas in 17 patients of them were confirmed by surgery. With 2.0T Spectro-20000(Gold-star, Korea), T1WI axial images and T2WI axial and sagittal images were obtained. Locations were classified into fundus, anterior body, posterior body, right body, left body, and cervix. Types were classified into submucosal, intramural, and subserosal. Associated findings were analyzed also. The most common location and type were posterior body and intramural type, respectively. Ten myomas were confirmed on surgery only, and the causes were as follows: first, all 10 myomas were less than 2 cm in size; second, 1 subserosal myoma was abutted to a large ovarian mass; third, small myomas were abutted to each other, or small one was adjacent to larger one and considered as one large myoma. Degenerative change was noted in 50% of histologically confirmed cases. High signal halo on T2WI was noted in 14%. MR is excellent in detection and localization of uterine leiomyoma larger than 2cm, and may be a preoperative diagnostic method of choice in patient who need myomectomy for presee in patient who need myomectomy for preservation of childbearing function

  18. Laparoscopic Myomectomy for Large Myomas

    OpenAIRE

    Yoon, Hyo Jin; Kyung, Min Sun; Jung, Un Suk; Choi, Joong Sub

    2007-01-01

    The aim of this study was to assess the feasibility and efficacy of laparoscopic myomectomy (LM) for large myomas. A subpopulation of 51 patients with myomas 8 cm or larger in diameter was selected from 155 patients who underwent LM at Kangbuk Samsung Hospital from July 2003 to November 2006. The mean age of the patients was 34.9±5.6 yr, mean parity was 0.6±0.9, and 8 patients had a previous operative history. The most common operative indication was a palpable abdominal mass (24 patients, ...

  19. Role of transvaginal sonography and hysteroscopy in abnormal uterine bleeding: does the diagnostic yield increase by combining transvaginal sonography, hysteroscopy and biopsy?

    Directory of Open Access Journals (Sweden)

    Nivedita Krishnamoorthy

    2014-08-01

    Methods: This was a descriptive cross sectional study between January 2013 to June2014 in Sri Manakula Vinayagar medical college and hospital. After obtaining ethics committee approval, 100 consecutive patients with abnormal uterine bleeding between the age group of 35 and 55 years, who consented to participate in the study, were subjected to transvaginal sonography followed by diagnostic hysteroscopy combined with a directed biopsy. TVS and hysteroscopy was performed by two different investigators. The endometrial curettings and any intracavitary lesion were subjected to histopathological examination. Results tabulated and analysed using MS EXCEL and cross tabulation using Epi-info. Sensitivity, specificity, PPV, NPV for each pathology by TVS and hysteroscopy with HPE as the gold standard was calculated. Also the pathology causing abnormal uterine bleeding was computed by taking into account the endometrial characteristics and the associated lesions diagnosed by TVS, hysteroscopy and histopathological examination report. Results: 61 patients had only single lesions in the form of normal endometrium, atrophic endometrium, endometrial hyperplasia, endometrial polyp, malignancy and IU synechiae whereas 39 patients had lesions like intramural fibroids, adenomyosis, submucus myoma and polyps associated with different types of endometrium. The diagnostic accuracy of TVS and hysteroscopy were comparable for normal endometrium whereas hysteroscopy was found to be more accurate for endometrial polyps, endometrial hyperplasia and atrophic endometrium. Conclusions: The combination of transvaginal sonography, hysteroscopy and directed biopsy was found to increase the diagnostic yield in patients with abnormal uterine bleeding. As the diagnostic accuracy increased by combining the three modalities, an effective and appropriate management can be planned. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 919-923

  20. Long-acting progestin-only contraceptives impair endometrial vasculature by inhibiting uterine vascular smooth muscle cell survival.

    Science.gov (United States)

    Kayisli, Umit A; Basar, Murat; Guzeloglu-Kayisli, Ozlem; Semerci, Nihan; Atkinson, Helen C; Shapiro, John; Summerfield, Taryn; Huang, S Joseph; Prelle, Katja; Schatz, Frederick; Lockwood, Charles J

    2015-04-21

    Molecular mechanisms responsible for abnormal endometrial vasculature in women receiving long-acting progestin-only contraceptives (LAPCs) are unknown. We hypothesize that LAPCs impair vascular smooth muscle cell (VSMC) and pericyte proliferation and migration producing thin-walled hyperdilated fragile microvessels prone to bleeding. Proliferating cell nuclear antigen (PCNA) and ?-smooth muscle actin (?SMA) double-immunostaining assessed VSMC differentiation and proliferation in endometria from women before and after DepoProvera (Depo) treatment and from oophorectomized guinea pigs (OVX-GPs) treated with vehicle, estradiol (E2), medroxyprogesterone acetate (MPA), or E2+MPA. Whole-genome profiling, proliferation, and migration assays were performed on cultured VSMCs treated with MPA or etonogestrel (ETO). Endometrial vessels of Depo-administered women displayed reduced ?SMA immunoreactivity and fewer PCNA (+) nuclei among ?SMA (+) cells (P PCNA (+) nuclei in VSMC (P < 0.005). In conclusion, LAPCs promote abnormal endometrial vessel formation by inhibiting VSMC proliferation and migration. PMID:25847994

  1. A Histerossonografia na Avaliação da Cavidade Uterina em Pacientes Menopausadas / Sonohysterography in the evaluation of the uterine cavity in postmenopausal women

    Scientific Electronic Library Online (English)

    Benito Pio Vitório, Ceccato Júnior; Victor Hugo de, Melo; José Benedito de, Lira Neto.

    2002-09-01

    Full Text Available Objetivos: avaliar a acuidade diagnóstica da histerossonografia como método de avaliação da cavidade uterina em pacientes menopausadas com cavidade uterina alterada à ultra-sonografia endovaginal convencional. Métodos: este estudo consistiu na avaliação de 99 pacientes menopausadas com cavidade uter [...] ina anormal à ultra-sonografia endovaginal convencional, caracterizada por espessura endometrial maior ou igual a 5 mm em pacientes sem terapia de reposição hormonal, ou espessura endometrial maior ou igual a 8 mm em pacientes em terapia de reposição hormonal, com sangramento irregular. Estas pacientes foram submetidas à histerossonografia e após, foram obtidas amostras para avaliação histopatológica por biópsia dirigida por histeroscopia em 92 pacientes, biópsia endometrial em quatro pacientes e histerectomia em três pacientes. Os resultados da histerossonografia foram comparados com os resultados do exame histopatológico, considerado como "padrão-ouro". Resultados: houve oito casos de cavidade uterina normal e 20 casos de atrofia endometrial e a histerossonografia teve altos níveis de especificidade (97,8 e 97,5%) e baixa sensibilidade (35 e 25%). Houve altos níveis de sensibilidade (92,3 e 75,0%) e especificidade (94,1 e 97,9%) em pólipos (65 casos) e miomas submucosos (quatro casos). Houve três casos de câncer de endométrio e a histerossonografia teve sensibilidade e especificidade de 100%. Conclusões: a histerossonografia mostrou boa acuidade no diagnóstico de doenças focais (pólipos endometriais e miomas submucosos), com altos níveis de sensibilidade e especificidade. Houve três casos de câncer endometrial, e a histerossonografia diagnosticou corretamente todos eles. Mostrou também ser método acurado para excluir anormalidades endometriais. Entretanto, nos casos de espessamento endometrial difuso, a acuidade é baixa, porque endométrios atróficos ou normais freqüentemente aparecem como tendo espessamento difuso à ultra-sonografia endovaginal e à histerossonografia. A histerossonografia não teve complicações durante e após o procedimento. Abstract in english Purpose: to evaluate the diagnostic accuracy of sonohysterography as a diagnostic method for the evaluation of the uterine cavity in postmenopausal women with abnormal uterine cavity at conventional endovaginal sonography. Methods: this study consisted of the evaluation of 99 postmenopausal patients [...] with abnormal uterine cavity on conventional endovaginal sonography, that was defined as endometrial thickness equal to or larger than 5 mm in a postmenopausal patient not on hormone replacement therapy, or endometrial thickness equal to or larger than 8 mm in patients on hormone replacement therapy, with irregular bleeding. These patients were subjected to sonohysterography, and specimens were obtained for pathologic examination by biopsy guided by histeroscopy in 92 patients, endometrial biopsy in four patientes and hysterectomy in three patients. The results of sonohysterography were compared with the pathologic findings, considered "gold standard". Results: there were eight cases of normal uterine cavity and 20 cases of atrophic endometrium and sonohysterography had high levels of specificity (97.8 and 97.5%) and low sensitivity (35 and 25%). There were high levels of sensitivity (92.3 and 75.0%) and specificity (94.1 and 97.9%) for polyps (65 cases) and submucous myomas (four cases). There were three cases of endometrial carcinoma and the sonohysterography had a sensitivity and specificity of 100%. Conclusions: sonohysterography showed to be accurate in the diagnostic of focal diseases (endometrial polyps and submucous myomas). There were three cases of endometrial cancer, and sonohysterography correctly diagnosed all of them. This method was also accurate to exclude endometrial abnormality. However, in the cases of diffusely thickened endometrium, the accuracy was low, because atrophic and normal endometrium on histopathology frequently appears as diffusely thickened endometrium at endova

  2. A Histerossonografia na Avaliação da Cavidade Uterina em Pacientes Menopausadas Sonohysterography in the evaluation of the uterine cavity in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Benito Pio Vitório Ceccato Júnior

    2002-09-01

    Full Text Available Objetivos: avaliar a acuidade diagnóstica da histerossonografia como método de avaliação da cavidade uterina em pacientes menopausadas com cavidade uterina alterada à ultra-sonografia endovaginal convencional. Métodos: este estudo consistiu na avaliação de 99 pacientes menopausadas com cavidade uterina anormal à ultra-sonografia endovaginal convencional, caracterizada por espessura endometrial maior ou igual a 5 mm em pacientes sem terapia de reposição hormonal, ou espessura endometrial maior ou igual a 8 mm em pacientes em terapia de reposição hormonal, com sangramento irregular. Estas pacientes foram submetidas à histerossonografia e após, foram obtidas amostras para avaliação histopatológica por biópsia dirigida por histeroscopia em 92 pacientes, biópsia endometrial em quatro pacientes e histerectomia em três pacientes. Os resultados da histerossonografia foram comparados com os resultados do exame histopatológico, considerado como "padrão-ouro". Resultados: houve oito casos de cavidade uterina normal e 20 casos de atrofia endometrial e a histerossonografia teve altos níveis de especificidade (97,8 e 97,5% e baixa sensibilidade (35 e 25%. Houve altos níveis de sensibilidade (92,3 e 75,0% e especificidade (94,1 e 97,9% em pólipos (65 casos e miomas submucosos (quatro casos. Houve três casos de câncer de endométrio e a histerossonografia teve sensibilidade e especificidade de 100%. Conclusões: a histerossonografia mostrou boa acuidade no diagnóstico de doenças focais (pólipos endometriais e miomas submucosos, com altos níveis de sensibilidade e especificidade. Houve três casos de câncer endometrial, e a histerossonografia diagnosticou corretamente todos eles. Mostrou também ser método acurado para excluir anormalidades endometriais. Entretanto, nos casos de espessamento endometrial difuso, a acuidade é baixa, porque endométrios atróficos ou normais freqüentemente aparecem como tendo espessamento difuso à ultra-sonografia endovaginal e à histerossonografia. A histerossonografia não teve complicações durante e após o procedimento.Purpose: to evaluate the diagnostic accuracy of sonohysterography as a diagnostic method for the evaluation of the uterine cavity in postmenopausal women with abnormal uterine cavity at conventional endovaginal sonography. Methods: this study consisted of the evaluation of 99 postmenopausal patients with abnormal uterine cavity on conventional endovaginal sonography, that was defined as endometrial thickness equal to or larger than 5 mm in a postmenopausal patient not on hormone replacement therapy, or endometrial thickness equal to or larger than 8 mm in patients on hormone replacement therapy, with irregular bleeding. These patients were subjected to sonohysterography, and specimens were obtained for pathologic examination by biopsy guided by histeroscopy in 92 patients, endometrial biopsy in four patientes and hysterectomy in three patients. The results of sonohysterography were compared with the pathologic findings, considered "gold standard". Results: there were eight cases of normal uterine cavity and 20 cases of atrophic endometrium and sonohysterography had high levels of specificity (97.8 and 97.5% and low sensitivity (35 and 25%. There were high levels of sensitivity (92.3 and 75.0% and specificity (94.1 and 97.9% for polyps (65 cases and submucous myomas (four cases. There were three cases of endometrial carcinoma and the sonohysterography had a sensitivity and specificity of 100%. Conclusions: sonohysterography showed to be accurate in the diagnostic of focal diseases (endometrial polyps and submucous myomas. There were three cases of endometrial cancer, and sonohysterography correctly diagnosed all of them. This method was also accurate to exclude endometrial abnormality. However, in the cases of diffusely thickened endometrium, the accuracy was low, because atrophic and normal endometrium on histopathology frequently appears as diffusely thickened endometrium at endovaginal sonography and sonohysterography. Sonohyst

  3. Long-acting progestin-only contraceptives impair endometrial vasculature by inhibiting uterine vascular smooth muscle cell survival

    Science.gov (United States)

    Kayisli, Umit A.; Basar, Murat; Guzeloglu-Kayisli, Ozlem; Semerci, Nihan; Atkinson, Helen C.; Shapiro, John; Summerfield, Taryn; Huang, S. Joseph; Prelle, Katja; Schatz, Frederick; Lockwood, Charles J.

    2015-01-01

    Molecular mechanisms responsible for abnormal endometrial vasculature in women receiving long-acting progestin-only contraceptives (LAPCs) are unknown. We hypothesize that LAPCs impair vascular smooth muscle cell (VSMC) and pericyte proliferation and migration producing thin-walled hyperdilated fragile microvessels prone to bleeding. Proliferating cell nuclear antigen (PCNA) and ?-smooth muscle actin (?SMA) double-immunostaining assessed VSMC differentiation and proliferation in endometria from women before and after DepoProvera (Depo) treatment and from oophorectomized guinea pigs (OVX-GPs) treated with vehicle, estradiol (E2), medroxyprogesterone acetate (MPA), or E2+MPA. Whole-genome profiling, proliferation, and migration assays were performed on cultured VSMCs treated with MPA or etonogestrel (ETO). Endometrial vessels of Depo-administered women displayed reduced ?SMA immunoreactivity and fewer PCNA (+) nuclei among ?SMA (+) cells (P < 0.008). Microarray analysis of VSMCs identified several MPA- and ETO-altered transcripts regulated by STAT1 signaling (P < 2.22 × 10?6), including chemokine (C-C motif) ligand 2 (CCL2). Both MPA and ETO reduce VSMC proliferation and migration (P < 0.001). Recombinant CCL2 reversed this progestin-mediated inhibition, whereas a STAT1 inhibitor abolished the CCL2 effect. Similarly, the endometria of MPA treated OVX-GPs displayed decreased ?SMA staining and fewer PCNA (+) nuclei in VSMC (P < 0.005). In conclusion, LAPCs promote abnormal endometrial vessel formation by inhibiting VSMC proliferation and migration. PMID:25847994

  4. Embolization of symptomatic myomas (UAE): technique, indication and results

    International Nuclear Information System (INIS)

    Presentation of indication, technique and results of transarterial uterine artery embolization (UAE) for the treatment of symptomatic myomas. Technical requirements are presented like DSA, catheters, superselective catheterisation and the different embolization materials as polyvinylalcohol (PVA) or microspheres, as well as the follow-up after UAE. The technical success rate of UAE is documented to range between 98 to 100% and myomatous symptomatology disappears in 85 to 94% of the cases. A reduction in the size of the myomata after UAE is observed between 48 to 70%. A resolution of the hemorrhage disappears in 80 to 96% of the cases immediately. Particulate embolization of the uterine artery is a new minimally invasive therapy in the management of symptomatic leiomyomas with a high efficiency and low rate of major complications. Further studies may prove the longterm results after UAE, the influence on fertility and possible late complications. (orig.)

  5. Evaluation of uterine and fibroid blood supplies before and after uterine artery embolization with dynamic enhanced CT scan

    International Nuclear Information System (INIS)

    Objective: To research the blood supply changes of uterine and fibroid before and after UAE for uterine fibroids. Methods: Sixteen patients with symptomatic uterine myoma were treated by Seldinger's bilateral uterine arteries embolization. The same level dynamic enhanced CT scans were undertaken 7 days before and after the procedure with another one 3 months later. The CT values of uterine and fibroid were measured and analyzed. Results: 16 cases finished the same level dynamic CT enhancement scans successfully. The dynamic enhanced curves and the CT values showed no significant difference in uterine but had significant difference in fibroids. The fibroids were in a state of ischemia after the procedure. Conclusions: Selective uterine arterial embolization is a new safety and effective method for treatment of uterine myoma

  6. Therapeutic management of uterine fibroid tumors: updated French guidelines.

    Science.gov (United States)

    Marret, Henri; Fritel, Xavier; Ouldamer, Lobna; Bendifallah, Sofiane; Brun, Jean-Luc; De Jesus, Isabelle; Derrien, Jean; Giraudet, Géraldine; Kahn, Vanessa; Koskas, Martin; Legendre, Guillaume; Lucot, Jean Philippe; Niro, Julien; Panel, Pierre; Pelage, Jean-Pierre; Fernandez, Hervé

    2012-12-01

    The medical management of symptomatic non-submucosal uterine fibroid tumors (leiomyomas or myomas) is based on the treatment of abnormal uterine bleeding by any of the following: progestogens, a levonorgestrel-releasing intrauterine device, tranexamic acid, nonsteroidal anti-inflammatory drugs, or GnRH analogs. Selective progesterone receptor modulators are currently being evaluated and have recently been approved for fibroid treatment. Neither combined estrogen-progestogen contraception nor hormone treatment of the menopause is contraindicated in women with fibroids. When pregnancy is desired, whether or not infertility is being treated by assisted reproductive technology, hysteroscopic resection in one or two separate procedures of submucosal fibroids less than 4 cm in length is recommended, regardless of whether they are symptomatic. Interstitial, also known as intramural, fibroids have a negative effect on fertility but treating them does not improve fertility. Myomectomy is therefore indicated only for symptomatic fibroids; depending on their size and number, and may be performed by laparoscopy or laparotomy. Physicians must explain to women the potential consequences of myomas and myomectomy on future pregnancy. For perimenopausal women who have been informed of the alternatives and the risks, hysterectomy is the most effective treatment for symptomatic fibroids and is associated with a high rate of patient satisfaction. When possible, the vaginal or laparoscopic routes should be preferred to laparotomy for hysterectomies for fibroids considered typical on imaging. Because uterine artery embolization is an effective treatment with low long-term morbidity, it is an option for symptomatic fibroids in women who do not want to become pregnant, and a validated alternative to myomectomy and hysterectomy that must be offered to patients. Myolysis is under assessment, and research on its use is recommended. Isolated laparoscopic ligation of the uterine arteries is a potential alternative to uterine artery embolization; it also complements myomectomy by reducing intraoperative bleeding. It is possible to use second-generation techniques of endometrial ablation to treat submucosal fibroids in women whose families are complete. Subtotal hysterectomy is a possible alternative to total hysterectomy for fibroid treatment, given that by laparotomy the former has a lower complication rate than the latter, while by laparoscopy, these rates are the same. In each case, the patient is informed about the benefit and risk associated with each therapeutic option. PMID:22939241

  7. Enzymes of the AKR1B and AKR1C subfamilies and uterine diseases

    Directory of Open Access Journals (Sweden)

    TeaLanisnik Rizner

    2012-03-01

    Full Text Available Endometrial and cervical cancers, uterine myoma, and endometriosis are very common uterine diseases. Worldwide, more than 800,000 women are affected annually by gynecological cancers, as a result of which, more than 360,000 die. During their reproductive age, about 70% of women develop uterine myomas, 10% to 15% suffer from endometriosis, and 35% to 50% from infertility associated with endometriosis. Uterine diseases are associated with aberrant inflammatory responses and concomitant increased production of prostaglandins (PG. They are also related to decreased differentiation, due to low levels of protective progesterone and retinoic acid, and to enhanced proliferation, due to high local concentrations of estrogens. The pathogenesis of these diseases can thus be attributed to disturbed PG, estrogen and retinoid metabolism and actions. Five human members of the aldo-keto reductase 1B (AKR1B and 1C (AKR1C superfamilies, i.e., AKR1B1, AKR1B10, AKR1C1, AKR1C2 and AKR1C3, have roles in these processes and can thus be implicated in uterine diseases. AKR1B1 and AKR1C3 catalyze the formation of PGF2alpha which stimulates cell proliferation. AKR1C3 converts PGD2 to 9alpha,11beta-PGF2, and thus counteracts the formation of 15deoxy-PGJ2, which can activate pro-apoptotic peroxisome-proliferator-activated receptor beta. AKR1B10 catalyzes the reduction of retinal to retinol, and in thus lessens the formation of retinoic acid, with potential pro-differentiating actions. The AKR1C1-AKR1C3 enzymes also act as 17-keto- and 20-ketosteroid reductases to varying extents, and are implicated in increased estradiol and decreased progesterone levels. This review comprises a short introduction to uterine diseases, followed by an overview of the current literature on the AKR1B and AKR1C expression in the uterus and in uterine diseases. The potential implications of the AKR1B and AKR1C enzymes and their pathophysiologies are then discussed, followed by conclusions and future perspectives.

  8. Uterine leiomyosarcomas and leiomyomas: Two similar uterine solid tumors, totally different for prognosis

    Directory of Open Access Journals (Sweden)

    Andrea Tinelli

    2011-10-01

    Full Text Available The uterine leiomyosarcoma (LMS is a rare sarcoma arising from the smooth muscle cells found within the myometrium, it is clinically aggressive smooth muscle malignancy, accounting for 2% to 6% of uterine malignancies and an annual incidence of 1.7 per 100,000 women. Although uterine malignancies such as endometrial cancer are common, uterine LMS accounts for only 1% of uterine cancers and is a part of uterine sarcomas’ group, who comprises: carcinosarcoma (formerly known as MMMT, malignant mixed Mullerian tumor (40% to 50%, leiomyosarcoma (30% to 40% and endometrial stromal sarcoma (10% to 15%. Every group has its own risk factors, presenting symptoms, treatment response and prognosis.

  9. Ulipristal acetate in the management of symptomatic uterine fibroids: facts and pending issues.

    Science.gov (United States)

    Pérez-López, F R

    2015-04-01

    Various treatment options have been proposed for the management of human symptomatic uterine fibroids (or myomas). Despite this, the most popular one is surgery (myomectomy or hysterectomy). Ulipristal acetate (UA) is a selective progesterone receptor modulator. In women programmed for surgical treatment for uterine fibroids, oral UA treatment (5 or 10 mg/day) controls symptoms, reduces tumor size and improves quality of life as compared to placebo and is not inferior to monthly intramuscular injection of leuprolide acetate for 3 months. Women treated with up to 4 courses of UA (10 mg/day for 3 months) followed or not by norethisterone acetate (10 mg/day for 10 days or placebo) reported a high rate of bleeding control, and improved quality of life, pain anxiety and depression. Median fibroid volume after successive courses of UA treatment ranged from -63% to -72% as compared to baseline value. Endometrium showed benign histological changes without hyperplasia, while adverse events were mild or moderate throughout the several courses of treatment. There is a need for global cost assessment of UA treatment for uterine fibroids, including those women that do not reach their expected outcome and need other complementary explorations or treatments. Studies are needed in non-Caucasian women, in infertile patients and in cases of fibroids associated with adenomyosis. Furthermore, assessment of long-term UA treatment should include endometrial, cardiocirculatory and neurological endpoints. PMID:25390187

  10. CA 125 and other tumor markers in uterine leiomyomas and their association with lesion characteristics

    OpenAIRE

    BABACAN, Ali; Kizilaslan, Cem; Gun, Ismet; MUHCU, Murat; Mungen, Ercument; ATAY, Vedat

    2014-01-01

    The aim of this study was to investigate the factors associated with serum levels of several tumor markers in a group of patients operated for uterine myoma. One hundred thirty-seven female patients operated for uterine myoma were included. Serum samples were examined for CA 125, CA 19-9, CA 15-3, carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) levels as part of routine workup. Pathological and morphological characteristics of the patients were retrieved from medical records. The m...

  11. Transvaginal sonography combined with saline contrast sonohysterography in evaluating the uterine cavity in premenopausal patients with abnormal uterine bleeding

    DEFF Research Database (Denmark)

    Dueholm, M; Forman, Axel

    2001-01-01

    To evaluate whether saline contrast sonohysterography (SCSH) adds additional information to that obtained by transvaginal sonography (TVS) for predicting endometrial abnormality in premenopausal patients with abnormal uterine bleeding.

  12. Uterine fibroid embolization

    International Nuclear Information System (INIS)

    Full text: Introduction: Today, after numerous lengthy randomized trials embolization of uterine fibroids has become a standard treatment. Percutaneous embolization of myomas is a micro - invasive surgery, which can be regarded as an alternative to traditional surgery. Although these data 2/3 of the patients were not informed about this treatment option. What you will learn: The uterine embolization is minimal invasive non-surgical procedure. It is an alternative treatment to surgery. Under local anesthesia in the femoral artery puncture reaches the internal iliac artery and uterine arteries. Reached selectively by the catheter and chemicals, which causes clogging, are injected into them. In the vessels that feed fibroids occur a process like an attack, the feeding stops, it starts to shrink and it is replaced by fibrous tissue. The blood vessels of the healthy tissue are different in size and have a plurality of collateral connections as opposed to those of the myoma and thus the blood supply to the normal tissue of the uterus is not distorted. Discussion: Nowadays there are more well- calibrated materials for embolization and those with a particle size of about 700µ are proven as the most successful. The procedure is well tolerated, but after a pain occurs, which has to be covered with anesthetics. Usually pain and metrorrhagia disappear immediately. The fibroids themselves shrink to varying degrees. Hospital stay was significantly shorter than that after surgery, and remained fertile power. Complications are few and rare require further treatment. Multiple nodes are problematic and it is difficult to detect the primary one. A three and six months tracking by MRI is desirable. Conclusion: Embolization of uterine myoma is an established method of treatment primarily on clinical symptoms resulting therefrom. In all patients rapidly disappear metrorrhagia symptoms and morbidity, the volume of the assembly decrease, which together with shorter hospital stays and fertility preservation is well accepted by patients and therefore it is a good alternative to surgery

  13. Vascular endothelial growth factor-D over-expressing tumor cells induce differential effects on uterine vasculature in a mouse model of endometrial cancer

    OpenAIRE

    Stacker Steven A; Achen Marc G; Cann Leonie M; Lederman Fiona L; Donoghue Jacqueline F; Girling Jane E; Rogers Peter AW

    2010-01-01

    Abstract Background It has been hypothesised that increased VEGF-D expression may be an independent prognostic factor for endometrial cancer progression and lymph node metastasis; however, the mechanism by which VEGF-D may promote disease progression in women with endometrial cancer has not been investigated. Our aim was to describe the distribution of lymphatic vessels in mouse uterus and to examine the effect of VEGF-D over-expression on these vessels in a model of endometrial cancer. We hy...

  14. Uterine Fibroid Embolization Can Still Be Improved: Observations on Post-Procedure Magnetic Resonance Imaging

    International Nuclear Information System (INIS)

    PURPOSE: To evaluate the efficacy and completeness of uterine fibroid embolization (UFE) measured by changes in volume and signal intensity at magnetic resonance imaging (MRI), and to compare with clinical outcome. MATERIAL AND METHODS: 40 women with symptomatic uterine fibroids underwent bilateral uterine artery embolization. At MRI studies, including post-contrast sequences before and repeatedly after treatment, the uterus and dominant fibroids were evaluated for volume, location, and contrast enhancement. Prior to treatment, all myomas showed significant contrast enhancement. The mean uterine volume was 929 ml. Clinical examinations with emphasis on menorrhagia, pelvic pain, and urinary dysfunction were performed before and 6 and 12 months after treatment. RESULTS: UFE was bilaterally successful in 38 patients. After UFE, MRI showed no enhancement of myomas in 30 patients. In 8 patients, post-procedural MRI revealed partially remaining vascularization of fibroids despite angiographically complete embolization of the uterine arteries. On average, uterine volume decreased by 46.2% at 12 months. There was significant improvement of symptoms in the majority of patients, but slightly less improvement in patients with partially remaining vascularization of myomas. CONCLUSION: UFE causes significant volume reduction of myomas and clinical improvement. MRI can reveal remaining vascularization in myomas despite angiographically complete embolization of uterine arterieslete embolization of uterine arteries

  15. A case of mesodermic mixed tumor of the uterus developing after the treatment of myoma with x-ray irradiation

    International Nuclear Information System (INIS)

    A case of mesodermic mixed tumor primarily developing in the endometrium was reported with some discussion. The anamnesis was interesting that the patient had been exposed to the secondary radioactivity of the atomic bomb in Hiroshima and to X-ray for the treatment of myoma. Histological examination revealed adenoma as the epithelial element and fibromyxoma-like tissues, cartilage tissues, vascular tissues, and endometrial interstitium-like tissues as the non-epithelial elements. (Chiba, N.)

  16. Management of Endometrial Precancers

    Science.gov (United States)

    Trimble, Cornelia L.; Method, Michael; Leitao, Mario; Lu, Karen; Ioffe, Olga; Hampton, Moss; Higgins, Robert; Zaino, Richard; Mutter, George L.

    2013-01-01

    In the United States, endometrial cancer is the most commonly diagnosed cancer of the female reproductive system. Strategies to sensitively and accurately diagnose premalignant endometrial lesions are sorely needed. We reviewed studies pertaining to the diagnostic challenges of endometrial precancers, their predictive value, and evidence to support management strategies. Currently, two diagnostic schema are in use; the 4-class WHO94 hyperplasia system, based on morphologic features of architectural complexity and nuclear atypia, and more recently, the 2-class endometrial intraepithelial neoplasia system, which is quantitative. Diagnosis should employ criteria and terminology which distinguish between clinicopathologic entities that can be managed differently. In some instances, such as for women with hereditary nonpolyposis colon cancer (HNPCC), biomarkers may aid in diagnosis, but the clinical utility of biomarkers has yet to be determined. Total hysterectomy is curative for atypical endometrial hyperplasia or endometrial intraepithelial neoplasia, and provides a definitive standard for assessment of a concurrent carcinoma, where clinically appropriate. If hysterectomy is performed for atypical endometrial hyperplasia or endometrial intraepithelial neoplasia, intraoperative assessment of the uterine specimen for occult carcinoma is desirable, but optional. Nonsurgical management may be appropriate for patients who wish to preserve fertility or those for whom surgery is not a viable option. Treatment with progestin therapy may provide a safe alternative to hysterectomy; however, clinical trials of hormonal therapies for atypical endometrial hyperplasia or endometrial intraepithelial neoplasia have not yet established a standard regimen. Future studies will need to determine the optimal non-surgical management of AEH/EIN, standardizing agent, dose, schedule, clinical outcomes, and appropriate follow-up. PMID:23090535

  17. Sensibilidade e especificidade da histerossonografia nas afecções endometriais em mulheres assintomáticas pós-menopausa Sensitivity and specificity of hysterosonography in endometrial abnormalities in asymptomatic postmenopausal women

    Directory of Open Access Journals (Sweden)

    Sonia Tamanaha

    2004-12-01

    Full Text Available OBJETIVOS: 1 Estimar sensibilidade e especificidade da histerossonografia nas afecções endometriais, utilizando-se como padrão-ouro a histeroscopia diagnóstica; 2 comparar concordância entre a ultra-sonografia, a histerossonografia e a histeroscopia através do índice de Kappa (K. MÉTODOS: Foram estudadas 50 mulheres assintomáticas após menopausa, todas tinham suspeita de afecções endometriais pela ultra-sonografia transvaginal e, por isso, complementaram avaliação endometrial com a histerossonografia, a histeroscopia diagnóstica e a biópsia orientada. Para comparação dos resultados entre esses exames utilizou-se índice de Kappa. RESULTADOS: Afecções endometriais mais freqüentes: pólipos (58%, sinéquias (20%, mioma submucoso (12% e espessamento endometrial (6%. Cavidade normal (4% dos exames histeroscópicos. A sensibilidade da histerossonografia para diagnóstico de pólipo foi de 89,7%; a especificidade de 81% e o (K de 71,1%. Para sinéquia a sensibilidade foi de 80%, a especificidade 100% e o (K de 86,5%; para mioma submucoso: a sensibilidade foi de 83,3%; a especificidade de 97,7% e o (K de 81,1% e para espessamento endometrial a sensibilidade foi de 33,3%, a especificidade de 89,4% e o (K de15,5%. CONCLUSÕES: A histerossonografia apresentou ótima concordância com a histeroscopia para sinéquias e miomas submucosos; boa concordância para pólipo e péssima concordância para espessamentos endometriais. Revelou-se, também, tratar-se de método simples, eficiente e que pode ser utilizado para a avaliação da cavidade uterina em mulheres após menopausa.BACKGROUND: To estimate sensitivity and specificity of hysterosonography for diagnosis of endometrial cavity abnormalities. The gold-standard was hysteroscopy; to compare the agreement between ultrasonographic, hysterosonographic and hysteroscopic findings using the KIA (Kappa Index Agreement. METHODS: Fifty asymptomatic postmenopausal women that had a suspicion of endometrial abnormalities based upon transvaginal ultrasonography were studied. Hysterosonography, diagnostic hysteroscopy and oriented biopsy were performed and the Kia was used to compare results. RESULTS: The most frequent abnormalities were polyps (58%, synechiae (20%, submucous myoma (12% and endometrial thickening (6%. The uterine cavity was considered normal in 4% of the evaluations by hysteroscopy. The sensitivity of hysterosonography to diagnose polyps was of 89.7%, the specificity of 81.0% and the KIA of 71.1%. For synechia sensitivity of hysterosonography was of 80%, specificity of 100% and the KIA of 86.5%; for submucous myoma sensitivity was of 83.3%; specificity of 97.7% and the KIA of 81.1%, and for endometrial thickening, sensitivity was of 33.3%, specificity of 89.4% and the KIA of 15.5%. CONCLUSION: Hysterosonography showed very good agreement with hysteroscopy for the diagnosis of synechiae and submucous myomas; good agreement for polyps and poor agreement for endometrial thickening. Based upon this data hysterosonography may be deemed a simple, efficient, and accurate method for the evaluation of the uterine cavity in the postmenopausal period.

  18. Sensibilidade e especificidade da histerossonografia nas afecções endometriais em mulheres assintomáticas pós-menopausa / Sensitivity and specificity of hysterosonography in endometrial abnormalities in asymptomatic postmenopausal women

    Scientific Electronic Library Online (English)

    Sonia, Tamanaha; José Mendes, Aldrighi; Roberto Euzébio dos, Santos; Roberto Adelino Almeida, Prado.

    2004-12-01

    Full Text Available OBJETIVOS: 1) Estimar sensibilidade e especificidade da histerossonografia nas afecções endometriais, utilizando-se como padrão-ouro a histeroscopia diagnóstica; 2) comparar concordância entre a ultra-sonografia, a histerossonografia e a histeroscopia através do índice de Kappa (K). MÉTODOS: Foram e [...] studadas 50 mulheres assintomáticas após menopausa, todas tinham suspeita de afecções endometriais pela ultra-sonografia transvaginal e, por isso, complementaram avaliação endometrial com a histerossonografia, a histeroscopia diagnóstica e a biópsia orientada. Para comparação dos resultados entre esses exames utilizou-se índice de Kappa. RESULTADOS: Afecções endometriais mais freqüentes: pólipos (58%), sinéquias (20%), mioma submucoso (12%) e espessamento endometrial (6%). Cavidade normal (4%) dos exames histeroscópicos. A sensibilidade da histerossonografia para diagnóstico de pólipo foi de 89,7%; a especificidade de 81% e o (K) de 71,1%. Para sinéquia a sensibilidade foi de 80%, a especificidade 100% e o (K) de 86,5%; para mioma submucoso: a sensibilidade foi de 83,3%; a especificidade de 97,7% e o (K) de 81,1% e para espessamento endometrial a sensibilidade foi de 33,3%, a especificidade de 89,4% e o (K) de15,5%. CONCLUSÕES: A histerossonografia apresentou ótima concordância com a histeroscopia para sinéquias e miomas submucosos; boa concordância para pólipo e péssima concordância para espessamentos endometriais. Revelou-se, também, tratar-se de método simples, eficiente e que pode ser utilizado para a avaliação da cavidade uterina em mulheres após menopausa. Abstract in english BACKGROUND: To estimate sensitivity and specificity of hysterosonography for diagnosis of endometrial cavity abnormalities. The gold-standard was hysteroscopy; to compare the agreement between ultrasonographic, hysterosonographic and hysteroscopic findings using the KIA (Kappa Index Agreement). METH [...] ODS: Fifty asymptomatic postmenopausal women that had a suspicion of endometrial abnormalities based upon transvaginal ultrasonography were studied. Hysterosonography, diagnostic hysteroscopy and oriented biopsy were performed and the Kia was used to compare results. RESULTS: The most frequent abnormalities were polyps (58%), synechiae (20%), submucous myoma (12%) and endometrial thickening (6%). The uterine cavity was considered normal in 4% of the evaluations by hysteroscopy. The sensitivity of hysterosonography to diagnose polyps was of 89.7%, the specificity of 81.0% and the KIA of 71.1%. For synechia sensitivity of hysterosonography was of 80%, specificity of 100% and the KIA of 86.5%; for submucous myoma sensitivity was of 83.3%; specificity of 97.7% and the KIA of 81.1%, and for endometrial thickening, sensitivity was of 33.3%, specificity of 89.4% and the KIA of 15.5%. CONCLUSION: Hysterosonography showed very good agreement with hysteroscopy for the diagnosis of synechiae and submucous myomas; good agreement for polyps and poor agreement for endometrial thickening. Based upon this data hysterosonography may be deemed a simple, efficient, and accurate method for the evaluation of the uterine cavity in the postmenopausal period.

  19. The Impact of Uterine Leiomyomas on Reproductive Outcomes

    OpenAIRE

    Cook, Heather; Ezzati, Mohammad; Segars, James H.; Mccarthy, Desiree

    2010-01-01

    Uterine leiomyomas (fibroids, myomas) are a common benign disease of the uterus with a prevalence of 8–18%. Prevalence rates vary with race, and fibroids are most common in African American women. Uterine leiomyomas can also be present during pregnancy, which may occur more frequently than previously suspected, with prevalence rates reported of up to 10%. Recent evidence has emerged to clarify the relationship of uterine fibroids on fertility and obstetrical outcomes. In t...

  20. Uterine Fibroid Embolization Can Still Be Improved: Observations on Post-Procedure Magnetic Resonance Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Dorenberg, E.J.; Novakovic, Z.; Smith, H.J.; Hafsahl, G.; Jakobsen, J.Aa. [Rikshospitalet, Oslo (Norway). Dept. of Radiology and Dept. of Gynecology

    2005-08-01

    PURPOSE: To evaluate the efficacy and completeness of uterine fibroid embolization (UFE) measured by changes in volume and signal intensity at magnetic resonance imaging (MRI), and to compare with clinical outcome. MATERIAL AND METHODS: 40 women with symptomatic uterine fibroids underwent bilateral uterine artery embolization. At MRI studies, including post-contrast sequences before and repeatedly after treatment, the uterus and dominant fibroids were evaluated for volume, location, and contrast enhancement. Prior to treatment, all myomas showed significant contrast enhancement. The mean uterine volume was 929 ml. Clinical examinations with emphasis on menorrhagia, pelvic pain, and urinary dysfunction were performed before and 6 and 12 months after treatment. RESULTS: UFE was bilaterally successful in 38 patients. After UFE, MRI showed no enhancement of myomas in 30 patients. In 8 patients, post-procedural MRI revealed partially remaining vascularization of fibroids despite angiographically complete embolization of the uterine arteries. On average, uterine volume decreased by 46.2% at 12 months. There was significant improvement of symptoms in the majority of patients, but slightly less improvement in patients with partially remaining vascularization of myomas. CONCLUSION: UFE causes significant volume reduction of myomas and clinical improvement. MRI can reveal remaining vascularization in myomas despite angiographically complete embolization of uterine arteries.

  1. A case of parasitic myoma diagnosed by immunohistochemistry

    Directory of Open Access Journals (Sweden)

    Kamac?, M.

    2004-01-01

    Full Text Available A case of parasitic myoma diagnosed by immunohistochemistry is presented . The importance of histopathological and immumohistochemical procedures in the differential diagnosis of parasitic myoma from stromal tumors was discussed.

  2. Dasatinib in Treating Patients With Recurrent or Persistent Ovarian, Fallopian Tube, Endometrial or Peritoneal Cancer

    Science.gov (United States)

    2015-06-12

    Endometrial Clear Cell Adenocarcinoma; Estrogen Receptor Negative; Ovarian Clear Cell Cystadenocarcinoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Recurrent Uterine Corpus Carcinoma

  3. Analysis of the factors to affect uterine artery embolization for the treatment of uterine fibroid

    International Nuclear Information System (INIS)

    Objective: To observe the effect of uterine artery embolization for the treatment of uterine fibroids and analyze the influencing factors. Methods: 46 cases with symptomatic uterine myoma were treated by superselective catheterization of the bilateral uterine arteries using PVA particles. All patients were followed up for 6-9 months after uterine artery embolization to observe the improvement about symptoms and the changes of fibroid volume. The different clinical effects and the various factors were analyzed. Results: The clinical symptoms improved significantly, especially the bleeding of uterus. The average volume of fibroids decreased 45.6% in 6 months, 58.4% in 9 months after the proceduce. A lot of factors, including blood vessel anatomy, endocrine secretion, embolization technique and fibroid type can effect the clinical efficacy of uterine artery embolization for the treatment of uterine fibroids. Conclusions: Selective uterine artery embolization is a new safety and effective method for treatment of uterine myoma. Its clinical effect is correlative with a lot of factors, including blood vessel anatomy, endocrine secretion, embolization technique and fibroid type. (authors)

  4. Miomatosis uterina e infertilidad: ¿qué evidencias tenemos como causa y como tratamiento? / Uterine fibroids and infertility: what evidence do we have regarding cause and treatment?

    Scientific Electronic Library Online (English)

    Luis Ernesto, Pérez; Ivonne, Díaz; Luis, Ospina.

    2008-12-01

    Full Text Available Objetivos: revisar las evidencias actuales que determinen el impacto de la miomatosis uterina en la infertilidad, así como la seguridad y la eficacia de las diferentes formas de tratamiento quirúrgico conservador. Metodología: revisión sistemática cualitativa, consultando las fuentes de datos de Coc [...] hrane (Menstrual Disorders and subfertility), Medline (PubMed -MeSH), y de OVID (EBM); desde 1995 a 2008. Resultados: muchos estudios observacionales han sugerido que los miomas causantes de infertilidad son todos los submucosos, los intramurales mayores de 5 cm que alteren la cavidad uterina y también los subserosos cuya cantidad y tamaño distorsionen la fisiología reproductiva. Pero no hay estudios aleatorizados controlados (RCTs) que soporten estas afirmaciones. En la actualidad, las miomectomías constituyen la mejor forma de tratamiento para pacientes infértiles. Por histeroscopia se deben resecar miomas submucosos menores de 5 cm, tipos 0 y I; por laparoscopia miomas intramurales o subserosos menores de 10 cm y no más de 5 miomas; finalmente, por laparotomía es posible resecar todo tipo de miomas, independientemente de su localización, tamaño y número. No hay RCTs que comparen la histeroscopia con otras técnicas de miomectomías; pero sí los hay mostrando que las indicaciones para laparotomía y laparoscopia son igualmente efectivas en resultados reproductivos. Conclusión: hay evidencias limitadas soportando la miomatosis como causante de infertilidad, y las miomectomías por histeroscopia respecto a otros tratamientos conservadores. Sin embargo, hay RCTs que muestran iguales resultados reproductivos al realizar miomatomías intramurales o subserosas por laparoscopia y por laparotomía en pacientes seleccionadas. Abstract in english Objectives: reviewing the evidence to determine the impact of fibroids on infertility and different types of conservative surgical treatment’s efficacy and safety. Methodology: the Cochrane Menstrual Disorders and Sub-fertility Review Group specialized register of controlled trials, MEDLINE (PUBMED- [...] MeSH), and OVID (EBM) were searched from 1995 to 2008 for carrying out a qualitative systematic review. Main results: many observational, retrospective studies have suggested that all infertility-producing myomas are submucosal, intramural myomas bigger than 5 cm thereby altering the endometrial cavity and subserosal myomas whose size distorts reproductive physiology; however, no randomised controlled trials (RCT) were found to support such affirmations. Submucosal myomas must be removed by hysteroscopy (with the exception of myomas bigger than 5 cm or type II); however, no RCTs were found comparing hysteroscopic treatment with other types of treatment. Intramural and subserosal myomas must be removed by laparoscopy or laparotomy (depending on their localisation and size) supported by RCTs showing that there are no outcome differences in terms of reproductive results. Conclusions: there is limited evidence for suggesting the impact of uterine myomas on infertility and the removal of submucosal myomas by hysteroscopy. Some RCTs show no differences in fertility efficacy outcome if intramural or subserosal myomas are removed via laparotomy or laparoscopy.

  5. Role of emmprin in endometrial cancer

    Directory of Open Access Journals (Sweden)

    Nakamura Keiichiro

    2012-05-01

    Full Text Available Abstract Background Extracellular matrix metalloproteinase inducer (Emmprin/CD147 is a transmembrane glycoprotein that belongs to the immunoglobulin superfamily. Enriched on the surface of many tumor cells, emmprin promotes tumor growth, invasion, metastasis and angiogenesis. We evaluated the clinical importance of emmprin and investigated its role in endometrial cancer. Methods Emmprin expression was examined in uterine normal endometrium, endometrial hyperplasia and cancer specimens by immunohistochemistry. In addition, the biological functions and inhibitory effects of an emmprin knockdown were investigated in HEC-50B and KLE endometrial cancer cell lines. Results The levels of emmprin expression were significantly increased in the endometrial cancer specimens compared with the normal endometrium and endometrial hyperplasia specimens (p?p?p? Conclusions The present findings suggest that low emmprin expression might be a predictor of favorable prognosis in endometrial cancer patients, and that emmprin may represent a potential therapeutic target for endometrial cancer.

  6. Cesarean Section followed by myomectomy in a pregnancy complicated by left intraligamentous myoma

    Directory of Open Access Journals (Sweden)

    Arifuddin Djuanna

    2004-02-01

    Full Text Available A 20-year-old primigravida with 38th weeks of gestation complicated with a left large solid intraligamentous uterine tumor. The operation started with lower segment cesarean section to delivere the fetus. Intramural uterotonica was given and the uterus contracted well; intra- and up to 24 hours post-operatively oxytocin infusion was administered. Double circle stitching technique was performed on lateral side of the mioma before starting myomectomy. No blood transfusion was given. The histopatological report was leiomyoma. She was discharged in healthy condition 4 days post-operatively. (Med J Indones 2004; 13: 66-8 Keywords: Myomectomy, cesarean section, intraligamentous myoma

  7. [Post-menopausal metrorrhagia: endometrial ultrasonic aspects].

    Science.gov (United States)

    Longo, M; Buzzi, M; Abbondante, G; Giovagnorio, P; Vitagliano, M; Tocci, B; Eleuteri Serpieri, D; Napolitano, C

    1990-01-01

    Main causes of uterine post-menopausal bleeding are estrogenic substitutive therapy, ipo/atrophy, hyperplasia, carcinoma of endometrium and sarcoma. To evaluate the real usefulness of echotomography in these conditions, 128 patients in post-menopause (end of menstrual cycles from over an year) with at least one uterine bleeding were considered. The patients were submitted to pelvic ultrasonography in order to study uterine and ovarian morphology and, in particular, to examine endometrial echopattern. Endometrial reliefs were classified into 4 groups of echopattern and put in comparison with histopathology. From this comparison a well defined role of echotomography in the study of post-menopausal bleeding is evidenced: in cases of "abnormal echopattern" the probability of endometrial pathology is elevated (83.3%), with a good "sensibility" but without a so good "specificity" of ultrasounds: therefore its "subsidiary" but "necessary" role in the diagnosis of climateric uterine bleeding is emphasized. PMID:2192983

  8. Sarcoma del estroma endometrial de grado alto / High degree endometrial stromal sarcoma

    Scientific Electronic Library Online (English)

    Mariuska, Forteza Sáez; Maylin América, Ramos Alfonso; Migdalia, Pérez Trejo; Dulvis Amanda, Almeida Arias; Danay, Corrales Otero.

    2014-09-01

    Full Text Available El sarcoma del estroma endometrial es un tumor infrecuente, que comprende menos del 1 % de los tumores malignos ginecológicos. Presentamos el caso de una adolescente de 16 años con hemorragia uterina anormal a la que se le realizó histerectomía subtotal. Microscópicamente, la neoplasia estaba consti [...] tuida por una proliferación maligna de células estromales del endometrio. El estudio inmuno-histoquímico mostró positividad para vimentina, desmina, CD10, CD117. El CD10 es un marcador inmuno-histoquímico del estroma endometrial normal y de los tumores del estroma endometrial, y es útil para el diagnóstico diferencial entre el sarcoma del estroma endometrial y el leiomioma celular o el leiomiosarcoma uterino. Las mejores opciones de tratamiento se obtienen con un enfoque multidisciplinario y en centros especializados. Abstract in english Endometrial stromal sarcoma is a rare tumor comprising less than 1 % of gynecological malignancies. We report the case of a 16 year-old adolescent with abnormal uterine bleeding who underwent hysterectomy subtotal. At microscopy the neoplasm was composed of malignant proliferation of endometrial str [...] omal cells. Immunohistochemical studies were positive for vimentin, desmin, CD10 and CD117. CD10 is an immunohistochemical marker of normal endometrial stroma and of endometrial stromal neoplasms. This marker is useful in the differential diagnosis of endometrial stromal sarcoma versus uterine cellular leiomyoma or uterine leiomyosarcoma. The best treatment options are obtained with a focus multidisciplinary, in specialized centers.

  9. Angiographic classification of uterine fibroids and its significance to therapeutic embolization strategy

    International Nuclear Information System (INIS)

    Objective: To analyze the vascular manifestations of uterine myoma, to offer a proposal for the angiographic classification of fibroids, and to discuss its practical significance to the strategy of uterine artery embolization. Methods: Fifty patients with fibroids were performed uterine artery embolization with dextran microspheres. After bilateral hypogastric and uterine arteriography, the angiographic manifestations were studied to determine the bilateral uterine arterial blood supply and the feeding proportions to the uterus and myoma respectively. the cross median line anastomoses of bilateral uterine arteries and ovarian parenchymal opacification were also evaluated. Results: According to the different feeding proportions to the uterine leiomyoma by bilateral uterine arteries, the fibroids could be divided into three types: unilateral, predominantly unilateral, and evenly bilateral supplying type. The constitution ratios of these three types were 6%, 84%, and 10% in 50 patients, of which the predominantly unilateral type was the majority occupying 84%. The obvious anastomoses between the bilateral uterine arteries were found in 5, and accessory uterine artery in 2 cases. In addition, the ovarian branches of uterine artery and ovarian opacification were revealed in 15 patients, of which the ipsilateral ovarian artery was retrogradely filled through ovarian anastomoses in 5(10%) cases. Conclusion: The individualized strategy of uterine artery embolization should bey of uterine artery embolization should be advocated according to this angiographic classification of uterine myoma, the distal microsphere embolization have to be reasonably tailored in proportion to the concrete blood feeding ratio to the uterine fibroids by each side. The opacification of ovarian branches of uterine artery or ovarian artery indicates that >350 ?m diameter microspheres should be used for the uterine artery embolization in order to protect the ovarian function. (authors)

  10. The value of uterine artery embolization in treatment of hysteromyoma

    International Nuclear Information System (INIS)

    Objective: To investigate the value of UAE in treatment of Hysteromyoma. Methods: Select 20 cases of patients with symptomatic uterine fibroids, intubate with Uterine artery, then inject Polyvinyl alcohol particles transcatheter Embolizae Uterine artery. After the operation, observe the patient follow-up for 6-18 months, to find the situation of symptom improvement and the change of the size of uterus and myoma. Results: After the operation of UAE 2-6 months, the symptoms of the patients improve significantly or disappear. After 6-18 months, B-mode ultrasonography shows that Myoma volume narrow 30%-85%, average to narrow 60%. Uterine volume narrow 25%-70%, average to narrow 50%. No Serious complications. Conclusion: UAE is a safe and effective method to cure Hysteromyoma. It worth promoting in clinical sicience. (authors)

  11. Achados histeroscópicos em mulheres na pós-menopausa com diagnóstico de espessamento endometrial por ultra-sonografia transvaginal / Hysteroscopic findings in postmenopausal women with endometrial thickening diagnosed by transvaginal ultrasound

    Scientific Electronic Library Online (English)

    Adriana Bittencourt, Campaner; Sebastião, Piato; Paulo Ayrosa Galvão, Ribeiro; Tsutomo, Aoki; Ricardo da Fonseca, Nadais; Roberto Adelino de Almeida, Prado.

    2004-02-01

    Full Text Available OBJETIVO: correlacionar espessamento endometrial diagnosticado por ultra-sonografia com os achados histeroscópicos, em mulheres na pós-menopausa. MÉTODOS: foi realizado estudo transversal com avaliação histeroscópica em 121 mulheres na pós-menopausa, com diagnóstico de espessamento do endométrio por [...] ultra-sonografia transvaginal. Das pacientes incluídas, 23 (19%) recebiam diferentes esquemas de hormonioterapia e 98 não referiam uso de reposição hormnonal.; 55 pacientes queixavam-se de sangramento por via vaginal e as restantes apresentavam-se sem esta condição. Os exames endoscópicos foram realizados ambulatorialmente, utilizando-se histeroscópio rígido de 4 mm. Para a distensão da cavidade uterina empregou-se gás carbônico (CO2). Biópsia foi praticada em todas as pacientes, com auxílio de cureta tipo Novak, de 3 mm, e o material obtido submetido a estudo histopatológico. RESULTADOS: a espessura do endométrio variou entre 6 e 38 mm, com média de 10,7 ± 5,3 mm. Os achados histeroscópicos foram: lesão polipóide, em 51 pacientes (42,1%); endométrio atrófico, em 15 (12,4%); sinéquia senil, em 15 (12,4%); espessamento focal, em 13 (10,7%); lesão cerebróide, em 6 (5,0%); endométrio proliferativo, em 5 (4,1%); muco, em 5 (4,1%); mioma, em 4 (3,3%); endométrio secretor, em 3 (2,5%); hiperplasia endometrial, em 3 (2,5%) e atrofia cística, em 1 (0,8%). Observou-se correlação entre os achados histeroscópicos e os resultados da histopatologia em 30 dos 51 casos de pólipo, em 12 dos 15 de endométrio atrófico e na totalidade dos casos sugestivos de hiperplasia endometrial e de adenocarcinoma. CONCLUSÃO: na maioria das pacientes, o exame histeroscópico revelou que não se tratava de real espessamento endometrial, mas sim de outras variedades de lesão da cavidade uterina. Abstract in english PURPOSE: to correlate endometrial thickening diagnosed by ultrasonography with hysteroscopic findings in postmenopausal women. METHODS: a transversal study with hysteroscopic evaluation was performed in 121 postmenopausal women, with endometrial thickening diagnosed through transvaginal ultrasonogra [...] phy. In 98 women there was no history of hormonal replacement therapy, while the remaining 23 received different types of hormone; 55 patients complained of vaginal bleeding and the remaining did not present this condition. The endoscopic examinations were performed in the outpatient clinic, using a 4 mm rigid hysteroscope. For uterine cavity distention carbon dioxide (CO2) was used. Biopsy was performed in all patients, with a 3 mm Novak type curette, and the collected material was submitted to a histopathological study. RESULTS: endometrial thickening varied from 6 to 38 mm, with a mean of 10.7 ± 5.3 mm. The hysteroscopic findings were: polypoid lesion in 51 patients (42.1%); atrophic endometrium in 15 patients (12.4%); senile synechia in 15 patients (12.4%), focal thickening in 13 patients (10.7%); cerebroid lesion in 6 patients (5.0%); proliferative endometrium in 5 patients (4.1%); mucus in 5 patients (4.1%); myoma in 4 patients (3.3%); secreting endometrium in 3 patients (2.5%); endometrial hyperplasia in 3 patients (2.5%); and cystic atrophy in 1 patient (0.8%). Correlation between hysteroscopic findings and cytopathology was observed in 30 of 51 cases of polypoid lesion, in 12 of 15 cases of atrophic endometrium and in all cases in which the diagnosis of endometrial hyperplasia or adenocarcinoma was suspected. CONCLUSION: in the majority of the patients, the hysteroscopic examinations revealed that there was no genuine endometrial thickening but rather other types of lesion in the uterine cavity.

  12. Achados histeroscópicos em mulheres na pós-menopausa com diagnóstico de espessamento endometrial por ultra-sonografia transvaginal Hysteroscopic findings in postmenopausal women with endometrial thickening diagnosed by transvaginal ultrasound

    Directory of Open Access Journals (Sweden)

    Adriana Bittencourt Campaner

    2004-02-01

    Full Text Available OBJETIVO: correlacionar espessamento endometrial diagnosticado por ultra-sonografia com os achados histeroscópicos, em mulheres na pós-menopausa. MÉTODOS: foi realizado estudo transversal com avaliação histeroscópica em 121 mulheres na pós-menopausa, com diagnóstico de espessamento do endométrio por ultra-sonografia transvaginal. Das pacientes incluídas, 23 (19% recebiam diferentes esquemas de hormonioterapia e 98 não referiam uso de reposição hormnonal.; 55 pacientes queixavam-se de sangramento por via vaginal e as restantes apresentavam-se sem esta condição. Os exames endoscópicos foram realizados ambulatorialmente, utilizando-se histeroscópio rígido de 4 mm. Para a distensão da cavidade uterina empregou-se gás carbônico (CO2. Biópsia foi praticada em todas as pacientes, com auxílio de cureta tipo Novak, de 3 mm, e o material obtido submetido a estudo histopatológico. RESULTADOS: a espessura do endométrio variou entre 6 e 38 mm, com média de 10,7 ± 5,3 mm. Os achados histeroscópicos foram: lesão polipóide, em 51 pacientes (42,1%; endométrio atrófico, em 15 (12,4%; sinéquia senil, em 15 (12,4%; espessamento focal, em 13 (10,7%; lesão cerebróide, em 6 (5,0%; endométrio proliferativo, em 5 (4,1%; muco, em 5 (4,1%; mioma, em 4 (3,3%; endométrio secretor, em 3 (2,5%; hiperplasia endometrial, em 3 (2,5% e atrofia cística, em 1 (0,8%. Observou-se correlação entre os achados histeroscópicos e os resultados da histopatologia em 30 dos 51 casos de pólipo, em 12 dos 15 de endométrio atrófico e na totalidade dos casos sugestivos de hiperplasia endometrial e de adenocarcinoma. CONCLUSÃO: na maioria das pacientes, o exame histeroscópico revelou que não se tratava de real espessamento endometrial, mas sim de outras variedades de lesão da cavidade uterina.PURPOSE: to correlate endometrial thickening diagnosed by ultrasonography with hysteroscopic findings in postmenopausal women. METHODS: a transversal study with hysteroscopic evaluation was performed in 121 postmenopausal women, with endometrial thickening diagnosed through transvaginal ultrasonography. In 98 women there was no history of hormonal replacement therapy, while the remaining 23 received different types of hormone; 55 patients complained of vaginal bleeding and the remaining did not present this condition. The endoscopic examinations were performed in the outpatient clinic, using a 4 mm rigid hysteroscope. For uterine cavity distention carbon dioxide (CO2 was used. Biopsy was performed in all patients, with a 3 mm Novak type curette, and the collected material was submitted to a histopathological study. RESULTS: endometrial thickening varied from 6 to 38 mm, with a mean of 10.7 ± 5.3 mm. The hysteroscopic findings were: polypoid lesion in 51 patients (42.1%; atrophic endometrium in 15 patients (12.4%; senile synechia in 15 patients (12.4%, focal thickening in 13 patients (10.7%; cerebroid lesion in 6 patients (5.0%; proliferative endometrium in 5 patients (4.1%; mucus in 5 patients (4.1%; myoma in 4 patients (3.3%; secreting endometrium in 3 patients (2.5%; endometrial hyperplasia in 3 patients (2.5%; and cystic atrophy in 1 patient (0.8%. Correlation between hysteroscopic findings and cytopathology was observed in 30 of 51 cases of polypoid lesion, in 12 of 15 cases of atrophic endometrium and in all cases in which the diagnosis of endometrial hyperplasia or adenocarcinoma was suspected. CONCLUSION: in the majority of the patients, the hysteroscopic examinations revealed that there was no genuine endometrial thickening but rather other types of lesion in the uterine cavity.

  13. Abnormal uterine bleeding. Diagnostic value of hysteroscopy.

    OpenAIRE

    Madan, S. M.; Al-jufairi, Z. A.

    2001-01-01

    OBJECTIVES To determine the specificity, sensitivity and predictive value of hysteroscopic impression versus histological diagnosis of endometrial curettings in evaluating patients with abnormal uterine bleeding. In addition, to determine whether office hysteroscopy can eliminate hospital diagnostic dilatation and curettage for patients with abnormal uterine bleeding. METHODS A retrospective study of 556 patients who underwent hysteroscopy and dilatation and curettage for abnormal ut...

  14. Comparative analysis between the cytobrush and low-volume uterine flush techniques for endometrial cytology in clinically normal postpartum crossbred dairy cowsComparação das técnicas de citologia endometrial escova citológica e lavado uterino de baixo volume no pós-parto de vacas leiteiras mestiças

    Directory of Open Access Journals (Sweden)

    João Paulo Elsen Saut

    2013-10-01

    Full Text Available This study compared two frequently employed techniques for the collection of endometrial and inflammatory cells and characterized postpartum endometrial cytology (EC of clinically normal postpartum crossbred dairy cows in dairy farming system in Southwestern Brazil. Thirty-four crossbred, clinically healthy dairy cows with normal delivery and puerperium, complete uterine involution and without any treatment were monitored until 42 days in milk (DIM. All cows were evaluated by complete clinical and gynecological examinations at days 0, 7, 14, 21, 28, and 42 DIM. The gynecological examinations were done by transrectal palpation, ultrasonography, vaginoscopy, evaluation of the vaginal mucus and EC by using the cytobrush (CB and low-volume uterine flush (LVF techniques. The agreement (Kappa statistic between the two technicians was good for CB (86% and LVF (80.3% for the counting of the percentage of neutrophils. The average number of neutrophils was significantly higher throughout the experiment for LVF, but a reduced percentage of neutrophils were observed during the postpartum period for both techniques. The amount of macrophages, lymphocytes, and eosinophils were not affected during postpartum and there was no significant difference relative to these cells when the two techniques were compared. There were significant differences in the percentage of cows with subclinical endometritis only at d28 by CB (22.2% and LVF (59.3%.Objetivou-se comparar duas técnicas frequentemente usadas na colheita de células endometriais e inflamatórias e caracterizar a citologia endometrial (CE de vacas leiteiras mestiças no pós-parto fisiológico, criadas em sistemas de fazendas leiteiras do sudoeste do Brasil. Foram utilizadas 34 vacas clinicamente sadias com parto e puerpério fisiológico, completa involução uterina e sem qualquer tratamento até os 42 dias pós-parto (dpp. Realizou-se o exame clínico e ginecológico no parto e aos 7, 14, 21, 28 e 42 dpp. O exame ginecológico foi executado pela palpação retal, ultrassonografia, vaginoscopia, avaliação de muco vaginal e CE realizada com escova citológica (CB ou por lavado uterino de baixo volume (LVF. A concordância (Kappa statistic entre os técnicos na contagem da porcentagem de neutrófilos foi boa para CB (86% e para LVF (80,3%. A média de neutrófilos foi maior em todos os momentos na técnica de LVF, porém a redução de neutrófilos foi observada durante o pós-parto nas duas técnicas de citologia. A contagem de macrófagos, linfócitos e eosinófilos não variou durante o pós-parto e não houve diferença entre as técnicas CB e LVF. Houve diferença apenas aos 28 dpp, na porcentagem de vacas com endometrite subclínica, entre as técnicas CB (22.2% e LVF (59.3%.

  15. Uterine sarcomas: clinical presentation and MRI features.

    Science.gov (United States)

    Santos, Pedro; Cunha, Teresa Margarida

    2015-01-01

    Uterine sarcomas are a rare heterogeneous group of tumors of mesenchymal origin, accounting for approximately 8% of uterine malignancies. They comprise leiomyosarcoma, endometrial stromal sarcoma, undifferentiated endometrial sarcoma, and adenosarcoma. Compared with the more common endometrial carcinomas, uterine sarcomas behave more aggressively and are associated with a poorer prognosis. Due to their distinct clinical and biological behavior, the International Federation of Gynecology and Obstetrics introduced a new staging system for uterine sarcomas in 2009, categorizing uterine carcinosarcoma as a variant of endometrial carcinoma, rather than a pure sarcoma. Magnetic resonance imaging (MRI) has a developing role in the assessment of these malignancies. Features such as tumor localization, irregular or nodular margins, necrosis, rapid growth, intense contrast enhancement, and restriction at diffusion-weighted imaging can suggest the diagnosis and help differentiate from more common leiomyomas and endometrial carcinoma. MRI is therefore extremely useful in preoperative detection and staging and, consequently, in determination of appropriate management. This pictorial review aims to discuss the clinical features of uterine sarcomas, as well as their most common appearances and distinct characteristics in MRI. PMID:25347940

  16. Endometrial Hyperplasia

    Science.gov (United States)

    ... be done with an endometrial biopsy , dilation and curettage , or hysteroscopy . What treatments are available for endometrial ... in the blood are too high. Dilation and Curettage: A procedure in which the cervix is opened ...

  17. Preliminary Experience with Locoregional Intraarterial Chemotherapy of Uterine Cervical or Endometrial Cancer Using the Peripheral Implantable Port System (PIPSTM): A Feasibility Study

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the suitability of a percutaneously implantable catheter port system (PIPS)for repeated intraarterial locoregional chemotherapy (ILC) for cervical and endometrial carcinoma. In 30 patients with advanced, recurrent, or high-risk cervical (n 23) or endometrial(n = 7) carcinoma, PIPS for ILC was implanted via a femoral access, the catheter localized in the infrarenal abdominal aorta. Chemotherapy was performed adjuvantly after surgery(n = 14) or neo-adjuvantly to enable surgery, or for palliation (n = 16). Port implantation, catheter placement, and repeated port puncture was uneventful in all patients.Complications included catheter dislocation (n = 1),catheter thrombosis (n = 2), subcutaneous infection(n = 1), port-bed skin atrophy (n = 1),requiring port explantation in 3 patients. At 2 years follow-up,complete remission was observed in 7/14 patients with adjuvant chemotherapy, partial remission in 3/14. Successful down-staging could be achieved in 4/8 patients with neo-adjuvant chemotherapy. The PIPS is suitable for repeated ILC which may be a valuable method for pre- and post-surgical therapy of advanced or high-risk cervical and endometrial cancer, for adjuvant chemotherapy as well as neo-adjuvantly for down-staging, or for palliation

  18. Cost effectiveness of endometrial ablation with the NovaSure® system versus other global ablation modalities and hysterectomy for treatment of abnormal uterine bleeding: US commercial and Medicaid payer perspectives

    Directory of Open Access Journals (Sweden)

    Miller JD

    2015-01-01

    Full Text Available Jeffrey D Miller,1 Gregory M Lenhart,1 Machaon M Bonafede,1 Cindy M Basinski,2 Andrea S Lukes,3 Kathleen A Troeger4 1Truven Health Analytics, Cambridge, MA, 2Basinski, LLC, Newburgh, IN, 3Carolina Women’s Research and Wellness Center, Durham, NC, 4Hologic, Inc, Marlborough, MA, USA Objectives: Abnormal uterine bleeding (AUB interferes with physical, emotional, and social well-being, impacting the quality of life of more than 10 million women in the USA. Hysterectomy, the most common surgical treatment of AUB, has significant morbidity, low mortality, long recovery, and high associated health care costs. Global endometrial ablation (GEA provides a surgical alternative with reduced morbidity, cost, and recovery time. The NovaSure® system utilizes unique radiofrequency impedance-based GEA technology. This study evaluated cost effectiveness of AUB treatment with NovaSure ablation versus other GEA modalities and versus hysterectomy from the US commercial and Medicaid payer perspectives. Methods: A health state transition (semi-Markov model was developed using epidemiologic, clinical, and economic data from commercial and Medicaid claims database analyses, supplemented by published literature. Three hypothetical cohorts of women receiving AUB interventions were simulated over 1-, 3-, and 5-year horizons to evaluate clinical and economic outcomes for NovaSure, other GEA modalities, and hysterectomy. Results: Model analyses show lower costs for NovaSure-treated patients than for those treated with other GEA modalities or hysterectomy over all time frames under commercial payer and Medicaid perspectives. By Year 3, cost savings versus other GEA were $930 (commercial and $3,000 (Medicaid; cost savings versus hysterectomy were $6,500 (commercial and $8,900 (Medicaid. Coinciding with a 43%–71% reduction in need for re-ablation, there were 69%–88% fewer intervention/reintervention complications for NovaSure-treated patients versus other GEA modalities, and 82%–91% fewer versus hysterectomy. Furthermore, NovaSure-treated patients had fewer days of work absence and short-term disability. Cost-effectiveness metrics showed NovaSure treatment as economically dominant over other GEA modalities in all circumstances. With few exceptions, similar results were shown for NovaSure treatment versus hysterectomy. Conclusion: Model results demonstrate strong financial favorability for NovaSure ablation versus other GEA modalities and hysterectomy from commercial and Medicaid payer perspectives. Results will interest clinicians, health care payers, and self-insured employers striving for cost-effective AUB treatments. Keywords: NovaSure, abnormal uterine bleeding, menorrhagia, hysterectomy, global endometrial ablation, cost-effectiveness analysis

  19. Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jeong Seon; Lee, Do Yon; Kim, Yong Tae; Park, Ki Hyun; Park, Yong Won; Cho, Jae Sung; Kim, Myung Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of); Won, Je Hwan [Ajou Univ. College of Medicine, Suwon (Korea, Republic of); Kang, Byung Chul [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-09-01

    To determine the efficacy and clinical outcome of uterine arterial embolization as a new approach to the management of uterine leiomyomas. Uterine arterial embolization was performed in 21 patients aged 26-62(mean, 42) years. Twenty of these had menorrhagia, dysmenorrhea, and mass-related symptoms (low abdominal discomfort, backache, urinary frequency, etc.) and one was diagnosed incidentally. Bilateral uterine arteries were selected individually and polyvinyl alcohol and/or gelfoam was used as an embolic material. Nineteen patients were followed up after embolization. Seventeen (89.5 %)reported satisfactory improvement of symptoms and follow-up sonography three months later showed a 58.5 % reduction in mean myoma volume. In 17 patients (89.5 %), the menstrual cycle returned to normal. All patients experienced pain after the procedure and other complications were vaginal bleeding (26.3 %) and fever (23.8 %). Uterine arterial embolization represents a new approach to the management of uterine leiomyoma-related symptoms. Further investigations and long-term follow-up are, however, enquired.

  20. Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome

    International Nuclear Information System (INIS)

    To determine the efficacy and clinical outcome of uterine arterial embolization as a new approach to the management of uterine leiomyomas. Uterine arterial embolization was performed in 21 patients aged 26-62(mean, 42) years. Twenty of these had menorrhagia, dysmenorrhea, and mass-related symptoms (low abdominal discomfort, backache, urinary frequency, etc.) and one was diagnosed incidentally. Bilateral uterine arteries were selected individually and polyvinyl alcohol and/or gelfoam was used as an embolic material. Nineteen patients were followed up after embolization. Seventeen (89.5 %)reported satisfactory improvement of symptoms and follow-up sonography three months later showed a 58.5 % reduction in mean myoma volume. In 17 patients (89.5 %), the menstrual cycle returned to normal. All patients experienced pain after the procedure and other complications were vaginal bleeding (26.3 %) and fever (23.8 %). Uterine arterial embolization represents a new approach to the management of uterine leiomyoma-related symptoms. Further investigations and long-term follow-up are, however, enquired

  1. Hysteroscopic endometrial resection: efficacy and factors for failure

    OpenAIRE

    Geraldo Rodrigues Lima; Fausto Farah Baracat; Umberto Gazi Lippi; Daniella De Batista Depes; Simone Denise David; Reginaldo Guedes Coelho Lopes; José Francisco Dória Ramos

    2008-01-01

    Objective: To evaluate the effectiveness of hysteroscopic endometrial ablation in women with abnormal benign uterine bleeding resistant to clinical treatment, and to identify factors potentially related to its failure. Methods: Ninety patients with abnormal benign uterine bleeding were retrospectively evaluated. They were submitted to endometrial ablation between January 2000 and August 2003. Their mean age was 44.3 years and their average parity was 2.3 childbirths. All patients had been giv...

  2. Role of Local Anesthetics on Pain Relief in Endometrial Biopsy: Randomized Clinical Trial

    OpenAIRE

    Elaheh Ouladsahebmadarek; Parvin Mostafa Gharabaghi; Fatemeh Behjati; Azadeh Azadi; Mahin Seidhejazie

    2014-01-01

    Objectives: Endometrial biopsy is necessary for diagnosing the reason of abnormal uterine bleeding in perimenopausal women. Currently outpatient endometrial biopsy is used for evaluation of abnormal uterine bleeding which is associated with moderate to severe pain. Using lidocaine is one of the procedures which is used for pain relief while biopsy. This study is aimed at comparing the effect of different local anesthesia procedures on pain relief during endometrial biopsy. Materials and Me...

  3. Bmp2 Is Critical for the Murine Uterine Decidual Response? †

    OpenAIRE

    Lee, Kevin Y.; Jeong, Jae-wook; Wang, Jinrong; Ma, Lijiang; Martin, James F.; Tsai, Sophia Y.; Lydon, John P.; Demayo, Francesco J.

    2007-01-01

    The process of implantation, necessary for all viviparous birth, consists of tightly regulated events, including apposition of the blastocyst, attachment to the uterine lumen, and differentiation of the uterine stroma. In rodents and primates the uterine stroma undergoes a process called decidualization. Decidualization, the process by which the uterine endometrial stroma proliferates and differentiates into large epithelioid decidual cells, is critical to the establishment of fetal-maternal ...

  4. Endometrial spiral artery Doppler parameters in unexplained infertility patients: is endometrial perfusion an important factor in the etiopathogenesis?

    OpenAIRE

    Selda Uysal; Elif Pelin Özün Özbay; Tekin Ekinci; Hayri Aksüt; ?ebnem Karasu; Ahmet Zeki I??k; Ferit Soylu

    2012-01-01

    Objective: Uterine perfusion, particularly the endometrial blood flow, may have an important role in endometrial receptivity. In order to assess the contribution of sub endometrial blood flow in the etiopathogenesis of unexplained infertility mid luteal- peri-implantation period spiral artery transvaginal color Doppler parameters were measured and compared with fertile controls. Material and Methods: Forty-two consecutive patients admitted to Izmir Katip Celebi University Ataturk Training an...

  5. FDG PET/CT diagnostic criteria may need adjustment based on MRI to estimate the presurgical risk of extrapelvic infiltration in patients with uterine endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sudo, Satoko; Sakuragi, Noriaki [Hokkaido University Graduate School of Medicine, Department of Gynecology, Sapporo (Japan); Hattori, Naoya; Manabe, Osamu; Hirata, Kenji; Tamaki, Nagara [Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Kitaku, Sapporo (Japan); Kato, Fumi; Mimura, Rie; Magota, Keiichi; Sugimori, Hiroyuki [Hokkaido University Graduate School of Medicine, Department of Diagnostic and Interventional Radiology, Sapporo (Japan)

    2015-04-01

    The staging of endometrial cancer requires surgery which carries the risk of morbidity. FDG PET/CT combined with anatomical imaging may reduce the number of unnecessary lymphadenectomies by demonstrating the risk of extrapelvic infiltration. The purpose of this study was to optimize FDG PET/CT diagnostic criteria for risk assessment in endometrial cancer after first-line risk triage with MRI. The study population comprised 37 patients who underwent curative surgery for the treatment of endometrial cancer. First, the risk of extrapelvic infiltration was triaged using MRI. Second, multiple glucose metabolic profiles of the primary lesion were assessed with FDG PET/CT, and these were correlated with the histopathological risk of extrapelvic infiltration including lymphovascular space invasion (LVSI) and high-grade malignancy (grades 2 and 3). The results of histological correlation were used to adjust FDG PET/CT diagnostic criteria. Presurgical assessment using MRI was positive for deep (>50 %) myometrial invasion in 17 patients. The optimal FDG PET/CT diagnostic criteria vary depending on the results of MRI. Specifically, SUVmax (?16.0) was used to indicate LVSI risk with an overall diagnostic accuracy of 88.2 % in patients with MRI findings showing myometrial invasion. High-grade malignancy did not correlate with any of metabolic profiles in this patient group. In the remaining patients without myometrial invasion, lesion glycolysis (LG) or metabolic volume were better indicators of LVSI than SUVmax with the same diagnostic accuracy of 80.0 %. In addition, LG (?26.9) predicted high-grade malignancy with an accuracy of 72.2 %. Using the optimized cut-off criteria for LVSI, glucose metabolic profiling of primary lesions correctly predicted lymph node metastasis with an accuracy of 73.0 %, which was comparable with the accuracy of visual assessment for lymph node metastasis using MRI and FDG PET/CT. FDG PET/CT diagnostic criteria may need adjustment based on the anatomical information provided by MRI. The optimized criteria can predict the risk of pathology-proven LVSI correctly in 83.8 % of patients before surgery, and thus would improve presurgical treatment planning. (orig.)

  6. FDG PET/CT diagnostic criteria may need adjustment based on MRI to estimate the presurgical risk of extrapelvic infiltration in patients with uterine endometrial cancer

    International Nuclear Information System (INIS)

    The staging of endometrial cancer requires surgery which carries the risk of morbidity. FDG PET/CT combined with anatomical imaging may reduce the number of unnecessary lymphadenectomies by demonstrating the risk of extrapelvic infiltration. The purpose of this study was to optimize FDG PET/CT diagnostic criteria for risk assessment in endometrial cancer after first-line risk triage with MRI. The study population comprised 37 patients who underwent curative surgery for the treatment of endometrial cancer. First, the risk of extrapelvic infiltration was triaged using MRI. Second, multiple glucose metabolic profiles of the primary lesion were assessed with FDG PET/CT, and these were correlated with the histopathological risk of extrapelvic infiltration including lymphovascular space invasion (LVSI) and high-grade malignancy (grades 2 and 3). The results of histological correlation were used to adjust FDG PET/CT diagnostic criteria. Presurgical assessment using MRI was positive for deep (>50 %) myometrial invasion in 17 patients. The optimal FDG PET/CT diagnostic criteria vary depending on the results of MRI. Specifically, SUVmax (?16.0) was used to indicate LVSI risk with an overall diagnostic accuracy of 88.2 % in patients with MRI findings showing myometrial invasion. High-grade malignancy did not correlate with any of metabolic profiles in this patient group. In the remaining patients without myometrial invasion, lesion glycolysis (LG) or metabolic volume wtter indicators of LVSI than SUVmax with the same diagnostic accuracy of 80.0 %. In addition, LG (?26.9) predicted high-grade malignancy with an accuracy of 72.2 %. Using the optimized cut-off criteria for LVSI, glucose metabolic profiling of primary lesions correctly predicted lymph node metastasis with an accuracy of 73.0 %, which was comparable with the accuracy of visual assessment for lymph node metastasis using MRI and FDG PET/CT. FDG PET/CT diagnostic criteria may need adjustment based on the anatomical information provided by MRI. The optimized criteria can predict the risk of pathology-proven LVSI correctly in 83.8 % of patients before surgery, and thus would improve presurgical treatment planning. (orig.)

  7. Can ABCF2 protein expression predict the prognosis of uterine cancer?

    OpenAIRE

    Nishimura, S.; Tsuda, H.; Miyagi, Y.; Hirasawa, A.; Suzuki, A.; Kataoka, F.; Nomura, H.; Chiyoda, T.; Banno, K.; Fujii, T.; Susumu, N.; Aoki, D.

    2008-01-01

    Uterine cervical and endometrial cancers are common malignant solid neoplasms for which there are no useful prognostic markers. In this study, we evaluate the relationship between ATP-binding cassette superfamily F2 (ABCF2) expression and clinical factors including clinical stage, histologic type, grade and prognosis in uterine cervical and endometrial cancer. Two hundred and sixty seven cervical and 103 endometrial cancers were studied. ATP-binding cassette superfamily F2 cytoplasmic express...

  8. Adjuvant therapy for endometrial cancer

    OpenAIRE

    Deleon, Maria C.; Ammakkanavar, Natraj R.; Matei, Daniela

    2014-01-01

    Endometrial cancer is a common gynecologic malignancy typically diagnosed at early stage and cured with surgery alone. Adjuvant therapy is tailored according to the risk of recurrence, estimated based on the International Federation of Gynecology and Obstetrics (FIGO) stage and other histological factors. The objective of this manuscript is to review the evidence guiding adjuvant therapy for early stage and locally advanced uterine cancer. For patients with early stage disease, minimizing tox...

  9. Contrast enhancement versus vasculature of uterine tumors

    Energy Technology Data Exchange (ETDEWEB)

    Kormano, M.; Kiilholma, P.; Groenroos, M.

    1984-05-01

    The relative contrast enhancement of normal myometrium and small or medium size uterine fibroids and clinical stage I endometrial carcinomas were correlated to their microangiographically demonstrable vascularity. In four cases small uterine fibroids showed contrast enhancement equal to normal myometrium, independent of their vascularity in microangiography. In five, endometrial carcinomas contrast enhancement was always below that of the surrounding myometrium in CT. Intratumour vasculature showed great variability in microangiography. No correlation between the topographic variations in the arrangement or density of tumour blood vessels and the degree of contrast enhancement was found. Contrast enhancement of small uterine fibroids was greater than that of small adenocarcinomas. More contrast material accumulates into the extravascular space of the smooth muscle tissue of the fibroid than into the extravascular space of endometrial carcinoma.

  10. Inflammation and endometrial bleeding.

    Science.gov (United States)

    Berbic, M; Ng, C H M; Fraser, I S

    2014-12-01

    Most of the key physiological processes in the human reproductive tract involve a significant inflammatory component. These processes include follicle development, ovulation, implantation, pregnancy, labor, postpartum, remodeling and menstruation. In this context, the term 'inflammation' usually means an influx of leukocytes ('immune cells'), often of different types, into a reproductive tract tissue. These examples of inflammation are not overtly associated with any infective process. There may also be evidence that these invading leukocytes have altered their functions to take on specific and relevant local regulatory roles. Specific sequential changes in different leukocytes can be demonstrated within human endometrium during the different phases of the normal menstrual cycle. Leukocytes are fairly sparse in numbers through the proliferative phase, but increase substantially into and through the secretory phase, so much so that around 40% of all stromal cells in the premenstrual phase are leukocytes, mainly uterine natural killer cells, a large granulated lymphocyte. Other leukocytes which play key roles in menstruation appear to be macrophages, mast cells, dendritic cells, neutrophils, eosinophils and regulatory T cells. Premenstrual withdrawal of progesterone increases the endometrial expression of inflammatory mediators, including IL-8 and MCP-1, which are believed to drive endometrial leukocyte recruitment at this time. Macrophages and neutrophils are rich sources of defensins and whey acid protein motif proteins, which play important roles in ensuring microbial protection while the epithelial barrier is disrupted. Mast cells are increasingly activated as the menstrual phase approaches, and leukocyte proteases trigger a cascade of matrix metalloproteinases and degradation of extracellular matrix. Dendritic cells and other antigen-presenting cells (e.g. macrophages) almost certainly facilitate clearance of cellular debris from the uterine cavity, and reduce the amount of viable cellular material transiting the Fallopian tubes. All of these processes are influenced or controlled by regulatory T cells. Many of these leukocytes also have the potential to release regulatory molecules which stimulate endometrial repair mechanisms. Increasing recent evidence also implicates disturbances of immune cells and their cytokine mediators in contributing to symptoms of abnormal uterine bleeding and pelvic pain. These recent findings all point towards the importance of the 'inflammatory process' in both normal and abnormal endometrial bleeding. PMID:25247830

  11. Endometrial Cancer

    Science.gov (United States)

    ... may put you at greater risk for getting endometrial cancer. One risk factor is age. Endometrial cancer is most common in women who are older than 50 years of age. You may also be at greater risk if you have had high levels of estrogen ...

  12. Endometrial ossification.

    Science.gov (United States)

    Ejeckam, G C; Haseeb, F; Ahamad, R; Azadeh, B

    1991-07-01

    A case of endometrial ossification in a 22-year-old woman is reported. Chronic endometritis following post-abortion evacuation was considered the basis for the osseous metaplasia in her endometrium. Besides being a reversible cause of infertility, endometrial ossification needs to be differentiated from mixed mesodermal tumours of the endometrium. PMID:1816670

  13. Involvements of Estrogen Receptor, Proliferating Cell Nuclear Antigen and p53 in Endometrial Adenocarcinoma Development in Donryu Rats

    OpenAIRE

    YOSHIDA, Midori; Katsuda, Shin-ichi; Maekawa, Akihiko

    2012-01-01

    Involvements of estrogen receptor (ER)?, proliferating cell nuclear antigen (PCNA) and p53 in the uterine carcinogenesis process in Donryu rats, a high yield strain of the uterine cancer were investigated immunohistochemically. ER? was expressed in atypical endometrial hyperplasia, accepted as a precancerous lesion of the uterine tumors, as well as well- and in moderately-differentiated endometrial adenocarcinomas, and the intensities of expression were similar to those in the ...

  14. Abnormal uterine bleeding: a clinicohistopathological analysis

    OpenAIRE

    Anupamasuresh Y; Suresh YV; Prachi Jain

    2014-01-01

    Background: Abnormal uterine bleeding (AUB) is one of the most common problem for the patients and the gynecologists. It adversely effects on the quality of life and psychology of women. It is of special concern in developing country as it adds to the causes of anemia. Management of Abnormal Uterine Bleeding (AUB) is not complete without tissue diagnosis especially in perimenopausal and post-menopausal women. Histological characteristics of endometrial biopsy material as assessed by light mic...

  15. Embolização das artérias uterinas com partículas de PVA-PVAC esférico como preparo para posterior ressecção cirúrgica de miomas / Uterine artery embolization with spherical pva-pvac particles as preparation for surgical resection of miyomas

    Scientific Electronic Library Online (English)

    Juraci, Ghiaroni; Gaudencio Espinosa, Lopez; Antonio Carlos, Coutinho Junior; Alberto, Schanaider.

    2013-10-01

    Full Text Available OBJETIVO: avaliar a utilização de uma nova partícula de polivinil álcool e polivinil acetato (PVA-PVAc) esférica, para embolização das artérias uterinas, em pacientes portadoras de mioma, com indicação cirúrgica. MÉTODOS: doze pacientes foram submetidas à embolização de miomas uterinos com partícula [...] s de PVA-PVAc. Três a nove meses depois, realizou-se uma laparotomia com miomectomia. Analisaram-se os seguintes parâmetros: volume do útero e do maior mioma; concentrações do hormônio folículo estimulante e de hemoglobina; sangramento menstrual (número de dias e de absorventes utilizados), sinais e sintomas antes do tratamento, após a embolização e após a miomectomia. RESULTADOS: a média de idade foi 37 anos e a média do volume uterino, previamente ao tratamento, de 939,3cc. Três anos após a embolização, observou-se diminuição do volume uterino (p=0,0005). Houve melhora na concentração de hemoglobina (p= 0,0004), com elevação após a embolização, sem variação subsequente à miomectomia. Não ocorreu variação significante do hormônio folículo estimulante, (p=0,17). Não foi constatado nenhum caso de falência ovariana, mas uma das pacientes apresentou atrofia de endométrio. Duas pacientes engravidaram, com bons indicadores obstétricos. Quanto aos sinais e sintomas, houve melhora após a embolização, que se manteve após a miomectomia. CONCLUSÃO: a embolização arterial com partículas de PVA-PVAc esférico mostrou-se promissora no preparo para uma intervenção cirúrgica com retirada dos miomas, pois, associou-se à redução do volume uterino, à diminuição do sangramento operatório e tornou possível a utilização de incisões menores, aumentando a chance de preservação do útero. Abstract in english OBJECTIVE: To evaluate the use of a new spherical particle of polyvinyl alcohol and polyvinyl acetate (PVA-PVAc) for uterine artery embolization in patients with myoma with surgical indication. METHODS: twelve patients underwent uterine myoma embolization with PVA-PVAc particles. Three to nine month [...] s later, they were submitted to laparotomy with myomectomy. We analyzed the following parameters: volume of the uterus and of the bigger myoma; concentrations of follicle stimulating hormone and hemoglobin; menstrual bleeding (number of days and used absorbents), signs and symptoms before treatment, after embolization and after myomectomy. RESULTS: The mean age was 37 years and mean uterine volume prior to treatment, 939.3 cc. Three years after embolization, there was reduction in uterine volume (p = 0.0005), increase in hemoglobin concentration after embolization (p = 0.0004), without variation after the myomectomy. There was no significant variation of the follicle stimulating hormone (p = 0.17). There was no case of ovarian failure, but one of the patients had endometrial atrophy. Two patients became pregnant, with good obstetric indicators. Signs and symptoms improved after embolization, and remained after myomectomy. CONCLUSION: Arterial embolization with spherical PVA-PVAc particles is promising in the preparation for myoma surgery, since it was associated with a reduction in uterine volume, decrease in intraoperative bleeding and made possible the use of smaller incisions, increasing the chance of preserving the uterus.

  16. Endometrial polyps

    Science.gov (United States)

    ... can be cancerous or precancerous. The chance of cancer is higher if you are postmenopausal, on Tamoxifen, or have heavy or irregular periods. These factors may increase the risk for endometrial polyps: Obesity Tamoxifen, a treatment for breast cancer ...

  17. Successful Pregnancy after Treatment with Ulipristal Acetate for Uterine Fibroids

    OpenAIRE

    Javier Monleón; Alicia Martínez-Varea; Daniela Galliano; Antonio Pellicer

    2014-01-01

    This case report presents a clinical pregnancy after ulipristal acetate (UA) to decrease uterine fibroid size. A 37-year-old patient, gravida 1, abortus 1, with uterine fibroids was treated with 5?mg of UA daily for 13 weeks starting eight months after a multiple laparotomic myomectomy. Fibroid shrinkage and restoration of the morphology of endometrial cavity were evaluated in order to allow a subsequent pregnancy. A decrease of the uterine fibroids and a normal morphology of the endometria...

  18. Saline infusion sonohysterography versus hysteroscopy for uterine cavity evaluation

    OpenAIRE

    Khan Faryal; Jamaat Sadia; Al-Jaroudi Dania

    2011-01-01

    Background and Objectives: The most frequent procedures performed on women with abnormal uterine bleeding are 2D and 3D ultrasound. The most common accepted approach for the management of abnormal uterine bleeding is 2D TV scan followed by therapeutic hysteroscopy. The purpose of this prospective study was to assess whether 3D saline infusion sonohysterography (3D SIS) could replace diagnostic hysteroscopy (DH) for the diagnosis of endometrial pathology, in patients with abnormal uterine blee...

  19. Receptor Tyrosine Kinases and Their Hormonal Regulation in Uterine Leiomyoma

    OpenAIRE

    Yu, Linda; Moore, Alicia B; Dixon, Darlene

    2010-01-01

    Uterine leiomyomas (fibroids, myomas) are benign tumors that develop from smooth muscle cells. Although the most common gynecologic tumor in premenopausal women, there is still little known of the etiology, the genetics and basic/molecular biology, or the influence of the environment on the development and growth of these tumors. The fact that fibroids occur during the reproductive years and regress after menopause indicates a growth dependent on ovarian hormones. Studies have supported a rol...

  20. Uterine Fibroids: Pathogenesis and Interactions with Endometrium and Endomyometrial Junction

    OpenAIRE

    Ciavattini, Andrea; Di Giuseppe, Jacopo; Stortoni, Piergiorgio; Montik, Nina; Giannubilo, Stefano R.; Litta, Pietro; Islam, Md Soriful; Tranquilli, Andrea L.; Reis, Fernando M.; Ciarmela, Pasquapina

    2013-01-01

    Uterine leiomyomas (fibroids or myomas) are benign tumors of uterus and clinically apparent in a large part of reproductive aged women. Clinically, they present with a variety of symptoms: excessive menstrual bleeding, dysmenorrhoea and intermenstrual bleeding, chronic pelvic pain, and pressure symptoms such as a sensation of bloatedness, increased urinary frequency, and bowel disturbance. In addition, they may compromise reproductive functions, possibly contributing to subfertility, early pr...

  1. Cost effectiveness of endometrial ablation with the NovaSure® system versus other global ablation modalities and hysterectomy for treatment of abnormal uterine bleeding: US commercial and Medicaid payer perspectives

    Science.gov (United States)

    Miller, Jeffrey D; Lenhart, Gregory M; Bonafede, Machaon M; Basinski, Cindy M; Lukes, Andrea S; Troeger, Kathleen A

    2015-01-01

    Objectives Abnormal uterine bleeding (AUB) interferes with physical, emotional, and social well-being, impacting the quality of life of more than 10 million women in the USA. Hysterectomy, the most common surgical treatment of AUB, has significant morbidity, low mortality, long recovery, and high associated health care costs. Global endometrial ablation (GEA) provides a surgical alternative with reduced morbidity, cost, and recovery time. The NovaSure® system utilizes unique radiofrequency impedance-based GEA technology. This study evaluated cost effectiveness of AUB treatment with NovaSure ablation versus other GEA modalities and versus hysterectomy from the US commercial and Medicaid payer perspectives. Methods A health state transition (semi-Markov) model was developed using epidemiologic, clinical, and economic data from commercial and Medicaid claims database analyses, supplemented by published literature. Three hypothetical cohorts of women receiving AUB interventions were simulated over 1-, 3-, and 5-year horizons to evaluate clinical and economic outcomes for NovaSure, other GEA modalities, and hysterectomy. Results Model analyses show lower costs for NovaSure-treated patients than for those treated with other GEA modalities or hysterectomy over all time frames under commercial payer and Medicaid perspectives. By Year 3, cost savings versus other GEA were $930 (commercial) and $3,000 (Medicaid); cost savings versus hysterectomy were $6,500 (commercial) and $8,900 (Medicaid). Coinciding with a 43%–71% reduction in need for re-ablation, there were 69%–88% fewer intervention/reintervention complications for NovaSure-treated patients versus other GEA modalities, and 82%–91% fewer versus hysterectomy. Furthermore, NovaSure-treated patients had fewer days of work absence and short-term disability. Cost-effectiveness metrics showed NovaSure treatment as economically dominant over other GEA modalities in all circumstances. With few exceptions, similar results were shown for NovaSure treatment versus hysterectomy. Conclusion Model results demonstrate strong financial favorability for NovaSure ablation versus other GEA modalities and hysterectomy from commercial and Medicaid payer perspectives. Results will interest clinicians, health care payers, and self-insured employers striving for cost-effective AUB treatments. PMID:25610002

  2. Acute tissue effects during transcervical endometrial resection

    DEFF Research Database (Denmark)

    Holm-Nielsen, P; Nyland, M H

    1993-01-01

    The acute tissue effects of transcervical endometrial resection (TCRE) with a standard Iglesias resectoscope using glycine 1.5% for irrigation were studied in 8 women prior to hysterectomy. Combinations of 80 or 120 W cutting current with blend 1 or 2 were applied for endometrial resection, preceded by cornual endometrial coagulation with the roller ball electrode with a coagulation effect of 40 or 60 W. The temperature was measured at the uterine vessels, ovarian ligaments and serosal surface. The increase in temperature at the serosal surface was 2.0 degrees C during cornual coagulation and 0.3 degrees C during endometrial resection, independent of the current effect applied. The maximum depth of tissue damage was 1.7 mm. No change in temperature was found at the uterine vessels or ovarian ligaments. The tissue destruction and the increase in temperature of the uterine surface are minimal, and TCRE offers excellent histological material. Careful coagulation/resection in the cornual and isthmus regions is recommended.

  3. Uterine restoration after repeated sloughing of fibroids or vaginal expulsion following uterine artery embolization

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hye Ri; Kim, Nack Keun; Lee, Mee Hwa [Pochon CHA University, Department of Obstetrics and Gynecology, Bundang CHA General Hospital, Sungnam-si, Kyonggi-do (Korea); Kim, Man Deuk; Kim, Hee Jin; Yoon, Sang-Wook [Pochon CHA University, Department of Diagnostic Radiology, Bundang CHA General Hospital, Sungnam-si, Kyonggi-do (Korea); Park, Won Kyu [Yeungnam University, Department of Diagnostic Radiology, Kyongson, Dyongbuk (Korea)

    2005-09-01

    The aim of our study is to present our experience with uterine restoration after repeated sloughing of uterine fibroids or transvaginal expulsion following uterine artery embolization (UAE) and to determine its safety and outcome. One hundred and twenty-four women (mean age, 40.3 years; age range, 29-52 years) with symptomatic uterine fibroids were included in this retrospective study. We performed arterial embolization with poly(vinyl alcohol) particles (250-710 {mu}m). Clinical symptoms and follow-up information for each patient were obtained through medical records. At an average of 3.5 months (range, 1-8 months) after embolization, magnetic resonance imaging examinations with T1- and T2-weighted and gadolinium-enhanced T1-weighted images were obtained for all patients. The mean follow-up duration was 120 days (90-240 days). Eight (6.5%) patients experienced uterine restoration after repeated sloughing of uterine fibroids or spontaneous transvaginal expulsion. The locations of the leiomyomas were submucosal (n=5), intramural (n=2) and transmural (n=1). The maximum diameter of the fibroids ranged from 3.5 to 18.0 cm, with a mean of 8.4 cm. The time interval from embolization to the uterine restoration was 7-150 days (mean 70.5 days). The clinical symptoms before and during vaginal sloughing or expulsion were lower abdominal pain (n=4), vaginal discharges (n=3), infection of necrotic myomas (n=2) and cramping abdominal pain (n=1). Gentle abdominal compression (n=1) and hysteroscopic assistance (n=1) were required to remove the whole fibroid. No other clinical sequelae, either early or delayed, were documented. Magnetic resonance images revealed the disappearance of leiomyomas, intracavitary rupture resulting in transformation of intramural or transmural myomas into submucosal myomas and localized uterine wall defects. Although the small size of this study precludes a strict conclusion, there appear to be few serious complications directly related to vaginal expulsion. Vaginal expulsion or fibroid sloughing is a possible course following UAE that is manageable, and the patients should be informed about this possibility. (orig.)

  4. Uterine restoration after repeated sloughing of fibroids or vaginal expulsion following uterine artery embolization

    International Nuclear Information System (INIS)

    The aim of our study is to present our experience with uterine restoration after repeated sloughing of uterine fibroids or transvaginal expulsion following uterine artery embolization (UAE) and to determine its safety and outcome. One hundred and twenty-four women (mean age, 40.3 years; age range, 29-52 years) with symptomatic uterine fibroids were included in this retrospective study. We performed arterial embolization with poly(vinyl alcohol) particles (250-710 ?m). Clinical symptoms and follow-up information for each patient were obtained through medical records. At an average of 3.5 months (range, 1-8 months) after embolization, magnetic resonance imaging examinations with T1- and T2-weighted and gadolinium-enhanced T1-weighted images were obtained for all patients. The mean follow-up duration was 120 days (90-240 days). Eight (6.5%) patients experienced uterine restoration after repeated sloughing of uterine fibroids or spontaneous transvaginal expulsion. The locations of the leiomyomas were submucosal (n=5), intramural (n=2) and transmural (n=1). The maximum diameter of the fibroids ranged from 3.5 to 18.0 cm, with a mean of 8.4 cm. The time interval from embolization to the uterine restoration was 7-150 days (mean 70.5 days). The clinical symptoms before and during vaginal sloughing or expulsion were lower abdominal pain (n=4), vaginal discharges (n=3), infection of necrotic myomas (n=2) and cramping abdominal pain (n=1). Gentle abdominal compression (n=1) and). Gentle abdominal compression (n=1) and hysteroscopic assistance (n=1) were required to remove the whole fibroid. No other clinical sequelae, either early or delayed, were documented. Magnetic resonance images revealed the disappearance of leiomyomas, intracavitary rupture resulting in transformation of intramural or transmural myomas into submucosal myomas and localized uterine wall defects. Although the small size of this study precludes a strict conclusion, there appear to be few serious complications directly related to vaginal expulsion. Vaginal expulsion or fibroid sloughing is a possible course following UAE that is manageable, and the patients should be informed about this possibility. (orig.)

  5. Ultrasonographic findings of Myoma, H-mole and Missed abortion

    International Nuclear Information System (INIS)

    Ultrasonography is very important in the diagnosis of various kinds of diseases in Obsterics and Gynecology. It has high diagnostic accuracy in the diagnosis of pelvic masses and widely used for the detection of normal orpathologic pregnancy. But still it is difficult to differentiate degenerated myoma, H-mole and missed abortion by ultrasonography. So the authors analyzed the ultrasonographic findings of 81 patients with myoma(29 cases), H-mole(23 cases), and missed abortion(29 cases) and the results are as follows; 1. Diagnostic accuracy was 8.6% in myoma, 87% in H-mole and 89% in missed abortion. 2. The most typical ultrasonographic finding of myoma was obulated mass contour with nonhomogenous internal echo. 3. The most characteristic finding of H-mole was fine vesicular pattern internal echo with globular enlargement of uterus. 4. The most frequent finding of missed abortion was deformed gestational sac with or without remained fetal echo. 5. Clinical correlation was very important for accurate diagnosis, especially when differential diagnosis was very difficult between myoma with marked cystic degeneration, missed abortion with large distorted gestational sac and H-mole with severe degeneration

  6. Radiation therapy of the uterine cancer

    International Nuclear Information System (INIS)

    Cervical and endometrial cancer of the uterus, and ovarian cancer are three major malignant diseases in gynecology in Japan. These diagnosis and therapy are almost established. In uterine cervical cancer, radiation therapy and surgery of these diseases are two main treatment methods, and both treatment results are almost the same. And radiation therapy is also used as postoperative treatment to patients with high risk factors. In endometrial cancer, surgery is main therapy. Radiation therapy is undergone only to medically inoperable cases preoperative radiation is widely carried out in Europe and America, but almost none in Japan. Postoperative irradiation is adapted to the cases with high risk factors. But recent advance of chemotherapy changes the importance of radiation therapy in such patients. I review the literatures of radiation therapy of uterine cervical cancer and of endometrial cancer. (author)

  7. Radiation therapy of the uterine cancer

    Energy Technology Data Exchange (ETDEWEB)

    Noguchi, Hiroshi [Matsumoto National Hospital, Nagano (Japan)

    1999-02-01

    Cervical and endometrial cancer of the uterus, and ovarian cancer are three major malignant diseases in gynecology in Japan. These diagnosis and therapy are almost established. In uterine cervical cancer, radiation therapy and surgery of these diseases are two main treatment methods, and both treatment results are almost the same. And radiation therapy is also used as postoperative treatment to patients with high risk factors. In endometrial cancer, surgery is main therapy. Radiation therapy is undergone only to medically inoperable cases preoperative radiation is widely carried out in Europe and America, but almost none in Japan. Postoperative irradiation is adapted to the cases with high risk factors. But recent advance of chemotherapy changes the importance of radiation therapy in such patients. I review the literatures of radiation therapy of uterine cervical cancer and of endometrial cancer. (author)

  8. Steroid content in endometrial tissue.

    Science.gov (United States)

    Suri, N K

    1997-04-01

    In the human endometrium, the role of C19 steroids is at present unclear. Radioimmunoassays (RIA) were developed which had sufficient specificity and accuracy to measure testosterone, 5 alpha-dihydroxytestosterone (5 alpha-DHT), oestradiol, progesterone and androstenedione in endometrial samples. Amounts of androstenedione were greater (range 1.2-20.8 ng/mg tissue) than other steroids. Samples were obtained from patients presenting conditions such as subfertility, postmenopausal bleeding, dysfunctional uterine bleeding and abdominal pain. Patients used as normals were admitted for sterilisation. A significant positive correlation (r = 0.80) was found between the levels of testosterone and 5 alpha-reductase system. No relationship was observed in tissue steroid concentration and age of the patients. Steroid concentrations were found to be high in tissue obtained from patients with endometrial carcinomas whereas progesterone concentration being low in subfertiles. PMID:9299827

  9. Avaliação da cavidade uterina com hístero-sonografia em pacientes com falha de implantação após fertilização in vitro / Evaluation of the uterine cavity by sonohysterography in patients with implantation failure after in vitro fertilization

    Scientific Electronic Library Online (English)

    Teiichi, Ninomiya; Luiz Eduardo Trevisan de, Albuquerque; Daniele Mansur, Varjão; Karina Bertono de, Faria; Rudson Carlos Martins de, Oliveira; Luiz Eduardo Vieira, Diniz.

    2003-08-01

    Full Text Available OBJETIVO: analisar a acurácia da hístero-sonografia (HSoG) na avaliação da cavidade uterina nas pacientes que tiveram falha de implantação na primeira tentativa de fertilização in vitro. MÉTODOS: foram analisadas prospectivamente, em estudo duplo-cego, pacientes previamente submetidas à transferênci [...] a de pelo menos um embrião e que apresentaram falha de implantação. As pacientes foram submetidas a HSoG e em seguida a histeroscopia diagnóstica, realizadas por equipes diferentes, não havendo troca de informações sobre os resultados das mesmas. Os resultados foram agrupados e interpretados somente após o término da pesquisa. A HSoG foi realizada após cateterização do colo uterino por sonda uretral nº 8 e injeção de soro fisiológico. A interface anecóica proporcionada pela solução salina permite determinar as anormalidades, tais como pólipos uterinos ou miomas submucosos. A histeroscopia diagnóstica foi realizada com equipamento Karl Storz, óptica rígida de 4 mm a 30°, e distensão da cavidade uterina com soro fisiológico. Não utilizou-se anestesia local nem houve a necessidade de realizar dilatação cervical. RESULTADOS: foram estudadas 28 pacientes das 33 inicialmente selecionadas para o presente estudo. A HSoG diagnosticou anormalidades em 8 pacientes, sendo que em cinco pacientes foram encontrados pólipos endometriais (62,5%), pólipos endocervicais em duas pacientes (25,0%) e mioma submucoso em uma (12,5%). A histeroscopia (padrão-ouro) diagnosticou alterações em 7 pacientes, sendo que em duas pacientes (28,6%) foram encontrados pólipos endometriais, em outras duas pacientes (28,6%) pólipos cervicais e em uma paciente, mioma submucoso (14,2%). A HSoG, quando comparada com a histeroscopia diagnóstica, apresentou sensibilidade de 71,4%, especificidade de 85,7%, valor preditivo positivo de 62,5% e valor preditivo negativo de 90%. CONCLUSÕES: por apresentar valor preditivo positivo baixo, todas as vezes que a HSoG for anormal, sugerimos confirmar o exame pela histeroscopia diagnóstica. Pelo fato de a HSoG apresentar boa especificidade e bom valor preditivo negativo, poderíamos sugerir que diante de HSoG normal não há necessidade de indicação de se avaliar a cavidade uterina pela histeroscopia diagnóstica antes de realizar a fertilização in vitro. Concluímos que a histero-sonografia é bom método para rastreamento de lesões polipóides da cavidade uterina que possam responder pela falha de implantação nas técnicas de fertilização in vitro. Abstract in english PURPOSE: to analyze the accuracy of sonohysterography for the evaluation of the uterine cavity in patients with an implantation failure, at the first attempt of an in vitro fertilization cycle. METHODS: in a prospective double blind study, the authors analyzed patients previously submitted to at lea [...] st one embryo transfer, who presented implantation failures. The patients were submitted to a sonohysterographic examination followed by a diagnostic hysteroscopic examination, carried out by different professionals each of whom was not aware of the results of the other. The results were recorded and only interpreted after the end of the trial. Sonohysterography was performed by the introduction of a urethral catheter 8 into the uterine cervix followed by infusion of physiological saline. The anechoic interface shown by the physiological saline can reveal abnormalities, like uterine polyps or submucosal myomas. Hysteroscopy was performed with a Karl Storz equipment, 4 mm 30º rigid telescope, and infusion of physiological saline for uterine cavity distention. RESULTS: twenty-eight of the 33 originally selected patients for this study were analyzed. Sonohysterography detected abnormalities in 8 patients, five with endometrial polyps (62.5%), two with endocervical polyps (25.0%), and one with submucosal myoma (12.5%). Hysteroscopy (gold standard) detected abnormalities in 7 patients, two with endometrial polyps (28.6%), two with cervical polyps (28.6%) and one with submucosal myoma (

  10. Use of Outpatient Endometrial Biopsy in a Population with Intellectual Disability

    Science.gov (United States)

    Jaffe, Joshua S.

    2008-01-01

    Background: To demonstrate the feasibility of outpatient endometrial sampling to evaluate abnormal uterine bleeding in a population of women with intellectual disability. Method: Retrospective chart review was completed of all endometrial biopsies performed on women attending a dedicated gynaecology clinic for women with intellectual disability…

  11. Pre-cycle saline infusion sonography minimizes assisted reproductive technologies cycle cancellation due to endometrial polyps.

    Science.gov (United States)

    Yauger, Belinda J; Feinberg, Eve C; Levens, Eric D; Gustofson, Robert L; Larsen, Frederick W; DeCherney, Alan H

    2008-10-01

    Pre-ART cycle screening with saline infusion sonohysterography is effective at limiting cycle cancellation caused by endometrial polyps to 0.5%. Although a thickened lining at the time of baseline ultrasound can be indicative of a uterine polyp, a normal endometrial lining does not eliminate the possibility that a polyp will be discovered during the cycle. PMID:18155202

  12. Gestação de termo após ablação endometrial / Full-term pregnancy after endometrial ablation

    Scientific Electronic Library Online (English)

    Rievane S., Damião; Frederico F., Rodrigues; Salete Yatabe José Francisco D., Ramos; Reginaldo G. C., Lopes; Umberto G, Lippi.

    1999-06-01

    Full Text Available A ablação endometrial por via histeroscópica é uma técnica utilizada em casos de sangramento uterino anormal com resposta desfavorável ao tratamento clínico. Mesmo com destruição ou ressecção das camadas funcional e basal do endométrio é possível ocorrer uma gravidez posterior à intervenção. No enta [...] nto essas gestações freqüentemente terminam em abortamento ou se apresentam com complicações. Relata-se o caso de uma paciente que desenvolveu gravidez a termo sem intercorrências após ter realizado ablação endometrial por sangramento uterino anormal resistente ao tratamento clínico. Abstract in english Endometrial ablation is a useful technique in patientes with abnormal uterine bleeding without response to clinical measures. Pregnancy is possible even after the destruction or resection of the endometrium. The case reported is a normal term pregnancy after endometrial ablation because ot menorrhag [...] ia without successful prior clinical treatment.

  13. Hounsfield number measurement after a uterine fibroid embolization: significance as a predictive factor of embolization success

    International Nuclear Information System (INIS)

    To assess the usefulness of the Hounsfield number, measured by a non-contrast enhanced pelvic CT, after a uterine artery embolization as an index of the successful outcome of a uterine fibroid embolization (UFE). The study subjects included 15 women (age range: 28-49 years, mean age: 36.4 years) diagnosed with symptomatic uterine myomas and seen from March 2003 to August 2005. A non-contrast enhanced pelvic CT scan was performed six hours after a uterine artery embolization. The global and maximal CT numbers were measured for each myoma. In addition, a pelvic MRI was performed to measure the volume of each myoma prior to and 6 months after the UFE. The relationship between fibroid volume reduction and the global CT number were prospectively analysed. The mean global CT number was 91.25 HU in Group I and 40.8 HU in Group II. Further, the mean fibroid volume reduction rate was 73% in Group I and 10% in Group II (? < 0.05). The global CT number measured by a non-contrast enhanced pelvic CT is a useful predictive factor of a successful uterine fibroid embolization

  14. Uterine Fibroids

    Science.gov (United States)

    ... Content What are uterine fibroids? Uterine fibroids are growths made of smooth muscle cells and other tissue that develop within the ... Haneke, K., Vahdat, H. L., et al. (2008). Growth of uterine leiomyomata among premenopausal black and white women. Proceedings of the National Academy of Sciences of ...

  15. Superoxide dismutase and lipid hydroperoxides in blood and endometrial tissue of patients with benign, hyperplastic and malignant endometrium

    Directory of Open Access Journals (Sweden)

    Snežana Peji?

    2008-09-01

    Full Text Available Epidemiological and experimental data point to involvement of oxygen derived radicals in the pathogenesis of gynecological disorders, as well as in cancer development. The objective of the present study was to examine changes in activities and levels of copper/zinc superoxide dismutase (CuZnSOD and lipid hydroperoxides (LOOH in blood and endometrial tissue of patients diagnosed with uterine myoma, endometrial polypus, hyperplasia simplex, hyperplasia complex and adenocarcinoma endometrii. The results of our study have shown decreased SOD activities and unchanged SOD protein level in blood of all examined patients in comparison to healthy subjects. Decrease of both SOD activity and level was found in endometrium of patients with hyperplasia simplex, hyperplasia complex and adenocarcinoma in comparison to women with polypus or myoma. LOOH level was elevated in both tissues of patients with hyperplasiaor adenocarcinoma in comparison to healthy subjects or patients with benign diagnosis. Our findings suggest that the decrease in SOD activity and level, as well as the increase in LOOH level, in patients with gynecological disorders, render these patients more susceptible to oxidative damage caused by reactive oxygen species (ROS. An imbalance in ROS formation and SOD level may be important in the pathogenesis and/or perpetuation of tissue damage in gynecological patients. Since evidence suggests that SOD may be a therapy target for cancer treatment, our findings provide a basis for further research and options for clinical applications.Resultados epidemiológicos e experimentais apontam para o envolvimento dos radicais derivados do oxigênio na patogênese das moléstias ginecológicas, assim como no desenvolvimento do câncer. O objetivo do presente estudo foi o de examinar as alterações nas atividades e níveis de Cu/Zn superóxido dismutase (CuZnSOD e hidroperóxidos lipídicos (LOOHno sangue e tecido endometrial de pacientes diagnosticados com mioma uterino, pólipo endometrial, hiperplasia simplex, hiperplasia complex e adenocarcinoma do endométrio. Os resultados de nosso estudo mostraram atividades de SOD diminuídas e nível de SOD proteína inalterado no sangue de todos os pacientes examinados em comparação a indivíduos saudáveis. Diminuição de ambos, atividade de SOD e nível protéico, foram encontrados no endométrio de pacientes com hiperplasia simplex, hiperplasia complex e adenocarcinoma em comparação às mulheres com pólipos e/ou mioma. O nível de LOOH estava elevado em ambos os tecidos de pacientes com hyperplasia e adenocarcinoma em comparação a indivíduos saudáveis ou pacientes com diagnóstico benigno. Nossos resultados sugerem que um decréscimo na atividade e nível protéico de SOD, assim como um incremento no nível de LOOH, em pacientes com desordens ginecológicas, tornam esses pacientes mais susceptíveis ao dano oxidativo causado pelas espécies reativas de oxigênio (ROS. Um desequilíbrio na formação de ROS e no nível de SOD pode ser importante na patogênese e/ou perpetuação do dano tecidual em pacientes ginecológicos. Desde que existe evidência de que SOD pode ser um alvo para terapia de câncer, nossos resultados fornecem uma base para futura pesquisa e opções para aplicações clínicas.

  16. Superoxide dismutase and lipid hydroperoxides in blood and endometrial tissue of patients with benign, hyperplastic and malignant endometrium

    Scientific Electronic Library Online (English)

    Snežana, Peji& #263; ; Ana, Todorovi& #263; ; Vesna, Stojiljkovi& #263; ; Dragana, Cvetkovi& #263; ; Nenad, Lu& #269; i& #263; ; Ratko M., Radoji& #269; i& #263; ; Zorica S., Sai& #269; i& #263; ; Snežana B., Pajovic.

    2008-09-01

    Full Text Available Resultados epidemiológicos e experimentais apontam para o envolvimento dos radicais derivados do oxigênio na patogênese das moléstias ginecológicas, assim como no desenvolvimento do câncer. O objetivo do presente estudo foi o de examinar as alterações nas atividades e níveis de Cu/Zn superóxido dism [...] utase (CuZnSOD) e hidroperóxidos lipídicos (LOOH)no sangue e tecido endometrial de pacientes diagnosticados com mioma uterino, pólipo endometrial, hiperplasia simplex, hiperplasia complex e adenocarcinoma do endométrio. Os resultados de nosso estudo mostraram atividades de SOD diminuídas e nível de SOD proteína inalterado no sangue de todos os pacientes examinados em comparação a indivíduos saudáveis. Diminuição de ambos, atividade de SOD e nível protéico, foram encontrados no endométrio de pacientes com hiperplasia simplex, hiperplasia complex e adenocarcinoma em comparação às mulheres com pólipos e/ou mioma. O nível de LOOH estava elevado em ambos os tecidos de pacientes com hyperplasia e adenocarcinoma em comparação a indivíduos saudáveis ou pacientes com diagnóstico benigno. Nossos resultados sugerem que um decréscimo na atividade e nível protéico de SOD, assim como um incremento no nível de LOOH, em pacientes com desordens ginecológicas, tornam esses pacientes mais susceptíveis ao dano oxidativo causado pelas espécies reativas de oxigênio (ROS). Um desequilíbrio na formação de ROS e no nível de SOD pode ser importante na patogênese e/ou perpetuação do dano tecidual em pacientes ginecológicos. Desde que existe evidência de que SOD pode ser um alvo para terapia de câncer, nossos resultados fornecem uma base para futura pesquisa e opções para aplicações clínicas. Abstract in english Epidemiological and experimental data point to involvement of oxygen derived radicals in the pathogenesis of gynecological disorders, as well as in cancer development. The objective of the present study was to examine changes in activities and levels of copper/zinc superoxide dismutase (CuZnSOD) and [...] lipid hydroperoxides (LOOH) in blood and endometrial tissue of patients diagnosed with uterine myoma, endometrial polypus, hyperplasia simplex, hyperplasia complex and adenocarcinoma endometrii. The results of our study have shown decreased SOD activities and unchanged SOD protein level in blood of all examined patients in comparison to healthy subjects. Decrease of both SOD activity and level was found in endometrium of patients with hyperplasia simplex, hyperplasia complex and adenocarcinoma in comparison to women with polypus or myoma. LOOH level was elevated in both tissues of patients with hyperplasiaor adenocarcinoma in comparison to healthy subjects or patients with benign diagnosis. Our findings suggest that the decrease in SOD activity and level, as well as the increase in LOOH level, in patients with gynecological disorders, render these patients more susceptible to oxidative damage caused by reactive oxygen species (ROS). An imbalance in ROS formation and SOD level may be important in the pathogenesis and/or perpetuation of tissue damage in gynecological patients. Since evidence suggests that SOD may be a therapy target for cancer treatment, our findings provide a basis for further research and options for clinical applications.

  17. Achados histeroscópicos na cavidade endometrial após ablação endometrial / Hysteroscopic appearance of the endometrial cavity after endometrial ablation

    Scientific Electronic Library Online (English)

    Aline Rocha, Guerin; Reginaldo Guedes Coelho, Lopes; Daniella de Batista, Depes; João Alfredo, Martins.

    2014-05-20

    Full Text Available OBJETIVO: Verificar o aspecto da cavidade uterina após a ablação endometrial histeroscópica, a prevalência de sinéquias após o procedimento e, com isso, avaliar a importância da histeroscopia realizada no pós-operatório dessas pacientes. MÉTODOS: Foram avaliados, retrospectivamente, os laudos [...] dos exames de 153 pacientes que haviam sido submetidas à histeroscopia ambulatorial após ablação do endométrio devido a sangramento uterino anormal de causa benigna, no período entre janeiro de 2006 e julho de 2011. As pacientes foram divididas em dois grupos: HIST?60 (n=90), com pacientes submetidas ao exame no período de 40 a 60 dias após o procedimento, e grupo HIST>60 (n=63), das que foram examinadas entre 61 dias e 12 meses. RESULTADOS: No grupo HIST?60, 30% das pacientes apresentavam algum grau de sinéquia; aderências grau I foram descritas em 4,4%; grau II em 6,7%; grau IIa em 4,4%; grau III em 7,8%; e 2,2% apresentavam grau IV. No HIST>60, sinéquias foram descritas em 53,9% dos casos, 3,2% tinham sinéquias grau I; 11,1%, grau II; 7,9%, grau IIa; 15,9%, grau III; e 4,8%, grau IV. Hematometra foi descrito em 2,2% dos casos do HIST?60 e em 6,3% no HIST>60. CONCLUSÕES: A cavidade uterina de pacientes submetidas à histeroscopia ambulatorial até 60 dias após a ablação endometrial mostrou menor número de sinéquias quando comparada com as cavidades uterinas de pacientes que foram submetidas ao exame após 60 dias. Acompanhamento em longo prazo é necessário para avaliar plenamente o impacto da histeroscopia ambulatorial após a ablação endometrial. Abstract in english PURPOSE: To examine the aspect of the uterine cavity after hysteroscopic endometrial ablation, to determine the prevalence of synechiae after the procedure, and to analyze the importance of hysteroscopy during the postoperative period. METHODS: The results of the hysteroscopic exams of 153 pat [...] ients who underwent outpatient hysteroscopy after endometrial ablation due to abnormal uterine bleeding of benign etiology during the period from January 2006 to July 2011 were retrospectively reviewed. The patients were divided into two groups: HIST?60 (n=90) consisting of patients undergoing the exam 40-60 days after the ablation procedure, and the group HIST>60 (n=63) consisting of patients undergoing the exam between 61 days and 12 months after the procedure. RESULTS: In the HIST?60 group, 30% of the patients presented some degree of synechiae: synechiae grade I in 4.4% of patients, grade II in 6.7% , grade IIa in 4.4%, grade III in 7.8%, and grade IV in 2.2%. In the HIST>60 group, 53.9% of all cases had synechiae, 3.2% were grade I, 11.1% grade II, 7.9% grade IIa, 15.9% grade III, and 4.8% grade IV. Hematometra was detected in 2.2 % of all cases in group HIST?60 and in 6.3% of all cases in group HIST>60. CONCLUSIONS: The uterine cavity of the patients submitted to diagnostic hysteroscopy up to 60 days after endometrial ablation showed significantly fewer synechiae compared to the uterine cavity of patients who underwent the exam after 60 days. Long-term follow-up is necessary to fully evaluate the importance of outpatient hysteroscopy after endometrial ablation regarding menstrual patterns, risk of cancer and prevalence of treatment failure.

  18. Endometrial cancer. Prevention, detection, management, and follow up.

    OpenAIRE

    Elit, L.

    2000-01-01

    OBJECTIVE: To review risk factors for uterine cancer; to discuss strategies for detecting uterine cancer; to outline prognostic factors and treatment; and to review the role of follow up for patients who have completed primary therapy. QUALITY OF EVIDENCE: MEDLINE was searched from January 1996 to June 1998 using the terms endometrial neoplasms, estrogen replacement therapy, hormone replacement therapy, tamoxifen, and screening. Only English language articles were reviewed. Study types includ...

  19. Technetium-99m-HEDP concentration in calcified myoma

    International Nuclear Information System (INIS)

    This case emphasizes once more the need to interpret data in the clinical context, and it describes for the first time a concentration of /sup 99m/Tc-labeled HEDP in a calcified myoma of the uterus. Soft-tissue concentration of labeled phosphates should always be kept in mind when interpreting whole-body bone scans

  20. Biomarkers as prognostic factors in endometrial cancer.

    OpenAIRE

    Terlikowski, S?awomir J.; Bo?ena Dobrzycka

    2010-01-01

    Endometrial cancer is the most common gynecologic malignancy in more developed countries. Approximately 75% of cases are diagnosed at an early stage with a tumor confined to the uterine corpus. Although most patients are cured by surgery alone, about 15-20% with no signs of locally advanced or metastatic disease at primary treatment recurs, with limited responsiveness to systemic therapy. The most common basis for determining the risk of recurrent disease has been classification of endometria...

  1. Biomarkers as prognostic factors in endometrial cancer.

    Directory of Open Access Journals (Sweden)

    S?awomir J Terlikowski

    2010-11-01

    Full Text Available Endometrial cancer is the most common gynecologic malignancy in more developed countries. Approximately 75% of cases are diagnosed at an early stage with a tumor confined to the uterine corpus. Although most patients are cured by surgery alone, about 15-20% with no signs of locally advanced or metastatic disease at primary treatment recurs, with limited responsiveness to systemic therapy. The most common basis for determining the risk of recurrent disease has been classification of endometrial cancers into two subtypes. Type I, associated with a good prognosis and endometrioid histology and type II, associated with a poor prognosis and non-endometrioid histology. This review will focus primarily on the molecular biomarkers that have supported the dualistic model of endometrial carcinoma and help determine which patients would benefit from either adjuvant therapy or more aggressive primary treatment.

  2. Re-intervention after uterine leiomyoma embolisation is related to incomplete infarction and presence of submucous leiomyomas.

    DEFF Research Database (Denmark)

    Dueholm, Margit; Langfeldt, Sten

    2014-01-01

    Objective To evaluate outcome of invasive gynecological re-interventions after uterine artery embolisation (UAE) in relation to leiomyoma characteristics. Design A cohort of 114 women with symptomatic myomas underwent UAE. Myoma characteristics were determined by contrast-enhanced magnetic resonance imaging (MRI) before and 6 months after treatment. The median follow-up time after UAE was 55.9 months; (range 20–116). Data on gynecological re-interventions were obtained for all patients and were analysed using the Kaplan–Meier method. Data were obtained on frequency of invasive re-interventions: major myoma procedures (hysterectomy, re-embolisation, laparoscopic or abdominal myomectomy) and outpatient hysteroscopic myoma procedures. Myoma characteristics with impact on outcome of re-interventions were determined by statistical analysis. Results Total re-intervention rate was 35.1%. Hysterectomy was performed due to myoma related symptoms in 6.1% of patients, but 23.7% of patients underwent additional uterineprocedures, mainly outpatient hysteroscopy (15%). Major myoma re-intervention correlated with the extent of the infarct at follow-up MRI (n = 107). Patients had undergone major re-intervention (3 years) as follows: infarct group C (<80%, n = 16) 44%, infarct group B (80–99%, n = 16) 19%, and infarct group A (100%, n = 75) 10.1% ((p < 0.01) for both A vs B + C and A + B vs C). Major re-interventions were not associated with the presence of submucous myomas; but the hazard ratio (CI 95%) for undergoing hysteroscopic re-intervention was 8.4 (2–29) (p = 0.001) in patients with submucous myomas, but 12.7 (5–35) (p < 0.0001) in patients with more than one submucous myomas. Conclusions Complete infarction after UAE reduces the need for major re-interventions. Assessment of complete infarction may be considered to improve quality in UAE procedures. Patients with more than one submucous myoma at UAE may often have hysteroscopic removal of residual myomas.

  3. Uterine peristalsis-induced stresses within the uterine wall may sprout adenomyosis.

    Science.gov (United States)

    Shaked, Sivan; Jaffa, Ariel J; Grisaru, Dan; Elad, David

    2015-06-01

    Adenomyosis is a disease in which ectopic endometrial glands and stromal cells appear in the uterine myometrium. This pathology is common among women of reproductive age, and in addition to chronic pelvic pain and heavy periods it may also cause infertility. The 'tissue injury and repair' mechanism in response to increased intrauterine pressures was proposed as the etiology for migration of fragments of basal endometrium into the myometrial wall. In order to investigate this mechanism, a conceptual two-dimensional model of the uterine wall subjected to intrauterine pressures was implemented using ADINA commercial software. The stress field within the uterine wall was examined for a variety of intrauterine sinusoidal pressure waves with varying frequencies. The results revealed that: (1) as the wavelength of the subjected pressure wave decreased, high concentration of stresses developed near the inner uterine cavity; (2) as the pressure wave frequency increased, high gradients of the stresses were obtained; (3) at menstrual phase, the highest stresses obtained at the endometrial-myometrial interface. Therefore, increased uterine activity results in high stresses which may lead to tissue lesions and detachment of endometrial cells. PMID:25217062

  4. Investigation of amyloid deposition in uterine leiomyoma patients

    Directory of Open Access Journals (Sweden)

    Jinping Liu

    2012-08-01

    Full Text Available Objects: To investigate the pathogenesis of amyloid presented in uterine leiomyoma. Methods: 36 uterine leiomyoma patients were recruited and divided into two groups according to Congo red staining results. 6 cases are Congo red staining-positive, and 30 cases Congo red staining-negative which represented amyloid positive and amyloid negative respectively. All patients’ serum total protein (TP, albumin (Alb and prealbumin (PA levels were measured as well as blood hemoglobin (Hb, cell counts of white blood cell (WBC, neutrophils (NEU and lymphocyte (LYM. Glycogen in tissue was compared between amyloid accumulated and amyloid negative sections with periodic acid schiff staining (PAS in leiomyoma patients. Results: All of blood Hb concentration, WBC, NEU and LYM have not been found significant differences between two groups. Also no obvious infiltration of inflammatory cells was observed in tissue with amyloid deposition in uterine leiomyoma patients. And levels of TP, Alb and prealbumin have not been found significant differences between two groups. The amyloid was negative in leiomyoma entity cells range by Congo red staining, while small blood vessels in myoma tissues were positively detected with high rate. Amyloid was found in normal tissue around myoma as well as in blood vessel of pseudo-capsule. Increased PAS-positive material induced by leiomyoma was not correlated with amyloid deposition. Conclusions: Metabolic changes in the setting of functional alterations of cell in local microenvironment with uterine leiomyoma, may be related to the amyloid deposition.

  5. Uterine Sarcoidosis: A Rare Extrapulmonary Site of Sarcoidosis

    OpenAIRE

    Marak, Creticus P.; Narendrakumar Alappan; Amit Chopra; Olena Dorokhova; Sumita Sinha; Guddati, Achuta K

    2013-01-01

    Sarcoidosis is a multisystem disease which is most commonly manifested in the pulmonary system. However, extrapulmonary manifestations have also been frequently reported. Isolated occurrence of sarcoidosis in the genital system is rare and poses a diagnostic and therapeutic dilemma. Uterine sarcoidosis can present with cervical erosions, endometrial polypoid lesions, and recurrent serometra. In majority of cases, it is diagnosed by endometrial curettage, but it has also been detected by exami...

  6. Endometrial Ablation

    OpenAIRE

    Hadibroto, Budi R.

    1990-01-01

    Sekitar 9 – 30% wanita usia reproduksi mengalami ketidak-teraturan haid dan 25 – 50% dilakukan prosedur bedah ginekologi untuk penanganan disfungsi haid. Ablasi endometrium merupakan salah satu prosedur untuk penanganan perdarahan uterus yang abnormal. Dengan perkembangan alat-alat bedah untuk ablasi. DeCherney pertama sekali melakukan reseksi endometrial menggunakan kauterisasi monopolar. Saat ini dengan semakin berkembangnya histeroskopi, digunakan alat seperti rollerball ukuran 3 mm un...

  7. Histopathological study of endometrium in cases of abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Saroj A. Bolde

    2014-08-01

    Full Text Available Background: Abnormal uterine bleeding is one of the commonest complaints in women and when it occurs without organic lesions like tumor, inflammation, it is called as dysfunctional uterine bleeding. Aim of current study was to find out the histopathological pattern of endometrium in Abnormal Uterine Bleeding (AUB also to study organic causes of AUB. Methods: Specimens received as endometrial curettage and hysterectomy specimens were studied followed by correlation of histopathology with age and clinical presentation. Results: The patients were mainly from the age group of 30-49 years (74.24%. The most common menstrual disorder was menorrhagia (46.86%. In dysfunctional uterine bleeding the most common histological pattern of endometrium includes proliferative endometrium (22.8% followed by endometrial hyperplasia (19.40%, atrophic endometrium (7.16%, secretory endometrium (5.97%, irregular shedding [1.80%], irregular ripening (1.20% and anovulatory endometrium (0.59%. Organic lesions encountered in AUB cases were leiomyoma (17.92%, endometrial polyp (1.79%, endometrial carcinoma (1.50%, endometriosis (0.59% and choriocarcinoma (0.29%. Conclusion: It is important to know the histological pattern of the endometrium like proliferative endometrium, endometrial hyperplasia, atrophic endometrium, secretory endometrium, irregular ripening and shredding and organic lesions in patients diagnosed as AUB in different age groups since recognition of these conditions will help and will avoid further complications. [Int J Res Med Sci 2014; 2(4.000: 1378-1381

  8. Effects of operative hysteroscopy with anti-adhesive solution in the patients who have abnormal uterine bleeding or intrauterine lesions

    OpenAIRE

    Junsik Park; Soo-Ho Chung; Hae-Hyeog Lee; Tae-Hee Kim

    2013-01-01

    Objective: The purpose of this study was to evaluate the efficacy, safety, and benefits of hysteroscopic surgery in the treatment of dysfunctional uterine bleeding (DUB) or intrauterine lesions causing uterine bleeding. Methods: This study prospectively enrolled 100 patients who underwent operative hysteroscopy in tertiary referral university center because of uterine bleeding due to endometrial polyps or uterine submucosal leiomyomas diagnosed by transvaginal ultrasonogram. Indications for ...

  9. Pólipos endometriais / Endometrial polyps

    Scientific Electronic Library Online (English)

    Antonio Alberto, Nogueira.

    2005-05-01

    Full Text Available Os pólipos endometriais são lesões benignas, com baixo potencial de malignização. No período reprodutivo seu diagnóstico é obtido nas pacientes sintomáticas, com sangramento uterino anormal ou infertilidade. Na pós-menopausa em sua maioria são assintomáticos, podendo estar associados a sangramento a [...] normal em torno de um terço dos casos. São mais freqüentes na pós-menopausa e os fatores de risco para câncer de endométrio não têm sido associados da mesma maneira, como de risco para pólipos endometriais, embora sejam hormônio-dependentes, como nas pacientes usuárias do tamoxifeno, por exemplo. Seu diagnóstico definitivo é realizado pelo exame histológico com amostra obtida de maneira mais eficiente por biópsia dirigida por meio da histeroscopia, assim como seu tratamento mais efetivo é a ressecção histeroscópica. Pólipos podem apresentar recorrência após tratamento. A polipectomia é altamente satisfatória na pós-menopausa, tem menor taxa de sucesso em mulheres sintomáticas no período reprodutivo e melhora as taxas de fertilidade em mulheres inférteis. Abstract in english Endometrial polyps are benign lesions, with a low potential of malignancy. In the reproductive period their diagnosis is established in symptomatic patients with abnormal uterine bleeding or infertility. Postmenopausal women are mostly asymptomatic but in approximately one third of the cases there i [...] s an association with abnormal bleeding. They are more frequent after the menopause and risk factors of cancer of the endometrium have not been associated in the same way as risk for endometrial polyps, although they are hormone-dependent as in patients in use of tamoxifen, for instance. Their definitive diagnosis is established by hysteroscopy-guided biopsy and their most effective treatment is hysteroscopic resection. Polyps may recur after treatment. Polypectomy is highly satisfactory after the menopause, is less successful in symptomatic women in the reproductive period and improves fertility rates in infertile women.

  10. Pólipos endometriais Endometrial polyps

    Directory of Open Access Journals (Sweden)

    Antonio Alberto Nogueira

    2005-05-01

    Full Text Available Os pólipos endometriais são lesões benignas, com baixo potencial de malignização. No período reprodutivo seu diagnóstico é obtido nas pacientes sintomáticas, com sangramento uterino anormal ou infertilidade. Na pós-menopausa em sua maioria são assintomáticos, podendo estar associados a sangramento anormal em torno de um terço dos casos. São mais freqüentes na pós-menopausa e os fatores de risco para câncer de endométrio não têm sido associados da mesma maneira, como de risco para pólipos endometriais, embora sejam hormônio-dependentes, como nas pacientes usuárias do tamoxifeno, por exemplo. Seu diagnóstico definitivo é realizado pelo exame histológico com amostra obtida de maneira mais eficiente por biópsia dirigida por meio da histeroscopia, assim como seu tratamento mais efetivo é a ressecção histeroscópica. Pólipos podem apresentar recorrência após tratamento. A polipectomia é altamente satisfatória na pós-menopausa, tem menor taxa de sucesso em mulheres sintomáticas no período reprodutivo e melhora as taxas de fertilidade em mulheres inférteis.Endometrial polyps are benign lesions, with a low potential of malignancy. In the reproductive period their diagnosis is established in symptomatic patients with abnormal uterine bleeding or infertility. Postmenopausal women are mostly asymptomatic but in approximately one third of the cases there is an association with abnormal bleeding. They are more frequent after the menopause and risk factors of cancer of the endometrium have not been associated in the same way as risk for endometrial polyps, although they are hormone-dependent as in patients in use of tamoxifen, for instance. Their definitive diagnosis is established by hysteroscopy-guided biopsy and their most effective treatment is hysteroscopic resection. Polyps may recur after treatment. Polypectomy is highly satisfactory after the menopause, is less successful in symptomatic women in the reproductive period and improves fertility rates in infertile women.

  11. Endometrial aspiration biopsy: a non-invasive method of obtaining functional lymphoid progenitor cells and mature natural killer cells.

    LENUS (Irish Health Repository)

    McMenamin, Moya

    2012-09-01

    The aim of this study was to compare the efficacy of endometrial aspiration biopsy (EAB) with the more traditional dilatation and curettage (D&C) for the procurement of lymphoid progenitor cells and uterine natural killer (NK) populations in endometrial tissue. This prospective observational study conducted in a tertiary referral university hospital examined endometrium obtained from 32 women admitted for laparoscopic gynaecological procedures. Each participant had endometrium sampled using both EAB and D&C. Both methods were assessed as a source of uterine NK and lymphoid progenitor cells. Similar proportions of mature CD45+CD56+ NK cells (range 25.4-36.2%) and CD45+CD34+ lymphoid progenitors (range 1.2-2.0%) were found in tissue obtained using both EAB and D&C. These cells were adequate for flow cytometric analysis, magnetic bead separation and culture. Colony formation by the CD34+ population demonstrated maturational potential. Tissues obtained via endometrial biopsy and D&C are equivalent, by analysis of uterine NK and lymphoid progenitor cells. The aim of this study was to compare two methods of endometrial sampling - endometrial aspiration biopsy and traditional dilatation and curettage - for the procurement of haematopoietic stem cells and uterine natural killer (NK) populations in endometrial tissue. Thirty-two women who had gynaecological procedures in a tertiary referral hospital participated in this study and had endometrial tissue collected via both methods. Similar populations of mature NK cells and haematopoietic stem cells were found in tissue obtained using both endometrial aspiration biopsy and dilatation and curettage. Tissue obtained via endometrial aspiration biopsy was adequate for the culture and growth of haematopoietic stem cells. We conclude that tissue obtained via endometrial biopsy and dilatation and curettage is equivalent, by analysis of uterine NK and haematopoietic stem cells using flow cytometry. This has implications for further more extensive study of endometrial haematopoietic stem cell populations, as these samples can be collected in a clinical setting without a requirement for general anaesthesia.

  12. Uterine morphology and peristalsis in women with polycystic ovary syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Leonhardt, Henrik; Hellstroem, Mikael [Department of Radiology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden)], E-mail: henrik.leonhardt@vgregion.se; Gull, Berit; Nilsson, Lars; Janson, Per O. [Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Kishimoto, Keiko [Department of Radiology, St Marianna University School of Medicine, Kanagawa (Japan); Kataoka, Masako [Department of Radiology, Kyoto University Hospital, Kyoto (Japan); Stener-Victorin, Elisabet [Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg (Sweden)

    2012-12-15

    Background. Polycystic ovary syndrome (PCOS) is associated with chronic oligo-anovulation and high circulating sex hormone levels. Women with PCOS have an increased risk of developing endometrial cancer. In anovulatory women with PCOS a positive relationship between endometrial thickness and endometrial hyperplasia has been observed. Uterine peristalsis, which has been suggested to be of importance for female fertility, has not previously been studied in PCOS. Purpose. To assess whether women with PCOS have altered endometrial thickness, uterine wall morphology, and peristalsis. Material and Methods. In this prospective case-control study 55 women with PCOS (mean age, 29.5 years {+-} 4.5 SD) and 28 controls (27.6 {+-} 3.2) were examined using magnetic resonance imaging (MRI), assessing thickness of endometrium, junctional zone (JZ), and myometrium, and evaluating the occurrence, frequency (waves/min), strength (amplitude), pattern, and direction of peristalsis. Uterine morphology was also assessed by transvaginal ultrasonography (TVUS). Results. The endometrium was thinner in PCOS with oligo-amenorrhea compared to controls, also after adjustments for age and BMI (adjusted P = 0.043). There was no difference in thickness of the JZ or the myometrium in cases versus controls. Uterine peristalsis was less commonly observed in women with PCOS than in controls (adjusted P = 0.014). Conclusion. There were no differences in myometrial morphology between PCOS and controls, but the endometrium was thinner in PCOS with oligo-amenorrhea. Based on cine MRI, uterine peristalsis was less common in PCOS than in controls.

  13. The prognostic role of matrix metalloproteinase-2 and -9 and their tissue inhibitor-1 and -2 in endometrial carcinoma

    OpenAIRE

    Honkavuori-toivola, Maria

    2014-01-01

    Abstract Endometrial carcinoma is the most common gynegologic malignancy in developed countries. Due to early symptoms, including abnormal uterine bleeding, endometrial cancer is often diagnosed at an early stage and in that case usually has a good prognosis and high cure rates. However, the nature of the disease is heterogeneous. During the last decades, the improvement in survival rates among endometrial cancer patients has not been significant, suggesting that the traditional clinic...

  14. Abnormal uterine bleeding in reproductive-aged women.

    Science.gov (United States)

    Matthews, Michelle L

    2015-03-01

    Abnormal uterine bleeding is a common medical condition with several causes. The International Federation of Gynecology and Obstetrics published guidelines in 2011 to develop universally accepted nomenclature and a classification system. In addition, the American College of Obstetrics and Gynecology recently updated recommendations on evaluation of abnormal uterine bleeding and indications for endometrial biopsies. This article reviews both medical and surgical treatments, including meta-analysis reviews of the most effective treatment options. PMID:25681843

  15. Pathology of endometrial ablation failures: a clinicopathologic study of 164 cases.

    Science.gov (United States)

    Simon, Rochelle A; Quddus, M Ruhul; Lawrence, W Dwayne; Sung, C James

    2015-05-01

    Endometrial ablation is a minimally invasive alternative to hysterectomy for abnormal uterine bleeding. Although the failure rate is low, continued bleeding or development of pelvic pain after ablation does occur. We analyzed the clinicopathologic features of 164 hysterectomy specimens after endometrial ablation, 19 of which were performed for indications other than failed ablation (control cases). Pathologic findings included: dense fibrosis and hyalinization of the endometrial surface ablative necrosis within the uterine cavity and adherent to the endometrial surface, persistent months after ablation; uterine cavity lined by superficial, large, congested, patent blood vessels with atherosis; ablation changes present only in the lower uterine segment; and residual endometrium present in the cornual regions. Patients with ablative necrosis underwent subsequent hysterectomy sooner than those without such debris (median of 5 vs. 23 mo, respectively). Patients with superficial abnormal vessels were also more likely to have a shorter ablation-hysterectomy interval than those without (median of 2 vs. 18 mo, respectively). Patients with associated adenomyosis or prior tubal ligation were significantly more likely to have continued bleeding. Possible sources of continued abnormal bleeding or pelvic pain include: the presence of ablative necrosis or superficial abnormal blood vessels, although the association did not reach statistical significance in this study; incomplete ablation, affecting only the lower uterine segment or sparing the cornual region; tubal endometriosis after ligation; and endometrial regeneration via adenomyosis. PMID:25760902

  16. Abnormal uterine bleeding: a clinicohistopathological analysis

    Directory of Open Access Journals (Sweden)

    Anupamasuresh Y

    2014-06-01

    Methods: In our prospective study of 359 Patients of the age between 46 and 73 years, clinical characteristics and the pattern of endometrial histopathology and their association in women, who present with abnormal uterine bleeding, are categorised into six groups. Results: In our study, a significant correlation of histopathology and BMI was observed with endometrial hyperplasia and malignancy in obese patient i.e. 37 out 96 and 13 out of 23 respectively. The incidence of malignancy has been increasing with the age being 1.6% in 46-50 years to 60% in 70-75 years. In our study 116 (32.3% had hypertension, 33 patients (9.2% had diabetes mellitus, 40 patients (11.1% had hypothyroidism. Conclusions: We found a maximum incidence of AUB in multiparous women. Clinicohistopathological analysis of AUB revealed endometrial hyperplasia in majority of patients. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 656-661

  17. Uterine Fibroids

    Science.gov (United States)

    Uterine fibroids are the most common benign tumors in women of childbearing age. Fibroids are made of muscle cells and other tissues ... of the uterus, or womb. The cause of fibroids is unknown. Risk factors include being African American ...

  18. Uterine Fibroids Fact Sheet

    Science.gov (United States)

    ... Our ePublications > Uterine fibroids fact sheet ePublications Uterine fibroids fact sheet Print this fact sheet Uterine fibroids ... fibroids? More information on uterine fibroids What are fibroids? Fibroids are muscular tumors that grow in the ...

  19. Primary uterine osteosarcoma presenting synchronously with bilateral breast carcinomas.

    Science.gov (United States)

    Powell, George; Barth, Laura; Todd, Richard; Ganesan, Raji

    2014-01-01

    Primary uterine sarcomas are infrequent neoplasms and most commonly leiomyosarcomas or endometrial stromal sarcomas. We report a rare case of primary uterine osteosarcoma discovered in a woman in her 60s following staging CT imaging for bilateral breast carcinomas. Examination of the subsequent hysterectomy specimen showed a tumour composed of malignant spindle cells and osteoclast-like giant cells associated with osteoid and neoplastic bone, in keeping with primary uterine osteosarcoma. Distinction of osteosarcoma from the more common carcinosarcoma is important due to the worse prognosis impacting on treatment decisions. In addition, synchronous presentation of this unusual tumour with bilateral breast carcinomas raises the possibility of a mutual genetic pathogenesis. PMID:24898994

  20. Endometrial cancer

    International Nuclear Information System (INIS)

    Endometrial cancers are frequent and affect mainly postmenopausal women. They are mostly diagnosed at an early stage with an excellent prognosis. Surgery is the reference for a precise FIGO staging who guide adjuvant treatment. Tumor extension, grade, myometrium invasion and involved lymph nodes will be discriminating in therapeutic strategy. The management of stages I and II has been recently amended by ESMO, who proposed surveillance, brachytherapy, and radiation therapy followed by brachytherapy for respectively low, intermediate and high risk groups. These recommendations are controversial and must be confirmed. Locally advanced stages represent a heterogeneous population in which surgery should be proposed if it is feasible then followed by radiotherapy and/or chemotherapy. Based on an illustrated clinical case, indications, delineation, dosimetry and complications expected with radiotherapy are demonstrated. (authors)

  1. Significance of negative hysteroscopic view in abnormal uterine bleeding.

    OpenAIRE

    Parasnis H; Parulekar S

    1992-01-01

    Ninety six cases of abnormal uterine bleeding were evaluated by both panoramic hysteroscopy and dilatation and curettage. The indications for hysteroscopy included postmenopausal bleeding, infertility with abnormal bleeding, abnormal bleeding and suspected leiomyoma with bleeding. Twenty three patients had abnormal hysteroscopy findings. Hysteroscopy diagnosed endometrial polyp and submucus leiomyoma with 100% accuracy. In 17 cases, the results of hysteroscopy and curettage were in agr...

  2. Surgical Methods for the Treatment of Uterine Fibroids – Risk of Uterine Sarcoma and Problems of Morcellation: Position Paper of the DGGG

    Science.gov (United States)

    Beckmann, M. W.; Juhasz-Böss, I.; Denschlag, D.; Gaß, P.; Dimpfl, T.; Harter, P.; Mallmann, P.; Renner, S. P.; Rimbach, S.; Runnebaum, I.; Untch, M.; Brucker, S. Y.; Wallwiener, D.

    2015-01-01

    The appropriate surgical technique to treat patients with uterine fibroids is still a matter of debate as is the potential risk of incorrect treatment if histological examination detects a uterine sarcoma instead of uterine fibroids. The published epidemiology for uterine sarcoma is set against the incidence of accidental findings during surgery for uterine fibroids. International comments on this topic are discussed and are incorporated into the assessment by the German Society for Gynecology and Obstetrics (DGGG). The ICD-O-3 version of 2003 was used for the anatomical and topographical coding of uterine sarcomas, and the “Operations- und Prozedurenschlüssel” (OPS) 2014, the German standard for process codes and interventions, was used to determine surgical extirpation methods. Categorical qualifiers were defined to analyze the data provided by the Robert Koch Institute (RKI), the German Federal Bureau of Statistics (DESTATIS; Hospital and Causes of Death Statistics), the population-based Cancer Register of Bavaria. A systematic search was done of the MEDLINE database and the Cochrane collaboration, covering the period from 1966 until November 2014. The incidence of uterine sarcoma and uterine fibroids in uterine surgery was compared to the literature and with the different registries. The incidence of uterine sarcoma in 2010, standardized for age, was 1.53 for Bavaria, or 1.30 for every 100?000 women, respectively, averaged for the years 2002–2011, and 1.30 for every 100?000 women in Germany. The mean incidence collated from various surveys was 2.02 for every 100?000 women (0.35–7.02; standard deviation 2.01). The numbers of inpatient surgical procedures such as myoma enucleation, morcellation, hysterectomy or cervical stump removal to treat the indication “uterine myoma” have steadily declined in Germany across all age groups (an absolute decrease of 17?% in 2012 compared to 2007). There has been a shift in the preferred method of surgical access from an abdominal/vaginal approach to endoscopic or endoscopically assisted procedures to treat uterine fibroids, with the use of morcellation increasing by almost 11?000 coded procedures in 2012. Based on international statements (AAGL, ACOG, ESGE, FDA, SGO) on the risk of uterine sarcoma as an coincidental finding during uterine fibroid surgery and the associated risk of a deterioration of prognosis (in the case of morcellation procedures), this overview presents the opinion of the DGGG in the form of four Statements, five Recommendation and four Demands. PMID:25797958

  3. Miomatosis uterina gigante Giant uterine myomatosis

    Directory of Open Access Journals (Sweden)

    Miguel Sarduy Nápoles

    2009-09-01

    Full Text Available El gran tamaño de algunos tumores ha sido descrito con asombro a través del tiempo. Entre ellos se incluyen los ginecológicos, sobre los cuales se describen casos de crecimiento descomunal, e incluyen los uterinos u ováricos. El caso de mayor tamaño fue descrito por Hunt en 1888 como hallazgo en una necropsia, con el "asombroso" peso de 63,5 kg. La terminología de estos tumores de gran tamaño contiene calificativos muy variados y confusos, entre los cuales se incluyen "inmensos", "enormes" "extensos", "voluminosos", "masivos", "grandes", "muy grandes", "gigantes", "gigantescos". Beacham y otros, en 1971 definieron como "gigantes" a los tumores uterinos u ováricos con peso superior a 25 lbs (11,3 kg. Briceño-Pérez y otros en el año 2001 propusieron utilizar el término de "grandes miomas uterinos" (GMU para aquellos con peso entre 0,8 Kg (peso límite aproximado para decidir la vía quirúrgica abdominal o vaginal y 11,3 Kg (peso límite establecido por Beacham y colaboradores para los miomas uterinos gigantes. El caso que se presenta fue operado el día 20 de enero de 2009 en el Centro de Investigaciones Médico Quirúrgicas, al cual se le realizó histerectomía total con el diagnóstico de miomatosis gigante del útero cuyo peso fue de 11,31 kg. Se hacen recomendaciones para el manejo quirúrgico de las pacientes con tumores ginecológicos gigantes.The large size of some tumors has been described with surprise over the time. Among them are included the gynecologic ones, on which are presented cases of an enormous growth and the uterine and ovarian types are also included. The largest size of a tumor was described by Hunt in 1888 as a necropsy finding, which weighing 63,5 kg. Terminology of these large size tumors include very varied and confused epithets: "inmenses", "huges", "extensive", "bulkies", "mass", "larges", "very larges", "giants" , and "gigantics". Beachman et al, in 1971 defined as "giants" the uterine or ovarian tumors weighing more than 25 pounds (11,3 kg. Briceño-Pérez et al in 2001 proposed the use of the term "large uterine myomas" (LUM for those weighing between 0,8 kg (limit weight established by Beacham et al for the giant uterine myomas. Present case was operated on in January 20, 2009 in Medical and Surgical Researches Center, performing a total hysterectomy diagnosed with uterine giant myomatosis weighing 11,31 kg. Authors made recommendations on surgical management of patients presenting giant gynecological tumors.

  4. Miomatosis uterina gigante / Giant uterine myomatosis

    Scientific Electronic Library Online (English)

    Miguel, Sarduy Nápoles; Raúl, Vasallo Prieto; Simeón, Collera; Ysis M., Martínez Chang; Jorge Miguel, Correa Padilla; Javier, Rivero Ojeda; Joel, Frigola Cartaya; Carlos, Alfonso Sabatier.

    2009-09-01

    Full Text Available El gran tamaño de algunos tumores ha sido descrito con asombro a través del tiempo. Entre ellos se incluyen los ginecológicos, sobre los cuales se describen casos de crecimiento descomunal, e incluyen los uterinos u ováricos. El caso de mayor tamaño fue descrito por Hunt en 1888 como hallazgo en una [...] necropsia, con el "asombroso" peso de 63,5 kg. La terminología de estos tumores de gran tamaño contiene calificativos muy variados y confusos, entre los cuales se incluyen "inmensos", "enormes" "extensos", "voluminosos", "masivos", "grandes", "muy grandes", "gigantes", "gigantescos". Beacham y otros, en 1971 definieron como "gigantes" a los tumores uterinos u ováricos con peso superior a 25 lbs (11,3 kg). Briceño-Pérez y otros en el año 2001 propusieron utilizar el término de "grandes miomas uterinos" (GMU) para aquellos con peso entre 0,8 Kg (peso límite aproximado para decidir la vía quirúrgica abdominal o vaginal) y 11,3 Kg (peso límite establecido por Beacham y colaboradores para los miomas uterinos gigantes). El caso que se presenta fue operado el día 20 de enero de 2009 en el Centro de Investigaciones Médico Quirúrgicas, al cual se le realizó histerectomía total con el diagnóstico de miomatosis gigante del útero cuyo peso fue de 11,31 kg. Se hacen recomendaciones para el manejo quirúrgico de las pacientes con tumores ginecológicos gigantes. Abstract in english The large size of some tumors has been described with surprise over the time. Among them are included the gynecologic ones, on which are presented cases of an enormous growth and the uterine and ovarian types are also included. The largest size of a tumor was described by Hunt in 1888 as a necropsy [...] finding, which weighing 63,5 kg. Terminology of these large size tumors include very varied and confused epithets: "inmenses", "huges", "extensive", "bulkies", "mass", "larges", "very larges", "giants" , and "gigantics". Beachman et al, in 1971 defined as "giants" the uterine or ovarian tumors weighing more than 25 pounds (11,3 kg). Briceño-Pérez et al in 2001 proposed the use of the term "large uterine myomas" (LUM) for those weighing between 0,8 kg (limit weight established by Beacham et al for the giant uterine myomas). Present case was operated on in January 20, 2009 in Medical and Surgical Researches Center, performing a total hysterectomy diagnosed with uterine giant myomatosis weighing 11,31 kg. Authors made recommendations on surgical management of patients presenting giant gynecological tumors.

  5. Endometrial cytology and computerized morphometric analysis of epithelial nuclei: a useful tool for reproductive diagnosis in the bitch.

    Science.gov (United States)

    Groppetti, D; Pecile, A; Arrighi, S; Di Giancamillo, A; Cremonesi, F

    2010-04-15

    New diagnostic approaches are required to recognize early canine hypofertility or infertility. We suggest that the identification of different cytologic types, cellular aspects, and nuclear features of the endometrial epithelial cells may be suitable for this purpose. This study was performed on the bitch (Canis familiaris) during the physiologic reproductive cycle and in uterine diseases. We also applied computerized cytomorphometry to evaluate nuclear area, perimeter, diameter, density, aspect, and roundness of endometrial epithelial cells in healthy dogs (N=35) at different stages of the reproductive cycle (before puberty, during proestrus, estrus, diestrus, and anestrus) and in bitches affected by uterine disorders (N=10). The stage of the estrous cycle was determined by vaginal cytology and progesterone evaluation and also confirmed by clinical and histologic observations. Samples for endometrial cytology were collected in vivo by uterine flushing with transcervical uterine cannulation. After uterine sampling, each dog underwent OHE or uterine stump revision. Cytologic analyses were compared with histologic examinations to verify the uterine condition. The uterine cellular population was represented by endometrial epithelial cells, erythrocytes, neutrophils, lymphocytes, eosinophils, macrophages, plasma cells, and cervical or incidental vaginal cells. Bacteria and amorphous material were observed. The proportion of different cells and nuclear features in the cytologic samples varied throughout the stages of the reproductive cycle and between normal and pathologic uterine conditions. The computer-assisted nuclear morphometry, performed in cytologic specimens by means of the six nuclear parameters chosen to evaluate the endometrial epithelial cell population, proved to be useful for determining the stage of the reproductive cycle. Furthermore, this system was demonstrated to be a valid support to diagnose and distinguish uterine disorders. PMID:20116837

  6. Sequential observation of spontaneous endometrial adenocarcinoma development in Donryu rats.

    Science.gov (United States)

    Nagaoka, T; Takeuchi, M; Onodera, H; Matsushima, Y; Ando-Lu, J; Maekawa, A

    1994-01-01

    Sequential observation of spontaneous endometrial adenocarcinoma development revealed a clear, hormone-dependent, histogenetic pathway in Donryu rats. The first histological changes of the uterine endometrium appeared in both the lining epithelium and uterine gland of the endometrium at 6 mo of age, along with the beginning of persistent estrus. These changes included areas of tall columnar epithelium and gland formation in the lining epithelium as well as metaplastic change in the uterine gland. At 8 mo of age, endometrial hyperplasias were found, with subsequent increase in both incidence and degree. At 8-10 mo of age, hyperplasias were all within the limit of grade ++. After 12 mo of age, however, severe hyperplasias (grade ) began to increase markedly, and adenocarcinomas developed at 15 mo of age. The findings thus suggest that uterine endometrial adenocarcinomas arise from hyperplastic lesions, which should therefore be regarded as preneoplastic, as in the human case. Sequential analysis of plasma gonad steroids also ascertained a link between the appearance of these lesions and an increased estrogen:progesterone ratio, suggesting that estrogen may play an important role in development of both hyperplastic and neoplastic lesions. In Fischer-344 rats used for comparative assessment of strain differences, neither advanced histological changes nor hormonal changes were evident. PMID:7817117

  7. An Unusual Case of Vaginal Myoma Presenting with Postmenopausal Bleeding

    Directory of Open Access Journals (Sweden)

    Lajya Devi Goyal

    2013-06-01

    Full Text Available Vaginal leiomyomas are uncommon benign tumour with variable clinical presentation. These tumours arise most commonly from anterior vaginal wall. We report a case of 50-year old postmenopausal woman who presented with urinary retention, profuse vaginal bleeding and mass protruding into vagina. Local examination revealed a pedunculated mass attached to the posterior vaginal wall with vascular stalk one cm below the cervix. Mass was hanging outside vulva and vascular pedicle was profusely bleeding. The pedicle was ligated and tumour was excised. Subsequent histopathology revealed a vaginal myoma.

  8. Application of saline infusion sonography in the diagnosis of endometrial polyps

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    K. Drljevi?

    2006-08-01

    Full Text Available Endometrial polyps represent benign focused growths of endometrium with the prevalnece of 5-10 in 100 patients older than 30 years of age. The most frequent symptom is irregular uterine bleeding. Saline Infusion Sonography (SIS is the least invasive and the simplest method for detection of an abnormality of the uterine cavity. In this paper we have presented a case of a65- year old patient with endometrial polypus, irregular uterine bleeding referred to hyperplasia endometria as a working diagnosis. Using the Saline Infusion Sonography check-up the diagnosis of endometrial polypus was established including its localization, diameter and other diagnostic parameters. The results of this study have shown that the Saline Infusion Sonography provides more information about the state of uterocervical cavity as compared to the standard transvaginal sonography.

  9. Comparison of efficacy of oral drotaverine plus mefenamic acid with paracervical block and with intravenous sedation for pain relief during hysteroscopy and endometrial biopsy

    OpenAIRE

    Sharma J; Aruna J; Kumar Praveen; Roy Kallol; Malhotra Neena; Kumar Sunesh

    2009-01-01

    Background : Office hysteroscopy with endometrial biopsy is usually the first investigation for abnormal uterine bleeding and other uterine diseases. Aims: To evaluate the effect of oral drotaverine with mefenamic acid on pain perception during hysteroscopy and endometrial biopsy and to compare it with that of paracervical block using 1% lignocaine and with that of intravenous sedation using diazepam with pentazocine. Settings and Design : Outpatient gynecological department and open ...

  10. Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas

    Energy Technology Data Exchange (ETDEWEB)

    Nishino, Mizuki E-mail: mizuki@mbox.kyoto-inet.or.jpnishinomizuki@hotmail.com; Togashi, Kaori; Nakai, Asako; Hayakawa, Katsumi; Kanao, Shotarou; Iwasaku, Kazuhiro; Fujii, Shingo

    2005-01-01

    Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. Results: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. Conclusions: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss.

  11. MRI of endometrial cancer

    International Nuclear Information System (INIS)

    This study was performed to clarify the signal characteristics of endometrial cancer especially on enhanced MRI. Authors selected 21 ceses of endometrial cancer and 16 cases of noncancerous endometrium who had Gd-DTPA enhanced MRI. We compared preoperative MRI reports with postsurgical-histological proof and measured signal intensity of endometrial cancer, noncancerous endometrium and myometrium using region-of-interest. The accuracy of preoperative MRI in diagnosis of endometrial cancer was 97%. There were 6 cases suspected as endometrial cancer without preoperative proof. Three cases of them, who had endometrial cancer, were diagnosed correctly on MRI. The other 3 cases, one with endometrial hyperplasia, one with atypical hyperplasia and one with normal endometrium, were diagnosed as having noncancerous endometrium on MRI. These facts indicate that MRI including enhanced study has good accuracy. On unenhanced T1 weighted image, the signal intensity of endometrial cancer was not different from myometrium and normal endometrium. But on enhanced MRI, endometrial cancer showed lower signal intensity than myometrium and normal endometrium (p<0.01). Endometrial cancer was less enhanced than myometrium and normal endometrium after administration of Gd-DTPA (p<0.01). We have to pay attention to signal intensity and enhancement effect of endometrial region on enhanced MRI. The less enhanced endometrium suggests abnormal endometrium including cancer. (author)dometrium including cancer. (author)

  12. Role of Local Anesthetics on Pain Relief in Endometrial Biopsy: Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Elaheh Ouladsahebmadarek

    2014-01-01

    Full Text Available Objectives: Endometrial biopsy is necessary for diagnosing the reason of abnormal uterine bleeding in perimenopausal women. Currently outpatient endometrial biopsy is used for evaluation of abnormal uterine bleeding which is associated with moderate to severe pain. Using lidocaine is one of the procedures which is used for pain relief while biopsy. This study is aimed at comparing the effect of different local anesthesia procedures on pain relief during endometrial biopsy. Materials and Methods: In this randomized clinical trial, 160 multiparous 40-55 years old women with AUB (Abnormal Uterine Bleeding, candidates for endometrial biopsy, were randomly assigned into four equal groups, to receive: 1-intrauterine lidocaine; 2-cervical spray lidocaine; 3- intrauterine lidocaine plus cervical spray lidocaine; or 4-intrauterine distilled water. Pain relief was measured at 3 different times: during endometrial biopsy, just after and 15 minutes after biopsy. Results: Pain intensity was reduced significantly at different times in intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine receivers in compare with the groups which received cervical spray lidocaine and distilled water. The mean of difference pain relief during biopsy and 15 minutes after that was reduced significantly in the group which received intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine in comparison with the other two groups. Conclusion: Intrauterine lidocaine was effective during endometrial biopsy, and using it with cervical spray lidocaine had no more beneficial effect.

  13. General Information About Endometrial Cancer

    Science.gov (United States)

    ... if you think you may be at risk. Risk factors for endometrial cancer include the following: Being obese . Having high blood pressure . Having diabetes mellitus . Taking tamoxifen for breast ... increase the risk of endometrial cancer. Endometrial cancer may develop in ...

  14. A case of malignant low grade endometrial stromal sarcoma and review of the literature

    Directory of Open Access Journals (Sweden)

    Amrish N Pandya, Arpita Nishal, Hemali Tailor

    2011-01-01

    Full Text Available Low grade endometrial stromal sarcoma is a rare pelvic malignancy that arises from the endometrium. This article describes the morphological features of one such tumour discovered as finding in a hysterectomy specimen of a 32 year lady with a clinical diagnosis of dysfunctional uterine bleeding with multiple fibroids. Morphological and immunohistochemical evaluations were performed and a final diagnosis of low grade endometrial stromal sarcoma was given. This report is aimed to present a case of endometrial stromal tumor because of its rare existence and difficulties in establishing histological diagnosis.

  15. Ressecção Histeroscópica do Endométrio: Resultados e Fatores de Risco para insucesso / Hysteroscopic Endometrial Resection: Results and Risk Factors for Failures

    Scientific Electronic Library Online (English)

    Frederico Faria, Rodrigues; Michelle Soares de, Moura; Eduardo Camargo, Millen; José Francisco Dória, Ramos; Salete, Yatabe; Reginaldo Guedes Coelho, Lopes; Umberto Gazi, Lippi.

    2001-08-01

    Full Text Available Objetivo: estudar o resultado da ablação endometrial histeroscópica, com o uso de ressectoscópio, em pacientes com sangramento uterino anormal de etiologia benigna e refratária ao tratamento clínico, e relatar os fatores associados aos insucessos. Métodos: foram avaliados retrospectivamente informaç [...] ões sobre 64 pacientes com sangramento uterino anormal de causa benigna, submetidas à intervenção entre abril de 1994 e fevereiro de 2000. A média de idade foi de 42,9 anos e a paridade média, de 2,6 partos. Foi realizada histeroscopia diagnóstica com biópsia endometrial pré-operatoriamente. Duas pacientes receberam previamente gestrinona, seis danazol e 44 análogo do GnRH. No ato cirúrgico realizou-se a cauterização elétrica do fundo uterino e das regiões cornuais. Depois, com o ressectoscópio, foi removido o endométrio até 1 cm cranialmente ao orifício interno e na profundidade de 2 a 3 mm na musculatura. A distensão uterina se fazia com glicina a 1,5% até há dois anos, quando se passou a usar o manitol a 3%. O seguimento foi de 11,5 meses em média. Resultados: estabeleceu-se amenorréia em 31,2% das pacientes e hipomenorréia em 45,3%. Houve persistência do sangramento anormal em 23,5%. Houve uma perfuração uterina na cérvico-dilatação (1,5%). Os resultados foram melhores nas pacientes com mais de 40 anos de idade, nas multíparas e nas que usaram análogos do GnRH. Nos casos de falhas houve freqüência estatisticamente significante (p=0,04) de miomas submucosos de 46,6% contra 20,6% no grupo com hipomenorréia e 20% no grupo com amenorréia. O uso de análogo do GnRH fez decrescer de modo significante (p=0,03) os insucessos. No grupo de pacientes nos quais se considerou haver falha da cirurgia, 46% tiveram, ao exame anatomopatológico, endométrio secretor; no grupo com hipomenorréia, 10,3% tiveram este resultado histológico e no grupo com amenorréia, 10%, o que não apresentou significância estatística (p=0,12). Conclusão: o método mostrou-se útil para tratar o sangramento uterino anormal de etiologia benigna. Recomenda-se o uso de análogos do GnRH previamente à intervenção. Sugere-se que as pacientes mais jovens, com menor paridade e com diagnóstico pré-operatório de mioma submucoso recebam atenção especial, pois entre elas ocorrem falhas com maior freqüência. Abstract in english Purpose: to evaluate the results of 64 hysteroscopic endometrial ablations using a resectoscope in women with abnormal uterine bleeding of benign etiology and nonresponsive to clinical measures and to describe the failures and their associated conditions. Methods: sixty-four patients with abnormal u [...] terine bleeding were submitted to the intervention between April 1994 and February 2000. The mean age was 42.9 years and the mean parity, 2.6 deliveries. Diagnostic hysteroscopy and endometrial biopsy were performed preoperatively. Before surgery, two women received gestrinone, six danazol and 44 GnRH analogue. During the surgery electric cauterization of the fundus uteri and cornual regions was made. Afterwards, with a resectoscope, the endometrium was removed as far as 1 cm above the internal ostium, and as deep as 2 to 3 mm into the myometrium. The uterine distension was obtained with 1.5% glycine and since two years ago with 3% manitol. The average follow-up was 11.5 months. After six months of endometrial ablation, the patients with persistence of symptoms were submitted to hysterectomy. Results: amenorrhea occurred in 31.2% of the patients and hypomenorrhea in 45.3%. The abnormal bleeding was maintained in 23.5%. There was one uterine perforation during the dilatation of the cervix. Results were better in the higher age and parity ranges and in the women who received GnRH analogues (p=0.03). Where the method was not successful there was a statistically significant frequency of submucous myoma (p=0.04) and a nonsignificant increase of secretory endometrium (p=0.12). Conclusions: the method is useful for the management of abnormal uterine bleeding of benign

  16. What is the influence of cyclooxygenase-2 on postmenopausal endometrial polyps?

    Science.gov (United States)

    Pereira, A K C; Garcia, M T; Pinheiro, W; Ejzenberg, D; Soares, J M; Baracat, E C

    2015-08-01

    Background The genesis of the endometrial polyp is as yet unclear. There is evidence that the polyp is related to the inflammatory process and that it interacts with the cyclooxygenase-2 (COX-2) enzyme. Objective To review the influence of COX-2 on the postmenopausal endometrial polyp. Methods A systematic review was made of the Medline, Embase, and Cochrane databases, covering the years of 2001-2014. The inclusion criteria were: experimental studies with immunohistological analysis of COX-2 in endometrial polyps; women; hysteroscopic and surgical evaluation; and studies with comparisons between the endometrial polyp and other tissues (normal endometrium, adjacent endometrium, and other uterine diseases). The exclusion criteria were: polyps in other organs; genetic polymorphisms; endometrial cancer exclusively; abnormal uterine bleeding unrelated to polyps. The search key words (taken from the Medical Subject Headings - MeSH) were endometrial polyp and cyclooxygenase-2. Results Seven of ten articles were selected. Results showed positive COX-2 expression in the glandular epithelium of the polyps, and expression was more intense when the polyp was malignant. However, there was a study which did not find any difference between polyps and the normal endometrium, and there was another which compared polyps in menacme with postmenopausal polyps. Conclusion There is no consensus in the literature as to the participation of COX-2 in the development of benign and/or malignant endometrial polyps. In all of the studies, COX-2 was present in the postmenopausal polyps and with greater intensity in the malignant ones. PMID:25242379

  17. K-ras exon 2 point mutations in human endometrial cancer.

    Science.gov (United States)

    Semczuk, A; Schneider-Stock, R; Berbec, H; Marzec, B; Jakowicki, J A; Roessner, A

    2001-03-26

    In the present study, we screened for the K-ras exon 2 point mutations in a group of 87 gynecological neoplasms (82 endometrial carcinomas, four carcinomas of the uterine cervix and one uterine carcinosarcoma) using the non-isotopic PCR-SSCP-direct sequencing techniques. Direct sequencing analysis revealed CAA-->CAC (Gln-->His) K-ras codon 61 point mutations in two (2.4%) of the 82 endometrial carcinomas mentioned above. These two cases were endometrial endometrioid carcinomas at an early clinical stage of disease (stage IB and IC due to FIGO). Those endometrial carcinomas that showed K-ras exon 2 point mutations revealed a strong positivity for heterogeneous nuclear retinoblastoma protein staining; none of these, however, have had the K-ras codon 12 point mutation. In addition, there were no K-ras gene point mutations in three endometrial carcinomas lacking the Rb protein immunohistochemically. None of the cervical carcinomas tested had K-ras gene point mutations, whereas one carcinosarcoma harbored K-ras codon 61 point mutation (CAA-->CAC). In conclusion, our data support the view that K-ras exon 2 point mutations are rare events in human endometrial cancer. Rb and K-ras gene abnormalities may occur independently of each other during endometrial carcinogenesis in humans. PMID:11179836

  18. Redução Endometrial por Vídeo-Histeroscopia: experiência em um Hospital de Ensino Endometrial Resection by Video-Hysteroscopy: experience in a Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Caio Parente Barbosa

    1998-08-01

    Full Text Available Objetivo: demonstrar a efetividade da redução endometrial vídeo-histeroscópica no tratamento do sangramento uterino anormal. Métodos: foram analisados os prontuários de 60 pacientes com sangramento uterino anormal não-controlado clinicamente. Resultados: oitenta e oito por cento das pacientes tiveram resposta adequada ao tratamento (53,3% oligomenorréia e 35% amenorréia. Foi encontrado um índice de 8,3% de complicações (5 perfurações uterinas. Conclusão: a redução endometrial vídeo-histeroscópica é uma técnica eficaz no tratamento do sangramento uterino anormal não-controlado clinicamente, com baixos índices de complicações intra e pós-operatórias.Objective: to demonstrate the effectiveness of video-hysteroscopic endometrial resection in the treatment of abnormal uterine bleeding. Patients and method: The authors studied 60 records of patients with abnormal uterine bleeding who did not respond to clinical treatment. Results: eighty-eight percent of the patients had adequate response to the treatment (53% oligomenorrhea and 35% amenorrhea. The complication rate was 8.3% (5 uterine perforations. Conclusion: video-hysteroscopic endometrial resection is an effective technique to treat abnormal uterine bleeding which failed to respond to clinical management. The intra and postoperative complication rates are low.

  19. Redução Endometrial por Vídeo-Histeroscopia: experiência em um Hospital de Ensino / Endometrial Resection by Video-Hysteroscopy: experience in a Teaching Hospital

    Scientific Electronic Library Online (English)

    Caio Parente, Barbosa; Marcelo Ettruri, Santos; Ana Cristina, Napolitano; Paula Harue, Tamanaka; Emerson Barchi, Cordts.

    1998-08-01

    Full Text Available Objetivo: demonstrar a efetividade da redução endometrial vídeo-histeroscópica no tratamento do sangramento uterino anormal. Métodos: foram analisados os prontuários de 60 pacientes com sangramento uterino anormal não-controlado clinicamente. Resultados: oitenta e oito por cento das pacientes tivera [...] m resposta adequada ao tratamento (53,3% oligomenorréia e 35% amenorréia). Foi encontrado um índice de 8,3% de complicações (5 perfurações uterinas). Conclusão: a redução endometrial vídeo-histeroscópica é uma técnica eficaz no tratamento do sangramento uterino anormal não-controlado clinicamente, com baixos índices de complicações intra e pós-operatórias. Abstract in english Objective: to demonstrate the effectiveness of video-hysteroscopic endometrial resection in the treatment of abnormal uterine bleeding. Patients and method: The authors studied 60 records of patients with abnormal uterine bleeding who did not respond to clinical treatment. Results: eighty-eight perc [...] ent of the patients had adequate response to the treatment (53% oligomenorrhea and 35% amenorrhea). The complication rate was 8.3% (5 uterine perforations). Conclusion: video-hysteroscopic endometrial resection is an effective technique to treat abnormal uterine bleeding which failed to respond to clinical management. The intra and postoperative complication rates are low.

  20. Progesterone inhibits uterine gland development in the neonatal mouse uterus.

    Science.gov (United States)

    Filant, Justyna; Zhou, Huaijun; Spencer, Thomas E

    2012-05-01

    Uterine glands and their secretions are required for conceptus (embryo/fetus and associated placenta) survival and development. In most mammals, uterine gland morphogenesis or adenogenesis is a uniquely postnatal event; however, little is known about the mechanisms governing the developmental event. In sheep, progestin treatment of neonatal ewes permanently ablated differentiation of the endometrial glands. Similarly, progesterone (P4) inhibits adenogenesis in neonatal mouse uterus. Thus, P4 can be used as a tool to discover mechanisms regulating endometrial adenogenesis. Female pups were treated with sesame vehicle alone as a control or P4 from Postnatal Day 2 (PD 2) to PD 10, and reproductive tracts were examined on PD 5, 10, or 20. Endometrial glands were fully developed in control mice by PD 20 but not in P4-treated mice. All other uterine cell types appeared normal. Treatment with P4 stimulated proliferation of the stroma but suppressed proliferation of the luminal epithelium. Microarray analysis revealed that expression of genes were reduced (Car2, Fgf7, Fgfr2, Foxa2, Fzd10, Met, Mmp7, Msx1, Msx2, Wnt4, Wnt7a, Wnt16) and increased (Hgf, Ihh, Wnt11) by P4 in the neonatal uterus. These results support the idea that P4 inhibits endometrial adenogenesis in the developing neonatal uterus by altering expression of morphoregulatory genes and consequently disrupting normal patterns of cell proliferation and development. PMID:22238285

  1. Analysis of amenorrhea after transcatheter uterine artery embolization for uterine fibroids

    International Nuclear Information System (INIS)

    Objective: To investigate the causes of amenorrhea after transcatheter uterine artery embolization (TUAE) for uterine fibroids. Methods: Two hundreds thirty-one cases of uterine fibroids with the range of age from 29 to 51 years (mean, 39.5 years) underwent TUAE between April 1999 and May 2004. TUAE was performed by injecting lipiodol-pingyangmycine emulsion (LPE) into bilateral uterine arteries, followed by administration of gelatin sponge particles in 186 of 231 patients. LPE was prepared with pingyangmycine 8-16 mg and ultra fluid lipiodol 6-20 ml. Results: Amenorrhea occurred in 2 of 231 (0.87%) patients respectively at 3 and 4 months after TUAE. Premature ovarian failure was proved to be etiology of amenorrhea in one patient because her serum estradiol (E2) became decreased and serum follicle-stimulating hormone (FSH) level increased. This woman had normal amenorrhea later after receiving estrogen-progestogen sepuential therapy for 12 months. Another patient's amenorrhea was proved to be associated with endometrial atrophy after TUAE by hysteroscope. Conclusion: Amenorrhea caused by premature ovarian failure and endometrial atrophy may occur in a tiny minority of women undergoing TUAE. (authors)

  2. Prospective observational study of Thermablate Endometrial Ablation System as an outpatient procedure.

    Science.gov (United States)

    Prasad, Padmini; Powell, Martin C

    2008-01-01

    This single-arm prospective observational study was designed to evaluate patient acceptability and feasibility of the Thermablate endometrial ablation (EA) system (TEAS), a new-generation endometrial thermal balloon ablation system, as an office procedure. It was set up in a one-stop menstrual disorder clinic with a facility for outpatient hysteroscopy in the Queen's Medical Center, Nottingham University Hospitals, Nottingham, United Kingdom. Seventy premenopausal women mainly, with menorrhagia, without earlier endometrial preparation were included in the study. The exclusion criteria were women requesting general anesthesia, presence of submucous myoma, suggestion of malignant lesions, and a desire to preserve fertility. The intervention involved the use of global thermal EA with TEAS. This is an endometrial balloon ablation system that combines a "thermablation" time of 128 seconds with automatic controls of the treatment parameters of temperature and pressure, without any earlier endometrial preparation. Patients were given diclofenac sodium (100 mg orally) 2 hours before the procedure, with intracervical 4% prilocaine and intracavitary lidocaine gel for analgesia. Main results involved measurement of overall satisfaction with TEAS as an outpatient (office) procedure, intraoperative and postoperative pain scores, need for additional analgesia, nausea and vomiting rate, total time in clinic and the need for any admission, speed of recovery, and time away from home. In conclusion, the TEAS appears to be a well-accepted and safe outpatient procedure for treating menorrhagia. PMID:18602047

  3. Treatment of Endometrial Cancer in Patient with Malignant Obesity

    OpenAIRE

    Popovic, Miroslav D.; Banicevic, Arnela Ceric; Popovic, Biljana; Ceric, Amela; Banicevic, Andrija; Popadic, Danijela

    2014-01-01

    Our 60-year-old patient menarche in 13-year, two delivery, last menstruation in 53-year, without uterine bleeding or any kind of symptomatology. The gynecological transvaginal ultrasound examination showed hyperplasio endometrii (20mm). After curettage, pathological examination was diagnostic polypus carcinomatoides. The patient with HTA and obesity was admitted to and operated on at the Gynecological Department due to endometrial carcinoma (FIGO stage IA1). Because of her giant obesity, BMI ...

  4. Long-term follow up after uterine artery embolization for symptomatic uterine leiomyomas

    DEFF Research Database (Denmark)

    Poulsen, Bente; Munk, Torben

    2011-01-01

    Uterine artery embolization is one of the established treatment options for symptomatic uterine leiomyomas, with a proven effect on the size of leiomyomas and providing short-term relief of symptoms. Only few studies have addressed long-term satisfaction with the treatment. We conducted a historical cohort study of 96 patients. The patients were treated at a median age of 43years (range 23-59years). The median size of the largest myoma was 69mm (range 20-170mm). By use of a postal questionnaire (response rate 86%) and audit of patient files, we found that 53% reported full recovery of symptoms and 36% some effect on symptoms after a median of 8.9years (range 8-9.4years). Overall, 25% of the women reported a need for further treatment. The rate of eventual hysterectomy was 22%. We confirm that uterine artery embolization is a safe and well-tolerated procedure with a high long-term satisfaction rate.

  5. BAJA INCIDENCIA DE PATOLOGIA ENDOMETRIAL EN MUJERES POSTMENOPAUSICAS CON SANGRADO ANORMAL QUE RECIBEN TERAPIA DE REEMPLAZO HORMONAL

    Scientific Electronic Library Online (English)

    Marcelo, Bianchi P.; Eugenio, Arteaga U.; Paulina, Villaseca D..

    Full Text Available Se realiza un estudio para analizar la frecuencia de patología endometrial en mujeres posmenopáusicas sanas con sangrado uterino anormal bajo terapia de reemplazo hormonal (TRH). Se estudiaron 104 mujeres posmenopáusicas que presentaron sangrado uterino anormal (irregular o excesivo) durante TRH con [...] estrógenos y progesterona en diferentes esquemas (57% secuencial continuo; 31% combinado continuo; 12% secuencial discontinuo. A todas las pacientes se les realizó una biopsia ambulatoria aspirativa de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 38,5%; endometrio proliferativo 25%; endometrio atrófico 11,5%; hierplasia endometrial sin atipias 4,8%; pólipo endometrial benigno 2,9%; tejido endometrial benigno, inactivo o fragmentos de epitelio 11,5%; adenocarcinoma de endometrio 1% y ausencia de tejido endometrial 4,8%. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en alrededor del 95% de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 5% de los casos sugiriendo atrofia endometrial o patología focal no diagnosticada por el método. La ausencia de lesiones premalignas y la baja incidencia de patología maligna de endometrio en nuestro estudio confirman su baja incidencia en mujeres que reciben esquemas adecuados de terapia de reemplazo hromonal Abstract in english Objetive: To analyze the frequency of endometrial pathology in healthy postmenopausal women who presented abnormal uterine bleeding during hormone replacement therapy (HRT). Material and method: 104 postmenopausal women presenting abnormal uterine bleeding (irregular or excessive) while using HRT wi [...] th estrogen and progestin in different schemes. All the patients underwent endometrial aspiration biopsies. Results: Endometrial biopsy was well tolerated and no infectious or hemorrhagic complications related to the procedure were observed. Results of endometrial sampling were as followed: secretor endometrium 38.5%; proliferative endometrium 25%; atrophic endometrium 11.5%; hyperplastic endometrium without atypia 4.8%; benign endometrial polyps 2.9%; benign endometrial tissue, inactive or fragment of epithelium 11.5%: endometrial adenocarcinoma 1%; and absence of endometrial tissue 4.8%. No samples with diagnosis of endometrial hyperplasia with atypia were found. Conclusions: Aspirative curettage of the endometrium permitted to know the endometrial condition in about 95% of patients. Histologic sample for diagnosis was not obtained in 5% of cases, thus suggesting endometrial atrophy or focal pathology misdiagnosed by the method used. The abscense of premalignant and the low incidence of malignant pathology in our study confirms their low incidence in patients receiving adquate regime of HRT

  6. BAJA INCIDENCIA DE PATOLOGIA ENDOMETRIAL EN MUJERES POSTMENOPAUSICAS CON SANGRADO ANORMAL QUE RECIBEN TERAPIA DE REEMPLAZO HORMONAL

    Directory of Open Access Journals (Sweden)

    Marcelo Bianchi P.

    2002-01-01

    Full Text Available Se realiza un estudio para analizar la frecuencia de patología endometrial en mujeres posmenopáusicas sanas con sangrado uterino anormal bajo terapia de reemplazo hormonal (TRH. Se estudiaron 104 mujeres posmenopáusicas que presentaron sangrado uterino anormal (irregular o excesivo durante TRH con estrógenos y progesterona en diferentes esquemas (57% secuencial continuo; 31% combinado continuo; 12% secuencial discontinuo. A todas las pacientes se les realizó una biopsia ambulatoria aspirativa de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 38,5%; endometrio proliferativo 25%; endometrio atrófico 11,5%; hierplasia endometrial sin atipias 4,8%; pólipo endometrial benigno 2,9%; tejido endometrial benigno, inactivo o fragmentos de epitelio 11,5%; adenocarcinoma de endometrio 1% y ausencia de tejido endometrial 4,8%. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en alrededor del 95% de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 5% de los casos sugiriendo atrofia endometrial o patología focal no diagnosticada por el método. La ausencia de lesiones premalignas y la baja incidencia de patología maligna de endometrio en nuestro estudio confirman su baja incidencia en mujeres que reciben esquemas adecuados de terapia de reemplazo hromonalObjetive: To analyze the frequency of endometrial pathology in healthy postmenopausal women who presented abnormal uterine bleeding during hormone replacement therapy (HRT. Material and method: 104 postmenopausal women presenting abnormal uterine bleeding (irregular or excessive while using HRT with estrogen and progestin in different schemes. All the patients underwent endometrial aspiration biopsies. Results: Endometrial biopsy was well tolerated and no infectious or hemorrhagic complications related to the procedure were observed. Results of endometrial sampling were as followed: secretor endometrium 38.5%; proliferative endometrium 25%; atrophic endometrium 11.5%; hyperplastic endometrium without atypia 4.8%; benign endometrial polyps 2.9%; benign endometrial tissue, inactive or fragment of epithelium 11.5%: endometrial adenocarcinoma 1%; and absence of endometrial tissue 4.8%. No samples with diagnosis of endometrial hyperplasia with atypia were found. Conclusions: Aspirative curettage of the endometrium permitted to know the endometrial condition in about 95% of patients. Histologic sample for diagnosis was not obtained in 5% of cases, thus suggesting endometrial atrophy or focal pathology misdiagnosed by the method used. The abscense of premalignant and the low incidence of malignant pathology in our study confirms their low incidence in patients receiving adquate regime of HRT

  7. Uterine morphology and peristalsis in women with polycystic ovary syndrome

    International Nuclear Information System (INIS)

    Background. Polycystic ovary syndrome (PCOS) is associated with chronic oligo-anovulation and high circulating sex hormone levels. Women with PCOS have an increased risk of developing endometrial cancer. In anovulatory women with PCOS a positive relationship between endometrial thickness and endometrial hyperplasia has been observed. Uterine peristalsis, which has been suggested to be of importance for female fertility, has not previously been studied in PCOS. Purpose. To assess whether women with PCOS have altered endometrial thickness, uterine wall morphology, and peristalsis. Material and Methods. In this prospective case-control study 55 women with PCOS (mean age, 29.5 years ± 4.5 SD) and 28 controls (27.6 ± 3.2) were examined using magnetic resonance imaging (MRI), assessing thickness of endometrium, junctional zone (JZ), and myometrium, and evaluating the occurrence, frequency (waves/min), strength (amplitude), pattern, and direction of peristalsis. Uterine morphology was also assessed by transvaginal ultrasonography (TVUS). Results. The endometrium was thinner in PCOS with oligo-amenorrhea compared to controls, also after adjustments for age and BMI (adjusted P = 0.043). There was no difference in thickness of the JZ or the myometrium in cases versus controls. Uterine peristalsis was less commonly observed in women with PCOS than in controls (adjusted P = 0.014). Conclusion. There were no differences in myometrial morphology between PCOS and controls, but theology between PCOS and controls, but the endometrium was thinner in PCOS with oligo-amenorrhea. Based on cine MRI, uterine peristalsis was less common in PCOS than in controls

  8. [Uterine inversion].

    Science.gov (United States)

    Dirken, J J; Vlaanderen, W

    1994-01-01

    Inversion of the uterus is a rare complication of childbirth. A primigravida aged 21 and a multigravida aged 32, hospitalized as emergency cases because of inversion of the uterus with major blood loss, were treated with infusion of liquids (to combat shock), repositioning of the uterus under anaesthesia and prevention of reinversion by uterine tonics. Inversion of the uterus should be part of the differential diagnosis in every case of fluxus post partum. PMID:8289958

  9. Endometrial adenocarcinoma after endometrial ablation. A case report

    OpenAIRE

    Areia, Al; Branco, M.; Frutuoso, C.; Oliveira, Cf

    2006-01-01

    The authors present a case of endometrial adenocarcinoma after endometrial ablation, emphasizing the importance of close surveillance of these patients, patient selection and education. Even patients with none of the risk factors for endometrial cancer or contraindications to endometrial ablation should be checked carefully.

  10. Adenovirus mediated homozygous endometrial epithelial Pten deletion results in aggressive endometrial carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Joshi, Ayesha; Ellenson, Lora Hedrick, E-mail: lora.ellenson@med.cornell.edu

    2011-07-01

    Pten is the most frequently mutated gene in uterine endometriod carcinoma (UEC) and its precursor complex atypical hyperplasia (CAH). Because the mutation frequency is similar in CAH and UEC, Pten mutations are thought to occur relatively early in endometrial tumorigenesis. Previous work from our laboratory using the Pten{sup +/-} mouse model has demonstrated somatic inactivation of the wild type allele of Pten in both CAH and UEC. In the present study, we injected adenoviruses expressing Cre into the uterine lumen of adult Pten floxed mice in an attempt to somatically delete both alleles of Pten specifically in the endometrium. Our results demonstrate that biallelic inactivation of Pten results in an increased incidence of carcinoma as compared to the Pten{sup +/-} mouse model. In addition, the carcinomas were more aggressive with extension beyond the uterus into adjacent tissues and were associated with decreased expression of nuclear ER{alpha} as compared to associated CAH. Primary cultures of epithelial and stromal cells were prepared from uteri of Pten floxed mice and Pten was deleted in vitro using Cre expressing adenovirus. Pten deletion was evident in both the epithelial and stromal cells and the treatment of the primary cultures with estrogen had different effects on Akt activation as well as Cyclin D3 expression in the two purified components. This study demonstrates that somatic biallelic inactivation of Pten in endometrial epithelium in vivo results in an increased incidence and aggressiveness of endometrial carcinoma compared to mice carrying a germline deletion of one allele and provides an important in vivo and in vitro model system for understanding the genetic underpinnings of endometrial carcinoma.

  11. Small endometrial carcinoma 10 mm or less in diameter: clinicopathologic and histogenetic study of 131 cases for early detection and treatment

    International Nuclear Information System (INIS)

    Natural history and clinicopathologic features of early endometrial carcinoma are not evident. Its knowledge is essential to make up strategies for prevention, early detection, and treatment of endometrial carcinoma. Especially it is important to know pathways of endometrial carcinogenesis and frequency of endometrial carcinomas arising from endometrial hyperplasia. Clinicopathologically 131 patients with endometrial carcinoma measuring ?10 mm in diameter (“small endometrial carcinoma”) were studied to get useful information for early diagnosis, treatment, and histogenesis. The entire endometrium of surgically removed uterus was step-cut and examined. The patients were, on average, 5 years younger than the controls whose carcinomas measure >10 mm (P < 0.0001). Of the 131 patients, 20% were asymptomatic although only 5% of the controls were asymptomatic (P < 0.0001). Seventy-six percent had the carcinomas located in the upper third section of the uterine corpus. Macroscopically 44% of the tumors were flat and 56% were elevated. Incidence of nodal and ovarian metastases were <1%. Forty percent of “small endometrial carcinomas” were associated with endometrial hyperplasia and 60% were not. It is logical to believe that there are two pathways of endometrial carcinogenesis: carcinomas occurring from hyperplasia (40%) and carcinomas occurring from normal endometrium (60%). As hyperplasia-carcinoma sequence is not a prevent carcinomas only by treatment of hyperplasia. Effort must be focused on detecting early de novo carcinomas. As most “small endometrial carcinomas” arise in the upper third of the corpus, careful endometrial sampling there is important for early detection

  12. Uterine horn aplasia with complications in two mixed-breed bitches : case report

    Directory of Open Access Journals (Sweden)

    M.L. Schulman

    2012-07-01

    Full Text Available Unilateral segmental uterine horn aplasia was found in 2 mixed-breed bitches. The 1st bitch was presented with clinical signs of acute abdominal pain, and pyometra was suspected. Pyometra was confirmed surgically with rupture of a blind-ending cranial portion of the anomalous right uterine horn, which had resulted in peritonitis. The 2nd bitch was presented for routine ovariohysterectomy. The right uterine horn was affected by segmental aplasia, with mucometra of the cranial portion of the affected horn. Histopathology demonstrated both uteri to have diffuse cystic endometrial hyperplasia. It is postulated that cystic endometrial hyperplasia, together with the congenital anomaly, resulted in pyometra in one case and in mucometra in the other case. This is believed to be the 1st report of uterine horn aplasia in the bitch in association with clinical signs and lesions other than infertility.

  13. Endometrial Cancer Prevention

    Science.gov (United States)

    ... lower during pregnancy and when breast-feeding. Being pregnant and/or breast-feeding may lower the risk of endometrial cancer. The risk of endometrial cancer may be lower in women who have a higher number of pregnancies and ...

  14. HIPERPLASIA ENDOMETRIAL: ANÁLISIS DE SERIE DE CASOS DIAGNOSTICADOS EN BIOPSIA ENDOMETRIAL

    Directory of Open Access Journals (Sweden)

    Ernesto García Ayala

    2010-01-01

    Full Text Available Antecedentes: La hiperplasia endometrial es una entidad en la que existe una proliferación de glándulas endometriales de tamaño y forma irregular, con mayor proporción de glándulas sobre el estroma, a consecuencia de una excesiva exposición a los estrógenos. Aproximadamente, en el 15% de legrados/biopsias endometriales de mujeres postmenopausicas con cuadro clínico de hemorragia uterina anormal, se diagnostica esta entidad. Objetivo: Describir la incidencia y hallazgos histopatológicos en legrado/biopsia endometrial en pacientes de un hospital público de tercer nivel. Métodos: Se revisaron 22.048 procedimientos realizados en el Hospital Universitario de Santander, procesados en el Departamento de Patología de la Universidad Industrial de Santander, en el periodo comprendido entre 1 de enero de 2005 y 31 de diciembre 2008, de los cuales 1.750 correspondieron a legrados/biopsias de endometrio y en 168 de estos se realizó el diagnóstico histopatológico de hiperplasia endometrial. Resultados: Se encontró que el promedio de edad de presentación de está entidad fue de 44,8 años y que el mayor porcentaje de pacientes (68,5% estuvieron en el grupo de la hiperplasia simple sin atipia. En el 19,7% de los casos hubo evidencia de atipia. Conclusiones: El promedio de edad encontrado y los porcentajes por subgrupos de hiperplasia estuvieron en relación a otros estudios. Se destaca una menor proporción de casos con atipia.Background: Endometrial hyperplasia is an entity in which there is a proliferation of endometrial glands of irregular size and shape, with the highest proportion of glands on the stroma, resulting from excessive exposure to estrogen. Approximately 15% of curettages/endometrial biopsies of postmenopausal women with clinical symptoms of abnormal uterine bleeding is diagnosed this entity. Objective: To describe the incidence and pathological findings in curettage/endometrial biopsy in patients of a tertiary public hospital. Methods: A retrospective review of 22,048 surgical procedures performed in the University Hospital of Santander, processed in the Pathology Department of Industrial University of Santander in the period from 1 January 2005 and 31 December 2008, of which 1,750 corresponded to curettage/biopsy of the endometrium and in 168 of these histopathological diagnosis was made of endometrial hyperplasia. Results: We found that the average age of presentation in this institution was 44.8 years and that the greater percentage of patients (68.5% were in the group of simple hyperplasia without atypia. In 19.7% of the cases had evidence of atypia. Conclusions: The mean age and percentages found by hyperplasia subgroups were relatively within limits with regard to other studies, although broadly outlined in a lower proportion of cases with atypia.

  15. HIPERPLASIA ENDOMETRIAL: ANÁLISIS DE SERIE DE CASOS DIAGNOSTICADOS EN BIOPSIA ENDOMETRIAL

    Scientific Electronic Library Online (English)

    Ernesto, García Ayala; Laura, Cárdenas Mastrascusa; Diana, Sandoval Martínez; Henry, Mayorga Anaya.

    Full Text Available Antecedentes: La hiperplasia endometrial es una entidad en la que existe una proliferación de glándulas endometriales de tamaño y forma irregular, con mayor proporción de glándulas sobre el estroma, a consecuencia de una excesiva exposición a los estrógenos. Aproximadamente, en el 15% de legrados/bi [...] opsias endometriales de mujeres postmenopausicas con cuadro clínico de hemorragia uterina anormal, se diagnostica esta entidad. Objetivo: Describir la incidencia y hallazgos histopatológicos en legrado/biopsia endometrial en pacientes de un hospital público de tercer nivel. Métodos: Se revisaron 22.048 procedimientos realizados en el Hospital Universitario de Santander, procesados en el Departamento de Patología de la Universidad Industrial de Santander, en el periodo comprendido entre 1 de enero de 2005 y 31 de diciembre 2008, de los cuales 1.750 correspondieron a legrados/biopsias de endometrio y en 168 de estos se realizó el diagnóstico histopatológico de hiperplasia endometrial. Resultados: Se encontró que el promedio de edad de presentación de está entidad fue de 44,8 años y que el mayor porcentaje de pacientes (68,5%) estuvieron en el grupo de la hiperplasia simple sin atipia. En el 19,7% de los casos hubo evidencia de atipia. Conclusiones: El promedio de edad encontrado y los porcentajes por subgrupos de hiperplasia estuvieron en relación a otros estudios. Se destaca una menor proporción de casos con atipia. Abstract in english Background: Endometrial hyperplasia is an entity in which there is a proliferation of endometrial glands of irregular size and shape, with the highest proportion of glands on the stroma, resulting from excessive exposure to estrogen. Approximately 15% of curettages/endometrial biopsies of postmenopa [...] usal women with clinical symptoms of abnormal uterine bleeding is diagnosed this entity. Objective: To describe the incidence and pathological findings in curettage/endometrial biopsy in patients of a tertiary public hospital. Methods: A retrospective review of 22,048 surgical procedures performed in the University Hospital of Santander, processed in the Pathology Department of Industrial University of Santander in the period from 1 January 2005 and 31 December 2008, of which 1,750 corresponded to curettage/biopsy of the endometrium and in 168 of these histopathological diagnosis was made of endometrial hyperplasia. Results: We found that the average age of presentation in this institution was 44.8 years and that the greater percentage of patients (68.5%) were in the group of simple hyperplasia without atypia. In 19.7% of the cases had evidence of atypia. Conclusions: The mean age and percentages found by hyperplasia subgroups were relatively within limits with regard to other studies, although broadly outlined in a lower proportion of cases with atypia.

  16. PATOLOGIA ENDOMETRIAL EN MUJERES CON SANGRADO ANORMAL DURANTE TERAPIA DE REEMPLAZO HORMONAL

    Directory of Open Access Journals (Sweden)

    Marcelo Bianchi P.

    2003-01-01

    Full Text Available Se presenta un estudio para analizar la incidencia de patología endometrial en mujeres sanas posmenopáusicas que reciben terapia de reemplazo hormonal (TRH y que presentan sangrado uterino anormal. Se estudiaron 188 mujeres posmenopáusicas que presentaron flujo rojo uterino anormal (irregular o excesivo durante TRH con estrógenos y progesterona en diferentes esquemas (49% secuencial continuo; 39% combinado continuo; 12% secuencial discontinuo. Al 100% de las pacientes se les realizó en forma ambulatoria un estudio biópsico aspirativo de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 28,8%; endometrio proliferativo 31,3%; endometrio atrófico 18,0%; hiperplasia endometrial sin atipías 4,3%; pólipo endometrial benigno 2,7%; tejido endometrial benigno, inactivo o fragmentos de epitelio 11,7%; adenocarcinoma de endometrio 0,5% y ausencia de tejido endometrial 2,7%. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en 97,3% de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 2,7% de los casos sugiriendo atrofia endometrial o patología focal no diagnosticada por el método. Se concluye que la baja incidencia de patología maligna de endometrio en nuestro estudio confirma su baja incidencia en mujeres que reciben esquemas adecuados de terapia de reemplazo hormonalObjetive: To analyze the frequency of endometrial pathology in healthy postmenopausal women who presented abnormal uterine bleeding during HRT. Subject and Methods: The case of 188 postmenopausal women (54,8 + 6.6 years of age and 38,1 months of therapy presenting abnormal uterine bleeding (irregular or excessive while using HRT with estrogen and progestin in different schemes (49% sequential continuous; 39% combined continuous; 12% sequential discontinuous. All the patients underwent endometrial aspiration biopsies between January 1996 and October 2002 using a 2 mm (Z sampler aspiration curette. The samples were preserved in formaline, processed with standard methods and stained by hematoxylin and eosin. Results: We found secretor endometrium 28,8%; proliferative endometrium 31,3%; atrophic endometrium 18,0%; hyperplastic endometrium without atypia 4,3%; benign endometrial polyps 2,7%; benign endometrial tissue, inactive or fragment of epithelium 11,7%: endometrial adenocarcinoma 0,5%; and absence of endometrial tissue 2,7%. Conclusions: Aspirative curettage of the endometrium permitted to know the endometrial condition in 97.3% of patients; the remaining 2.7% could correspond to atrophic endometrium of misdiagnosed focal pathology. We conclude that on standard HRT regimens the prevalence of malignant pathology in patients with irregular bleeding is very low

  17. PATOLOGIA ENDOMETRIAL EN MUJERES CON SANGRADO ANORMAL DURANTE TERAPIA DE REEMPLAZO HORMONAL

    Scientific Electronic Library Online (English)

    Marcelo, Bianchi P.; Cecilia, Berrios C.; Paulina, Villaseca D.; Eugenio, Arteaga U..

    Full Text Available Se presenta un estudio para analizar la incidencia de patología endometrial en mujeres sanas posmenopáusicas que reciben terapia de reemplazo hormonal (TRH) y que presentan sangrado uterino anormal. Se estudiaron 188 mujeres posmenopáusicas que presentaron flujo rojo uterino anormal (irregular o exc [...] esivo) durante TRH con estrógenos y progesterona en diferentes esquemas (49% secuencial continuo; 39% combinado continuo; 12% secuencial discontinuo. Al 100% de las pacientes se les realizó en forma ambulatoria un estudio biópsico aspirativo de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 28,8%; endometrio proliferativo 31,3%; endometrio atrófico 18,0%; hiperplasia endometrial sin atipías 4,3%; pólipo endometrial benigno 2,7%; tejido endometrial benigno, inactivo o fragmentos de epitelio 11,7%; adenocarcinoma de endometrio 0,5% y ausencia de tejido endometrial 2,7%. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en 97,3% de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 2,7% de los casos sugiriendo atrofia endometrial o patología focal no diagnosticada por el método. Se concluye que la baja incidencia de patología maligna de endometrio en nuestro estudio confirma su baja incidencia en mujeres que reciben esquemas adecuados de terapia de reemplazo hormonal Abstract in english Objetive: To analyze the frequency of endometrial pathology in healthy postmenopausal women who presented abnormal uterine bleeding during HRT. Subject and Methods: The case of 188 postmenopausal women (54,8 + 6.6 years of age and 38,1 months of therapy) presenting abnormal uterine bleeding (irregul [...] ar or excessive) while using HRT with estrogen and progestin in different schemes (49% sequential continuous; 39% combined continuous; 12% sequential discontinuous). All the patients underwent endometrial aspiration biopsies between January 1996 and October 2002 using a 2 mm (Z sampler) aspiration curette. The samples were preserved in formaline, processed with standard methods and stained by hematoxylin and eosin. Results: We found secretor endometrium 28,8%; proliferative endometrium 31,3%; atrophic endometrium 18,0%; hyperplastic endometrium without atypia 4,3%; benign endometrial polyps 2,7%; benign endometrial tissue, inactive or fragment of epithelium 11,7%: endometrial adenocarcinoma 0,5%; and absence of endometrial tissue 2,7%. Conclusions: Aspirative curettage of the endometrium permitted to know the endometrial condition in 97.3% of patients; the remaining 2.7% could correspond to atrophic endometrium of misdiagnosed focal pathology. We conclude that on standard HRT regimens the prevalence of malignant pathology in patients with irregular bleeding is very low

  18. The value of diagnostic hysteroscopy with biopsy in the preoperative of endometrial ablation

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    Salete Yatabe

    2011-12-01

    Full Text Available Objective: To assess the value of diagnostic hysteroscopy with biopsy in the preoperative preparation for endometrial ablation. Methods: It was a prospective non-randomized study conducted at the division of Gynecologic Endoscopy of Hospital do Servidor Público Estadual “Francisco Morato de Oliveira” from March 2007 to May 2009. A total of 45 patients with abnormal uterine bleeding, and referred to endometrial ablation were included. All women underwent a diagnostic hysteroscopy, and were treated with a GnRH analogous – goserelin – 10.8 mg before surgery. The endometrial ablation was performed with a surgical resectoscope. Patients were submitted to one directed endometrial biopsy, one guided endometrial biopsy with Novak curette, and to endometrial ablation, which was considered as reference for pathological examination with samples from the biopsies. Data were analyze using the SPSS-v16 software, and considered significance at p = 0.05. Results: The mean age of women was 44.20 years (33-56, parity of 2.67 (0-9, uterus size of 139.99 calculated in cc (42-278, and the mean duration of symptoms was 3.68 years (0.5-15. The guided endometrial biopsy showed sensitivity of 80% for endometrium without atypia, and the directed endometrial biopsy had sensitivity of 60%. For proliferative endometrium the directed endometrial biopsy showed sensitivity of 76 and 100% for secretory endometrium, which was higher than the guided endometrial biopsy with 53 and 50%, respectively. Conclusion: The directed biopsy before endometrial ablation had lower sensitivity than guided biopsy for endometrium without atypia, however it was higher for proliferative and secretory endometrium.

  19. Uterine Fibroid Embolization

    OpenAIRE

    Malek, R.; Padidar, A.

    2003-01-01

    Uterine fibroids are commonly asymptomatic. They often cause pelvic pain, abnormal and increased vaginal bleeding, etc. Traditional treatment of symptomatic uterine fibroids was trans-abdominal hysterectomy. Nowadays, uterine artery embolization (UAE), also called uterine fibroid embolization, is considered as a safe and highly-effective nonsurgical treatment for women with symptomatic uterine fibroid tumors. Advantages of UAE over conventional hormonal suppression and surgical procedures inc...

  20. RESECCIÓN ENDOMETRIAL HISTEROSCÓPICA MÁS INSERCIÓN DE DIU-LNG EN EL SANGRADO UTERINO ANORMAL REFRACTARIO A TRATAMIENTO MÉDICO

    Directory of Open Access Journals (Sweden)

    Juan Carlos Carvajal V

    2007-01-01

    Full Text Available Objetivo: Evaluar los resultados del tratamiento del sangrado uterino anormal (SUA refractario a tratamiento médico, con resección endometrial histeroscópica asociado a la inserción de un sistema intrauterino de liberación de levonorgestrel. Método: Estudio prospectivo de 24 pacientes con SUA tratadas con resección endometrial histeroscópica seguida de inserción de un dispositivo intrauterino que libera 20 microgramos diarios de levonorgestrel. Resultados: En 23 de las 24 pacientes tratadas se obtuvo un resultado favorable en término de control del SUA, con un período de seguimiento promedio de 18,3 meses. Una paciente requirió histerectomía por persistencia de dolor pélvico. Conclusión: Asociar a la resección endometrial histeroscópica la inserción de un sistema intrauterino de liberación de levonorgestrel mejora los resultados de la cirugía conservadora pudiendo evitar la histerectomía en el 95,9% de las mujeres con SUA de causa benignaObjective: To evaluate hysteroscopic endometrial resection associated to levonorgestrel intrauterine device insertion as a treatment of abnormal uterine bleeding of benign cause. Method: 24 patients with abnormal uterine bleeding, were treated with hysteroscopic endometrial resection followed by the insertion of a intrauterine levonorgestrel device. Results: 23 of 24 patients no report symptoms after 18.3 months follow up. One hysterectomy was performed for persistent chronic pelvic pain. Conclusions: Endometrial ablations with diathermic loop followed by the insertion of intrauterine levonorgestrel device improve the results of the conservative surgeries, avoiding 95.9% of hysterectomies in patients with abnormal uterine bleeding

  1. RESECCIÓN ENDOMETRIAL HISTEROSCÓPICA MÁS INSERCIÓN DE DIU-LNG EN EL SANGRADO UTERINO ANORMAL REFRACTARIO A TRATAMIENTO MÉDICO

    Scientific Electronic Library Online (English)

    Juan Carlos, Carvajal V; Juan, Rodríguez C; Tamara, Briceño C; Julio, Veas P.

    Full Text Available Objetivo: Evaluar los resultados del tratamiento del sangrado uterino anormal (SUA) refractario a tratamiento médico, con resección endometrial histeroscópica asociado a la inserción de un sistema intrauterino de liberación de levonorgestrel. Método: Estudio prospectivo de 24 pacientes con SUA trata [...] das con resección endometrial histeroscópica seguida de inserción de un dispositivo intrauterino que libera 20 microgramos diarios de levonorgestrel. Resultados: En 23 de las 24 pacientes tratadas se obtuvo un resultado favorable en término de control del SUA, con un período de seguimiento promedio de 18,3 meses. Una paciente requirió histerectomía por persistencia de dolor pélvico. Conclusión: Asociar a la resección endometrial histeroscópica la inserción de un sistema intrauterino de liberación de levonorgestrel mejora los resultados de la cirugía conservadora pudiendo evitar la histerectomía en el 95,9% de las mujeres con SUA de causa benigna Abstract in english Objective: To evaluate hysteroscopic endometrial resection associated to levonorgestrel intrauterine device insertion as a treatment of abnormal uterine bleeding of benign cause. Method: 24 patients with abnormal uterine bleeding, were treated with hysteroscopic endometrial resection followed by the [...] insertion of a intrauterine levonorgestrel device. Results: 23 of 24 patients no report symptoms after 18.3 months follow up. One hysterectomy was performed for persistent chronic pelvic pain. Conclusions: Endometrial ablations with diathermic loop followed by the insertion of intrauterine levonorgestrel device improve the results of the conservative surgeries, avoiding 95.9% of hysterectomies in patients with abnormal uterine bleeding

  2. The biology of uterine sarcomas: A review and update

    Science.gov (United States)

    KOBAYASHI, HIROSHI; UEKURI, CHIAKI; AKASAKA, JURIA; ITO, FUMINORI; SHIGEMITSU, AIKO; KOIKE, NATSUKI; SHIGETOMI, HIROSHI

    2013-01-01

    Uterine sarcoma is a rare neoplasm, accounting for only 5% of uterine malignancies. The pathogenesis of uterine sarcoma remains largely unknown, although recent basic science and pre-clinical animal models have provided a better understanding of tumor biology. The aim of this study was to review the clinical features, imaging characteristics, genetic aberrations and therapeutic approaches in uterine sarcoma. This study reviewed the English-language literature on clinical and basic studies on uterine sarcoma. The common variants of uterine sarcoma are carcinosarcoma, leiomyosarcoma and endometrial stromal sarcoma (ESS). Genetic profiling efforts have identified amplification, overexpression and mutation, while the molecular mechanisms of tumorigenesis driven by these genomic and genetic aberrations have yet to be fully elucidated yet. Recent genome-wide studies have also identified complex chromosomal rearrangements as oncogenic mechanisms. The cell cycle regulators, p16 and p53, are frequently over-expressed and appear to be involved in key modifications of sarcomagenesis. Molecular-targeted therapy has now been evaluated in clinical trials for certain subtypes. In conclusion, aberrations of cell cycle control would be a critical step in the development of uterine sarcoma. This review has provided new areas of study targeting molecular and genetic pathways. PMID:24649216

  3. Avaliação de morfologia e histologia endometrial de mulheres após a menopausa / Assessment of endometrial morphology and histology in postmenopausal women

    Scientific Electronic Library Online (English)

    Luis Paulo Galvao, Wolff; André Aguiar do, Monte; Ana Carolina de Souza, Atti; Ilza Maria Urbano, Monteiro.

    Full Text Available OBJETIVO: Avaliar ambulatorialmente a morfologia e histologia endometrial de mulheres sem sangramento genital após a menopausa. MÉTODOS: Em estudo descritivo foram selecionadas 52 mulheres, após a menopausa, entre 50 e 60 anos, sem terapia hormonal nos últimos seis meses. Todas foram submetidas a ex [...] ame ultrassonográfico, histeroscópico e biópsias endometriais. RESULTADOS: Das 52 mulheres selecionadas 32 (61,5%) apresentaram ultrassonografia normal, cavidade uterina normal com endométrio atrófico à histeroscopia, confirmada pela biópsia endometrial. Vinte (38,4%) apresentaram achados histeroscópicos ou histológicos anormais, sendo que apenas cinco destas mostraram endométrio com espessura superior a cinco milímetros ao ultrassom. CONCLUSÃO: A histeroscopia diagnóstica associada à biópsia aspirativa (Pipelle) pode evidenciar alterações não observadas ao ultrassom transvaginal. Abstract in english OBJECTIVE: Evaluate in outpatients , the endometrial morphology and histology of non- bleeding postmenopausal women. METHODS: We conducted a descriptive study where 52 menopausal women were selected, between 50 and 60 years of age, who had not used hormone replacement therapy in the last six months [...] and did not present any kind of vaginal bleeding after menopause. These women underwent ultrasound examination, hysteroscopy and biopsy, and then endometrial findings were analyzed. RESULTS: Of the 52 women selected, thirty two (61,5%) had normal ultrasound, normal uterine cavity with atrophic endometrium, hysteroscopy, confirmed by endometrial biopsy. Twenty (38,4%) had hysteroscopuc and histologic alterations and only five women showed by ultrasound an endometrial thickness of more than five millimeters. CONCLUSION: Diagnostic Hysteroscopy associated with aspiration biopsy (Pipelle) performed in the day care facility can reveal endometrial alterations that cannot be diagnosed by transvaginal ultrasound.

  4. Local and systemic effects of embryos on uterine tissues during early pregnancy in pigs.

    Science.gov (United States)

    Franczak, Anita; Bogacki, Marek

    2009-06-01

    In the pig, the periimplantation period is critical for successful establishment of pregnancy. We studied the influence of embryos on oxytocin (OT) and progesterone (P(4)) regulated endometrial and myometrial secretion of 1) luteotrophic prostaglandin E(2) (PGE(2)) and 2) luteolytic prostaglandin F(2alpha) and its metabolite (PGFM) on days 12-14 of pregnancy in pigs. We used unilaterally pregnant pigs created by a surgical procedure in which one uterine horn remained intact and the second horn was cut transversely so that part of the horn was detached from the uterine body. The animals were divided into two groups, inseminated gilts (days 12-14 of pregnancy, n=6) and uninseminated cyclic gilts, which were used as controls (days 12-14 of estrous cycle, n=5). Embryos developed only in the patent part of the uterus and not in the occluded horn. The abundance of OTR mRNA was increased in the endometrium and decreased in the myometrium of the gravid uterine horn in the pregnant pigs compared with the non-gravid uterine horn or either uterine horn in the cyclic pigs, indicative of a local effect of the conceptus. The presence of embryos in the uterine horn during the periimplantation period determines endometrial metabolism of PGF(2alpha) and the local response of the endometrium to OT and P(4). OT stimulates PGF(2alpha) secretion and PGFM accumulation in endometrial cultures only from the non-gravid uterine horn and controls PGE(2) secretion from the endometrium and myometrium in the pregnant gilts. The results indicate a more systemic affect of pregnancy on the uterine response to OT and a possibly the local effect of the conceptus in promoting progesterone's inhibition of OT-stimulated PGE(2) secretion and uterine metabolism of PGF(2alpha). PMID:19293562

  5. Citología endometrial en pacientes posmenopáusicas con terapia hormonal

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    Belkys Chacín Peña

    2008-06-01

    Full Text Available Objetivo: Demostrar la utilidad de la toma de muestra con Uterobrush® y compararlo con la biopsia endometrial, en pacientes posmenopáusicas con terapia hormonal. Método: Estudio prospectivo durante un lapso de seis meses, en el cual se incluyeron 30 pacientes, de las cuales 15 referían sangrado genital anormal y 15 no referían sintomatología. A cada paciente se le realizó citología endometrial con Uterobrush® y posteriormente se le realizó biopsia de endometrio con cureta de Novak. El diagnóstico citológico se comparó con el diagnóstico biópsico, para obtener la sensibilidad y especificidad de la técnica con Uterobrush®. Ambiente: Consulta externa del Servicio de Ginecología del Instituto Autónomo Hospital Universitario de Los Andes (IAHULA Mérida. Resultados: El procedimiento fue fácil en un 73,3 % de las pacientes, no refiriendo dolor. No se presentó sangrado posterior a la introducción del Uterobrush® en un 53,3 %. Las muestras fueron adecuadas en el 70 % de los casos. La principal causa de limitación fue la mala preservación de las células. Al comparar los diagnósticos citológicos con la biopsia encontramos una sensibilidad del 71 % y una especificidad del 75 %. Conclusión: La citología endometrial con Uterobrush® es un procedimiento aceptable, fácil de usar, económico, y bien tolerado por las pacientes; siendo útil para la valoración endometrial en mujeres posmenopáusicas y en aquellas que así lo ameriten, pero no se pretende desplazar a la biopsia endometrial sino sugerir estudios más extensos.Objective: To demonstrate the efficacy of endometrial cytology with the Uterobrush® sampler and compare it with endometrial biopsy, in postmenopausal women under hormonal replacement therapy. Method: Prospective study with 30 patients during a lapse of six months, fifteen of them refered abnormal uterine bleeding and the other fifteen did not. Endometrial cytology sampling was done with Uterobrush® and biopsy with Novak´s currette to all patients. Difficulty, pain, bleeding, cervical characteristics, celularity and adequacy of the sampling where assessed, cytology was compared with biopsy diagnosis. Setting: Gynecology service of the University Hospital of Los Andes, Results: 73.3 % of the patients did not refer pain. No bleeding was present after the introduction of Uterobrush ® in 53.3 %. The samples were adequate in 70 % of cases. Principal cause of limitation was poor fixation of cells. When comparing cytologic diagnosis with biopsy we found a sensitivity of 71 % and 75 % specificity. Conclusions: The endometrial cytology with Uterobrush® is a procedure easy to use, economic, and well tolerated by the patients; being useful to evaluate the endometrium in post menopausal women, but not pretending to overtake endometrial biopsy.

  6. A Novel Role for the AAA ATPase Spastin as a HOXA10 Transcriptional Corepressor in Ishikawa Endometrial Cells

    OpenAIRE

    Daftary, Gaurang S.; Tetrault, Amy M.; Jorgensen, Elisa M.; Sarno, Jennifer; Taylor, Hugh S.

    2011-01-01

    Homeobox A10 (HOXA10), a transcription factor required for uterine development and embryo receptivity, functions downstream of estrogen and progesterone in uterine endometrium. HOXA10 represses endometrial expression of empty spiracles homeobox 2 (EMX2), the human ortholog of Drosophila empty spiracles. The ATPases associated with various cellular activities (AAA) ATPase spastin has a well-characterized role in neurotransmitter trafficking. In this study, we characterize a novel role of spast...

  7. Saline infusion sonohysterography versus hysteroscopy for uterine cavity evaluation

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    Khan Faryal

    2011-01-01

    Full Text Available Background and Objectives: The most frequent procedures performed on women with abnormal uterine bleeding are 2D and 3D ultrasound. The most common accepted approach for the management of abnormal uterine bleeding is 2D TV scan followed by therapeutic hysteroscopy. The purpose of this prospective study was to assess whether 3D saline infusion sonohysterography (3D SIS could replace diagnostic hysteroscopy (DH for the diagnosis of endometrial pathology, in patients with abnormal uterine bleeding. Design and Setting: A prospective study in the ultrasound department of the Women?s Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia from January 2008 to February 2010. Patients and Methods: 0One hundred and one patients with abnormal uterine bleeding, suspected to have endometrial abnormality by 2D and 3D transvaginal scan, were prospectively studied. Of these, 55 patients had undergone both 3D SIS and DH, followed by verification of results with histopathology. Results: Upon comparison of 3D SIS and DH individually with histopathology, specificity and sensitivity for 3D SIS were 67% and 100%, respectively, and for hysteroscopy 67% and 98%, respectively. In addition, the positive predictive value and negative predictive value were 98% and 100%, respectively, for 3D SIS, while for DH they were 98% and 67%, respectively. Conclusion: 3D SIS is a safe alternative to hysteroscopy. However, larger randomized controlled trials should be conducted to ascertain the validity and reliability of this advantageous, less-invasive procedure, for women with abnormal uterine bleeding, who require evaluation of the endometrial cavity.

  8. Balão Térmico para Ablação Endometrial: Resultados Preliminares Endometrial Ablation Using a Thermal Balloon: Preliminary Results

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    Francesco Viscomi

    2000-05-01

    Full Text Available Objetivos: os autores mostram a experiência preliminar com o uso do balão térmico para ablação do endométrio em pacientes com queixas de menorragia. Pacientes e Métodos: foram submetidas a este procedimento 20 pacientes. Após exame pélvico completo e ultra-sonografia endovaginal, todas as pacientes foram submetidas à histeroscopia diagnóstica com biópsia de endométrio para excluir causas de malignidade. Das 20 pacientes que se submeteram ao tratamento com balão térmico, 16 foram submetidas em regime ambulatorial com anestesia local. O procedimento teve duração de 8 minutos e 30 segundos. Resultados: duas das 20 pacientes mostraram-se insatisfeitas, mantendo o quadro hemorrágico inalterado, e 18 pacientes referiram melhora da sintomatologia. Não houve complicações do procedimento. Conclusões: o uso do balão térmico para ablação endometrial mostrou-se seguro e eficaz para o tratamento da menorragia de causa benigna.Purpose: to evaluate thermal balloon endometrial ablation in the management of menorrhagia. Study design: twenty patients were submitted to endometrial ablation using the thermal balloon device, between June 1996 and June 1997. Local anesthesia was used in 16 patients. The device was introduced into the uterine cavity. The duration of the procedure was 8 minutes and 30 seconds. Results: two patients (10% did not show improvement of the symptons. Eighteen patients (90% referred improvement of symptoms. There was no complication during and after the procedure. Conclusions: The thermal balloon seems to be safe and efficient in the management of menorrhagia.

  9. Clinical evaluation of high-intensity focused ultrasound in treating uterus myomas

    International Nuclear Information System (INIS)

    Objective: To explore the safety and efficacy of high-intensity focused ultrasound (HIFU) for the treatment of uterus myomas. Methods: HIFU was performed in 47 patients with symptomatic hysteromyoma, who had a childbearing history and were 26-59 years old. Postoperative follow-up was carried out. Clinical symptoms and the tumor's size were observed before and after the HIFU treatment. The results were compared with each other. Results: After HIFU treatment, the symptoms such as dysmenorrhea and hypermenorrhea were markedly improved. Some patients developed hematuria or lower limb pain, which was relieved after symptomatic management. The average volume of myoma before the treatment was (47.6 ± 24.1) cm3 and it was reduced to (17.7 ± 13.1) cm3 at 6 months after the treatment, the difference was statistically significant (P < 0.05). Conclusion: HIFU is a safe and effective treatment for uterus myomas. (authors)

  10. Immature uterine teratoma associated with uterine inversion.

    Science.gov (United States)

    Souza, Karla Teixeira; Negrão, Marcelo Vailati; da Silva Rocha, Lucila Soares; Di Favero, Giovanni; da Costa, Samantha Cabral Severino; Diz, Maria Del Pilar Estevez

    2014-07-30

    Teratomas are the most commonly diagnosed germ cell tumors and occur primarily in testes and ovaries. Platinum-based therapy followed by surgical resection of the residual lesion is generally the recommended treatment. In contrast, immature uterine teratomas are rare, with few cases reported in the literature. Moreover, there is no standard treatment for these tumors. Non-puerperal uterine inversion is also rare in women younger than 45 years of age, and neoplastic lesions are responsible for this condition. Here, we report a case of an immature uterine teratoma associated with uterine inversion. The patient underwent surgery followed by adjuvant chemotherapy and continues to be monitored. PMID:25276328

  11. Development of a high-throughput assay for human proprotein convertase 5/6 for detecting uterine receptivity.

    Science.gov (United States)

    Heng, Sophea; Dynon, Kemperly; Li, Ying; Edgell, Tracey; Walton, Kelly; Rombauts, Luk J; Vollenhoven, Beverley; Nie, Guiying

    2015-04-15

    Embryo implantation requires a healthy embryo and a receptive uterus. In women, the inner lining of the uterus, the endometrium, remains in a hostile state and becomes receptive for embryo implantation for only a short period during each menstrual cycle. Determining endometrial receptivity is vital in in vitro fertilization (IVF) treatment because the timing of embryo transfer needs to be synchronized with endometrial receptivity. We have previously demonstrated that proprotein convertase 5/6A (PC6) is highly expressed in the receptive endometrium and that PC6 is critical for receptivity establishment in women. Furthermore, endometrial PC6 is secreted into the uterine fluid, and levels correlate with receptivity status. Detection of PC6 in uterine fluids, therefore, would provide a nonsurgical assessment of endometrial receptivity. However, to date no assays are available for human PC6. In this study, we produced three PC6 monoclonal antibodies (mAbs) and developed a sandwich enzyme-linked immunosorbent assay (ELISA) for PC6 detection in human uterine fluids. The PC6 mAbs were confirmed to be highly specific to PC6, and the ELISA detected PC6 in human uterine fluids with a significantly higher level during the receptive phase. This newly established PC6 ELISA provides an important tool in the development of noninvasive strategies to detect endometrial receptivity in women. PMID:25554488

  12. Ultrastructural assessment of leiomyoma tissue and different layers of myometrium in patients with uterine leiomyoma during hypo- and hyperestrogenic states after different schemes of gonadotroping relising hormone agonists use

    Directory of Open Access Journals (Sweden)

    Medvedev M.V.

    2011-01-01

    Full Text Available In study conducted ultrastructural analysis of cells and extracellular matrix of myoma tissue and different layers of myometrium in 35 patients with uterine leyomioma in long-term and short-term corre ction of hormonal status before surgery gosereline acetate. Study of ultrastructural characteristics we re performed on ultrathin sectio ns for transmission electron microscope. Studies have shown that the ultrastructural characteristics of uterine le yomioma were similar to those of unchanged myometrium. The most characteristic feature of uterine fibroids is excessive extracellular matrix elements, arranged randomly. Under the action of a-GnRH there were atrophic changes in myocytes, which in most cases do not lead to cell death and is reversible: reducing the size of myocytes in both myomatous tissue and in normal myometrium, two-fold reduction in myofilaments amount in unchanged myometrium and in uterine myoma. Under the influence of hyperestrogenemy, along with increasing size of the nucleus, endoplasmic reticulum elements and number of ribosom es the size of myocytes was likely to increase in both myoma tissue and myometrium; increased the ratio of condensed chromatin to uncondensed one (in simple fibroids – 1.7 times, in cellular fibroids – 2.1 times; increase in 1.5 times the number of myofilaments both in unchanged myometrium and in uterine myoma; increase in number of mitochondria and increase of their size in myomatous tissue only caused mainly by by intracellular edema. Elements of extracellu lar matrix do not depend on short-term action of hyperestrogeny and mid-term action of hypoestrogeny, bu t the synthesis of new fibers is reduc ed under action of artificial menopause.

  13. Pólipo endometrial, una causa infrecuente de sangrado genital anormal en la adolescencia

    Scientific Electronic Library Online (English)

    Constanza, Ralph T; Claudia, Zajer A; Valentina, De Petris V; Roger, Gejman E; Mauricio, Cuello F.

    Full Text Available Antecedentes: El sangrado genital anormal es una causa frecuente de consulta en la adolescencia. En este período, la principal causa de sangrado es la metrorragia asociada a ciclos anovulatorios producto de la inmadurez del eje hipotálamo-hipofisario-gonadal. Dentro de las causas infrecuentes de san [...] grado genital anormal en ese período está el pólipo endometrial. Caso clínico: Presentamos el caso de una niña de 13 años cuya causa de sangrado correspondió a un pólipo endometrial, sospechado por ultrasonografía, resecado mediante histeroscopia y confirmado mediante estudio histológico. Discusión: Pese a su baja incidencia, los pólipos endometriales deben ser considerados como parte del diagnóstico diferencial en adolescentes que consultan por trastorno menstrual, particularmente en aquellos casos sin respuesta a la terapia hormonal y donde la ultrasonografía muestra engrosamiento endometrial. Abstract in english Background: Abnormal genital bleeding is a common cause of medical consultation in patients during adolescence. In this period, the main cause of genital bleeding is metrorrhagia in relation to anovulatory cycles due to immaturity of hypothalamus- pituitary-gonadal axis. Among the uncommon causes of [...] bleeding at this age is the endometrial polyp. Case report: We report a 13 year old girl with abnormal uterine bleeding due to endometrial polyp, suspected during a pelvic ultrasound, removed by hysteroscopy, and confirmed by histological analysis. Discussion: Despite its low incidence, endometrial polyps should be included in the differential diagnosis of adolescents presenting menstrual disorders, particularly in those with no response to hormonal therapy and endometrial thickness in ultrasound.

  14. Endometrial HSD11B1 and cortisol regeneration in the ovine uterus: effects of pregnancy, interferon tau, and prostaglandins.

    Science.gov (United States)

    Dorniak, Piotr; Welsh, Thomas H; Bazer, Fuller W; Spencer, Thomas E

    2012-04-01

    In ruminants, the elongating conceptus secretes interferon tau (IFNT), the pregnancy recognition signal, and prostaglandins (PGs). Progesterone from the ovary induces prostaglandin synthase two (PTGS2) and hydroxysteroid (11-beta) dehydrogenase 1 (HSD11B1) in the endometrial epithelia, and PTGS2-derived PGs regulate endometrial functions and conceptus elongation. The enzyme HSD11B1 interconverts inactive cortisone and active cortisol. These studies determined the effects of pregnancy, IFNT, and PGs on endometrial HSD11B1 expression and activity in the ovine uterus. Study one found that HSD11B1 activity was present in both the endometrium and conceptus during early pregnancy. In study two, ewes received intrauterine infusions of vehicle as a control (CX) or meloxicam (MEL), a PTGS2 inhibitor, from Days 8 to 14 of pregnancy. Endometrial HSD11B1 activity and cortisol in the uterine lumen were substantially lower in MEL-infused ewes. In study three, cyclic ewes received intrauterine infusions of vehicle as a CX, MEL, recombinant ovine IFNT, or IFNT and MEL. Infusion of IFNT increased endometrial HSD11B1 expression and activity and cortisol in the uterine lumen, and this effect was diminished by coinfusion of MEL. In study four, cyclic ewes were infused with vehicle as a CX, IFNT, PGE2, PGF2 alpha, or PGI2. Infusion of all the PGs and IFNT increased endometrial HSD11B1 expression and activity, and IFNT and PGI2 infusion increased cortisol in the uterine lumen. These studies support the idea that IFNT and PGs from the conceptus regulate endometrial HSD11B1 expression and activity that regenerates bioactive cortisol in the ovine uterus during early pregnancy to influence endometrial functions and conceptus elongation. PMID:22205698

  15. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available Uterine Fibroid Embolization Baptist Health South Florida Miami, FL March 25, 2010 Good afternoon, and welcome to the Baptist ... is going to be an embolization of uterine fibroids. So we're going to show you the ...

  16. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... old. She has very symptomatic uterine fibroids, very heavy menstrual periods. Her periods last on the order ... we see in women with uterine fibroids is heavy bleeding. In fact, some of our patients have ...

  17. Rare case of aub in a postmenopausal women endometrial stromal sarcoma: A case report

    Directory of Open Access Journals (Sweden)

    Nishu Bhandari

    2014-11-01

    Full Text Available Endometrial Stromal Sarcomas (ESSs are very rare malignant tumors that constitute approximately 10% of all uterine sarcomas but only around 0.2% of all uterine malignancies(1 The annual incidence of ESS is 1–2 per million women. It is also known as endometrial stromal myosis. The median age was 44.35 ± 6 years. Women with ESS are younger than women with other uterine sarcomas, with a median age between 45 and 57 years and, generally do not have the usual risk factors for endometrial cancer. Reported cases of endometrial stromal sarcoma in a postmenopausal woman are a rare entity.These tumors are said to be hormone dependent and therefore seems to be more common in reproductive and perimenopausal age group. Patients mainly presents with complaints of heavy vaginal bleeding and pain abdomen. ESS can be mistaken for leiomyoma. Clinical and radiology findings are suggestive of a leiomyoma. HPE remains the mainstay for diagnosis of such tumors. As these tumors are known for their recurrences close follow up of these patients is very important.

  18. Activated mutant p110? causes endometrial carcinoma in the setting of biallelic Pten deletion.

    Science.gov (United States)

    Joshi, Ayesha; Miller, Christopher; Baker, Suzanne J; Ellenson, Lora H

    2015-04-01

    PTEN and PIK3CA mutations occur with high frequency in uterine endometrioid carcinoma (UEC). Although PTEN mutations are present in complex atypical hyperplasia and carcinoma, PIK3CA mutations are restricted to carcinoma. We generated mouse models harboring Pten loss and/or activated Pik3ca in the endometrial epithelium to investigate their respective roles in the pathogenesis of UEC. Presence of an activated mutant Pik3ca on the background of Pten loss led to aggressive disease, with 100% of mice exhibiting carcinoma. Expression of Pik3ca with E545K mutation alone was unable to cause hyperplasia or cancer in the uterus and did not activate Akt as effectively as Pten deletion in short-term cultures of mouse endometrial epithelium, likely explaining the lack of phenotype in vivo. We also report that nuclear localization of FOXO1 correlated with PTEN mutational status irrespective of the PIK3CA status in endometrial cancer cell lines. Furthermore, gene expression profiles resulting from Pten loss or activation of Pik3ca in primary mouse endometrial epithelial cells exhibit minimal overlap. Thus, Pten and Pik3ca have distinct consequences on the activation of the phosphatidylinositol 3-kinase pathway in endometrial epithelium and are likely to affect other nonoverlapping cellular mechanisms involved in the development and progression of the most common type of uterine cancer. PMID:25698082

  19. Apparent diffusion coefficient of diffusion weighted MRI in endometrial carcinoma—Relationship with local invasiveness

    International Nuclear Information System (INIS)

    Objective: To evaluate the relationship between apparent diffusion coefficient (ADC) value and the local invasiveness of endometrial carcinoma. Methods and materials: The MR imaging of seventy-three patients with endometrial carcinoma proved by post-operative pathology and sixty-four patients with healthy uteri were retrospectively reviewed. All MR examinations included axial T2WI and T1WI, sagittal T2WI and diffusion-weighted sequences (b = 0 and b = 1000 s/mm2). Tumor size, mean ADC value (ADCm) and quartile ADC (ADCq) were acquired on post-processing workstation using voxel-analysis software. Differences between the ADC values among three layers of normal uterine body and endometrial carcinomas were compared by ANOVA test. Groups were divided according to pathologic type, histologic grade, depth of myometrial infiltration, presence of cervical invasion and lymphovascular space invasion, and lymph node metastasis. Tumor size and ADC values were compared and analyzed. Results: ADC values were different in three zones of uterine body (P ?3 mm2/s] and highest in outer myometrium [(1.496 ± 0.196) × 10?3 mm2/s]. Mean ADC value of endometrial carcinomas [(1.011 ± 0.121) × 10?3 mm2/s] was lower than the normal uterine body. Quartile ADC and tumor size were greater in groups with more invasive pathologic factors (P < 0.05). Deep myometrial infiltration, cervical invasion, lymphovascular space invasion and lymph node metastasis were more common as quartile ADC values and tumor sizes increased. Conclusion: Mean ADC value was lower in endometrial carcinoma was lower than the normal uterus. Quartile ADC, representing the intra-tumor heterogeneity of water movement, had a profound relationship with invasiveness of endometrial carcinomas, while mean ADC value did not. ADC values may serve as a quantitative indicator to complement routine sequences.

  20. Uterine Artery Embolization Versus Laparoscopic Uterine Artery Occlusion: The Outcomes of a Prospective, Nonrandomized Clinical Trial

    International Nuclear Information System (INIS)

    Purpose: To compare outcomes of two different types of occlusive therapy of uterine fibroids. Methods: Women with fibroid(s) unsuitable for laparoscopic myomectomy (LM) were treated with uterine artery embolization (UAE) or laparoscopic uterine artery occlusion (LUAO). Results: Before the procedure, patients treated with UAE (n = 100) had a dominant fibroid greater in size (68 vs. 48 mm) and a mean age lower (33.1 vs. 34.9 years) than surgically treated patients (n = 100). After 6 months, mean shrinkage of fibroid volume was 53 % after UAE and 39 % after LUAO (p = 0.063); 82 % of women after UAE, but only 23 % after LUAO, had complete myoma infarction (p = 0.001). Women treated with UAE had more complications (31 vs. 11 cases, p = 0.006) and greater incidence of hysteroscopically verified intrauterine necrosis (31 vs. 3 %, p = 0.001). Both groups were comparable in markers of ovarian functions and number of nonelective reinterventions. The groups did not differ in pregnancy (69 % after UAE vs. 67 % after LUAO), delivery (50 vs. 46 %), or abortion (34 vs. 33 %) rates. The mean birth weight of neonates was greater (3270 vs. 2768 g, p = 0.013) and the incidence of intrauterine growth restriction lower (13 vs. 38 %, p = 0.046) in post-UAE patients. Conclusion: Both methods are effective in the treatment of women with future reproductive plans and fibroids not suitable for LM. UAE is more effective in causing complete ischemia of fibroids, but it is associated with greateribroids, but it is associated with greater risk of intrauterine necrosis. Both methods have low rate of serious complications (except for a high abortion rate).

  1. Uterine Artery Embolization Versus Laparoscopic Uterine Artery Occlusion: The Outcomes of a Prospective, Nonrandomized Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Mara, Michal; Kubinova, Kristyna, E-mail: kristyna.kubinova@gmail.com [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic); Maskova, Jana [Aberdeen Royal Infirmary, Department of Radiology (United Kingdom); Horak, Petr [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic); Belsan, Tomas [Central Military Hospital, Department of Radiology (Czech Republic); Kuzel, David [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic)

    2012-10-15

    Purpose: To compare outcomes of two different types of occlusive therapy of uterine fibroids. Methods: Women with fibroid(s) unsuitable for laparoscopic myomectomy (LM) were treated with uterine artery embolization (UAE) or laparoscopic uterine artery occlusion (LUAO). Results: Before the procedure, patients treated with UAE (n = 100) had a dominant fibroid greater in size (68 vs. 48 mm) and a mean age lower (33.1 vs. 34.9 years) than surgically treated patients (n = 100). After 6 months, mean shrinkage of fibroid volume was 53 % after UAE and 39 % after LUAO (p = 0.063); 82 % of women after UAE, but only 23 % after LUAO, had complete myoma infarction (p = 0.001). Women treated with UAE had more complications (31 vs. 11 cases, p = 0.006) and greater incidence of hysteroscopically verified intrauterine necrosis (31 vs. 3 %, p = 0.001). Both groups were comparable in markers of ovarian functions and number of nonelective reinterventions. The groups did not differ in pregnancy (69 % after UAE vs. 67 % after LUAO), delivery (50 vs. 46 %), or abortion (34 vs. 33 %) rates. The mean birth weight of neonates was greater (3270 vs. 2768 g, p = 0.013) and the incidence of intrauterine growth restriction lower (13 vs. 38 %, p = 0.046) in post-UAE patients. Conclusion: Both methods are effective in the treatment of women with future reproductive plans and fibroids not suitable for LM. UAE is more effective in causing complete ischemia of fibroids, but it is associated with greater risk of intrauterine necrosis. Both methods have low rate of serious complications (except for a high abortion rate).

  2. Successful robot-assisted surgery for treating endometrial cancer affecting bicornuate-bicollis or didelphic uterus

    Directory of Open Access Journals (Sweden)

    Francesco Petruzzelli

    2013-07-01

    Full Text Available Uterine anomalies are mainly associated with improper development of Mullerian ducts. To our knowledge, reports describing the use of a da Vinci Robot System for treating an endometrial cancer in a woman with an abnormal uterus are lacking. Here, we reported the description of two extremely obese women, affected by endometrial cancer and presenting bicornuate-bicollis and didelphic uterus have been treated by Robot System-assisted surgery. No operative and postoperative complications were recorded. Both women are disease-free to follow-up. A robot-assisted surgery could represent an effective treatment option for complex hysterectomies and in complicated patients, as those showing an extreme obesity.

  3. Diagnostic double guraded low-volume uterine lavage in mares

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Brandis, Louise

    2014-01-01

    Endometritis constitutes a major problem in the management of broodmares; hence diagnostic tests with a high sensitivity and specificity are desired. We hypothesize that a double guarded uterine flush technique for bacterial culture and cytology is comparable to standard diagnostic tests, the endometrial biopsy and double guarded swab. Endometrial biopsies (n=199), swabs (n=199) and double guarded lavage samples (n=199) were obtained from 34 mares at six different time points in four estrous cycles, and were evaluated cytologically and bacteriologically. Endometrial biopsies from the first cycle (n=34) were examined for the presence of polymorphonuclear neutrophils (PMNs) in the endometrial epithelium and was used as a gold standard for calculation of diagnostic sensitivity. E. coli was most frequently isolated (lavage: 31%, swab: 21%, biopsy: 12%) followed by ?-hemolytic streptococci (lavage: 11%, swab: 8%, biopsy: 7%) (positive bacterial growth > 4 Colony forming units (CFU)). Positive cytology was less likely to occur when E. coli was isolated from the diagnostic tests compared to the growth of ?-hemolytic streptococci. Isolation of pathogens from uterine samples was highly associated with the presence of PMNs on histology (p=0.003). Using the presence of PMNs in the endometrial tissue as the gold standard for diagnosing endometritis, the sensitivity of double guarded lavage culture was 0.75, and 0.33 and 0.5 for the swab and biopsy, respectively. In conclusion, the double guarded lavage technique was an accurate method for diagnosing mares with endometritis and the risk of false positive samples is considered to be minimal compared to other flushing techniques described. Key words: Endometritis, double guarded lavage, diagnostic test, E. coli, ?-hemolytic streptococci

  4. QUANTIFICATION OF NUCLEOLAR CHANNEL SYSTEMS: UNIFORM PRESENCE THROUGHOUT THE UPPER ENDOMETRIAL CAVITY

    Science.gov (United States)

    Szmyga, Michael J.; Rybak, Eli A.; Nejat, Edward J.; Banks, Erika H.; Whitney, Kathleen D.; Polotsky, Alex J.; Heller, Debra S.; Meier, U. Thomas

    2014-01-01

    Objective To determine the prevalence of nucleolar channel systems (NCSs) by uterine region applying continuous quantification. Design Prospective clinical study. Setting Tertiary care academic medical center. Patients 42 naturally cycling women who underwent hysterectomy for benign indications. Intervention NCS presence was quantified by a novel method in six uterine regions, fundus, left cornu, right cornu, anterior body, posterior body, and lower uterine segment (LUS), using indirect immunofluorescence. Main Outcome Measures Percent of endometrial epithelial cells (EECs) with NCSs per uterine region. Results NCS quantification was observer-independent (intraclass correlation coefficient [ICC] = 0.96) and its intra-sample variability low (coefficient of variability [CV] = 0.06). 11/42 hysterectomy specimens were midluteal, 10 of which were analyzable with 9 containing over 5% EECs with NCSs in at least one region. The percent of EECs with NCSs varied significantly between the lower uterine segment (6.1%; IQR = 3.0-9.9) and the upper five regions (16.9%; IQR = 12.7-23.4) with fewer NCSs in the basal layer of the endometrium (17% +/?6%) versus the middle (46% +/?9%) and luminal layers (38% +/?9%) of all six regions). Conclusions NCS quantification during the midluteal phase demonstrates uniform presence throughout the endometrial cavity, excluding the LUS, with a preference for the functional, luminal layers. Our quantitative NCS evaluation provides a benchmark for future studies and further supports NCS presence as a potential marker for the window of implantation. PMID:23137760

  5. Accuracy of doppler ultrasound in diagnosis of endometrial carcinoma

    International Nuclear Information System (INIS)

    Objective: To determine the accuracy of Doppler ultrasound in the diagnosis of endometrial carcinoma in patients presenting with post-menopausal bleeding while taking histopathological findings as the gold standard. Methods: The cross-sectional study was done at the Department of Radiology, Bahawal Victoria Hospital, Bahawalpur, from April 1 to September 30, 2009, and comprised 128 patients above 50 years of age having history of post-menopausal bleeding and who were referred to the department. Name, age and hospital registration number were recorded on a proforma. Doppler ultrasound was performed and endometrial thickness and uterine artery resistive index were recorded on transabdominal ultrasonography. Patients with endometrial thickness of more than 5mm and uterine artery resistive index of less than 0.7 were considered to be having endometrial carcinoma. Histopathology findings were also recorded using the hospital registration number of the patient. The findings of Doppler ultrasound scan were validated with the findings of histopathology. Results: Of the 128 patients, 48 (37.5%) were between the ages of 51 and 55 years; 46 (35.93%) were in the 56-60 age group; and 34 (26.57%) were over 65 years. On the basis of Doppler ultrasound findings, 106 (82.8%) patients were diagnosed as having endometrial carcinoma, while 22 (17.19%) were declared negative. Ultrasonography results were compared with histopathology findings. The percentages of true positive, true negative, false positive and false negative were calculated. There were 103 (80.47%) true positive; 12 (9.37%) false positive; 10 (7.81%) true negative; and 3 (2.35%) false negative. Specificity, sensitivity, positive predictive value and negative predictive value were found to be 97.16%, 76%, 89.56% and 76.92% respectively. Conclusion: The use of Doppler ultrasonography in non-invasive diagnosis of endometrial carcinoma in patients presenting with post-menopausal bleeding was quite useful with good sensitivity, specificity, as well as positive and negative predictive values. There were no procedural complications. (author)

  6. Treatment Options by Stage (Endometrial Cancer)

    Science.gov (United States)

    ... if you think you may be at risk. Risk factors for endometrial cancer include the following: Being obese . Having high blood pressure . Having diabetes mellitus . Taking tamoxifen for breast ... increase the risk of endometrial cancer. Endometrial cancer may develop in ...

  7. Comparison of transvagianl ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding

    International Nuclear Information System (INIS)

    To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination. endometrial cavitary lesions were classified as diffuse hyperplasis, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding

  8. What Is Endometrial Cancer?

    Science.gov (United States)

    ... grade cancers (grades 1 and 2). Type 1 endometrial cancers are thought to be caused by excess estrogen. They sometimes develop from atypical hyperplasia, an abnormal overgrowth of cells in the endometrium (see the risk factors section). Type 1 cancers are usually not very ...

  9. Effect of Isopropanolic Cimicifuga racemosa Extract on Uterine Fibroids in Comparison with Tibolone among Patients of a Recent Randomized, Double Blind, Parallel-Controlled Study in Chinese Women with Menopausal Symptoms.

    Science.gov (United States)

    Xi, Sisi; Liske, Eckehard; Wang, Shuyu; Liu, Jianli; Zhang, Zhonglan; Geng, Li; Hu, Lina; Jiao, Chunfeng; Zheng, Shurong; Zepelin, Hans-Heinrich Henneicke-von; Bai, Wenpei

    2014-01-01

    Objective. Effect of isopropanolic Cimicifuga racemosa extract (iCR) on uterine fibroid size compared with tibolone. Method. The randomized, double-blind, controlled study in China enrolled 244 patients aged 40-60 years with menopausal symptoms (Kupperman Menopause Index ? 15). The participants were treated with either iCR of 40 mg crude drug/day (N = 122) or tibolone 2.5?mg/day (N = 122) orally for 3 months in 2004. Now, we investigated the subset of all women (N = 62) with at least one uterine fibroid at onset of treatment for the effect of iCR (N = 34) on fibroid size compared with tibolone (N = 28) by transvaginal ultrasonography. Results. The median myoma volume decreased upon iCR by as much as -30% (P = 0.016) but increased upon tibolone by +4.7%. The percentage of volume change, mean diameter change and geometric mean diameter change of the iCR group compared to tibolone were statistically significant (P = 0.016, 0.021, 0.016 respectively). Conclusion. Our results suggest that iCR (Remifemin) is a valid herbal medicinal product in patients with uterine myomas as it provides adequate relief from menopausal symptoms and inhibits growth of the myomas in contrast to tibolone. PMID:24719645

  10. Preoperative staging of endometrial cancer using TVS, MRI, and hysteroscopy

    DEFF Research Database (Denmark)

    Ørtoft, Gitte; Dueholm, Margit

    2013-01-01

    OBJECTIVES: To evaluate the accuracy of different preoperative modalities for staging of endometrial cancer to restrict extensive surgery to patients at high risk of metastatic disease. SETTING: Aarhus University Hospital. POPULATION: 156 women referred in 2006-2011 because of atypical endometrial hyperplasia (G0) or endometrial cancer. METHODS: Patients were offered preoperative transvaginal ultrasonography (TVS), magnetic resonance imaging (MRI), and hysteroscopic-directed biopsies from the uterine tumor and cervix. Final pathology of the removed uterus was the reference standard. Patients were divided into low risk (<50% myometrial invasion, and grades 0, 1, 2, and no cervical invasion) or high risk (all others). MAIN OUTCOME MEASURES: Accuracy, sensitivity, specificity, positive/negative predictive value. RESULTS: Patients were aged 32-88 years, with a mean body mass index of 29. At final pathology 81% had cancer and 19% G0 or no residual tumor; 54% were high risk. Hysteroscopy-directed biopsies had a higher accuracy (92%) than endometrial biopsy (58%) for differentiating G0 from cancer (p < 0.001); grade 3 tumor identification had similar accuracy (93 vs. 92%). Deep myometrial invasion was estimated with higher accuracy by MRI (82%) than TVS (74%) (p < 0.02). For cervical involvement, hysteroscopy-directed biopsies had higher accuracy (94%) than MRI (84%,) and TVS (80%) (p < 0.02). Accuracy for identifying high-risk women was highest (83%) using a combination of MRI and hysteroscopic-directed biopsies, compared with TVS and endometrial biopsy (72%) (p < 0.05). CONCLUSION: Preoperative staging with MRI and hysteroscopy-directed biopsy can identify eight of 10 women with high risk of lymph node metastases and spare eight of 10 low-risk women extended surgery.

  11. Conceptus-derived prostaglandins regulate endometrial function in sheep.

    Science.gov (United States)

    Dorniak, Piotr; Bazer, Fuller W; Wu, Guoyao; Spencer, Thomas E

    2012-07-01

    In sheep, the trophectoderm of the elongating conceptus secretes interferon tau (IFNT) and prostaglandins (PGE2, PGF2alpha, PGI2). The PGs are derived from PG synthase 2 (PTGS2), and inhibition of PTGS2 in utero prevents conceptus elongation. IFNT increases expression of many genes in the endometrial epithelia that regulate conceptus elongation. This study tested the hypothesis that PGs secreted by the conceptus regulate endometrial functions that govern conceptus elongation. Cyclic ewes received intrauterine infusions of control vehicle or early pregnancy levels of IFNT, PGE2, PGF2alpha, or PGI2 from Days 10-14 postestrus. Expression levels of endometrial GRP, IGFBP1, and LGALS15, whose products stimulate trophectoderm cell migration and attachment, were increased by PGE2, PGI2, and IFNT. All PGs and IFNT increased expression of the HEXB protease gene, but only IFNT increased the CST6 protease inhibitor gene. Differential effects of PGs were observed for expression of the CTSL protease gene and its inhibitor, CST3. IFNT, PGF2alpha, and PGI2 increased ANGPTL3 expression, but only IFNT and PGE2 increased HIF1A expression, both of which regulate angiogenesis. For glucose transporters, IFNT and all PGs increased SLC2A1 expression, but only PGs increased SLC2A5 expression, whereas endometrial SLC2A12 and SLC5A1 expression levels were increased by IFNT, PGE2, and PGF2alpha. Infusions of all PGs and IFNT increased the amino acid transporter SLC1A5, but only IFNT increased SLC7A2 expression. In the uterine lumen, only IFNT increased glucose levels, and only PGE2 and PGF2alpha increased total amino acids. These results indicate that PGs and IFNT from the conceptus coordinately regulate endometrial functions important for growth and development of the conceptus during the peri-implantation period of pregnancy. PMID:22517622

  12. Uterine artery embolization to treat uterine fibroids

    International Nuclear Information System (INIS)

    The first reported application of uterine artery embolization, in 1979, was to treat life-threatening hemorrhage after a failed hysterectomy. Since then, uterine artery embolization has been used very successfully to control acute or delayed post-partum hemorrhage, post-surgical hemorrhage and hemorrhage from ectopic pregnancy, to treat uterine arteriovenous malformations and as prophylaxis before high-risk surgery, such as cesarean delivery in women with placenta previa. In contrast to these proven but underutilized applications, uterine embolization for fibroids has, in a short time, achieved significant notice in the lay press and is being widely offered. Ravina and colleagues, first reported uterine fibroid shrinkage after embolization for the treatment of acute bleeding. Since then, his group has performed over 100 procedures with up to a 6-year follow-up. The cumulative clinical success rate for the treatment of abnormal uterine bleeding due to fibroids is reported to be approximately 85% and for treatment of pain or pressure symptoms, about 75%. Six-month follow-up sonography reveals an average reduction of fibroid size of approximately 40%. However, to date, no studies have compared patients who undergo embolization with a nontreatment cohort or with surgical intervention. (author)

  13. Uterine artery embolization to treat uterine fibroids

    Energy Technology Data Exchange (ETDEWEB)

    Machan, L.; Martin, M. [Univ. of British Columbia Hospital, Dept. of Radiology, Vancouver, BC (Canada)

    2001-06-01

    The first reported application of uterine artery embolization, in 1979, was to treat life-threatening hemorrhage after a failed hysterectomy. Since then, uterine artery embolization has been used very successfully to control acute or delayed post-partum hemorrhage, post-surgical hemorrhage and hemorrhage from ectopic pregnancy, to treat uterine arteriovenous malformations and as prophylaxis before high-risk surgery, such as cesarean delivery in women with placenta previa. In contrast to these proven but underutilized applications, uterine embolization for fibroids has, in a short time, achieved significant notice in the lay press and is being widely offered. Ravina and colleagues, first reported uterine fibroid shrinkage after embolization for the treatment of acute bleeding. Since then, his group has performed over 100 procedures with up to a 6-year follow-up. The cumulative clinical success rate for the treatment of abnormal uterine bleeding due to fibroids is reported to be approximately 85% and for treatment of pain or pressure symptoms, about 75%. Six-month follow-up sonography reveals an average reduction of fibroid size of approximately 40%. However, to date, no studies have compared patients who undergo embolization with a nontreatment cohort or with surgical intervention. (author)

  14. Temsirolimus and Bevacizumab in Treating Patients With Advanced Endometrial, Ovarian, Liver, Carcinoid, or Islet Cell Cancer

    Science.gov (United States)

    2015-05-06

    Adult Hepatocellular Carcinoma; Advanced Adult Hepatocellular Carcinoma; Endometrial Serous Adenocarcinoma; Localized Non-Resectable Adult Liver Carcinoma; Lung Carcinoid Tumor; Malignant Ovarian Mixed Epithelial Tumor; Malignant Pancreatic Gastrinoma; Malignant Pancreatic Glucagonoma; Malignant Pancreatic Insulinoma; Malignant Pancreatic Somatostatinoma; Metastatic Digestive System Neuroendocrine Tumor G1; Ovarian Carcinosarcoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Serous Surface Papillary Adenocarcinoma; Pancreatic Alpha Cell Adenoma; Pancreatic Beta Cell Adenoma; Pancreatic Delta Cell Adenoma; Pancreatic G-Cell Adenoma; Pancreatic Polypeptide Tumor; Recurrent Adult Liver Carcinoma; Recurrent Digestive System Neuroendocrine Tumor G1; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Pancreatic Neuroendocrine Carcinoma; Recurrent Primary Peritoneal Carcinoma; Recurrent Uterine Corpus Carcinoma; Regional Digestive System Neuroendocrine Tumor G1; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IIIC Uterine Corpus Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer; Uterine Carcinosarcoma

  15. Temsirolimus and Bevacizumab in Treating Patients With Advanced Endometrial, Ovarian, Liver, Carcinoid, or Islet Cell Cancer

    Science.gov (United States)

    2015-07-16

    Adult Hepatocellular Carcinoma; Advanced Adult Hepatocellular Carcinoma; Endometrial Serous Adenocarcinoma; Localized Non-Resectable Adult Liver Carcinoma; Lung Carcinoid Tumor; Malignant Ovarian Mixed Epithelial Tumor; Malignant Pancreatic Gastrinoma; Malignant Pancreatic Glucagonoma; Malignant Pancreatic Insulinoma; Malignant Pancreatic Somatostatinoma; Metastatic Digestive System Neuroendocrine Tumor G1; Ovarian Carcinosarcoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Serous Surface Papillary Adenocarcinoma; Pancreatic Alpha Cell Adenoma; Pancreatic Beta Cell Adenoma; Pancreatic Delta Cell Adenoma; Pancreatic G-Cell Adenoma; Pancreatic Polypeptide Tumor; Recurrent Adult Liver Carcinoma; Recurrent Digestive System Neuroendocrine Tumor G1; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Pancreatic Neuroendocrine Carcinoma; Recurrent Primary Peritoneal Carcinoma; Recurrent Uterine Corpus Carcinoma; Regional Digestive System Neuroendocrine Tumor G1; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IIIC Uterine Corpus Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer; Uterine Carcinosarcoma

  16. Abnormal Uterine Bleeding

    Science.gov (United States)

    ... bleeding? • Glossary Abnormal Uterine Bleeding • Use of some birth control methods, such as an intrauterine device (IUD) or birth control pills • Infection of the uterus or cervix • Fibroids • ...

  17. Endometrial spiral artery Doppler parameters in unexplained infertility patients: is endometrial perfusion an important factor in the etiopathogenesis?

    Directory of Open Access Journals (Sweden)

    Selda Uysal

    2012-09-01

    Full Text Available Objective: Uterine perfusion, particularly the endometrial blood flow, may have an important role in endometrial receptivity. In order to assess the contribution of sub endometrial blood flow in the etiopathogenesis of unexplained infertility mid luteal- peri-implantation period spiral artery transvaginal color Doppler parameters were measured and compared with fertile controls. Material and Methods: Forty-two consecutive patients admitted to Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Obstetric and Gynecology with the diagnosis of unexplained infertility after standard diagnostic work up constituted the study group and they were compared with a fertile control group admitted to hospital with non specific gynecological complaints or for check-up in the same period. Mid luteal transvaginal color Doppler ultrasonography was applied to each patient by the same radiologist who was blind to the diagnosis of the particular patient and, RI (resistance index and PI (pulsatility index values were calculated. Results: There were no significant differences between the two groups, in respect to age, body mass index, basal hormonal and mid luteal progesterone levels (p>0.05. For the fertile control group, mid luteal-peri-implantation phase endometrial spiral artery mean RI values were calculated as 0.48±0.08 SD and mean PI values as 0.65±0.18 SD. For the study group, mean RI values were calculated as 0.54±0.07 SD, PI values were calculated as 0.80±0.16 SD. The differences for RI (p=0.009 and PI (p=0.004 were statistically significant. Conclusion: According to Doppler parameters, unexplained infertility patients have high impedance blood flow in spiral arteries which means that peri-implantation blood flow in these patient is lower than fertile controls. These findings suggest that endometrial perfusion may have an important contribution to etiopathogenesis of unexplained infertility.

  18. THE INVESTIGATION OF COMPLEX ENDOMETRIAL HYPERPLASIA PREVALENCE BY DIAGNOSTIC CURETTAGE AND SOME OF RISKFACTORS AFFILIATED TO IT IN AHVAZ-RAZI HOSPITAL

    Directory of Open Access Journals (Sweden)

    Ali Ghomeishi and Mahin Najafian*

    2014-12-01

    Full Text Available The endometrial hyperplasia indicates the wide spectrum of limit variation of endometrial hyperplasia which has changed from intensification of physiological status to carcinoma. The endometrial hyperplasia is the introduction of the endometrial cancer, which is the most common female genital tract malignancy. Studies suggest that abnormal uterine bleeding is the most common indication of the endometrial hyperplasia that is performed for diagnosis of diagnostic curettage. With regard to the mentioned issue of this study, in order to identify factors associated with endometrial hyperplasia have been performed. This cross-sectional study has been performed on one thousand diagnostic curettage specimen’s from 1390 to 1393 (During the last three years in RaziAhvaz hospital. The specimens based on the presence or absence of endometrial hyperplasia were divided into two groups. Then factors such as age, menstrual pattern, diabetes, hypertension, history of infertility, age over 45years, obesity, use of oral contraceptives were studied and compared. In this study of a thousand cases of diagnostic curettage, because of abnormal uterine bleeding in 160 patients(16% complex hyperplasia, with factors such as oligomenorrhea38% vs.8/5 % (P<0/0001 and diabetes (28% versus (P<0/001, hypertension 32% versus 12% (P<0/001, history of infertility, 19% vs. 5/5% (P<0/001, age over 45years, 32% versus 19% (P<0/001, obesity BMI> 30 46% versus 18% (P<0/001, nulliparity 9% versus 1% (P<0/001 had significant relationship with endometrial hyperplasia. But there was no significant relationship with use of oral contraceptive. According to this study, women who were obese and have history of hypertension, diabetes, infertility, menstrual disorders as oligomenorrhea are at high risk for developing endometrial hyperplasia which at last leads to endometrial cancer.

  19. Effects of reproduction on spontaneous development of endometrial adenocarcinomas and mammary tumors in Donryu rats.

    Science.gov (United States)

    Nagaoka, T; Takegawa, K; Takeuchi, M; Maekawa, A

    2000-04-01

    Effects of reproduction on spontaneous development of uterine endometrial adenocarcinomas and mammary tumors in Donryu rats were investigated. While the incidence of endometrial adenocarcinomas in Donryu rats was not influenced by a single reproductive experience (SRE), it showed a tendency to decrease in animals having three reproductive experiences (TRE), compared to the nulliparous case (NRE). In addition, both SRE and TRE animals showed delayed occurrence and decreased incidences and mean numbers of mammary tumors, along with reduced incidences of proliferative lesions in the pituitary gland and mucinous epithelium in the vagina. The appearance-time and incidences of persistent estrus in TRE rats were delayed and low, respectively, compared to the SRE and NRE values. The hormonal environment was altered in both groups, the prolactin level in TRE especially being decreased. These results suggest that suppression of the occurrence of endometrial adenocarcinomas and mammary tumors in rats experiencing reproduction is associated with change in the hormonal milieu. PMID:10804284

  20. Lower values of VEGF in endometrial secretion are a possible cause of subfertility in asthmatic patients

    DEFF Research Database (Denmark)

    Gade, Elisabeth Juul; Thomsen, Simon Francis

    2014-01-01

    Abstract Objective: Using endometrial secretion analysis, we assessed whether altered inflammatory cytokine levels can be detected in the uterine environment in asthma patients, thereby providing a possible cause of reduced fertility in asthmatics. Methods: Forty-four unexplained infertile women (aged 28-44) underwent asthma and allergy testing, questionnaires, endometrial secretion and blood samples in the mid-secretory phase of the menstrual cycle (day 19-23) during assisted reproduction. Differences in cytokines and growth factors were analyzed. Results: Mean log-VEGF in uteri was lower in asthma patients compared with controls (2.29 vs. 2.70, p=0.028). This was mainly due to lower values of VEGF among women with non-atopic asthma compared with women with atopic asthma (1.86 vs. 2.72, p=0.009) and with healthy controls (1.86 vs. 2.70, p=0.01). Asthma treatment status had no effect on VEGF levels in uteri. Serum high sensitivity CRP was negatively correlated with VEGF in endometrial secretions. No other significant correlations were observed between peripheral blood values and markers found in utero. Conclusion: Asthma is associated with lower values of VEGF in uterine endometrial secretions, which might affect the receptiveness of the endometrium and thereby increase time to pregnancy. The effect appears to be associated with non-atopic asthma with general increased systemic inflammation.

  1. Metaplasia óssea e esterilidade primária / Endometrial osseous metaplasia and primary infertility

    Scientific Electronic Library Online (English)

    Celeste P. Demeterco, Reggiani; Marcelo K., Murata; Marcelo G., Cequinel; César A., Cornel; Jorjan, Cruz; Jean F., Francisco; Augusto F., Beduschi.

    2001-03-01

    Full Text Available A metaplasia óssea do endométrio é uma condição rara e pode ser explicada por uma neoformação no endométrio, com deposição de sais de cálcio. Entretanto, a situação mais comum é a história prévia de abortamento com permanência de ossículos na cavidade uterina. Foi relatado um caso de ossificação end [...] ometrial em uma mulher de 31 anos, sem gravidez prévia ou história de aborto, apresentando dismenorréia e infertilidade. A ultra-sonografia pélvica mostrou área hiperecóica no fundo da cavidade uterina. A histeroscopia foi realizada e uma imagem sugestiva de tecido ósseo foi encontrada. Este tecido foi retirado e a histopatologia confirmou a ossificação endometrial. Abstract in english Endometrial metaplastic ossification is a rare condition and can be partially explained by a neoformation in the endometrium, with calcium deposition. However, a common situation is the previous history of abortion with persistence of ossicles in the uterine cavity. The endometrial ossification was [...] reported in a 31-year-old woman, without previous pregnancy or history of abortion. This patient presented dysmenorrhea and infertility. Pelvic ultrasonography showed a hyperechoic area in the uterine fundus. Histeroscopy was performed and an image suggestive of bone was seen. This tissue was removed by histeroscopy and the histopathological analysis confirmed endometrial ossification.

  2. Stimulation of decidua development by transplantation of endometrial stem cells

    Directory of Open Access Journals (Sweden)

    Alisa P. Domnina

    2013-08-01

    Full Text Available On all terms of pregnancy, insolvency of decidual reaction of endometrial cells is one of the reasons of miscarriages and fetal growth delay. The insufficient decidualization of endometrum leads to infertility in such pathologies, as Asherman’s syndrome and an endometrium atrophy. However, there are data on successful application of autologous bone marrow MSCs for Asherman’s syndrome treatment. The aim of this work was to assay the effect of endometrial mesenchymal stem cell (eMSC transplantation for decidualization process in pseudopregnant rat. Our study showed that injection of human eMSC suspension into the uterine lumen of pseudopregnant rats facilitated more intensive development of decidua in comparison with phosphate buffed saline (PBS injection in the control uterine horn. Histological analysis of decidua sections did not reveal any alterations in cell differentiation or tissue structure. In conclusion, we demonstrated for the first time that eMSC transplantation assists the development of all decidual tissue elements. It opens the possibility that eMSCs may be applied for cell therapy of infertility associated with decidualzation insufficiency.

  3. Resveratrol interferes with AKT activity and triggers apoptosis in human uterine cancer cells

    Directory of Open Access Journals (Sweden)

    Asselin Eric

    2006-10-01

    Full Text Available Abstract Background Endometrial cancer is the fourth most prominent cancer among all feminine cancers in the Western world. Resveratrol, a natural anti-oxidant found in red wine emerging as a novel anticancer agent, exerts antiproliferative and pro-apoptotic activity in various cancer cell types, but its effect on uterine cancer cells is poorly understood. At the molecular level, resveratrol has been reported to inhibit cyclooxygenase (COX expression and/or activity; in endometrial cancer cells, COX-2 is overexpressed and confers cellular resistance to apoptosis. The aim of the present study was to determine if resveratrol could exert anti-proliferative and pro-apoptotic activity over uterine cancer cells upon inhibition of COX-2 expression and/or activity. Six different human uterine cancer cell lines were used as a model (HeLa, Hec-1A, KLE, RL95-2, Ishikawa and EN-1078D. Results and discussion High-dose of resveratrol triggered apoptosis in five out of six uterine cancer cell lines, as judged from Hoechst nuclear staining and effector caspase cleavage. In accordance, uterine cancer cell proliferation was decreased. Resveratrol also reduced cellular levels of the phosphorylated/active form of anti-apoptotic kinase AKT. Endogenous COX-2 protein levels were decreased, concomitant with a decrease in production of COX metabolites PGE2 and PGF2?, in each uterine cancer cell line expressing detectable levels of COX-1 and/or COX-2 in presence of resveratrol. Although COX expression was identified as a target of resveratrol in uterine cancer cells, inhibition of COX activity or exogenously added PGE2 did not modulate the effect of resveratrol on cellular proliferation. Conclusion High-dose of resveratrol exerts tumoricidal activity over uterine cancer cells and regulates COX expression. In these cells, resveratrol would not directly target COX activity, but possibly other enzymes involved in prostaglandin synthesis that act downstream of the COXs.

  4. Pregnancy Following Uterine Artery Embolization with Polyvinyl Alcohol Particles for Patients with Uterine Fibroid or Adenomyosis

    International Nuclear Information System (INIS)

    Purpose:To determine whether uterine fibroid embolization (UFE) with polyvinyl alcohol (PVA) particles affects fertility in women desiring future pregnancy.Methods:Of 288 patients managed with UFE with PVA particles for uterine myoma or adenomyosis between 1998 and 2001, 94 patients were enrolled in this study. The age range of participants was 20-40 years. The data were collected through review of medical records and telephone interviews. Mean duration of follow-up duration was 35 months (range 22-60 months). Patients using contraception and single women were excluded, and the chance of infertility caused by possible spousal infertility or other factors was disregarded. Contrast-enhanced magnetic resonance imaging was performed in all patients before and after UFE, and the size of PVA particles used was 255-700 ?m.Results:Among 94 patients who underwent UFE with PVA, 74 were on contraceptives, 6 had been single until the point of interview, and 8 were lost to follow-up. Of the remaining 6 patients who desired future pregnancy, 5 (83%) succeeded in becoming pregnant (1 patient became pregnant twice). Of a total of 8 pregnancies, 6 were planned pregnancies and 2 occurred after contraception failed. Five deliveries were vaginal, and 2 were by elective cesarean. Artificial abortion was performed in 1 case of unplanned pregnancy. There was 1 case of premature rupture of membrane (PROM) followed by preterm labor and delivery of an infant who was small-for-gestational-age.infant who was small-for-gestational-age. After UFE, mean volume reduction rates of the uterus and fibroid were 36.6% (range 0 to 62.6%) and 69.3% (range 36.3% to 93.3%), respectively.Conclusion:Although the absolute number of cases was small, UFE with PVA particles ultimately did not affect fertility in the women who underwent the procedure

  5. Laparoscopic hysterectomy in the treatment of endometrial cancer: NCI experience

    International Nuclear Information System (INIS)

    The standard treatment for women with endometrial cancer is total abdominal hysterectomy and pelvic lymphadenectomy for surgical staging. Total laparoscopic radical hysterectomy (TLH) is an alternative approach providing surgical and patient related advantages to laparoscopy. Methods: Twenty female patients with early stage endometrial cancer were operated upon by TLH and pelvic lymphadenectomy, aiming to assess the safety and efficacy of TLH. Results: The mean operative time was 296.8 min conversion to laparotomy was done in one patient due to bleeding from the uterine vessels. The mean blood loss was 517.5 cc. The uterus was removed transvaginally in 18 patients (90%) and via a small Pfannenstiel incision in two patients (10%). The mean number of pelvic lymph nodes retrieval was 21.2. Postoperative bleeding occurred in one patient (5%) which necessitated exploration. One patient (5%) suffered a pulmonary embolism. Four patients (20%) developed pyrexia, and one patient (5%) suffered from a chest infection. One patient (5%) had wound infection. The mean hospital stay was 4.5 days (range 3-10). Conclusion: TLH with pelvic lymphadenectomy is a safe and effective approach in the treatment of early endometrial carcinoma.

  6. Modulation of the effects of norepinephrine uptake inhibitors on the norepinephrine-induced contractile response of the porcine uterine artery during early pregnancy.

    OpenAIRE

    Laporte, R.; Deroth, L

    1997-01-01

    The effects of norepinephrine (NE) uptake inhibitors on the porcine uterine artery's contractile response to NE and their potential alteration during early pregnancy (Day 13 postcoitus; day of coitus = Day 0) in comparison with the end of the luteal phase (Days 11-14; first day of behavioral estrus = Day 0) was investigated. This pregnancy time point is characterized by a transient increase in resting uterine blood flow dependent on the presence of blastocysts, an increased endometrial vascul...

  7. Genistein reduces angiogenesis and apoptosis in women with endometrial hyperplasia

    Directory of Open Access Journals (Sweden)

    Granese R

    2015-01-01

    Full Text Available Roberta Granese,1,* Alessandra Bitto,2,* Francesca Polito,2 Onofrio Triolo,1 Domenico Giordano,1 Angelo Santamaria,1 Francesco Squadrito,2 Rosario D’Anna1 1Department of Paediatric, Gynaecological, Microbiological, and Biomedical Sciences, 2Department of Clinical and Experimental Medicine, Section of Pharmacology, University of Messina, Messina, Italy*These authors contributed equally to this workAbstract: Endometrial hyperplasia without cytological atypia is commonly treated with progestins, but other treatments may be available with equivalent efficacy and reduced side effects. Here, we evaluate the effect of genistein aglycone on angiogenesis and apoptosis-related markers women with endometrial hyperplasia. Premenopausals (n=38 with nonatypical endometrial hyperplasia were administered either genistein aglycone (54 mg/day, n=19 or norethisterone acetate (10 mg/day, n=19 on days 16–25 of the menstrual cycle and evaluated for 6 months. Biopsies were taken during hysteroscopy at baseline and 6 months, and symptoms including excessive uterine bleeding were assessed at baseline and 3 and 6 months following recruitment. The expression of angiogenesis (Vegf, epithelial (Egf and Tgfb, and apoptosis-related (Bax, Bcl-2, and Casp-9 molecules, were assessed in uterine biopsies at baseline and after 6 months of therapy. Follicle-stimulating hormone, luteinizing hormone, estradiol, SHBG, and progesterone levels were also measured. After 6 months, 42% of genistein aglycone-administered patients had a significant improvement of symptoms compared to 47% of norethisterone acetate subjects. No significant differences were noted in hormone levels for any treatment. Gene expression revealed a significant reduction in Vegf, Egf, and Tgfb (P<0.05 versus baseline, and an increase in proapoptotic molecules (Bax and Casp-9, with a concomitant decrease in Bcl-2 values (P<0.05 in both groups. These results suggest that genistein aglycone might be useful for the management of endometrial hyperplasia without atypia in women who cannot or do not wish to be treated with progestin.Keywords: genistein, endometrial hyperplasia, Vegf, Bcl-2, Bax, Casp-9

  8. Involvements of Estrogen Receptor, Proliferating Cell Nuclear Antigen and p53 in Endometrial Adenocarcinoma Development in Donryu Rats.

    Science.gov (United States)

    Yoshida, Midori; Katsuda, Shin-Ichi; Maekawa, Akihiko

    2012-12-01

    Involvements of estrogen receptor (ER)?, proliferating cell nuclear antigen (PCNA) and p53 in the uterine carcinogenesis process in Donryu rats, a high yield strain of the uterine cancer were investigated immunohistochemically. ER? was expressed in atypical endometrial hyperplasia, accepted as a precancerous lesion of the uterine tumors, as well as well- and in moderately-differentiated endometrial adenocarcinomas, and the intensities of expression were similar to those in the luminal epithelial cells of the atrophic uterus at 15 months of age. The expression, however, was negative in the tumor cells of poorly differentiated type. Good growth of implanted grafts of the poorly-differentiated adenocarcinomas in both sexes with or without gonadectomy supported the estrogen independency of tumor progression to malignancy. PCNA labeling indices were increased with tumor development from atypical hyperplasia to adenocarcinoma. The tumor cells in poorly-differentiated adenocarcinomas were positive for p53 positive but negative for p21 expression, suggesting accumulation of mutated p53. These results indicate that the consistent ER? expression is involved in initiation and promotion steps of uterine carcinogenesis, but not progression. In addition, PCNA is related to tumor development and the expression of mutated p53 might be a late event during endometrial carcinogenesis. PMID:23345926

  9. A novel role for the AAA ATPase spastin as a HOXA10 transcriptional corepressor in Ishikawa endometrial cells.

    Science.gov (United States)

    Daftary, Gaurang S; Tetrault, Amy M; Jorgensen, Elisa M; Sarno, Jennifer; Taylor, Hugh S

    2011-09-01

    Homeobox A10 (HOXA10), a transcription factor required for uterine development and embryo receptivity, functions downstream of estrogen and progesterone in uterine endometrium. HOXA10 represses endometrial expression of empty spiracles homeobox 2 (EMX2), the human ortholog of Drosophila empty spiracles. The ATPases associated with various cellular activities (AAA) ATPase spastin has a well-characterized role in neurotransmitter trafficking. In this study, we characterize a novel role of spastin in transcriptional regulation. We identified spastin as a novel component of the HOXA10 transcriptional complex in Ishikawa nuclear extracts by immunoprecipitation and mass spectrophotometry. Using EMX2 as a model endometrial HOXA10 target gene, we show that the HOXA10-spastin corepressor complex bound the EMX2 promoter in chromatin immunoprecipitation assays. HOXA10 has been previously shown to repress endometrial EMX2 expression. We further observed that, although cotransfection of HOXA10 and spastin continued to repress endometrial EMX2-luciferase expression, the repression was reversed when spastin small interfering RNA was cotransfected with HOXA10. Mutations in the nuclear localization signal sequences of spastin abrogated not only its nuclear translocation but also its colocalization with HOXA10 as well as reversed EMX2-luciferase repression. Here, we describe a novel role for the AAA ATPase spastin in Ishikawa cells as a HOXA10 corepressor of EMX2. Uterine EMX2 levels are inversely related to embryo implantation rates. HOXA10 acts downstream of progesterone and has been shown to facilitate embryo implantation through regulation of endometrial EMX2 expression. Endometrial spastin, therefore, likely has a novel function downstream of estrogen and progesterone in implantation biology as a cofactor of HOXA10. PMID:21757506

  10. Risks of Endometrial Cancer Screening

    Science.gov (United States)

    ... at risk should discuss this with their doctor. Risk factors for endometrial cancer include the following: Taking tamoxifen for treatment or prevention of breast cancer . Taking estrogen alone. (Taking estrogen in ... increase the risk of endometrial cancer.) Being overweight . Eating a high- ...

  11. Sarcoma del estroma endometrial de grado alto: presentación de un caso / High degree endometrial stromal sarcoma: case report

    Scientific Electronic Library Online (English)

    Ernesto, Molina-Loza; Carlos, Altez-Navarro.

    Full Text Available El sarcoma del estroma endometrial (SEE) es un tumor infrecuente, que comprende menos del 1% de los tumores malignos ginecológicos. Presentamos el caso de una mujer de 24 años con hemorragia uterina anormal a la que se le realizó histerectomía con anexectomía bilateral por tumor pélvico. Microscópic [...] amente, la neoplasia estaba constituida por una proliferación maligna de células estromales del endometrio. El estudio inmunohistoquimico mostró positividad para vimentina y desmina. Se presenta el estudio clínico patológico, la nueva clasificación de la OMS y las opciones terapéuticas. Abstract in english Endometrial stromal sarcoma (ESS) is a rare tumor comprising less than 1% of gynecological malignancies. We report the case of a 24 year old woman with abnormal uterine bleeding who underwent hysterectomy and bilateral oophorectomy for pelvic tumor. At microscopy the neoplasm was composed of maligna [...] nt proliferation of endometrial stromal cells. Immunohistochemical studies were positive for vimentin and desmin. Clinical and pathologic findings are presented, as well as a review of the new WHO classification and treatment options.

  12. Uterine leiomyosarcoma: A case report

    OpenAIRE

    Kaur, Khushpreet; Kaur, Parneet; Kaur, Arvinder; Singla, Atish

    2014-01-01

    Uterine leiomyosarcoma is a rare uterine malignancy that arises from the smooth muscles of uterine wall. It accounts for only 1-2% of uterine malignancies. We report a case of a 60-year-old female who presented with postmenopausal bleeding and was diagnosed later to be a case of leiomyosarcoma of uterus. The diagnosis of leiomyosarcoma is made by histopathological examination, and surgery is the only treatment. The prognosis for female with uterine sarcoma primarily depends on the extent of d...

  13. Uterine Fibroid Embolization

    Directory of Open Access Journals (Sweden)

    "R. Malek

    2003-06-01

    Full Text Available Uterine fibroids are commonly asymptomatic. They often cause pelvic pain, abnormal and increased vaginal bleeding, etc. Traditional treatment of symptomatic uterine fibroids was trans-abdominal hysterectomy. Nowadays, uterine artery embolization (UAE, also called uterine fibroid embolization, is considered as a safe and highly-effective nonsurgical treatment for women with symptomatic uterine fibroid tumors. Advantages of UAE over conventional hormonal suppression and surgical procedures include avoidance of the side effects of drug therapy and surgery-related physical and psychological trauma. These patients commonly resume their normal activities within a week after the procedure; weeks earlier than that for trans-abdominal hysterectomy. Over the past 30 years, interventional radiologists have done UAE for treatment of emergency uterine bleeding. Since 1995, interventional radiologists have turned their attention to treatment of uterine fibroids with a similar procedure. The first fibroid embolization in Iran was done approximately three years ago. So far, more than 100 cases have been treated by this method and it is going to be quickly accepted as a safe alternate for surgery.

  14. Effect of Letrozole on Endometrial Histology in Patients with Disordered Proliferative Endometrium and Simple Hyperplasia

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    Parvin Mostafa Gharabaghi

    2014-01-01

    Full Text Available Objectives: This is a preliminary study investigating the efficacy of aromatase inhibitor letrozol on endometrial histology in patients with disordered proliferative endometrium or simple hyperplasia. Materials and Methods: In a randomized clinical trial, 92 patients with abnormal uterine bleeding who had disordered proliferative endometrium or simple hyperplasia in endometrial biopsy, were randomized into case and control groups. patients received 2.5 mg of letrozole daily in case group (n=46 and 40 mg of megestrol acetate daily in control group (n=46 for 3 months. Endometrial biopsy was performed 3 to 4 weeks after completion of therapy to assess response. Results: After intervention in letrozole group, response to treatment was seen in 93% cases (including endometrial atrophy in 58.7% cases and weakly proliferative endometrium in 34.78% cases and in megestrol group response to treatment was seen in 85% cases (including endometrial atrophy in 41.3% cases and weakly proliferative endometrium in 43.47% cases. The difference between two groups was not statistically significant (P=0.31. Conclusion: The results of this study show that pre and post menopausal women with disordered proliferative endometrium or simple hyperplasia can be successfully treated with letrozole alone. However, due to the lack of significant difference between the two groups, further studies with larger sample size is recommended for better clearance of the topic.

  15. Uterine Leiomyoma: Hysterosalpingographic Appearances

    Directory of Open Access Journals (Sweden)

    Firoozeh Ahmadi

    2008-01-01

    Full Text Available Uterine leiomyoma is the most common benign tumor of genital tract. The etiology of myomasis unknown. Leiomyoma shows a broad spectrum of radiographic appearances depending on thenumber, size, and location of the tumor. The diagnostic method for uterine leiomyomas is basedprimarily on the clinical situation. Despite of the varied diagnostic options such as; transvaginalsonography, sonohysterography, hysteroscopy, laparoscopy and MRI; hysterosalpingography isstill one of the valuable imaging methods for identification of uterine leiomyoma.The various features of the proved leiomyoma are illustrated in this pictorial review. The incidence,risk factors and clinical features will also be discussed briefly.

  16. Role of serum copper and ceruloplasmin level in patients with dysfunctional uterine bleeding

    OpenAIRE

    Khandhadiya, Ketki P.; Yousef Rezaei Chianeh; Pragna Rao.

    2014-01-01

    Background: Objective of current study was to study serum copper and ceruloplasmin levels in abnormal endometrial angiogenesis observed in dysfunctional uterine bleeding patients. Methods: Design: The present cross sectional study was undertaken in the departments of biochemistry and department of OBG, Kasturba medical college, Manipal University, Manipal, India. Population: This study was done in 40 females age between 18-45 years with history of, bleeding excessively for more than 3 mont...

  17. Reference Ranges for Uterine Artery Pulsatility Index during the Menstrual Cycle: A Cross-Sectional Study.

    OpenAIRE

    Guedes-martins, L.; Gaio, R.; Saraiva, J.; Cerdeira, S.; Matos, L.; Silva, E.; Macedo, F.; Almeida, H.

    2015-01-01

    BACKGROUND: Cyclic endometrial neoangiogenesis contributes to changes in local vascular patterns and is amenable to non-invasive assessment with Doppler sonography. We hypothesize that the uterine artery (UtA) impedance, measured by its pulsatility index (PI), exhibits a regular pattern during the normal menstrual cycle. Therefore, the main study objective was to derive normative new day-cycle-based reference ranges for the UtA-PI during the entire cycle from days 1 to 34 according to the ...

  18. Endometrial Histology of Depomedroxyprogesterone Acetate Users: A Pilot Study

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available Objective. To obtain pilot data on the endometrial histology of Depomedroxyprogesterone acetate (Depo-Provera, DMPA users experiencing breakthrough bleeding (BTB versus users with amenorrhea. To compare the endometrial histology of patients who used DMPA continuously for 3–12 months versus those who used it for 13 months or more. Methods. Cross-sectional study. Endometrial biopsy was obtained from all consenting patients who used DMPA for at least 3 months. Patients were divided into those with BTB in the last 3 months versus those with amenorrhea for at least 3 months. Histology results and duration of therapy were compared. Results. The proportion of women with chronic endometritis, uterine polyps, atrophic, proliferative, or progesterone-dominant endometrium did not differ between those DMPA users with BTB versus those with amenorrhea. Duration of therapy did not correlate with symptoms of BTB or endometrial histology. Chronic endometritis was the most common histologic finding (10/40, 25% and occurred more often in women experiencing BTB (35% versus 15% (RR 1.62 CI 0.91–2.87. Moreover, 45% of women with BTB had received DMPA for more than 12 months. Conclusions. BTB was more common than previously reported in women using DMPA for more than 12 months. Chronic endometritis, which may indicate an underlying infectious or intracavitary anatomic etiology, has not been previously reported as a frequent finding in DMPA users, and may be related to ethnic or other sociodemographic characteristics of our patient population. Further study to elucidate the etiology of chronic endometritis in these patients is warranted.

  19. Bmp2 Is Critical for the Murine Uterine Decidual Response? †

    Science.gov (United States)

    Lee, Kevin Y.; Jeong, Jae-Wook; Wang, Jinrong; Ma, Lijiang; Martin, James F.; Tsai, Sophia Y.; Lydon, John P.; DeMayo, Francesco J.

    2007-01-01

    The process of implantation, necessary for all viviparous birth, consists of tightly regulated events, including apposition of the blastocyst, attachment to the uterine lumen, and differentiation of the uterine stroma. In rodents and primates the uterine stroma undergoes a process called decidualization. Decidualization, the process by which the uterine endometrial stroma proliferates and differentiates into large epithelioid decidual cells, is critical to the establishment of fetal-maternal communication and the progression of implantation. The role of bone morphogenetic protein 2 (Bmp2) in regulating the transformation of the uterine stroma during embryo implantation in the mouse was investigated by the conditional ablation of Bmp2 in the uterus using the (PR-cre) mouse. Bmp2 gene ablation was confirmed by real-time PCR analysis in the PR-cre; Bmp2fl/fl (termed Bmp2d/d) uterus. While littermate controls average 0.9 litter of 6.2 ± 0.7 pups per month, Bmp2d/d females are completely infertile. Analysis of the infertility indicates that whereas embryo attachment is normal in the Bmp2d/d as in control mice, the uterine stroma is incapable of undergoing the decidual reaction to support further embryonic development. Recombinant human BMP2 can partially rescue the decidual response, suggesting that the observed phenotypes are not due to a developmental consequence of Bmp2 ablation. Microarray analysis demonstrates that ablation of Bmp2 leads to specific gene changes, including disruption of the Wnt signaling pathway, Progesterone receptor (PR) signaling, and the induction of prostaglandin synthase 2 (Ptgs2). Taken together, these data demonstrate that Bmp2 is a critical regulator of gene expression and function in the murine uterus. PMID:17515606

  20. CDB-2914 for Uterine Leiomyomata Treatment

    Science.gov (United States)

    Levens, Eric D.; Potlog-Nahari, Clariss; Armstrong, Alicia Y.; Wesley, Robert; Premkumar, Ahalya; Blithe, Diana L.; Blocker, Wendy; Nieman, Lynnette K.

    2009-01-01

    OBJECTIVE To evaluate whether 3-month administration of CDB-2914, a selective progesterone receptor modulator, reduces leiomyoma size and symptoms. METHODS Premenopausal women with symptomatic uterine leiomyomata were randomly assigned to CDB-2914 at 10 mg (T1) or 20 mg (T2) daily or to placebo (PLC) for 3 cycles or 90–102 days if no menses occurred. The primary outcome was leiomyoma volume change determined by magnetic resonance imaging at study entry and within 2 weeks of hysterectomy. Secondary outcomes included the proportion of amenorrhea, change in hemoglobin and hematocrit, ovulation inhibition, and quality-of-life assessment. RESULTS Twenty-two patients were allocated, and 18 completed the trial. Age and body mass index were similar among groups. Leiomyoma volume was significantly reduced with CDB-2914 administration (PLC 6%; CDB-2914 ?29%; P=.01), decreasing 36% and 21% in the T1 and T2 groups, respectively. During treatment, hemoglobin was unchanged, and the median estradiol was greater than 50 pg/mL in all groups. CDB-2914 eliminated menstrual bleeding and inhibited ovulation (% ovulatory cycles: CDB-2914, 20%; PLC, 83%; P=.001). CDB-2914 improved the concern scores of the uterine leiomyoma symptom quality-of-life subscale (P=.04). One CDB-2914 woman developed endometrial cystic hyperplasia without evidence of atypia. No serious adverse events were reported. CONCLUSION Compared with PLC, CDB-2914 significantly reduced leiomyoma volume after three cycles, or 90–102 days. CDB-2914 treatment resulted in improvements in the concern subscale of the Uterine Fibroid Symptom Quality of Life assessment. In this small study, CDB-2914 was well-tolerated without serious adverse events. Thus, there may be a role for CDB-2914 in the treatment of leiomyomata. PMID:18448745

  1. Ultrasonographic evaluation of abnormal uterine bleeding in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Bindushree Kadakola

    2015-02-01

    Full Text Available Background: Objectives of current study were to diagnose causes of Abnormal Uterine Bleeding (AUB in postmenopausal women (PMW and to correlate it with curettage and histopathological findings, hysteroscopy and thereby minimizing unnecessary interventions in the form of operations and hysteroscopy where sonography depicts normal findings. Methods: After obtaining ethical clearance present prospective observational study was conducted from November 2010 to November 2012, to evaluate the endometrium in 50 postmenopausal women (PMW with bleeding per vagina referred to the department of Radio diagnosis by the department of gynaecology in Bangalore medical college and research institute. After applying inclusion and exclusion criterias the cases were evaluated with ultrasonography both transabdominal (TAS and transvaginal scan (TVS where ever necessary. Histopathological and hysteroscopic correlation was done in all cases. Results: 58% of the PMW with bleed were in the age group of 51-60 years. Most common cause of PMB was atrophic endometrium (44%, endometrial polyp (22%, followed by malignancy (14%, and hyperplastic endometrium (6%. At Endometrium thickness less than 4 mm there were nil chances of carcinoma. Conclusions: In women with AUB in postmenopausal age ultrasonography (USG can be considered as an initial imaging modality for diagnosing endometrial diseases. The sensitivity and specificity of USG for Atrophic endometrium is 100% and 84% respectively with accuracy of 100%, endometrial polyp the specificity is 100% with accuracy of 88%. For malignancy USG showed 100% specificity and accuracy of 100%. Hence USG is highly accurate for evaluating endometrial pathologies. Being noninvasive, less costly and good patient compliance USG should be considered as an initial imaging modality over invasive investigations like D and C, hysteroscopy in evaluating endometrial disorders. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 229-234

  2. [Endometrial cancer imaging].

    Science.gov (United States)

    Taïeb, Sophie; Rocourt, Nathalie; Narducci, Fabrice; Ceugnart, Luc

    2012-01-01

    Endometrial cancer is staged according to the International Federation of Gynecology and Obstetrics surgical system. Clinical estimation of stage, however, can be inaccurate in more than 20%, and therefore, preoperative imaging of the disease may assist in planning the optimal course of treatment. Magnetic resonance imaging (MRI) may detect gross myometrial extension or extension of tumor to the cervical stroma, which can alter management and therefore help in preoperative surgical planning. This issue is increasingly relevant as less invasive surgical techniques, such as laparoscopic surgeries, are becoming more commonplace for lower stage cancers. Currently, MRI is the most widely used modality for preoperative planning. PMID:22134048

  3. Regulation of S100G Expression in the Uterine Endometrium during Early Pregnancy in Pigs

    Science.gov (United States)

    Choi, Yohan; Seo, Heewon; Shim, Jangsoo; Kim, Mingoo; Ka, Hakhyun

    2012-01-01

    Calcium ions play an important role in the establishment and maintenance of pregnancy, but molecular and cellular regulatory mechanisms of calcium ion action in the uterine endometrium are not fully understood in pigs. Previously, we have shown that calcium regulatory molecules, transient receptor potential vanilloid type 5 (TRPV6) and calbindin-D9k (S100G), are expressed in the uterine endometrium during the estrous cycle and pregnancy in a pregnancy status- and stage-specific manner, and that estrogen of conceptus origin increases endometrial TRPV6 expression. However, regulation of S100G expression in the uterine endometrium and conceptus expression of S100G has been not determined during early pregnancy. Thus, we investigated regulation of S100G expression by estrogen and interleukin-1? (IL1B) in the uterine endometrium and conceptus expression of S100G during early pregnancy in pigs. We obtained uterine endometrial tissues from day (D) 12 of the estrous cycle and treated with combinations of steroid hormones, estradiol-17? (E2) and progesterone (P4), and increasing doses of IL1B. Real-time RT-PCR analysis showed that E2 and IL1B increased S100G mRNA levels in the uterine endometrium, and conceptuses expressed S100G mRNA during early pregnancy, as determined by RT-PCR analysis. To determine if endometrial expression of S100G mRNA during the implantation period was affected by the somatic cell nuclear transfer (SCNT) procedure, we compared S100G mRNA levels in the uterine endometrium from gilts with SCNT-derived conceptuses with those from gilts with conceptuses derived from natural mating on D12 of pregnancy. Real-time RT-PCR analysis showed that levels of S100G mRNA in the uterine endometrium from gilts carrying SCNT-derived conceptuses was significantly lower than those from gilts carrying conceptuses derived from natural mating. These results showed that S100G expression in the uterine endometrium was regulated by estrogen and IL1B of conceptus origin, and affected by the SCNT procedure during early pregnancy. These suggest that conceptus signals regulate S100G, an intracellular calcium transport protein, for the establishment of pregnancy in pigs. PMID:25049477

  4. Metabolic vulnerabilities in endometrial cancer.

    Science.gov (United States)

    Byrne, Frances L; Poon, Ivan K H; Modesitt, Susan C; Tomsig, Jose L; Chow, Jenny D Y; Healy, Marin E; Baker, William D; Atkins, Kristen A; Lancaster, Johnathan M; Marchion, Douglas C; Moley, Kelle H; Ravichandran, Kodi S; Slack-Davis, Jill K; Hoehn, Kyle L

    2014-10-15

    Women with metabolic disorders, including obesity and diabetes, have an increased risk of developing endometrial cancer. However, the metabolism of endometrial tumors themselves has been largely understudied. Comparing human endometrial tumors and cells with their nonmalignant counterparts, we found that upregulation of the glucose transporter GLUT6 was more closely associated with the cancer phenotype than other hallmark cancer genes, including hexokinase 2 and pyruvate kinase M2. Importantly, suppression of GLUT6 expression inhibited glycolysis and survival of endometrial cancer cells. Glycolysis and lipogenesis were also highly coupled with the cancer phenotype in patient samples and cells. To test whether targeting endometrial cancer metabolism could be exploited as a therapeutic strategy, we screened a panel of compounds known to target diverse metabolic pathways in endometrial cells. We identified that the glycolytic inhibitor, 3-bromopyruvate, is a powerful antagonist of lipogenesis through pyruvylation of CoA. We also provide evidence that 3-bromopyruvate promotes cell death via a necrotic mechanism that does not involve reactive oxygen species and that 3-bromopyruvate impaired the growth of endometrial cancer xenografts. PMID:25205105

  5. Ten-year literature review of global endometrial ablation with the NovaSure® device

    Directory of Open Access Journals (Sweden)

    Gimpelson RJ

    2014-03-01

    Full Text Available Richard J Gimpelson Mercy Clinic, Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Mercy Hospital St Louis, St Louis, MO, USA Abstract: This review examines the peer-reviewed literature describing prospective studies that report amenorrhea rates, patient satisfaction, and surgical reintervention rates following the NovaSure® endometrial ablation procedure. A search of the English-language literature published from 2000 to 2011 was conducted using PubMed. Ten prospective studies, six single-arm NovaSure trials, and four randomized controlled trials comparing the NovaSure procedure with other global endometrial ablation modalities met the inclusion criteria and were reviewed. The follow-up periods ranged from 6 to 60 months. Amenorrhea rates for the NovaSure procedure ranged from 30.0% to 75.0%. Patients who reported being satisfied with the NovaSure procedure ranged from 85.0% to 94.0%. In randomized controlled trials with other global endometrial ablation modalities, amenorrhea rates at 12 months with the NovaSure procedure ranged from 43.0% to 56.0%, while other modalities ranged from 8% to 24%. In addition, this manuscript reviews the following: the NovaSure technology; use of the NovaSure procedure in the office setting; intraoperative and postoperative pain; effects on premenstrual syndrome (PMS; dysmenorrhea; special circumstances, including presence of uterine disease, history of cesarean delivery, coagulopathy, or use of anticoagulant medication; post-procedure uterine cavity assessment and cancer risk; contraception and pregnancy; and safety. Keywords: abnormal uterine bleeding, menorrhagia, endometrial ablation, NovaSure®

  6. Evaluation of abnormal uterine bleeding: role of diagnostic hysteroscopy and its correlation with histopathology

    Directory of Open Access Journals (Sweden)

    Rebecca Edwin

    2014-08-01

    Full Text Available Background: The objective was to assess the accuracy of diagnostic hysteroscopy in evaluation of abnormal uterine bleeding and to correlate hysteroscopic findings with histopathology reports. Methods: A prospective study was carried out at our institute from January 2010 to December 2013. Ninety cases were included in this study. Patients' age varied from 20 to 60. Those women with the history of abnormal uterine bleeding were admitted. In all cases diagnostic hysteroscopic examination and dilatation and curettage were carried out. Endometrium was sent for histopathology and correlation of hysteroscopic findings with histopathology reports was studied. Results: Various findings on hysteroscopy are as following: proliferative endometrium 36.66%, secretary endometrium 17.77% endometrial hyperplasia 24.44%, atrophic endometrium 5.55%, endometrial polyp 8.88%, submucous fibroid 4.44%, and endometrial carcinoma 2.22%. Conclusions: Hysteroscopy is an eye in uterus and it provides more accurate diagnosis than dilatation and curettage alone in patients with abnormal uterine bleeding. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 1082-1086

  7. Uterine changes during tamoxifen, toremifene, and other therapy for breast cancer. Evaluation with magnetic resonance imaging

    International Nuclear Information System (INIS)

    We have performed pelvic magnetic resonance imaging (MRI) in patients undergoing breast cancer surgery before and after adjuvant drug therapy. Our purpose was to detect any radiographic uterine changes induced by various types of adjuvant therapy on pre- and postmenopausal patients by evaluating prospectively performed MRI. Between September 2004 and December 2007, a total of 41 women with breast cancer (11 premenopausal, 30 postmenopausal) were enrolled. All underwent MRI of the pelvis before and after drug therapy, and uterine changes were evaluated. Postoperative drugs used were selective estrogen receptor modulators (SERMs) including tamoxifen and toremifene (n=18), aromatase inhibitors (n=13), and anticancer drugs (n=10). Only the postmenopausal patients receiving SERMs showed a significant increase in endometrial thickness: from 2.4±0.4 mm before therapy to 4.5±2.6 mm after therapy (P=0.0485). No statistically significant endometrial change was evident in postmenopausal patients treated with aromatase inhibitors (P=0.573) or anticancer drugs (P=0.754). Also, in premenopausal patients treated with SERMs or anticancer drugs, the change in endometrial thickness was not statistically significant (P=0.958, 0.370). This prospective study using MRI has demonstrated that uterine changes associated with adjuvant drugs for breast cancer occur exclusively in postmenopausal patients receiving SERMs. (author)

  8. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... And what we see here is a very abnormal uterine artery, the very rich blood supply. And ... the uterus. But, by and large, that very abnormal area that we saw going to the fibroids ...

  9. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... Cardiac and Vascular Institute, we've performed almost 1,000 uterine fibroid embolizations. Fibroids are common, benign ... embolization procedure. More contrast, please. Thanks, Dr. Powell. One thing I did want to mention. You heard ...

  10. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... We don't want to treat people with history of cervical cancer or uterine cancer. We have ... slow blood flow. Jim? All right, so that's perfect, Alex. So what we saw here was a ...

  11. Uterine Cancer Statistics

    Science.gov (United States)

    ... Research AMIGAS Fighting Cervical Cancer Worldwide Stay Informed Statistics for Other Kinds of Cancer Breast Cervical Colorectal ( ... Skin Vaginal and Vulvar Cancer Home Uterine Cancer Statistics Language: English Español (Spanish) Recommend on Facebook Tweet ...

  12. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... and fall into the uterine cavity, in which case we would refer you back to your gynecologist ... through the sheath. And we're using a series of small wires and these catheters that fit ...

  13. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... We don't want to treat people with history of cervical cancer or uterine cancer. We have ... it has that rich blood supply. And, of course, that's what causes part of the symptoms. And ...

  14. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... parts of it can actually break off and fall into the cavity. And a small percentage of ... fibroid, instead of shrinking, may break off and fall into the uterine cavity, in which case we ...

  15. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... has very symptomatic uterine fibroids, very heavy menstrual periods. Her periods last on the order of eight days, four ... painful intercourse, and very heavy and crampy menstrual periods. If we can come to our diagram here, ...

  16. Long-term efficiency and safety of trans-catheter uterine artery embolization by lipiodol-pingyingmycin emulsion for uterine fibroids

    International Nuclear Information System (INIS)

    Objective: To investigate the long-term efficiency and safety of trans-catheter uterine artery embolization using lipiodol-pingyingmycin emulsion (LPE-TUAE) for uterine fibroids. Methods: Two hundred and forty-three patients with uterine fibroids were treated by LPE-TUAE. Fourteen of them underwent hysterectomy or myomectomy 3 days to 6 months after LPE-TUAE. The specimens were studied pathologically. Another 229 patients were followed up for 1 to 4 years to observe the long-term outcomes. Results: Menorrhagia became normal or improved markedly in 96.0% (193/201). Lumbago and lower abdominal pain disappeared or relieved markedly in 949% (94/99). Bulk-related symptoms disappeared or lessened markedly in 96.0% (48/50). Ultrasound revealed that the average decreased rate in the largest fibroid volume were 60.7% at 1 year, 63.3% at 2 year, 65.6% at 3 year and 67.4% at 4 year after embolization, and the average decreased rate in the largest uterine volume were 49.6% at 1 year, 54.3% at 2 year, 55.2% at 3 year and 57.1% at 4 year after embolization. Reoccurrence rate of myoma was 10.8% 3-4 year after embolization. No significant difference was found in hormone level between pre- and post-embolization. Pathological studies of specimens showed that lipiodol was only accumulated in fibroids and was not seen in myometrium. Spotty necrosis 2 weeks after embolization and extensive patchy necrosis 3 weeks after embolization were occurred in fibroids. Necrosis was not showed in myon fibroids. Necrosis was not showed in myometrium. No serious complications occurred. Conclusion: LPE-TUAE possesses a good long-term effectiveness for uterine fibroids, which doesn't cause the damage on ovarian function and normal myometrium or serious complications. (authors)

  17. Unusual presentation of uterine leiomyoma.

    Science.gov (United States)

    Al Hadidi, Samer; Shaik Mohammed, Tabrez; Bachuwa, Ghassan

    2015-01-01

    Uterine leiomyoma is the most common pelvic tumour in women. The presentation of uterine leiomyoma varies. Symptoms may include abnormal uterine bleeding or abdominal pressure and heaviness; however, most cases are asymptomatic. We report a case with renal impairment as the first presentation of uterine leiomyoma in a patient who presented with extensive bilateral lower limb oedema and no menstrual symptoms. Imaging studies, a subsequent Papanicolaou test and uterine biopsy were suggestive of uterine leiomyoma, which was confirmed by pathological examination after hysterectomy. The patient's kidney impairment resolved completely after the procedure. PMID:25858937

  18. NMR guided focused ultrasound for myoma therapy - results from the first radiology-gynecology expert meeting

    International Nuclear Information System (INIS)

    The contribution on the results from the first radiology-gynecology expert meeting concerning NMR guided focused ultrasound (MRgFUS) for myoma therapy covers the following topics: structural prerequisites for MRgFUS therapy; required examinations before MRgFUS therapy; indication for MRgFUS therapy; success criteria for the MRgFUS therapy; contraindications; MRgFUS therapy for patients that want to have children; side effects and complications of MRgFUS therapy; post-examination after MRgFUS therapy.

  19. Analysis of ENPP2 in the Uterine Endometrium of Pigs Carrying Somatic Cell Nuclear Transfer Cloned Embryos

    Science.gov (United States)

    Seo, Heewon; Choi, Yohan; Yu, Inkyu; Shim, Jangsoo; Lee, Chang-Kyu; Hyun, Sang-Hwan; Lee, Eunsong; Ka, Hakhyun

    2013-01-01

    Somatic cell nuclear transfer (SCNT) is a useful tool for animal cloning, but the efficiency of producing viable offspring by SCNT is very low. To improve this efficiency in the production of cloned pigs, it is critical to understand the interactions between uterine function and cloned embryos during implantation. Lysophosphatidic acid (LPA) is a lipid mediator that plays an important role in the establishment of pregnancy in pigs; however, LPA production in the uterine endometrium of pigs carrying SCNT-cloned conceptuses has not been determined. Therefore, we investigated expression of ENPP2, an LPA-generating enzyme, in the uterine endometrium of gilts with conceptuses derived from SCNT during the implantation period. Uterine endometrial tissue and uterine flushing were obtained from gilts carrying SCNT-derived conceptuses and from gilts carrying conceptuses resulting from natural mating on d 12 of pregnancy. Our results demonstrated no difference in the level of ENPP2 mRNA expression in the uterine endometrium between gilts carrying SCNT-derived conceptuses and gilts carrying naturally-conceived conceptuses, but secretion of ENPP2 protein into the uterine lumen did decrease significantly in pigs with SCNT-derived conceptuses. These results indicate that expression and secretion of ENPP2, which are critical for appropriate LPA production and successful pregnancy, are dysregulated in the uterine endometrium of pigs carrying SCNT-derived conceptuses. PMID:25049907

  20. The prevalence of endometrial hyperplasia and endometrial cancer in women with polycystic ovary syndrome or hyperandrogenism

    DEFF Research Database (Denmark)

    Holm, Nina Sofie Lillegaard; Glintborg, Dorte

    2012-01-01

    Polycystic ovary syndrome may be associated with an increased risk of endometrial hyperplasia and endometrial cancer, but substantial evidence for this remains to be established. We investigated the prevalence of endometrial hyperplasia and endometrial cancer in a well characterized group of women with polycystic ovary syndrome and/or clinical/biochemical hyperandrogenism.

  1. The evaluation of the uterine cavity pathologies after abortion with hysteroscopy

    Directory of Open Access Journals (Sweden)

    Elçin Üzmez Telli

    2012-01-01

    Full Text Available Objective: To investigate the anatomy of uterine cavity in cases with history of spontaneous pregnancy loss. Material and Methods: This prospective cohort study was approved by Local Ethical Committee on 18th March 2009 with the application number of 179. 40 cases with at least two of them before 12 weeks of pregnancy or at least one miscarriage after 12 weeks of pregnancy and have no live birth are included in this study. The uterine cavity was evaluated with TVUSG after menstruation. Right after this examination hysteroscopy was performed to rule out uterine malformations. Results: A total of 40 patients with a median age of 28.70 years (range, 20-44 years were enrolled in the current study. The number of miscarriages ranged between one and six while the median is 2.92. Uterine malformation is observed in 13 (32.5% of cases. 25% of this uterine anomalies were congenital (uterus septus, uterus subseptus, uterus bicornis while 7.5% were acquired pathologies (submucous leiomyoma, endometrial polyp, adhesion. When we compared early abortion cases with late abortions, there was no statistical significance with respect to the rate of uterine malformations. There was no significant difference in uterine malformations among cases with two consecutive abortions and three or more consecutive abortions. It was observed that the use of transvaginal ultrasonography in screening uterine malformations is not adequate because of low sensitivity. Conclusion: Hysteroscopy is the gold standart in the evaluation of uterine cavity in spontaneous pregnancy loss. TVUSG is not adequate in evaluation because of its low sensitivity. Cases admitting with two consecutive abortions who seek for the etiology, hysteroscopy is a feasible method.

  2. Apparent diffusion coefficient of diffusion weighted MRI in endometrial carcinoma-Relationship with local invasiveness

    Energy Technology Data Exchange (ETDEWEB)

    Cao, Kun, E-mail: kun-cao@hotmail.com [Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Gao, Min, E-mail: gaominmin202@163.com [Department of Gynecology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Sun, Ying-Shi, E-mail: sunysabc@163.com [Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Li, Yan-Ling, E-mail: yanlingli1982@gmail.com [Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Sun, Yu, E-mail: sunyu_bch@163.com [Department of Pathology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Gao, Yu-Nong, E-mail: gaoyunong@vip.sina.com [Department of Gynecology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China); Zhang, Xiao-Peng, E-mail: zxp@bjcancer.org [Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142 (China)

    2012-08-15

    Objective: To evaluate the relationship between apparent diffusion coefficient (ADC) value and the local invasiveness of endometrial carcinoma. Methods and materials: The MR imaging of seventy-three patients with endometrial carcinoma proved by post-operative pathology and sixty-four patients with healthy uteri were retrospectively reviewed. All MR examinations included axial T2WI and T1WI, sagittal T2WI and diffusion-weighted sequences (b = 0 and b = 1000 s/mm{sup 2}). Tumor size, mean ADC value (ADCm) and quartile ADC (ADCq) were acquired on post-processing workstation using voxel-analysis software. Differences between the ADC values among three layers of normal uterine body and endometrial carcinomas were compared by ANOVA test. Groups were divided according to pathologic type, histologic grade, depth of myometrial infiltration, presence of cervical invasion and lymphovascular space invasion, and lymph node metastasis. Tumor size and ADC values were compared and analyzed. Results: ADC values were different in three zones of uterine body (P < 0.001), with the lowest in junctional zone [(1.126 {+-} 0.190) Multiplication-Sign 10{sup -3} mm{sup 2}/s] and highest in outer myometrium [(1.496 {+-} 0.196) Multiplication-Sign 10{sup -3} mm{sup 2}/s]. Mean ADC value of endometrial carcinomas [(1.011 {+-} 0.121) Multiplication-Sign 10{sup -3} mm{sup 2}/s] was lower than the normal uterine body. Quartile ADC and tumor size were greater in groups with more invasive pathologic factors (P < 0.05). Deep myometrial infiltration, cervical invasion, lymphovascular space invasion and lymph node metastasis were more common as quartile ADC values and tumor sizes increased. Conclusion: Mean ADC value was lower in endometrial carcinoma was lower than the normal uterus. Quartile ADC, representing the intra-tumor heterogeneity of water movement, had a profound relationship with invasiveness of endometrial carcinomas, while mean ADC value did not. ADC values may serve as a quantitative indicator to complement routine sequences.

  3. How Are Uterine Fibroids Diagnosed?

    Science.gov (United States)

    ... Clinical Trials Resources and Publications How are uterine fibroids diagnosed? Skip sharing on social media links Share ... probably won’t know that you have uterine fibroids. Sometimes, health care providers find fibroids during a ...

  4. Analysis of Prognostic Factors and Patterns of Recurrence in Patients With Pathologic Stage III Endometrial Cancer

    International Nuclear Information System (INIS)

    Purpose: To retrospectively assess prognostic factors and patterns of recurrence in patients with pathologic Stage III endometrial cancer. Methods and Materials: Between 1989 and 2003, 107 patients with pathologic International Federation of Gynecology and Obstetrics Stage III endometrial adenocarcinoma confined to the pelvis were treated at our institution. Adjuvant radiotherapy (RT) was delivered to 68 patients (64%). The influence of multiple patient- and treatment-related factors on pelvic and distant control and overall survival (OS) was evaluated. Results: Median follow-up for patients at risk was 41 months. Five-year actuarial OS was significantly improved in patients treated with adjuvant RT (68%) compared with those with resection alone (50%; p = 0.029). Age, histology, grade, uterine serosal invasion, adnexal involvement, number of extrauterine sites, and treatment with adjuvant RT predicted for improved survival in univariate analysis. Multivariate analysis revealed that grade, uterine serosal invasion, and treatment with adjuvant RT were independent predictors of survival. Five-year actuarial pelvic control was improved significantly with the delivery of adjuvant RT (74% vs. 49%; p = 0.011). Depth of myometrial invasion and treatment with adjuvant RT were independent predictors of pelvic control in multivariate analysis. Conclusions: Multiple prognostic factors predicting for the outcome of pathologic Stage III endometrial cancer patients were identified iometrial cancer patients were identified in this analysis. In particular, delivery of adjuvant RT seems to be a significant independent predictor for improved survival and pelvic control, suggesting that pelvic RT should be routinely considered in the management of these patients

  5. Intrauterine devices and endometrial cancer risk: a pooled analysis of the Epidemiology of Endometrial Cancer Consortium.

    Science.gov (United States)

    Felix, Ashley S; Gaudet, Mia M; La Vecchia, Carlo; Nagle, Christina M; Shu, Xiao Ou; Weiderpass, Elisabete; Adami, Hans Olov; Beresford, Shirley; Bernstein, Leslie; Chen, Chu; Cook, Linda S; De Vivo, Immaculata; Doherty, Jennifer A; Friedenreich, Christine M; Gapstur, Susan M; Hill, Dierdre; Horn-Ross, Pamela L; Lacey, James V; Levi, Fabio; Liang, Xiaolin; Lu, Lingeng; Magliocco, Anthony; McCann, Susan E; Negri, Eva; Olson, Sara H; Palmer, Julie R; Patel, Alpa V; Petruzella, Stacey; Prescott, Jennifer; Risch, Harvey A; Rosenberg, Lynn; Sherman, Mark E; Spurdle, Amanda B; Webb, Penelope M; Wise, Lauren A; Xiang, Yong-Bing; Xu, Wanghong; Yang, Hannah P; Yu, Herbert; Zeleniuch-Jacquotte, Anne; Brinton, Louise A

    2015-03-01

    Intrauterine devices (IUDs), long-acting and reversible contraceptives, induce a number of immunological and biochemical changes in the uterine environment that could affect endometrial cancer (EC) risk. We addressed this relationship through a pooled analysis of data collected in the Epidemiology of Endometrial Cancer Consortium. We combined individual-level data from 4 cohort and 14 case-control studies, in total 8,801 EC cases and 15,357 controls. Using multivariable logistic regression, we estimated pooled odds ratios (pooled-ORs) and 95% confidence intervals (CIs) for EC risk associated with ever use, type of device, ages at first and last use, duration of use and time since last use, stratified by study and adjusted for confounders. Ever use of IUDs was inversely related to EC risk (pooled-OR = 0.81, 95% CI = 0.74-0.90). Compared with never use, reduced risk of EC was observed for inert IUDs (pooled-OR = 0.69, 95% CI = 0.58-0.82), older age at first use (? 35 years pooled-OR = 0.53, 95% CI = 0.43-0.67), older age at last use (? 45 years pooled-OR = 0.60, 95% CI = 0.50-0.72), longer duration of use (? 10 years pooled-OR = 0.61, 95% CI = 0.52-0.71) and recent use (within 1 year of study entry pooled-OR = 0.39, 95% CI = 0.30-0.49). Future studies are needed to assess the respective roles of detection biases and biologic effects related to foreign body responses in the endometrium, heavier bleeding (and increased clearance of carcinogenic cells) and localized hormonal changes. PMID:25242594

  6. Imaging in endometrial carcinoma

    Science.gov (United States)

    Faria, Silvana C; Sagebiel, Tara; Balachandran, Aparna; Devine, Catherine; Lal, Chandana; Bhosale, Priya R

    2015-01-01

    Endometrial carcinoma (EC) is the most common gynecologic malignancy in the United States. Prognosis depends on patient age, histological grade, depth of myometrial invasion and/or cervical invasion, and the presence of lymph node metastases. Although EC is staged surgically according to the International Federation of Gynecology and Obstetrics (FIGO) system, preoperative imaging can assist in optimal treatment planning. Several imaging techniques such as transvaginal ultrasonography (TVUS), computed tomography (CT), and magnetic resonance imaging (MRI) have been used as diagnostic tools for preoperative staging of EC. Recently, positron emission tomography (PET), PET/CT, and PET/MRI have also been used in staging these patients. In this article, we review the value of imaging in diagnosis, staging, treatment planning, and detection of recurrent disease in patients with EC. PMID:25969637

  7. [Prevention and treatment of intra-uterine synechiae: Review of the literature].

    Science.gov (United States)

    Warembourg, S; Huberlant, S; Garric, X; Leprince, S; de Tayrac, R; Letouzey, V

    2015-04-01

    Intra-uterine adhesions are a major cause of secondary infertility. The prevalence of adhesions is probably underestimated due to the heterogeneity of the symptoms. An exhaustive literature search using search engines MEDLINE, Pubmed, Cochrane library and Web of Science was performed to make a focus on the origins, consequences and methods of prevention of intra-uterine adhesions. Intra-uterine adhesions are likely to occur after any endo-uterine surgery via dysregulated activation of coagulation chain linked to the inflammatory process. Early and late obstetric complications are also recognized as caused by adhesions. The diagnosis is currently performed by hysteroscopy but it remains an invasive procedure even if it can be done with an ambulatory management. Several research approaches inspired by intra-abdominal surgery for the prevention of pelvic adhesions have been developed. However, no current method of prevention has proven its effectiveness in terms of improving spontaneous fertility. The improvement in surgical practices, the design of new intra-uterine medical devices and new research especially in the field of endometrial stem cells can maybe reduce the rate of adhesions end their complications after intra-uterine surgery. PMID:25479692

  8. Can Endometrial Cancer Be Found Early?

    Science.gov (United States)

    ... 2015 Back to top » Guide Topics What Is Endometrial Cancer? Causes, Risk Factors, and Prevention Early Detection, Diagnosis, and Staging Treating Endometrial Cancer Talking With Your Doctor After Treatment What`s ...

  9. Lower values of VEGF in endometrial secretion are a possible cause of subfertility in non-atopic asthmatic patients

    DEFF Research Database (Denmark)

    Gade, Elisabeth Juul; Thomsen, Simon Francis

    2014-01-01

    Abstract Objective: Using endometrial secretion analysis, we assessed whether altered inflammatory cytokine levels can be detected in the uterine environment in asthma patients, thereby providing a possible cause of reduced fertility in asthmatics. Methods: Forty-four unexplained infertile women (aged 28-44) underwent asthma and allergy testing, questionnaires, endometrial secretion and blood samples in the mid-secretory phase of the menstrual cycle (day 19-23) during assisted reproduction. Differences in cytokines and growth factors were analyzed. Results: Mean log-VEGF in uteri was lower in asthma patients compared with controls (2.29 versus 2.70, p?=?0.028). This was mainly due to lower values of VEGF among women with non-atopic asthma compared with women with atopic asthma (1.86 versus 2.72, p?=?0.009) and with healthy controls (1.86 versus 2.70, p?=?0.01). Asthma treatment status had no effect on VEGF levels in uteri. Serum high sensitivity CRP was negatively correlated with VEGF in endometrial secretions. No other significant correlations were observed between peripheral blood values and markers found in utero. Conclusion: Asthma is associated with lower values of VEGF in uterine endometrial secretions, which might affect the receptiveness of the endometrium and thereby increase time to pregnancy. The effect appears to be associated with non-atopic asthma with general increased systemic inflammation.

  10. Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

    Directory of Open Access Journals (Sweden)

    Trefoux Bourdet A

    2015-03-01

    Full Text Available Alice Trefoux Bourdet, Dominique Luton, Martin Koskas Department of Obstetrics and Gynecology, Bichat University Hospital, Paris Diderot University, Paris, France Abstract: Uterine myoma is the most common benign uterine tumor in women of reproductive age and occurs in 20%–25% of the worldwide population. No currently approved medical treatment is able to completely eliminate fibroids. Surgery, particularly hysterectomy, predominates as the treatment strategy of choice, even though it is associated with risks and complications and causes infertility. Until recently, gonadotropin-releasing hormone agonists were the only available drugs for the preoperative treatment of fibroids. However, ulipristal acetate (UPA, an oral selective progesterone receptor modulator, was recently licensed in Europe for the same indication. Recent studies have demonstrated the efficacy and safety of UPA in the medical management of fibroids before surgery, with a better tolerability profile than leuprolide acetate. Analyzing the literature, we identified new management strategies involving UPA and surgery, considering advantages of both medical and surgical therapy. The advent of UPA will undoubtedly modify the surgical approach to fibroids, but the heterogeneity of these possible indications now requires various original clinical studies to identify the optimal indications for UPA in patients with symptomatic fibroid(s. Keywords: uterine fibroids, medical treatment, selective progesterone receptor modulator, ulipristal acetate, surgery

  11. Expression of the epidermal growth factor system in endometrioid endometrial cancer.

    DEFF Research Database (Denmark)

    Ejskjaer, Kirsten; SØrensen, Boe Sandahl

    2006-01-01

    OBJECTIVE: The Epidermal Growth Factor (EGF) system is expressed in healthy premenopausal endometrium. We describe the expression of the four receptors, HER1, HER2, HER3, HER4 and the six ligands amphiregulin, transforming growth factor alpha (TGF-alpha), heparin binding EGF like growth factor (HB-EGF), betacellulin, epiregulin and EGF in endometrioid endometrial cancer. METHODS: We have uterine samples from 45 women with endometrioid endometrial cancer. As normal counterparts, endometrial samples from thirteen postmenopausal women, and previous data on fourteen premenopausal women were employed. Extracted RNA was analyzed by real-time PCR; the receptors and ligands were localized by immunohistochemistry. RESULTS: Three receptors (HER1, HER2 and HER4) and two detectable ligands (TGF-alpha and HB-EGF) are expressed significantly higher in endometrial cancer than in healthy postmenopausal endometrium. Cancer tissue show significantly lower expression of HER1 and HER3, and higher expression of HER4, amphiregulin, TGF-alpha and HB-EGF compared to premenopausal endometrium; no difference is seen in HER2. EGF is undetectable in all of the samples. Immunohistochemically the receptors locate to the epithelium and/or glands while the ligands locate to the stroma (amphiregulin), the stroma and the epithelium (TGF-alpha, epiregulin), the epithelium (betacellulin) or are not detectable (HB-EGF, EGF). CONCLUSIONS: mRNA of all receptors and five ligands are present in endometrioid endometrial cancer, and the protein of all receptors and four ligands are identified by immunohistochemistry. The expression pattern in endometrioid endometrial cancer differs from the pattern in pre- and postmenopausal endometrium. The most remarkable finding is an increased level of HER4, a receptor which correlates to a favorable prognosis in other types of cancers. Udgivelsesdato: 2007-Jan

  12. Role of diagnostic hysteroscopy in evaluation of abnormal uterine bleeding and its histopathological correlation

    Directory of Open Access Journals (Sweden)

    Kamlesh R. Chaudhari

    2014-06-01

    Methods: This is a prospective interventional study conducted in the dept. of obstetrics and gynecology at K.J. Somaiya hospital in the period between January 2010 to December 2012. Women between 20-60 years of age of any parity who presented with complaints of Abnormal Uterine Bleeding (AUB and who did not require any emergency management were enrolled in the study after excluding pregnancy, uterine/cervical infection/PID, cervical malignancy, H/o uterine perforation, patients on Oral Contraceptive Pills (OCPs, and presence of medical contraindication to any invasive procedure. A total of 98 women were included in the study. They were counselled and informed consent was taken. Patients were evaluated with detailed history, thorough examination and investigations. Hysteroscopy was done under total intravenous anaesthesia followed by endometrial biopsy. Hysteroscopic findings were then correlated with histopathology reports. Results: The sensitivity, specificity, Positive Predictive Value (PPV, Negative Predictive Value (NPV and accuracy of diagnostic hysteroscopy in the study was 98.3%, 80.5%, 89.7%, 96.7% and 91.8% respectively. For the diagnosis of endometrial hyperplasia these were 92%, 92%, 89%, 94%, and 92 % respectively. For polyp these figures were 94%, 96%, 87%, 98%, 95% respectively; for endometrial atrophy there were 66%, 95%, 60 %, 98% and 94%; for submucous fibroid 91%, 95%, 78%, 98%, and 94%; for malignancy 75%, 98%, 75%, 98%, 97% respectively. Conclusions: With the above results it can be concluded that hysteroscopy is safe, sensitive and reliable diagnostic procedure. However endometrial biopsy improves the diagnostic accuracy of hysteroscopy. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 666-670

  13. An Immunohistochemical Study of Beta1 Integrin Molecules (VLA-4, VLA-5, VLA-6 in All Endometrial Compartments of Fertile and Infertile Women in Ahwaz-Iran

    Directory of Open Access Journals (Sweden)

    M. Ghafourian Boroujerdnia

    2009-01-01

    Full Text Available In some cases of infertility, implantation failure is due to a lack of expression of specific critical participating proteins such as cell adhesion molecules. The expression of beta 1 (?1 integrin molecules within endometrial tissue has been proposed as a marker of uterine receptivity during the implantation window. Present study was conducted to assess uterine receptivity in women with unexplained infertility using ?1 integrin molecules within endometrial tissue in comparison with fertile women. This retrospective study was performed using a semiquantitative analysis on the immunohistochemical staining of ?1 integrins (VLA-4, VLA-5, VLA-6 in the mid-secretory phase of endometrium. Specimens were obtained from 30 fertile women and 28 infertile patients with a history of unexplained infertility. Chi-Square test was used to compare the expression and defect of ?1 integrin molecules between two groups. The results showed ?1 integrin molecules were present in fertile and infertile endometrial uterine tissues with different reactivity in different compartments. VLA-5 and VLA-6 expression on endometrial compartments showed an unrelated pattern of staining in either fertile or infertile women. The majority of glandular epithelial cells and stromal cells expressed VLA-4 integrin molecules in fertile endometrium. However, the reactivity with VLA-4 reduced significantly in both glandular epithelial cells and stromal cells in infertile women (p = 0.001. In conclusion differences may explain causes of unexplained infertility and suggests that VLA-4 integrin molecule may contribute in uterine endometrial receptivity at the time of the implantation window which requires more investigations in benign gynecologic diseases.

  14. Uterine sarcomas-Recent progress and future challenges

    International Nuclear Information System (INIS)

    Uterine sarcomas are a group of rare tumours that provide considerable challenges in their treatment. Radiological diagnosis prior to hysterectomy is difficult, with the diagnosis frequently made post-operatively. Current staging systems have been unsatisfactory, although a new FIGO staging system specifically for uterine sarcomas has now been introduced, and may allow better grouping of patients according to expected prognosis. While the mainstay of treatment of early disease is a total abdominal hysterectomy, it is less clear whether routine oophorectomy or lymphadenectomy is necessary. Adjuvant pelvic radiotherapy may improve local tumour control in high risk patients, but is not associated with an overall survival benefit. Similarly there is no good evidence for the routine use of adjuvant chemotherapy. For advanced leiomyosarcoma, newer chemotherapy agents including gemcitabine and docetaxel, and trabectedin, offer some promise, while hormonal therapies appear to be more useful in endometrial stromal sarcoma. Novel targeted agents are now being introduced for sarcomas, and uterine sarcomas, and show some indications of activity. Non-pharmacological treatments, including surgical metastatectomy, radiofrequency ablation, and CyberKnife radiotherapy, are important additions to systemic therapy for advanced metastatic disease.

  15. Uterine sarcomas-Recent progress and future challenges

    Energy Technology Data Exchange (ETDEWEB)

    Seddon, Beatrice M., E-mail: beatrice.seddon@uclh.nhs.uk [London Sarcoma Service, Department of Oncology, University College Hospital, 1st Floor Central, 250 Euston Road, London, NW1 2PG (United Kingdom); Davda, Reena [London Sarcoma Service, Department of Oncology, University College Hospital, 1st Floor Central, 250 Euston Road, London, NW1 2PG (United Kingdom)

    2011-04-15

    Uterine sarcomas are a group of rare tumours that provide considerable challenges in their treatment. Radiological diagnosis prior to hysterectomy is difficult, with the diagnosis frequently made post-operatively. Current staging systems have been unsatisfactory, although a new FIGO staging system specifically for uterine sarcomas has now been introduced, and may allow better grouping of patients according to expected prognosis. While the mainstay of treatment of early disease is a total abdominal hysterectomy, it is less clear whether routine oophorectomy or lymphadenectomy is necessary. Adjuvant pelvic radiotherapy may improve local tumour control in high risk patients, but is not associated with an overall survival benefit. Similarly there is no good evidence for the routine use of adjuvant chemotherapy. For advanced leiomyosarcoma, newer chemotherapy agents including gemcitabine and docetaxel, and trabectedin, offer some promise, while hormonal therapies appear to be more useful in endometrial stromal sarcoma. Novel targeted agents are now being introduced for sarcomas, and uterine sarcomas, and show some indications of activity. Non-pharmacological treatments, including surgical metastatectomy, radiofrequency ablation, and CyberKnife radiotherapy, are important additions to systemic therapy for advanced metastatic disease.

  16. Endometrial stromal sarcoma: clinicopathological and immunophenotype study of 18 cases.

    Science.gov (United States)

    Vera, Adrián Antonio López; Guadarrama, Mónica Belinda Romero

    2011-10-01

    Malignant tumors of the uterine corpus are uncommon. They originate from the endometrial stroma, smooth muscle, blood vessels, or from a mixture of them. The objective of this article was to know the frequency and the clinical, morphologic, and immunophenotype characteristics of the endometrial stromal sarcoma (ESS). We reviewed the cases of ESS observed from 2002 to 2008 at the Pathology Unit of the General Hospital of Mexico. The following data were analyzed: age, clinical stage, degree of differentiation, and immunophenotype. We found 18 cases, and the average age of patients was 48.6 years; 66% were in clinical stages 1 and 2. Fifteen cases (83.3%) were classified as low-grade sarcomas and 3 (16.6%) as high-grade or undifferentiated sarcomas. We determined immunohistochemical markers in 17 cases; receptors to estrogens were positive in 5 (29.4%) and to progesterone in 9 (52.9%). CD10 was expressed in 10 (58.8%) and p53 in 11 cases (64.7%). Two cases were associated to primary tumors of the ovary (papillary cystadenocarcinoma). In conclusion, ESS was present at 0.6% in our institution; and most were low grade. Expression of markers, such as p53, CD10, and hormonal receptors, was positive. PMID:21652246

  17. Individual program of intracavitary gammatherapy of endometrial carcinoma by means of the AGAT-V apparatus

    International Nuclear Information System (INIS)

    Clinical, methodological and dosimetric aspects of the intracavitary gamma-therapy of endometrial carcinoma on the AGAT-V apparatus are considered. The results of dosimetric studies carried out with the aid of up-to-date computers providing necessary correlations between dose distributions formed on the AGAT-V apparatus and the dimensions of individual ''targets'' of a uterine primary tumour are discussed. Regimens of complex therapy used in tumoral processes of various extent depending on the pathogenesis, tumour morphology and the general condition of the patients are given. Observations of 35 patients with endometrial carcinoma of the 1-4 stages treated according to the elaborated schemes including harmonal and radiation therapy are described. A favourable immediate effect of a complex therapy including intracavitary gamma-therapy on the ''AGAT-V'' apparatus has been noted

  18. Quantitative light microscopic autoradiographic study on (/sup 3/H)leukotriene C4 binding to nonpregnant bovine uterine tissue

    Energy Technology Data Exchange (ETDEWEB)

    Chegini, N.; Rao, C.V.

    1988-05-01

    Mammalian uteri contain both lipoxygenase and cyclooxygenase pathways of arachidonic acid metabolism. Sulfidopeptidyl leukotrienes formed by the lipoxygenase pathway can stimulate uterine contractions and play a role in uterine preparation for implantation. These actions of leukotrienes are perhaps mediated by binding to specific receptors. To understand the cellular basis of leukotriene C4 action, the present quantitative light microscopic autoradiographic study was undertaken on nonpregnant bovine uterine tissue. The results demonstrated that the circular and elongated myometrial smooth muscle, uterine vascular smooth muscle, stromal cells of endometrium, and fibroblasts of perimetrium, but not the endometrial glands, vascular endothelium, and erythrocytes in lumen of arterioles, contained specific silver grains after incubation with (/sup 3/H)leukotriene C4. The number of grains per 100-micron2 areas were similar in circular and elongated myometrial smooth muscle (P greater than 0.05), which was higher than in other uterine cells (P less than 0.05-0.01). The grains in all cells were greatly reduced after coincubation with excess unlabeled leukotriene C4, but not with leukotriene A4, leukotriene B4, leukotriene D4, leukotriene E4, prostaglandin E2, prostaglandin F2 alpha, or prostacyclin. In conclusion, leukotriene C4 may regulate both uterine cells and uterine vasculature and exert contractile and noncontractile actions via the specific leukotriene C4-binding sites present in different cell types.

  19. Quantitative light microscopic autoradiographic study on [3H]leukotriene C4 binding to nonpregnant bovine uterine tissue

    International Nuclear Information System (INIS)

    Mammalian uteri contain both lipoxygenase and cyclooxygenase pathways of arachidonic acid metabolism. Sulfidopeptidyl leukotrienes formed by the lipoxygenase pathway can stimulate uterine contractions and play a role in uterine preparation for implantation. These actions of leukotrienes are perhaps mediated by binding to specific receptors. To understand the cellular basis of leukotriene C4 action, the present quantitative light microscopic autoradiographic study was undertaken on nonpregnant bovine uterine tissue. The results demonstrated that the circular and elongated myometrial smooth muscle, uterine vascular smooth muscle, stromal cells of endometrium, and fibroblasts of perimetrium, but not the endometrial glands, vascular endothelium, and erythrocytes in lumen of arterioles, contained specific silver grains after incubation with [3H]leukotriene C4. The number of grains per 100-micron2 areas were similar in circular and elongated myometrial smooth muscle (P greater than 0.05), which was higher than in other uterine cells (P less than 0.05-0.01). The grains in all cells were greatly reduced after coincubation with excess unlabeled leukotriene C4, but not with leukotriene A4, leukotriene B4, leukotriene D4, leukotriene E4, prostaglandin E2, prostaglandin F2 alpha, or prostacyclin. In conclusion, leukotriene C4 may regulate both uterine cells and uterine vasculature and exert contractile and noncontractile actions via the specific leukotriene C4-binding s via the specific leukotriene C4-binding sites present in different cell types

  20. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... people with history of cervical cancer or uterine cancer. We have to make sure that your symptoms are from your fibroids and they're not from other things such as endometriosis and other types of polyps and tumors that can occur in ...

  1. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... We don't want to treat people with history of cervical cancer or uterine cancer. We have to make sure that your symptoms are from your fibroids and they're not from other things such as endometriosis and other types of polyps ...

  2. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... part, the patient's out bed the same day, home the next day, back to work in a week, okay. OR Live bah 2777 show 5 If we come back to our chart here, I want to just show you again schematically what Dr. Powell is doing next door. So, he's got his catheter way down in the uterine artery. And these ...

  3. Effect of suppression of postpartum ovulation on endometrial inflammation in dairy cows.

    Science.gov (United States)

    Heppelmann, M; Brömmling, A; Ulbrich, S E; Weinert, M; Piechotta, M; Wrenzycki, C; Merbach, S; Schoon, H-A; Hoedemaker, M; Bollwein, H

    2015-07-01

    The objective of this study was to investigate the effect of time of first postpartum ovulation on endometrial inflammation in dairy cows with and without uterine disease during the early puerperal period. Transvaginal follicular puncture (FP) was carried out to suppress postpartum ovulation and formation of a CL until Day 42. Fifty-three lactating Holstein Friesian cows were divided into four groups on the basis of presence (UD+) or absence (UD-) of uterine disease, which was defined as retained fetal membranes and/or metritis, and whether FP had (FP+) or had not been (FP-) carried out. This resulted in the following groups: UD-FP- (n = 15), UD-FP+ (n = 13), UD+FP- (n = 13), and UD+FP+ (n = 12). Cloprostenol was given on Days 55 to 60 postpartum, and GnRH was administered 2 days later for synchronization of ovulation. In the FP- groups, endometrial swab and biopsy samples were collected during the second estrus (approximately Day 40) and during the estrus after synchronization. In the FP+ groups, the same samples were collected during the first estrus (approximately Day 49) and during the estrus after synchronization. The prevalence of positive bacteriologic cultures of the endometrium was not affected by FP (P > 0.05). Histologic signs of endometritis were more severe in UD+FP- cows at second sampling than in UD+FP+ cows (P ? 0.05). Endometrial expression of IL1? (in UD- after first sampling and in UD+ after second sampling) and IL1? (in UD- and UD+ after first sampling) was higher (P ? 0.05) in FP- cows than in FP+ cows. Regardless of group, cows with histopathologic evidence of endometritis had higher expression (P ? 0.05) of IL1?, IL1?, IL6, and TNF? than cows without endometritis. In conclusion, suppression of early ovulation by transvaginal FP enhances clearance of uterine inflammation in postpartum cows. PMID:25841545

  4. Status of carcinoma cervix and high risk HPV 16 DNA in women with postmenopausal uterine bleeding (PMB)

    OpenAIRE

    Veena Kashyap; Suresh Hedau

    2014-01-01

    Postmenopausal bleeding (PMB) is a discharge that occurs following the firm diagnosis of menopause, which is at least six months from the end of women’s menstrual cycle but not to be confused with infrequent or irregular periods occurring around the time of menopause. It is a common problem representing 5% of all gynecology outpatient attendances which are to eliminate endometrial cancer as the cause of bleed and PMB should be reported urgently to the gynecologist. Uterine bleeding in postm...

  5. The Clinical Relevance of Rising CA-125 Levels Within the Normal Range in Patients With Uterine Papillary Serous Cancer

    OpenAIRE

    Frimer, Marina; Hou, June Y.; Mcandrew, Thomas C.; Goldberg, Gary L.; Shahabi, Shohreh

    2013-01-01

    The utility of cancer antigen 125 (CA-125) levels as an adjunct method of monitoring patients with uterine papillary serous carcinoma (UPSC) or endometrial serous carcinoma after surgery and adjuvant treatment has been reported. Our goal was to determine the significance of rising CA-125 levels within the normal range in these patients in the posttreatment surveillance setting. All patients with UPSC who underwent surgical staging and had preoperative CA-125 measurement from...

  6. Effect of immunomodulatory therapy on the endometrial inflammatory response to induced infectious endometritis in susceptible mares

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Woodward, E. M.

    2012-01-01

    The objective of the present study was to evaluate the effect of immunomodulatory therapy (glucocorticoids (GC) and mycobacterium cell wall extract (MCWE)) on the endometrial gene expression of inflammatory cytokines in susceptible mares with induced infectious endometritis. Endometrial gene expression of pro- and anti-inflammatory cytokines; interleukin (IL)-1ß, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-a, IL-1 receptor antagonist (ra), acute phase protein (APP) serum amyloid A (SAA) and clinical parameters were evaluated. Five mares were classified as susceptible to persistent endometritis based on their endometrial histopathology and ability to clear an induced uterine inflammation. To investigate the effect of immunomodulatory therapy, the mares were inoculated with 10(5) colony forming units (CFU) Escherichia coli in three consecutive estrus cycles in a modified cross-over study design. Thus, each mare served as its own control and the treatment type was performed in randomized order. The effect of treatment with MCWE (1.5 mg Settle IV), dexamethasone (0.1 mg per kg IV) or no treatment was investigated. All mares were free from uterine inflammation before each E. coli inoculation. Endometrial biopsies were recovered 3, 24 and 72 h post inoculation. Relative gene-expression analyses were performed by quantitative reverse transcriptase PCR (qRT-PCR). Endometrial gene expression of inflammatory cytokines was modulated by administration of GC. Expression of proinflammatory cytokines (IL-1ß, IL-6, IL-8) and SAA was significantly lower in the GC treated group late in the study period (72 h) compared to "no treatment" and MCWE treatment. Increased expression of the anti-inflammatory cytokine IL-10 was observed 3 and 24 h after E. coli infusion and GC treatment. A significant decrease of SAA expression was observed after MCWE treatment compared to "no treatment". MCWE and GC treatment had a significant effect on the clearance of uterine pathogens and number of mares retaining fluid after E. coli infusion. The results of the current investigation suggest that GC is capable of effectively modulating the innate immune response to induced infectious endometritis in susceptible mares.

  7. Analysis of Epithelial Growth Factor-Receptor (EGFR Phosphorylation in Uterine Smooth Muscle Tumors: Correlation to Mucin-1 and Galectin-3 Expression

    Directory of Open Access Journals (Sweden)

    Udo Jeschke

    2013-02-01

    Full Text Available Uterine fibroids are the commonest uterine benign tumors. A potential mechanism of malignant transformation from leiomyomas to leiomyosarcomas has been described. Tyrosine phosphorylation is a key mechanism that controls biological functions, such as proliferation and cell differentiation. The aim of the current study was to evaluate the phosphorylation of epithelial growth factor-receptor (EGFR in normal myometrium, uterine myomas and uterine leiomyosarcomas. Formalin-fixed paraffin-embedded tissue samples from normal myometrium, leiomyomas and leiomyosarcomas were studied. Samples were immunohistochemically (IHC assessed using the anti-EGFR phosphorylation of Y845 (pEGFR-Y845 and anti-pEGFR-Y1173 phosphorylation-specific antibodies. IHC staining was evaluated using a semiquantitative score. The expression of pEGFR-Y845 was significantly upregulated in leiomyosarcomas (p < 0.001 compared to leiomyomas and normal myometrium. In contrast, pEGFR-Y1173 did not differ significantly between the three groups of the study. Correlation analysis revealed an overall positive correlation between pEGFR Y845 and mucin 1 (MUC1. Further subgroup analysis within the tumoral group (myomas and leiomyosarcomas revealed an additional negative correlation between pEGFR Y845 and galectin-3 (gal-3 staining. On the contrary no significant correlation was noted within the non-tumoral group. An upregulated EGFR phosphorylation of Y845 in leiomyosarcomas compared to leiomyomas implicates EGFR activation at this special receptor site. Due to these pEGFR-Y845 variations, it can be postulated that MUC1 interacts with it, whereas gal-3 seems to be cleaved from Y845 phosphorylated EGFR. Further research on this field could focus on differences in EGFR pathways as a potentially advantageous diagnostic tool for investigation of benign and malignant signal transduction processes.

  8. Ablación endometrial histeroscópica como tratamiento definitivo para el sangrado uterino anormal

    Scientific Electronic Library Online (English)

    Verónica, Chamy P; Javiera, Berhó F; Benjamín, Tudela S; Anibal, Scarella C.

    Full Text Available Introducción: El sangrado uterino anormal (SUA) afecta a un 19% de las mujeres. Su tratamiento definitivo consiste en la histerectomía, sin embargo la ablación endometrial histeroscópica surge como un tratamiento menos invasivo, menos riesgoso y más rápido. Objetivo: Evaluar la efectividad de la abl [...] ación endometrial histeroscópica como tratamiento definitivo para el SUA. Método: Estudio de cohorte retrospectivo obtenido de base de datos de protocolos operatorios específicos del total de histeroscopías quirúrgicas realizadas en el Servicio de Ginecología del Hospital Naval Almirante Nef de Viña del Mar, entre enero de 2002 y diciembre de 2010. Resultados: De las 507 histeroscopías quirúrgicas realizadas, 230 fueron por SUA. Del total de pacientes sometidas a ablación endometrial histeroscópica, 27 (11,7%) necesitaron un segundo procedimiento, de las cuales sólo 15 (6,5%) fueron por persistencia de SUA. No se encontró asociación entre la necesidad de un segundo procedimiento por SUA con características propias de la paciente ni del procedimiento quirúrgico. Conclusión: La ablación endometrial histeroscópica es una opción terapéutica efectiva y segura para el tratamiento del SUA, con baja necesidad de segundo procedimiento por persistencia de éste y bajo riesgo de complicaciones. La necesidad de un segundo procedimiento por SUA no se asocia con características propias de la paciente ni del procedimiento quirúrgico. Abstract in english Introduction: Abnormal uterine bleeding (AUB) affects 19% of women. Definitive treatment is hysterectomy, however hysteroscopic endometrial ablation is emerging as a less invasive, less risky and faster treatment. Objective: To evaluate the effectiveness of hysteroscopic endometrial ablation as defi [...] nitive treatment for AUB. Method: Retrospective cohort study database obtained from specific surgical protocols of all surgical hysteroscopies performed in the Gynecology Department of Hospital Naval Almirante Nef de Vina del Mar, between January 2002 and December 2010. Results: Of the 507 surgical hysteroscopies performed, 230 were because of AUB. Of all patients undergoing hysteroscopic endometrial ablation, 27 (11.7%) required a second procedure, of which only 15 (6.5%) were due to persistence of AUB. No association was found between the need for a second procedure because of AUB with patient characteristics or the surgical procedure itself. Conclusion: Hysteroscopic endometrial ablation is a safe and effective therapeutic option for AUB treatment, with a low need for a second procedure due to its persistence and with low risk of complications. The need of a second procedure because of AUB is not associated with patient characteristics or the surgical procedure itself.

  9. Microarray Analysis on Gene Regulation by Estrogen, Progesterone and Tamoxifen in Human Endometrial Stromal Cells

    Directory of Open Access Journals (Sweden)

    Chun-E Ren

    2015-03-01

    Full Text Available Epithelial stromal cells represent a major cellular component of human uterine endometrium that is subject to tight hormonal regulation. Through cell-cell contacts and/or paracrine mechanisms, stromal cells play a significant role in the malignant transformation of epithelial cells. We isolated stromal cells from normal human endometrium and investigated the morphological and transcriptional changes induced by estrogen, progesterone and tamoxifen. We demonstrated that stromal cells express appreciable levels of estrogen and progesterone receptors and undergo different morphological changes upon hormonal stimulation. Microarray analysis indicated that both estrogen and progesterone induced dramatic alterations in a variety of genes associated with cell structure, transcription, cell cycle, and signaling. However, divergent patterns of changes, and in some genes opposite effects, were observed for the two hormones. A large number of genes are identified as novel targets for hormonal regulation. These hormone-responsive genes may be involved in normal uterine function and the development of endometrial malignancies.

  10. Heightened Expression of Cyclooxygenase-2 and Peroxisome Proliferator-Activated Receptor-? in Human Endometrial Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Beverly J. Tong

    2000-01-01

    Full Text Available Epidemiological studies indicate that nonsteroidal anti-inflammatory drugs (NSAIDs significantly reduce the risk and mortality from colorectal cancer, in part by inhibiting prostaglandin (PG synthesis. Cyclooxygenase (COX, the rate-limiting enzyme in PG biosynthesis, exists in two isoforms, COX-1 and COX-2. Genetic and pharmacological evidences suggest that COX-2 is involved in the development of colorectal cancer. We have previously shown that COX-2derived prostacyclin participates in blastocyst implantation through activation of peroxisome proliferator activated receptor ? (PPAR?, a member of the nuclear hormone receptor family. Furthermore, our recent studies suggest that a similar pathway is operative during colorectal carcinogenesis. These observations prompted us to examine whether the COX-2-PPAR6 signaling pathway is also involved during development of uterine adenocarcinoma. Here we describe for the first time the heightened expression of COX-2 and PPAR?, but not COX-1, in uterine endometrial adenocarcinoma.

  11. Histeroscopia cirúrgica com ressectoscópio para polipectomia endometrial: eficácia e segurança / Operative hysteroscopy with resectoscope for endometrial polypectomy: efficacy and safety

    Scientific Electronic Library Online (English)

    Hélio de Lima Ferreira Fernandes, Costa; Arinaldo Vasconcelos de, Alencar; Maria do Socorro Alves, Carvalho; Silvana Rocha, Menelau; Laura Olinda Bregieiro Fernandes, Costa.

    2001-07-01

    Full Text Available Objetivos: avaliar os resultados das primeiras 104 polipectomias histeroscópicas em nossa instituição de ensino. Métodos: estudo retrospectivo descritivo. Foram revistos os registros das primeiras 136 histeroscopias cirúrgicas realizadas no serviço, sendo 104 polipectomias. Foram avaliadas caracterí [...] sticas das pacientes operadas como idade, paridade, fase da vida reprodutiva e sintomatologia; número e tamanho dos pólipos e os resultados em relação às complicações e remissão dos sintomas. Resultados: as pacientes tinham em média 52,7 anos, sendo três quartos delas multíparas. Encontravam-se na pós-menopausa 60 pacientes (57,7% do grupo). Cerca de metade das pacientes apresentavam sintomas atribuíveis aos pólipos, sendo o sangramento anormal o mais comum (47,1%). Em 16,3% dos casos havia mais de um pólipo, sendo que 84% deles mediam mais de 1 cm. A única complicação imediata de importância foi uma perfuração uterina, sendo que as complicações tardias foram raras e sem gravidade. O tempo médio de seguimento foi de 9 meses. Em 82% das pacientes houve remissão das queixas. Apenas 8,2% das pacientes necessitaram de histerectomia complementar, todas com outras doenças uterinas, como mioma, adenomiose ou hiperplasia endometrial atípica, a qual foi encontrada em apenas 1 paciente. Conclusões: a polipectomia histeroscópica mostrou-se método simples, seguro e eficaz no tratamento dos pólipos endometriais. A seleção das pacientes deve ser rigorosa para evitar procedimentos cirúrgicos complementares. Abstract in english Purpose: to evaluate the results of the first 104 hysteroscopic polypectomies in a teaching hospital. Methods: a retrospective descriptive study was designed. Medical records of the first 136 operative hysteroscopies - 104 of which polypectomies - were reviewed. Patient characteristics such as age, [...] parity, period of reproductive function and symptoms; number and size of polyps and results concerning complications and symptom relief were evaluated. Results: the average age of patients was 52.7 years. Three quarters of them were multiparous. Fifty-seven percent of the patients were menopaused. About half of the patients had symptoms related to polyps. Abnormal bleeding was the most frequent symptom (47.1%). In 16.3% of the patients more than 1 polyp were detected and 84% of the polyps were larger than 1 cm. The only immediate complication was a uterine perforation. Late complications were rare and mild. The follow-up period was 9 months on average. In 82% of teh patients the symptoms were controlled. Hysterectomy was necessary in 8.2% of the patients, all of them with other uterine diseases such as leiomyomas, adenomyosis and atypical endometrial hyperplasia in one patient). Conclusion: hysteroscopic polypectomy is a simple, safe and effective method for the treatment of endometrial polyps. Selection of patients must be rigorous to avoid further operative procedures.

  12. Histeroscopia cirúrgica com ressectoscópio para polipectomia endometrial: eficácia e segurança Operative hysteroscopy with resectoscope for endometrial polypectomy: efficacy and safety

    Directory of Open Access Journals (Sweden)

    Hélio de Lima Ferreira Fernandes Costa

    2001-07-01

    Full Text Available Objetivos: avaliar os resultados das primeiras 104 polipectomias histeroscópicas em nossa instituição de ensino. Métodos: estudo retrospectivo descritivo. Foram revistos os registros das primeiras 136 histeroscopias cirúrgicas realizadas no serviço, sendo 104 polipectomias. Foram avaliadas características das pacientes operadas como idade, paridade, fase da vida reprodutiva e sintomatologia; número e tamanho dos pólipos e os resultados em relação às complicações e remissão dos sintomas. Resultados: as pacientes tinham em média 52,7 anos, sendo três quartos delas multíparas. Encontravam-se na pós-menopausa 60 pacientes (57,7% do grupo. Cerca de metade das pacientes apresentavam sintomas atribuíveis aos pólipos, sendo o sangramento anormal o mais comum (47,1%. Em 16,3% dos casos havia mais de um pólipo, sendo que 84% deles mediam mais de 1 cm. A única complicação imediata de importância foi uma perfuração uterina, sendo que as complicações tardias foram raras e sem gravidade. O tempo médio de seguimento foi de 9 meses. Em 82% das pacientes houve remissão das queixas. Apenas 8,2% das pacientes necessitaram de histerectomia complementar, todas com outras doenças uterinas, como mioma, adenomiose ou hiperplasia endometrial atípica, a qual foi encontrada em apenas 1 paciente. Conclusões: a polipectomia histeroscópica mostrou-se método simples, seguro e eficaz no tratamento dos pólipos endometriais. A seleção das pacientes deve ser rigorosa para evitar procedimentos cirúrgicos complementares.Purpose: to evaluate the results of the first 104 hysteroscopic polypectomies in a teaching hospital. Methods: a retrospective descriptive study was designed. Medical records of the first 136 operative hysteroscopies - 104 of which polypectomies - were reviewed. Patient characteristics such as age, parity, period of reproductive function and symptoms; number and size of polyps and results concerning complications and symptom relief were evaluated. Results: the average age of patients was 52.7 years. Three quarters of them were multiparous. Fifty-seven percent of the patients were menopaused. About half of the patients had symptoms related to polyps. Abnormal bleeding was the most frequent symptom (47.1%. In 16.3% of the patients more than 1 polyp were detected and 84% of the polyps were larger than 1 cm. The only immediate complication was a uterine perforation. Late complications were rare and mild. The follow-up period was 9 months on average. In 82% of teh patients the symptoms were controlled. Hysterectomy was necessary in 8.2% of the patients, all of them with other uterine diseases such as leiomyomas, adenomyosis and atypical endometrial hyperplasia in one patient. Conclusion: hysteroscopic polypectomy is a simple, safe and effective method for the treatment of endometrial polyps. Selection of patients must be rigorous to avoid further operative procedures.

  13. Effects of Interceed on endometrial receptivity in rabbits with intrauterine adhesion

    Directory of Open Access Journals (Sweden)

    Hui-juan LI

    2015-06-01

    Full Text Available Objective?To observe the effect of anti-adhesion membrane made of oxidized regenerated cellulose (Interceed on endometrial receptivity in New Zealand white rabbits with intrauterine adhesion (IUA. Methods?Forty-eight female rabbits were randomly divided into 4 groups (12 each: normal control group (group A, Interceed control group (group B, untreated model group (group C, and Inte rceed therapy group (group D. Rabbits in group A received sham operation and underwent no modeling. The Interceed was placed into the normal rabbits' uteruses in group B. The IUA rabbit models were reproduced in group C and group D by both mechanical injury and infection. Rabbits in group C were not treated, and in group D Interceed was put into their uteruses 7 days after modeling. Four rabbits in each group were sacrificed on the 28th day, the uterine tissues were collected. The endometrial glands count was performed after HE staining, and the degree of endometrial fibrosis was assessed after Masson staining. For the remaining animals in each group, ovulation was induced by stimulating the vagina in estrus, and they were sacrificed and the uterine tissue was collected on the 7th day after pseudopregnancy. The expression of pinopodes in endometrium was observed by scanning electron microscopy, and that of integrin ?v?3 protein was determined by immunohistochemistry. Results?The expression of glands and the degree of fibrosis in endometrium was obviously improved in group D as compared with that of group C (P<0.05, but no significant difference was found among the groups A, B and D. In group A, and developed pinopodes were abundantly expressed in endometrial surface, and similar changes were found in group B. The expression of pinopodes in group C was scarce, and the development was not synchronized. More pinopodes, with irregular shape and synchronized development, were expressed in group D than in group C. The expression of integrin ?v?3 protein was significantly lower in group C than in group A and group D (P<0.05. Conclusion?Interceed may alleviate the endometrial pathological changes, increase the expression of integrin ?V?3 protein, ameliorate the expression and development of pinopodes, thus improve the endometrial receptivity. DOI: 10.11855/j.issn.0577-7402.2015.05.02

  14. Frequency of primary uterine malignancy in hystrectomy specimens of postmenopausal women - a study of 255 cases at combined military hospital peshawar

    International Nuclear Information System (INIS)

    Objective: To determine the frequency of primary uterine malignancy in hysterectomy specimens in women with postmenopausal bleeding. Study Design: A descriptive cross-sectional study. Place and Duration of study: It was conducted in the department of histopathology at Combined Military Hospital, Peshawar from 1st September 2010 to 31st May 2011. Material and Methods: A total of 255 hysterectomy specimens of postmenopausal women were examined grossly and microscopically to analyse the underlying pathology. Results: The mean age of patients with malignant diseases was 56.4 years and with benign diseases 49.3 years. Out of 255 patients 215 (95.6%) were found to have benign pathologies and 10 (4.4%) had malignant lesions. The frequency and histological pattern of primary uterine malignancy was; endometrial carcinoma 3.1%, cervical carcinoma 0.9% and leiomyosarcoma 0.4%. The benign pathologies included leiomyoma 35.6%, atrophic endometritis 16.4%, endometrial hyperplasia 15.1%, adenomysis 11.1%, endometrial polyp 10.2%, adenomyoma 6.7% and endometrial stromal nodule 0.4%. Conclusion: This study shows that frequency of malignancy in postmenopausal women is low in our set up and most of the underlying pathologies are benign. The most frequent malignancy found in postmenopausal women is endometrial carcinoma followed by cervical carcinoma. (author)

  15. Diagnostic Features and Therapeutic Consequences of Hysteroscopy in Women with Abnormal Uterine Bleeding and Abortion

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    Sedigheh A. Fard

    2012-01-01

    Full Text Available Problem statement: Hysteroscopy is a procedure in which the endometrial cavity is observable and subject of manipulation via transcervical route. Hysteroscopy is a minimally invasive process in diagnosis and treatment of many intrauterine and endocervical conditions. Polypectomy, myomectomy and endometrial ablation could be easily manageable by this procedure. According to safety and high efficiency of hysteroscopy, this method is changing to a widespread procedure in dealing with many gynecologic and obstetrical conditions. This study aimed at evaluating the diagnostic and therapeutical efficiency of hysteroscopy in managing of common conditions including abnormal uterine bleeding and abortion. Approach: In a descriptive cross-sectional setting, 243 women underwent hysteroscopy were evaluated in two groups: with uterine bleeding 236 cases and with recurrent abortions 7 cases. This study was conducted in Tabriz Alzahra Educational Center during a 15-month period. The main causes of the complaints were determined in each group. Six months after treatment, the overall success rate was recorded. Results: Hysteroscopy was the sole diagnostic procedure in 16.5 and 14.3% of the patients in groups with abnormal uterine bleeding and abortion, respectively. In the group with abnormal uterine bleeding, curettage, myomectomy, polypectomy, hysterectomy, laparoscopy and laparotomy were the main diagnostic-therapeutical approaches along with the hysteroscopy in descending order. In the group with recurrent abortion, laparoscopy, curettage and myomectomy were the main diagnostic-therapeutical approaches along with the hysteroscopy in descending. There was not any major complication. The diagnostic-therapeutical measures accompanying with the laparoscopy were successful in 73.5% of the bleeding group in follow-up period. Conclusion: Based on our results, hysteroscopy is a safe, accurate and highly-efficient procedure in managing women with abnormal uterine bleeding and recurrent abortion.

  16. Microarray Analysis of Gene Expression in the Uterine Endometrium during the Implantation Period in Pigs

    Science.gov (United States)

    Kim, Mingoo; Seo, Heewon; Choi, Yohan; Shim, Jangsoo; Kim, Heebal; Lee, Chang-Kyu; Ka, Hakhyun

    2012-01-01

    During embryo implantation in pigs, the uterine endometrium undergoes dramatic morphological and functional changes accompanied with dynamic gene expression. Since the greatest amount of embryonic losses occur during this period, it is essential to understand the expression and function of genes in the uterine endometrium. Although many reports have studied gene expression in the uterine endometrium during the estrous cycle and pregnancy, the pattern of global gene expression in the uterine endometrium in response to the presence of a conceptus (embryo/fetus and associated extraembryonic membranes) has not been completely determined. To better understand the expression of pregnancy-specific genes in the endometrium during the implantation period, we analyzed global gene expression in the endometrium on day (D) 12 and D15 of pregnancy and the estrous cycle using a microarray technique in order to identify differentially expressed endometrial genes between D12 of pregnancy and D12 of the estrous cycle and between D15 of pregnancy and D15 of the estrous cycle. Results showed that the global pattern of gene expression varied with pregnancy status. Among 23,937 genes analyzed, 99 and 213 up-regulated genes and 92 and 231 down-regulated genes were identified as differentially expressed genes (DEGs) in the uterine endometrium on D12 and D15 of pregnancy compared to D12 and D15 of the estrous cycle, respectively. Functional annotation clustering analysis showed that those DEGs included genes involved in immunity, steroidogenesis, cell-to-cell interaction, and tissue remodeling. These findings suggest that the implantation process regulates differential endometrial gene expression to support the establishment of pregnancy in pigs. Further analysis of the genes identified in this study will provide insight into the cellular and molecular bases of the implantation process in pigs. PMID:25049669

  17. CORRELACIÓN DE LA HISTEROSCOPIA Y BIOPSIA DIRIGIDA EN EL ESTUDIO DEL ENGROSAMIENTO ENDOMETRIAL PATOLÓGICO POR ULTRASONIDO

    Directory of Open Access Journals (Sweden)

    Macarena Socías T

    2007-01-01

    Full Text Available Objetivo: Correlacionar la histeroscopia con la biopsia dirigida en pacientes pre y postmenopáusicas con engrosamiento endometrial patológico al ultrasonido. Método: Estudio retrospectivo de 265 pacientes derivadas por engrosamiento endometrial patológico en la ecografía transvaginal y evaluadas mediante histeroscopia con biopsia dirigida. Resultados: 68,7% de las pacientes presentaron un aspecto histeroscópico benigno, 15,1% normal, 10,6% potencialmente maligno y 5,6% maligno. Los diagnósticos anátomo patológicos más frecuentes fueron: pólipo endometrial (n=92; 34,7%, endometrio proliferativo/secretor (n=84; 31,7% y mioma submucoso (n=38; 14,3%. Todos los cánceres endometriales (n=9 se presentaron en mujeres postmenopáusicas sin TRH y con endometrio 11 mm. La correlación entre histeroscopia y anatomía patológica para diagnóstico de patología benigna tuvo una sensibilidad y especificidad de 90,7% (95% IC 85,2 - 94,3 y 65,4% (95% IC 55,8 - 73,8; valor predictivo positivo y negativo fue de 80,2% (95% IC 73,8 - 85,4 y 82% (95% IC 72,3 - 88,7. Para diagnóstico de hiperplasia endometrial la sensibilidad y especificidad fue 60% (95% IC 31,3 - 83,2 y 91,4% (95% IC 87,3 - 94,2; el valor predictivo positivo y negativo fue de 21,4% (95% IC 10,7 - 39,5 y 98,3% (95% IC 95,7 - 99,3. Para diagnóstico de cáncer endometrial la sensibilidad y especificidad fue de 95% (95% IC 65,5 - 99,5 y 97,9% (95% IC 95,2 - 99; el valor predictivo positivo y negativo fue de 63,3% (95% IC 38,7 - 82,5 y 99,7% (95% IC 98,1 - 99,8. Conclusión: El 85% de las pacientes con engrosamiento endometrial presentaron una histeroscopia alterada (benigna, potencialmente maligna o maligna, confirmada en 80% de los casos por anatomía patológica. En un centro con experiencia la histeroscopia normal puede hacer innecesaria la biopsia. El aspecto potencialmente maligno a la histeroscopia puede ser un sobrediagnóstico, por lo que la anatomía patológica es imprescindible. Todos los cánceres endometriales fueron diagnosticados a la histeroscopiaObjective: Comparison of hysteroscopy with biopsy in pre- and post -menopausic patients with endometrial thickening on ultrasound. Methods: Retrospective study of 265 patients with pathologic endometrial thickening on transvaginal ultrasound and evaluated with hysteroscopy and biopsy. Results: 68.7% of the patients had benign hysteroscopy results, 15.1% were normal, 10.6% were potentially malignant, and 5.6% were malignant. The most frequent biopsy results were: endometrial polyp (n= 92, 34.7%, proliferate / secretor endometrium (n= 84, 31.7%, and submucosal myoma (n=38, 14.3%. All of the endometrial cancers (n= 9 were in post- menopausic women, with no history of hormone replacement therapy and with endometrial thickening 11mm. Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing benign pathology were 90.7% (95% CI 85.2 - 94.3 and 65.4% (95% CI 55.8 - 73.8, and the positive and negative predictive values were 80.2% (95% CI 73.8 - 85.4 and 81.9% (95% CI 72.3 - 88.7. Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing endometrial hyperplasia were 60% (95% CI 31.3 - 83.2 and 91.4% (95% CI 87.3 - 94.2, the positive and negative predictive values were 21.4% (95% CI 10.7 - 39.5 and 98.3% (95% CI 95.7 - 99.3. Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing endometrial cancer were 95% (95% CI 65.5 - 99.5 and 97.9% (95% CI 95.2 - 99, positive and negative predictive values were 63.3% (95% CI 38.7 - 82.5 and 99.7% (95% CI 98.1 - 99.8. Conclusion: 85% of the patients with endometrial thickening had an abnormal hysteroscopy result, which latter were confirmed in 80% of the cases with biopsy. In a center with experience, a normal hysteroscopy result can make biopsy unnecessary. Potentially malignant hysteroscopys tend to be over diagnosed, making biopsy fundamental. All endometrial cancers were detected by hysteroscopy in our study

  18. CORRELACIÓN DE LA HISTEROSCOPIA Y BIOPSIA DIRIGIDA EN EL ESTUDIO DEL ENGROSAMIENTO ENDOMETRIAL PATOLÓGICO POR ULTRASONIDO

    Scientific Electronic Library Online (English)

    Macarena, Socías T; Renato, Vargas S; Alberto, Costoya A; Bárbara, Monje R; María Teresa, Haye M.

    Full Text Available Objetivo: Correlacionar la histeroscopia con la biopsia dirigida en pacientes pre y postmenopáusicas con engrosamiento endometrial patológico al ultrasonido. Método: Estudio retrospectivo de 265 pacientes derivadas por engrosamiento endometrial patológico en la ecografía transvaginal y evaluadas med [...] iante histeroscopia con biopsia dirigida. Resultados: 68,7% de las pacientes presentaron un aspecto histeroscópico benigno, 15,1% normal, 10,6% potencialmente maligno y 5,6% maligno. Los diagnósticos anátomo patológicos más frecuentes fueron: pólipo endometrial (n=92; 34,7%), endometrio proliferativo/secretor (n=84; 31,7%) y mioma submucoso (n=38; 14,3%). Todos los cánceres endometriales (n=9) se presentaron en mujeres postmenopáusicas sin TRH y con endometrio 11 mm. La correlación entre histeroscopia y anatomía patológica para diagnóstico de patología benigna tuvo una sensibilidad y especificidad de 90,7% (95% IC 85,2 - 94,3) y 65,4% (95% IC 55,8 - 73,8); valor predictivo positivo y negativo fue de 80,2% (95% IC 73,8 - 85,4) y 82% (95% IC 72,3 - 88,7). Para diagnóstico de hiperplasia endometrial la sensibilidad y especificidad fue 60% (95% IC 31,3 - 83,2) y 91,4% (95% IC 87,3 - 94,2); el valor predictivo positivo y negativo fue de 21,4% (95% IC 10,7 - 39,5) y 98,3% (95% IC 95,7 - 99,3). Para diagnóstico de cáncer endometrial la sensibilidad y especificidad fue de 95% (95% IC 65,5 - 99,5) y 97,9% (95% IC 95,2 - 99); el valor predictivo positivo y negativo fue de 63,3% (95% IC 38,7 - 82,5) y 99,7% (95% IC 98,1 - 99,8). Conclusión: El 85% de las pacientes con engrosamiento endometrial presentaron una histeroscopia alterada (benigna, potencialmente maligna o maligna), confirmada en 80% de los casos por anatomía patológica. En un centro con experiencia la histeroscopia normal puede hacer innecesaria la biopsia. El aspecto potencialmente maligno a la histeroscopia puede ser un sobrediagnóstico, por lo que la anatomía patológica es imprescindible. Todos los cánceres endometriales fueron diagnosticados a la histeroscopia Abstract in english Objective: Comparison of hysteroscopy with biopsy in pre- and post -menopausic patients with endometrial thickening on ultrasound. Methods: Retrospective study of 265 patients with pathologic endometrial thickening on transvaginal ultrasound and evaluated with hysteroscopy and biopsy. Results: 68.7% [...] of the patients had benign hysteroscopy results, 15.1% were normal, 10.6% were potentially malignant, and 5.6% were malignant. The most frequent biopsy results were: endometrial polyp (n= 92, 34.7%), proliferate / secretor endometrium (n= 84, 31.7%), and submucosal myoma (n=38, 14.3%). All of the endometrial cancers (n= 9) were in post- menopausic women, with no history of hormone replacement therapy and with endometrial thickening 11mm. Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing benign pathology were 90.7% (95% CI 85.2 - 94.3) and 65.4% (95% CI 55.8 - 73.8), and the positive and negative predictive values were 80.2% (95% CI 73.8 - 85.4) and 81.9% (95% CI 72.3 - 88.7). Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing endometrial hyperplasia were 60% (95% CI 31.3 - 83.2) and 91.4% (95% CI 87.3 - 94.2), the positive and negative predictive values were 21.4% (95% CI 10.7 - 39.5) and 98.3% (95% CI 95.7 - 99.3). Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing endometrial cancer were 95% (95% CI 65.5 - 99.5) and 97.9% (95% CI 95.2 - 99), positive and negative predictive values were 63.3% (95% CI 38.7 - 82.5) and 99.7% (95% CI 98.1 - 99.8). Conclusion: 85% of the patients with endometrial thickening had an abnormal hysteroscopy result, which latter were confirmed in 80% of the cases with biopsy. In a center with experience, a normal hysteroscopy result can make biopsy unnecessary. Potentially malignant hysteroscopys tend to be over diagnosed, making biopsy fundamental. All endometrial cancers were detected by hysteroscopy in our study

  19. Ulipristal acetate: a novel pharmacological approach for the treatment of uterine fibroids

    Directory of Open Access Journals (Sweden)

    Biglia N

    2014-02-01

    Full Text Available Nicoletta Biglia,1 Silvestro Carinelli,2 Antonio Maiorana,3 Marta D'Alonzo,1 Giuseppe Lo Monte,4 Roberto Marci4 1Department of Obstetrics and Gynaecology, Mauriziano "Umberto I" Hospital, University of Turin, Turin, 2Department of Pathology, European Institute of Oncology, Milan, 3Department of Obstetrics and Gynecology, ARNAS Civico Hospital, Palermo, 4Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynecology, Infertility Unit, University of Ferrara, Ferrara, Italy Abstract: Uterine fibroids are the most common benign tumors of the female genital tract. The management of symptomatic fibroids has traditionally been surgical; however, alternative pharmacological approaches have been proposed to control symptoms. To date, gonadotropin-releasing hormone analogs are the only available drugs for the preoperative treatment of fibroids. However, the US Food and Drug Administration recently authorized ulipristal acetate (UPA, an oral selective progesterone-receptor modulator, for the same indication. UPA is a new, effective, and well-tolerated option for the preoperative treatment of moderate and severe symptoms of uterine fibroids in women of reproductive age. According to clinical data, UPA shows several advantages: it is faster than leuprolide in reducing the fibroid-associated bleeding, it significantly improves hemoglobin and hematocrit levels in anemic patients, and it grants a significant reduction in the size of fibroids, which lasts for at least 6 months after the end of the treatment. Furthermore, UPA displays a better tolerability profile when compared to leuprolide; in fact, it keeps estradiol levels at mid follicular phase range, thereby reducing the incidence of hot flushes and exerting no impact on bone turnover. On the grounds of this evidence, the administration of 5 mg/day ulipristal acetate for 3 months is suggested for different patient categories and allows for planning a treatment strategy tailored to meet an individual patient's needs. Keywords: ulipristal acetate, uterine fibroids, myomas, selective progesterone-receptor modulator, medical treatment of uterine fibroids

  20. Uterine fibroids: current perspectives

    OpenAIRE

    At, Khan; Shehmar M; Jk, Gupta

    2014-01-01

    Aamir T Khan,1 Manjeet Shehmar,1 Janesh K Gupta21Birmingham Women's Hospital, Edgbaston, Birmingham, UK; 2Academic Department of Obstetrics and Gynaecology, University of Birmingham, Birmingham, UKAbstract: Uterine fibroids are a major cause of morbidity in women of a reproductive age (and sometimes even after menopause). There are several factors that are attributed to underlie the development and incidence of these common tumors, but this further corroborates their relatively unkno...

  1. Magnetic resonance imaging of cancer of uterine cervix and body. Preliminary study in 9 cases of body cancer and 20 of cervical cancer

    International Nuclear Information System (INIS)

    We studied nine cases of endometrial carcinoma and twenty of cervix carcinoma. Correlation with histology is made after curietherapy in 8 cases of endometrial carcinoma. Tumor is not always seen and particularly when there is no mass effect on macroscopic examination. Myometral invasion is not seen with accuracy: the interruption of junctional zone is not a good sign. The cervix tumors are well seen on T2 sequences before any treatment. There extra uterine extension is difficult to appreciate. The best results of RMI were in the follow-up after radiotherapy. Therefore it appears actually to us the best indication of RMI

  2. Significance of negative hysteroscopic view in abnormal uterine bleeding.

    Directory of Open Access Journals (Sweden)

    Parasnis H

    1992-04-01

    Full Text Available Ninety six cases of abnormal uterine bleeding were evaluated by both panoramic hysteroscopy and dilatation and curettage. The indications for hysteroscopy included postmenopausal bleeding, infertility with abnormal bleeding, abnormal bleeding and suspected leiomyoma with bleeding. Twenty three patients had abnormal hysteroscopy findings. Hysteroscopy diagnosed endometrial polyp and submucus leiomyoma with 100% accuracy. In 17 cases, the results of hysteroscopy and curettage were in agreement and hysteroscopy revealed more information than curettage in 6 cases. Among the remaining 73 cases with ?negative? hysteroscopic view, an abnormality was detected by tissue sampling in only 2 patients. The specificity and positive predictive value of hysteroscopy is 100%. The sensitivity of hysteroscopy was greater (92% than that of curettage (76% and the negative predictive value of hysteroscopy was 2.8%. Thus, panoramic hysteroscopy may prove to be superior to curettage in making an accurate diagnosis of intrauterine pathology.

  3. Two case reports: Carcinoma of the cervix and carcinoma of the endometrium treated with radiotherapy after previous irradiation for benign uterine bleeding

    International Nuclear Information System (INIS)

    In the 1940s, 1950s and 1960s, low doses of radiotherapy were used to treat benign uterine bleeding. The cases of two women who received this form of therapy and later developed gynaecological malignancies and had high-dose pelvic radiotherapy are presented. A 76-year-old woman with an International Federation of Gynecology and Obstetrics (FIGO) stage-II B squamous cell carcinoma of the cervix received external beam radiotherapy and intra-uterine brachytherapy and a 77-year-old woman with a FIGO stage-I B endometrial adenocarcinoma received adjuvant postoperative pelvic radiotherapy. Both women had a significant past history of low-dose-rate intra-uterine irradiation for dysfunctional uterine bleeding. Therefore the theoretical question of carcinogenesis was raised, and also the practical questions of what dose had previously been given and what further dose could be safely given with regard to normal tissue tolerance. Copyright (1998) Blackwell Science Pty Ltd

  4. Diagnosis and Management of Formerly Called "Dysfunctional Uterine Bleeding" According to PALM-COEIN FIGO Classification and the New Guidelines.

    Science.gov (United States)

    Khrouf, Mohamed; Terras, Khaled

    2014-12-01

    In 2011, the FIGO classification system (PALM-COEIN) was published to standardize terminology, diagnostic and investigations of causes of abnormal uterine bleeding (AUB). According to FIGO new classification, in the absence of structural etiology, the formerly called "dysfunctional uterine bleeding" should be avoided and clinicians should state if AUB are caused by coagulation disorders (AUB-C), ovulation disorder (AUB-O), or endometrial primary dysfunction (AUB-E). Since this publication, some societies have released or revised their guidelines for the diagnosis and the management of the formerly called "dysfunctional uterine bleeding" according new FIGO classification. In this review, we summarize the most relevant new guidelines for the diagnosis and the management of AUB-C, AUB-O, and AUB-E. PMID:25489140

  5. Constitutive activation of transforming growth factor Beta receptor 1 in the mouse uterus impairs uterine morphology and function.

    Science.gov (United States)

    Gao, Yang; Duran, Samantha; Lydon, John P; DeMayo, Francesco J; Burghardt, Robert C; Bayless, Kayla J; Bartholin, Laurent; Li, Qinglei

    2015-02-01

    Despite increasing evidence pointing to the essential involvement of the transforming growth factor beta (TGFB) superfamily in reproduction, a definitive role of TGFB signaling in the uterus remains to be unveiled. In this study, we generated a gain-of-function mouse model harboring a constitutively active (CA) TGFB receptor 1 (TGFBR1), the expression of which was conditionally induced by the progesterone receptor (Pgr)-Cre recombinase. Overactivation of TGFB signaling was verified by enhanced phosphorylation of SMAD2 and increased expression of TGFB target genes in the uterus. TGFBR1 Pgr-Cre CA mice were sterile. Histological, cellular, and molecular analyses demonstrated that constitutive activation of TGFBR1 in the mouse uterus promoted formation of hypermuscled uteri. Accompanying this phenotype was the upregulation of a battery of smooth muscle genes in the uterus. Furthermore, TGFB ligands activated SMAD2/3 and stimulated the expression of a smooth muscle maker gene, alpha smooth muscle actin (ACTA2), in human uterine smooth muscle cells. Immunofluorescence microscopy identified a marked reduction of uterine glands in TGFBR1 Pgr-Cre CA mice within the endometrial compartment that contained myofibroblast-like cells. Thus, constitutive activation of TGFBR1 in the mouse uterus caused defects in uterine morphology and function, as evidenced by abnormal myometrial structure, dramatically reduced uterine glands, and impaired uterine decidualization. These results underscore the importance of a precisely controlled TGFB signaling system in establishing a uterine microenvironment conducive to normal development and function. PMID:25505200

  6. Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

    Science.gov (United States)

    Trefoux Bourdet, Alice; Luton, Dominique; Koskas, Martin

    2015-01-01

    Uterine myoma is the most common benign uterine tumor in women of reproductive age and occurs in 20%–25% of the worldwide population. No currently approved medical treatment is able to completely eliminate fibroids. Surgery, particularly hysterectomy, predominates as the treatment strategy of choice, even though it is associated with risks and complications and causes infertility. Until recently, gonadotropin-releasing hormone agonists were the only available drugs for the preoperative treatment of fibroids. However, ulipristal acetate (UPA), an oral selective progesterone receptor modulator, was recently licensed in Europe for the same indication. Recent studies have demonstrated the efficacy and safety of UPA in the medical management of fibroids before surgery, with a better tolerability profile than leuprolide acetate. Analyzing the literature, we identified new management strategies involving UPA and surgery, considering advantages of both medical and surgical therapy. The advent of UPA will undoubtedly modify the surgical approach to fibroids, but the heterogeneity of these possible indications now requires various original clinical studies to identify the optimal indications for UPA in patients with symptomatic fibroid(s). PMID:25848323

  7. Two different embolic agents in the treatment of uterine arterial embolization for symptomatic fibroids

    International Nuclear Information System (INIS)

    Objective: To compare the efficacy and safety of dextran microspheres and polyvinyl alcohol particles in the uterine arterial embolization (UAE)for symptomatic uterine leiomyomata. Methods: Forty women (mean aged 38.5 years, ranged 28-44 years)with symptomatic myomas were randomly divided into two groups with 20 patients in each, PVA (polyvinyl alcohol particles, 355-500 ?m)was used as embolic agents in group A and dextran microspheres(Sephadex G-50, 100-300 ?m)in group B. The mean diameter of fibroids was 6.5 cm (range, 3-12 cm)with symptoms of menorrahgia, bulk-related symptoms, dysmenorrhea and infertility. Analgesics, anti-infection and rehydration treatments were used after the procedure. The hospital stay, post-embolization syndromes, follow-up materials were reviewed and compared. Results: The hospital stay and the post embolization pain showed no obvious difference between the two groups, simultaneously with no serious complications. The average follow-up duration was 9 months (range, 6-24 months). The average volumes of uterus and fibroid in group A and B decreased gradually during follow-up: 53.4%, 55% and 48.6%, 40.9%, respectively. Conclusion: Dextran microspheres is as the same effective and safe as PVA particles for UAE, but rather cheaper than latter. Further prospective study is warranted. (authors)

  8. Chorionic gonadotropin and uterine dialogue in the primate

    Directory of Open Access Journals (Sweden)

    Strakova Zuzana

    2004-07-01

    Full Text Available Abstract Implantation is a complex spatio-temporal interaction between the growing embryo and the mother, where both players need to be highly synchronized to be able to establish an effective communication to ensure a successful pregnancy. Using our in vivo baboon model we have shown that Chorionic Gonadotropin (CG, as the major trophoblast derived signal, not only rescues the corpus luteum but also modulates the uterine environment in preparation for implantation. This response is characterized by an alteration in both the morphological and biochemical activity in the three major cell types: luminal and glandular epithelium and stromal fibroblasts. Furthermore, CG and factors from the ovary have a synergistic effect on the receptive endometrium. Novel local effects of CG which influence the immune system to permit the survival of the fetal allograft and prevent endometrial cell death are also discussed in this review. An alternate extracellular signal-regulated kinase (ERK activation pathway observed in epithelial endometrial cells and the possibility of differential expression of the CG/LH-R isoforms during gestation, open many questions regarding the mechanism of action of CG and its signal transduction pathway within the primate endometrium.

  9. The relationship between preoperative endometrial thickness, the anteroposterior diameter of the uterus and clinical outcome following transcervical resection of the endometrium

    DEFF Research Database (Denmark)

    Istre, O; Forman, Axel

    1996-01-01

    The objective of this study was to identify whether the endometrial thickness, or the anteroposterior diameter of the uterus as assessed by transvaginal ultrasonography (TVS), could be used to predict the clinical outcome following transcervical resection of the endometrium (TCRE). An open observational trial was carried out, involving 195 consecutive patients undergoing TCRE, 188 of whom completed follow-up. The patients were examined by TVS preoperatively, and then 6 weeks, 6 months and 1 year following TCRE. In all examinations, endometrial thickness, the anteroposterior diameter and residual endometrium, uterine morphology and the clinical outcome as measured by pain reduction, bleeding index and amenorrhea were assessed. Patients with a preoperative endometrial thickness of 8 mm or less had a higher rate of amenorrhea after 1 year than patients with an endometrial thickness exceeding 8 mm. Outcome did not relate to the histological phase of the endometrium obtained during resection. Neither the uterine anteroposterior diameter, or the presence of submucous fibroids, had any influence on the clinical outcome. Cavity fluid was observed in some cases but was not always associated with symptoms. Residual endometrium could be detected by TVS in 38% of the women after 1 year, but the vast majority of these patients reported a satisfactory outcome from the procedure. We conclude that the size of the anteroposterior diameter does not affect the clinical outcome of TCRE, whilst the preoperative endometrial thickness does have a significant impact on the likelihood of achieving amenorrhea after 1 year. The data suggest that TCRE should preferably be performed when the endometrium is at its thinnest and that there may be a useful role for agents that produce endometrial atrophy prior to surgery.

  10. Localisation of luminal epithelium edge in digital histopathology images of IHC stained slides of endometrial biopsies.

    Science.gov (United States)

    Li, Guannan; Sanchez, Victor; Patel, Gnyaneshwari; Quenby, Siobhan; Rajpoot, Nasir

    2015-06-01

    Diagnosis of recurrent miscarriage due to abnormally high number of uterine natural killer (uNK) cells has recently been made possible by a protocol devised by Quenby et al. Hum Reprod 2009;24(1):45-54. The diagnosis involves detection and counting of stromal and uNK cell nuclei in endometrial biopsy slides immunohistochemically stained with haematoxylin for staining cell nuclei and CD56 as a marker for the uNK cells. However, manual diagnosis is a laborious process, fraught with subjective errors. In this paper, we present a novel method for detection of uterine natural killer (uNK) cells in the human female uterus lining and localisation of the luminal epithelium edge in endometrial biopsies. Specifically, we employ a local phase symmetry based method to detect stromal cell nuclei and propose an adaptive background removal method that significantly eases the segmentation of uNK cell nuclei regions. We also propose a novel method using alpha shapes for the identification of epithelial cell nuclei and B-Spline curve fitting on identified cell nuclei to localise the luminal epithelium edge. The objective of edge localisation is to avoid cell nuclei near the luminal epithelium edge being counted in the diagnosis process due to their non-relevance to the calculation of stromal to uNK cell ratio that determines the diagnosis of recurrent miscarriages in the end. The resulting algorithm offers a promising potential for computer-assisted diagnosis of recurrent miscarriage due to its high accuracy. PMID:25529641

  11. The Content of Soluble HLA Class I and HLA-DR Molecules in Serum in Patients with Uterine Cervix and Body Pathology

    Directory of Open Access Journals (Sweden)

    ?.?. Mamaeva

    2014-06-01

    Full Text Available The aim of the investigation was to assess the correlation of the content of soluble HLA (sHLAI class I and HLA-DR (sHLA-DR molecules in blood serum of patients with uterine cervix and body pathologies, and their pathology type, tumor grade, the number and localization of myomatous nodes. Materials and Methods. 142 women with uterine cervix and body pathology aged 31–79 years (median — 52 years were under study. Serum level of sHLAI and sHLA-DR molecules was determined by enzyme immunoassay using monoclonal antibodies. Blood samples were drawn from cubital vein. All tests were performed before and after the treatment course. For enzyme immunoassay we used mouse monoclonal antibodies to reveal soluble differentiated molecules. Results. Malignant pathologies of uterine cervix and body and myomas were found to be accompanied by an increased serum level of sHLAI ? sHLA-DR molecules, its degree depending on the type of pathology diagnosed in patients with cervical cancer and hysterocarcinomas, and differentiation degree of adenocarcinoma in hysterocarcinoma patients, the number and localization of myomatous nodes. Initial concentration of soluble HLA class I and HLA-DR molecules in a preoperative period can serve as an additional diagnostic test in patients with uterine tumors for their further selection for surgery.

  12. Ovarian steroids in endometrial angiogenesis.

    Science.gov (United States)

    Perrot-Applanat, M; Ancelin, M; Buteau-Lozano, H; Meduri, G; Bausero, P

    2000-01-01

    Angiogenesis, the sprouting of new blood vessels from pre-existing ones, is fundamental for human endometrial development and differentiation, which are necessary for implantation. This vascular process is supposed to be mainly mediated by the vascular endothelial growth factor (VEGF), also named vascular permeability factor (VPF). We report here the expression and modulation of VEGF and its receptors, Flk-1/KDR and Flt-1, in the functionalis throughout the menstrual cycle. Using immunocytochemistry, VEGF is localized in glandular epithelial cells and in the surrounding stroma, as well as in capillaries and spiral arterioles. The localization of VEGF on the endothelium correlates with the presence of Flt-1 and Flk-1/KDR receptors on vascular structures, including capillary strands that have not yet formed a lumen and that have been previously described in tumors as angiogenic capillaries. The strongest immunoreactivity for both VEGF and Flk-1/KDR receptor on endothelial cells is detected in the proliferative and midsecretory phases. Enhanced expression of VEGF and its Flk-1 receptors on narrow capillary strands during the proliferative phase may account for the rapid capillary growth associated with endometrial regeneration from the residual basal layer following menstrual shedding of the functionalis. The vascular expression of Flt-1 is more important in the secretory than in the proliferative phase, associated with a high microvascular density and an increase in vascular permeability in the implantation period. Consistently with these in vivo observations, the treatment of isolated endometrial stromal cells with estradiol (E(2)), or E(2) + progesterone, significantly increased VEGF mRNA over the control value in a dose-dependent manner. These results demonstrate that the expression of VEGF and its receptors is cyclically modulated by ovarian steroids, and that this endothelial growth factor acts on the endothelium in a paracrine fashion to control endometrial angiogenesis and permeability. PMID:11108865

  13. [Transvaginal sonography as a screening method for the identification of patients at risk of postmenopausal endometrial pathology].

    Science.gov (United States)

    Zacchi, V; Zini, R; Canino, A

    1993-01-01

    Starting from the anatomopathological assumption that endometrial thickness in postmenopausal women never exceeds 3 mm, and in view of the reliability of measurements made using an echographic probe, the authors evaluated the value of transvaginosonography (TVS) as a mass screening method for postmenopausal endometrial pathologies. A group of 74 patients were examined who were recruited from those attending the out-patient menopause clinic. All subjects conformed to the following admission criteria: amenorrhea for the past two years; absence of oestroprogestin therapy for at least six months; absence of vaginal blood loss. A 5 MHz probe was used to measure maximum endometrial thickness on the longitudinal plane; values were divided by two if the surfaces were adjacent. Patients were monitored according to the following protocol: endometrial thickness under 1 mm control every 12 months; thickness between 1-3 mm--control every 3 months; thickness equal to or over 4 mm--hysteroscopy, targeted biopsy, possible scraping and TVS control after 3 months. The group was subdivided as follows: 65 patients (87.8%) were without risk; 3 patients (4%) belonged to the intermediate risk group; 6 patients (8.2%) belonged to the high risk group. Of the latter, 4 revealed an endometrial polyp, one presented uterine polymyomatosis and one a proliferative-type endometrium. The authors' experience is still limited but the absence of false positives encourages them to continue their research using this simple and well tolerated method. It might represent a valid alternative to hysteroscopy as a screening method in the asymptomatic population at risk for endometrial carcinoma. PMID:8414140

  14. Hysteroscopy as a standard procedure for assessing endometrial lesions among postmenopausal women / Histeroscopia como procedimento padrão para avaliação de lesões endometriais em mulheres na pós-menopausa

    Scientific Electronic Library Online (English)

    Camila Toffoli, Ribeiro; Júlio César, Rosa-e-Silva; Marcos Felipe, Silva-de-Sá; Ana Carolina Japur de Sá, Rosa-e-Silva; Omero Benedicto, Poli Neto; Francisco José Candido dos, Reis; Antonio Alberto, Nogueira.

    2007-11-01

    Full Text Available CONTEXTO E OBJETIVO: O câncer endometrial é o tipo mais prevalente de neoplasia maligna do trato genital. Os objetivos deste estudo foram: calcular a sensibilidade, especifi cidade e acurácia, bem como valor preditivo positivo e negativo das histeroscopias diagnósticas em comparação com a análise hi [...] stopatológica de todas as lesões da cavidade endometrial. DESENHO E LOCAL: Estudo retrospectivo e descritivo no setor de endoscopia ginecológica do hospital universitário, terciário e público da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. MÉTODOS: A histeroscopia diagnóstica foi indicada nas seguintes situações: espessura endometrial > 4 mm em pacientes assintomáticas, sangramento na pós-menopausa, endométrio irregular ou endométrio de difícil avaliação pelo ultra-som, com ou sem sangramento vaginal. A avaliação ultra-sonográfi ca foi realizada não mais que três meses antes da histeroscopia. RESULTADOS: A idade média das pacientes foi 61,1 ± 2,0 anos, e a duração média do período pós-menopausa foi de 12,7 ± 2,5 anos. Das 510 pacientes, 293 (57,5%) foram submetidas à biópsia endometrial, no estudo histopatológico, 18 pacientes apresentavam carcinoma endometrial, hiperplasia típica ou atípica e nenhuma delas apresentava espessura endometrial maior que 8 mm. Nenhuma diferença signifi cativa foi encontrada entre as espessuras medianas das várias lesões benignas (p > 0,05). A sensibilidade (94,4%), especifi cidade (97%), acurácia (96,8%) e valores preditivos positivo e negativo (68% e 99,6% respectivamente) foram altos em nosso estudo. CONCLUSÃO: Nossos resultados sugerem que a histeroscopia diagnóstica apresenta boa validade como ferramenta diagnóstica para lesões malignas e hiperplasias, bem como para lesões benignas, com exceção dos leiomiomas submucosos, para o qual a sensibilidade foi de somente 52,6%. Abstract in english CONTEXT AND OBJECTIVES: Endometrial cancer is the most prevalent type of malignant neoplasia of the genital tract. The objective of this study was to calculate the sensitivity, specificity, accuracy and positive and negative predictive values for diagnostic hysteroscopy, in comparison with histopath [...] ological tests, for all lesions of the endometrial cavity. DESIGN AND SETTING: Retrospective descriptive study at the public tertiary-level university hospital of Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. METHODS: Diagnostic hysteroscopy was indicated in the following instances: endometrial thickness > 4 mm in asymptomatic patients; postmenopausal bleeding; and irregular endometrium or endometrium difficult to assess from ultrasound, with or without vaginal bleeding. Ultrasound evaluations were carried out no more than three months prior to hysteroscopy. RESULTS: There were 510 patients, with a mean age of 61.1 ± 2.0 years and mean time elapsed since the menopause of 12.7 ± 2.5 years. Endometrial biopsies were performed on 293 patients (57.5%). Histopathological analysis showed that 18 patients presented endometrial carcinoma or typical or atypical hyperplasia, and none of them presented endometrial thickness of less than 8 mm. No significant differences were found between the median thicknesses of the various benign lesions (p > 0.05). In our data, the sensitivity, specificity, accuracy and positive and negative predictive values for cancer or hyperplasia were 94.4%, 97.0%, 96.8%, 68% and 99.6%, respectively. CONCLUSIONS: Our results suggest that hysteroscopy is valuable as a diagnostic tool for malignant/hyperplastic and benign lesions, except for submucous myomas, for which the sensitivity was only 52.6%.

  15. Potential proton beam therapy for recurrent endometrial cancer in the vagina.

    Science.gov (United States)

    Yanazume, Shintaro; Arimura, Takeshi; Kobayashi, Hiroaki; Douchi, Tsutomu

    2015-05-01

    Proton beam radiotherapy mainly has been used in the gynecological field in patients with cervical cancer. The efficacy of proton beam therapy in patients with recurrent endometrial cancer has not yet been determined. A 77-year-old endometrial cancer patient presented with recurrence in the vagina without distant metastasis following hysterectomy. A hard mass measuring 6?cm originated from the apex of the vagina, surrounded the vaginal cavity, and infiltrated the proximal and distal vagina. The patient received proton beam radiotherapy using a less invasive particle treatment system while minimizing the dose to the surrounding normal tissues. The dose to the planning target volume was 74?Gy (relative biological effectiveness) with 37 fractions. The patient was treated with 150-210-MeV proton beams for 53?days. Proton beam therapy led to the disappearance of tumors without any complications except for grade 1 cystitis although evidence of further complications is not available past our 6-month follow-up period. Proton beam therapy may become a useful treatment modality for recurrent endometrial cancer as well as cervical uterine cancer. PMID:25369803

  16. K-ras point mutations in spontaneously occurring endometrial adenocarcinomas in the Donryu rat.

    Science.gov (United States)

    Tanoguchi, K; Yaegashi, N; Jiko, K; Maekawa, A; Sato, S; Yajima, A

    1999-10-01

    The Donryu rat has been found to have a high incidence of spontaneous uterine endometrial carcinomas. Moreover the histologic findings, biological nature and pathogenesis of these rat tumors appear similar to those in humans. To determine if the incidence of H- and K-ras gene mutations in these rat tumors is similar to that in human endometrial cancers, we isolated DNA samples from 2 atypical hyperplasias, 5 simple or complex hyperplasia without atypia, 9 adenocarcinomas and 7 histologically normal tissues, amplified exons 1 and 2 of the H- and K-ras genes by PCR and hybridized the products with allele specific oligonucleotide probes. K-ras point mutations were observed in 1/2 of the atypical hyperplasia (codon 12: GGT-->GTT) and 3/9 of the carcinoma (codon 12: GGT-->GAT, GGT-->AGT, codon 61: CAA-->CAC), while they were not detected in 7 of the normal tissues and in 5 of the simple or complex hyperplasia without atypia. H-ras point mutations were not detected in any of these DNA samples. These frequencies in this rat model are similar to those in humans. The absence of K-ras mutations from simple and complex hyperplasia tissue samples suggests that these mutations are associated with cytological atypia. Our findings suggest that alterations in the K-ras gene may be one of the important initiating event in endometrial carcinogenesis in some of the Donryu rat, like the human. PMID:10775052

  17. Coffee and Endometrial Cancer Risk

    Medline Plus

    Full Text Available ... The researchers analyzed data from two groups of women…one in Europe… the other in the U.S. ... tomorrows. Related MedlinePlus Health Topics Diets Uterine Cancer Women's Health About MedlinePlus Site Map FAQs Contact Us ...

  18. The hysterosonography in the study of the bled

    International Nuclear Information System (INIS)

    Hysterosonography (HS) is the sterile saline infusion on the endometrium under sonographic control, to localize any uterine abnormalities to the endocavitary space, and determine endometrial or submucosal origin. Forty patients had HS, with hysteroscopic correlation on 23 patients. Fourteen patients were on reproductive age (Group I) and 9 were peri menopausal (Group II), all of them with abnormal uterine bleeding. Diagnostic accuracy of HSG on Group I was of 92.8%, and 100% on Group II patients. For Group I patients, the main abnormalities were endometrial polyps, submucosal myomas, septae and adherences. For Group II patients, the most frequent findings were polyps and submucosal myomas. We conclude that HS increases the specificity of trans vaginal ultrasound in the characterization of abnormalities of the endometrial cavity, and can establish which require hysteroscopy or other diagnostic or therapeutic methods

  19. Thermotolerance of human myometrium: implications for minimally invasive uterine therapies

    Science.gov (United States)

    Thomas, Aaron C.; Grisez, Brian T.; McMillan, Kathleen; Chill, Nicholas; Harclerode, Tyler P.; Radabaugh, Rebecca; Jones, Ryan M.; Coad, James E.

    2013-02-01

    Endometrial ablation has gained significant clinical acceptance over the last decade as a minimally invasive treatment for abnormal uterine bleeding. To improve upon current thermal injury modeling, it is important to better characterize the myometrium's thermotolerance. The extent of myometrial thermal injury was determined across a spectrum of thermal histories/doses (time-temperature combinations). Fresh extirpated human myometrium was obtained from 13 subjects who underwent a previous scheduled benign hysterectomy. Within two hours of hysterectomy, the unfixed myometrium was treated in a stabilized saline bath with temperatures ranging from 45-70 °C and time intervals from 30- 150 seconds. The time-temperature combinations were selected to simulate treatment times under 2.5 minutes. A total of six such thermal matrices, each comprised of 45 time-temperature combinations, were prepared for evaluation. The treated myometrium was cryosectioned for nitro blue tetrazolium (NBT) staining to assess for thermal respiratory enzyme inactivation. Image analysis was subsequently used to quantitatively assess the stained myometrium's capacity to metabolize the tetrazolium at each time-temperature combination. This colorimetric data was then used as marker of cellular viability and determine survival parameters with implications for developing minimally invasive uterine therapies.

  20. Staging of carcinoma of the uterine cervix and endometrium

    International Nuclear Information System (INIS)

    Carcinoma of the uterine cervix and endometrium are common gynecologic malignancies. Both carcinomas are staged and managed by means of the International Federation of Gynecology and Obstetrics (FIGO) staging system. In uterine cervical cancer, the FIGO staging system is determined preoperatively by limited conventional procedures. Although this system is effective for early stage disease, it has inherent inaccuracies in advanced stage diseases and does not address nodal involvement. CT and MR imaging are widely used as comprehensive imaging modalities to evaluate tumor size and extent, and nodal involvement. MR imaging is an excellent modality for depicting invasive cervical carcinoma and can provide objective measurement of tumor volume, and provides high negative predictive value for parametrial invasion and stage IVA disease. In contrast, endometrial cancer is surgically staged. Beside recognition of the important prognostic factors, including histologic subtype and grade, accurate assessment of the tumor extent on preoperative MR imaging is expected to greatly optimize surgical procedure and therapeutic strategy. Contrast-enhanced MR imaging can offer ''one stop'' examination for evaluating the depth of myometrial invasion cervical invasion and nodal metastases. Evaluation of myometrial invasion on MR imaging may be an alternative to gross inspection of the uterus during the surgery. (orig.)

  1. Current Evidence on Uterine Embolization for Fibroids

    OpenAIRE

    Spies, James B.

    2013-01-01

    Strong evidence for both safety and effectiveness of uterine fibroid embolization has been generated since the procedure's introduction. This review will focus on the key articles representing the best evidence to summarize the outcomes from uterine embolization. This review will attempt to answer three important questions associated with uterine embolization. First, does uterine embolization relieve symptoms caused by uterine fibroids? Second, how well does the improvement in symptoms and qu...

  2. Endocervical adenocarcinoma in situ presenting in fundal endometrial polyp: the mother of all skip lesions.

    Science.gov (United States)

    Roberts, Jennifer M; Cornall, Alyssa M; Lamaro, Vincent; Tabrizi, Sepehr N; Russell, Peter

    2015-05-01

    A 38-yr-old woman, with a previous history of low grade squamous intraepithelial lesion in the cervix, presented with heavy menstrual bleeding. At hysteroscopy, a fundal polyp was removed from the right cornu which displayed many glands lined by atypical, mitotically active epithelium with features characteristic of endocervical adenocarcinoma in situ (AIS) of intestinal subtype. Subsequent cervical liquid-based cytology and colposcopically directed biopsies revealed no causative lesion, but residual PreservCyt from the ThinPrep vial tested positive for high risk HPV type other than HPV 16 and 18. Further biopsies from the endocervical canal and base of the resected polyp showed intestinal type AIS, while all those from the intervening anterior and posterior endometrial lining exhibited normal endometrium only. Genomic DNA extracted from the endometrial polyp and second set of endocervical biopsies tested positive for HPV 31, an uncommon cause of endocervical glandular neoplasia. Endocervical AIS typically arises in the transformation zone but may be found exclusively in the endocervical canal and rarely as high as 30 mm from the ectocervix. Contiguous spread into the lower uterine segment is known to occur, as are proximate so-called skip lesions. However, finding a 'skip' lesion 80 mm from the transformation zone poses an interesting pathogenetic conundrum as well as a therapeutic dilemma in a young patient desirous of retaining fertility. Issues relating to pathogenesis include necessary metaplasia of the endometrial glandular epithelium to 'susceptible' endocervical type epithelium within the polyp or metastatic implantation of transformed endocervical glandular cells onto the polyp. The current management plan involves regular hysteroscopic surveillance of the uterine cavity. PMID:25844546

  3. Polipectomia endometrial histeroscópica: tratamento ambulatorial versus convencional / Hysteroscopic endometrial polypectomy: outpatient versus conventional treatment

    Scientific Electronic Library Online (English)

    Angela Mendes, Bergamo; Daniella de Batista, Depes; Ana Maria Gomes, Pereira; Taciana Cristina Duarte de, Santana; Umberto Gazi, Lippi; Reginaldo Guedes Coelho, Lopes.

    2012-09-01

    Full Text Available OBJETIVO: Comparar resultados da polipectomia histeroscópica endometrial efetuada ambulatorialmente, sem anestesia, com polipectomia histeroscópica convencional sob anestesia, em centro cirúrgico, avaliando taxa de sucesso, tempo de procedimento e complicações. Mensurar dor aferida pela paciente nos [...] dois grupos. MÉTODOS: Estudo transversal observacional de 60 pacientes com diagnóstico histeroscópico de pólipo endometrial divididas em dois grupos: Grupo Ambulatorial, composto por pacientes submetidas à polipectomia histeroscópica ambulatorial, utilizando-se pinça endoscópica em histeroscópio operatório ambulatorial de fluxo contínuo, por meio de vaginoscopia sem anestesia, e Grupo Convencional com pacientes submetidas à polipectomia histeroscópica em centro cirúrgico, utilizando-se ressectoscópio monopolar sob anestesia. RESULTADOS: Os grupos foram similares quanto a idade, paridade, tipo de parto e presença ou não de menopausa. Ambos os grupos apresentaram 100% de eficácia na exérese dos pólipos. O tempo médio de procedimento foi de 7 minutos no Grupo Ambulatorial e 35,16 minutos no Grupo Convencional. No Grupo Ambulatorial, as pacientes após a menopausa (p=0,04) e aquelas com pólipos >1cm (p=0,01) apresentaram tempo de procedimento maior. Durante o procedimento,a média de dor referida pelas pacientes, segundo a Escala Analógica Verbal de Dor, no Grupo Ambulatorial, foi de 2,93 e, após efeito anestésico do procedimento no Grupo Convencional, foi de 1,42 pontos. Não houve complicações no Grupo Ambulatorial. No Grupo Convencional, registraram-se um caso de perfuração uterina e um de falso trajeto. CONCLUSÃO: A polipectomia histeroscópica realizada em regime ambulatorial, sem anestesia, é um procedimento bem tolerado. Quando comparada ao tratamento convencional, apresenta a mesma eficácia, porém com menor tempo gasto no procedimento e menor índice de complicações. Abstract in english OBJECTIVE: To compare results of hysteroscopic polypectomy of the endometrium performed in an outpatient clinic, under no anesthesia, to conventional hysteroscopic polypectomy under anesthesia in the operating theatre, assessing success rate, procedure time and complications; and to measure pain ref [...] erred by patients in both groups. METHODS: An observational cross-sectional study of 60 patients with hysteroscopic diagnosis of endometrial polyps, divided into two groups: the Outpatient Group, comprising patients submitted to outpatient´s hysteroscopic polypectomy by continuous flow vaginoscopy using endoscopic forceps under no anesthesia, and the Conventional Group with patients submitted to hysteroscopic polypectomy in the operating theater, using a monopolar resectoscope under anesthesia. RESULTS: The groups were similar as to age, parity, mode of delivery and menopausal status. Both groups presented 100% efficacy in exeresis of polyps. The mean time of procedure was 7 minutes in the Outpatient Group and 35.16 minutes in the Conventional Group. In the Outpatient Group, menopausal patients (p=0.04) and those with polyps >1cm (p=0.01) had longer procedures. Using the Verbal Analog Scale of Pain, the mean score of pain referred by patients during the procedure was 2.93 in the Outpatient Group and, after anesthetic effect, 1.42 in the Conventional Group. There were no complications in the Outpatient Group. There was one case of uterine perforation and one case of false passage in the Conventional Group. CONCLUSION: Hysteroscopic polypectomy performed in an outpatient setting under no anesthesia is a well-tolerated procedure. As compared to conventional treatment, it displays the same efficacy, but the procedure time is shorter and the complication rate is lower.

  4. Myomectomy reduces endometrial T2 relaxation times.

    Science.gov (United States)

    Yoshino, Osamu; Hori, Masaaki; Osuga, Yutaka; Hayashi, Toshihiko; Sadoshima, Yoko; Tsuchiya, Hiroko; Nishii, Osamu; Taketani, Yuji

    2011-06-30

    Magnetic resonance imaging was used to measure the endometrial T2 relaxation times of patients with infertility with fibroma. Although the location of fibromas did not influence the T2 relaxation times, we did observe a significant decrease in endometrial T2 relaxation times after myomectomy. PMID:21315332

  5. Endometrial polyps in 2 African pygmy hedgehogs

    OpenAIRE

    Phillips, Irene D.; Taylor, Jacqueline J.; Allen, Andrew L.

    2005-01-01

    Reports of spontaneously occurring endometrial polyps in animals are rare and have only involved a few species. This report is intended to advise veterinarians that older African pygmy hedgehogs may develop endometrial polyps and that these lesions can be a cause of bloody vaginal discharge, sometimes interpreted as hematuria.

  6. Comparison of endometrial biopsy by PIPELLE with diagnostic curretage in patients with abnormal utrine bleeding, Imam Khomeini Hospital

    Directory of Open Access Journals (Sweden)

    Ghaemmaghami F

    1999-06-01

    Full Text Available It this prospective cross sectional study out-patient endometrial biopsy by PIPELLE was compared with diagnostic curretage (D&C in patients suffering of Abnormal Uterine bleeding (AUB. Diagnostic accuracy, sufficient tissue sampling, intensity of pain and effective factors in biopsy results were the evaluated parameters in this study. In 70 patients with complaint of AUB (20 of them were post-menoupsal age admitted in hospital for D&C endometrial biopsy was conducted by PIPELLE before operation and the results were compared. 96% of total patients (67 and 91% of patients with post menopause age had tolerance of undergoing out-patient PIPELLE biopsy of endometrium. 79% of these individuals complained of mild pain and 21% of moderate pain. Endometrium biopsy by PIPELLE in 77% of patients had similar accurate diagnostic results as compared to D&C. PIPELLE in 34% of patients (24 could not be conducted with the same accuracy of D&C patients, although in 14 (20% of them, notissue samples could be collected by D&C. In none of these methods endometrial hyperplasia or endometrial cancer were detected. This study showed that in 77% of the total patients, the extra cost and general anesthetical risk of D&C could have been eliminated, by utilization of out-patient biopsy with PIPELLE

  7. Miomas e infertilidade: bases fisiopatológicas e implicações terapêuticas Uterine leiomyomas and infertility: physiopathological basis and therapeutical implications

    Directory of Open Access Journals (Sweden)

    Ana Luiza Berwanger da Silva

    2005-03-01

    Full Text Available OBJETIVOS: analisar evidências da literatura médica que avaliam a relação entre miomas uterinos e infertilidade, assim como as vantagens e desvantagens dos diferentes tipos de tratamentos disponíveis. MÉTODOS: foi realizada uma revisão da literatura utilizando os termos (MeSh terms "miomas", "infertilidade", "tratamento", "miomectomia", "gestação", na base de dados "Pubmed" e na "The Cochrane Library 2003". O período analisado foi de 1989 a 2003. RESULTADOS: apesar de alguns resultados contraditórios, a maioria dos autores relata uma possível relação de causa-conseqüência entre determinados tipos de miomas e distúrbios reprodutivos. Em relação à terapêutica, observa-se claramente que a miomectomia representa a técnica cirúrgica com melhores resultados, não havendo diferença significativa entre as vias de acesso utilizadas, com exceção da miomatose submucosa, situação em que a via histeroscópica é preferida. As opções não-cirúrgicas de tratamento existentes não parecem ter indicação em pacientes inférteis. CONCLUSÕES: a possível associação entre miomas e distúrbios reprodutivos necessita de melhores investigações. O incremento nas taxas de gestação após ressecção cirúrgica de miomas submucosos leva-nos a acreditar que esses tumores tenham papel na etiologia da infertilidade. Em miomas de outras localizações, entretanto, a relação com infertilidade não é tão clara. A miomectomia é o procedimento de escolha para as pacientes que ainda desejam engravidar.OBJECTIVES: to analyze evidences in medical literature concerning the possible relation between uterine leiomyomas and infertility, and the advantages /disadvantages of the different treatments available. METHODS: literature review using the key words (MeSh terms "leiomyomas", "infertility", "treatment", "myomectomy", "pregnancy" in "Pubmed" and "The Cochrane Library 2003" database. The search period was from 1989 through 2003. RESULTS: although there are contradictory results, the majority of authors determined a possible cause-consequence relation between some types of leiomyomas and reproductive impairement. Concerning therapeutics, we were able to clearly place myomectomy as being the surgical technique with the best results. Surgical approaches used for this procedure did not show significant differences from each other, except for submucosal myomas, where histeroscopy is more effective. Other existent treatment options do not seem to be indicated for infertile patients with uterine leiomyomas. CONCLUSIONS: the possible association between myomas and reproductive impairment needs to be further investigated. Success indicated by gestational rates following surgical resection, mainly in patients with submucosal myomas, are an indication that they do have a role in infertility etiology. Concerning the treatment, it became clear that myomectomy is the procedure of choice for all patients desiring to become pregnant.

  8. Clinical efficiency investigation of laparoscopic uterine artery occlusion combined with myomectomy for uterine fibroids

    OpenAIRE

    Yin, Xiang-Hua; Gao, Ling-ling; Gu, Yang; Song, Jing-Zhe; Gao, Jing; Ji, Xiao-Ping

    2014-01-01

    To investigate the effectiveness of laparoscopic uterine artery occlusion combined with myomectomy for uterine fibroids. From August 2008 to August 2009, forty-eight women with uterine fibroids desiring to preserve their uteri underwent laparoscopic myomectomy. Among them, 18 women received laparoscopic uterine artery occlusion before uterine myomectomy while the others received laparoscopic myomectomy only. All of the 48 cases with uterine fibroids underwent laparoscopic myomectomy successfu...

  9. Retrospective database analysis of clinical outcomes and costs for treatment of abnormal uterine bleeding among women enrolled in US Medicaid programs

    OpenAIRE

    Bonafede MM; Miller JD; Laughlin-Tommaso SK; Lukes AS; Meyer NM; Lenhart GM

    2014-01-01

    Machaon M Bonafede,1 Jeffrey D Miller,1 Shannon K Laughlin-Tommaso,2 Andrea S Lukes,3 Nicole M Meyer,1 Gregory M Lenhart1 1Truven Health Analytics, Cambridge MA, 2Mayo Clinic, Department of Obstetrics and Gynecology, Rochester, MN, 3Women's Wellness Clinic and Research Center, Durham, NC, USA Background: Women with abnormal uterine bleeding (AUB) may be treated surgically with hysterectomy or global endometrial ablation (GEA), an outpatient procedure. We compared the costs and clinical ou...

  10. Long-term progestin contraceptives (LTPOC) induce aberrant angiogenesis, oxidative stress and apoptosis in the guinea pig uterus: A model for abnormal uterine bleeding in humans

    OpenAIRE

    Buchwalder Lynn; Schatz Frederick; Hickey Martha; Buhimschi Irina A; Krikun Graciela; Lockwood Charles J

    2010-01-01

    Abstract Background Irregular uterine bleeding is the major side effect of, and cause for, discontinuation of long-term progestin-only contraceptives (LTPOCs). The endometria of LTPOC-treated women display abnormally enlarged, fragile blood vessels (BV), decreased endometrial blood flow and oxidative stress. However, obtaining sufficient, good quality tissues have precluded elucidation of the mechanisms underlying these morphological and functional vascular changes. Methods The current study ...

  11. Evaluation and histopathological correlation of abnormal uterine bleeding in perimenopausal women

    Directory of Open Access Journals (Sweden)

    Avantika Gupta

    2013-08-01

    Full Text Available Objectives : To study the causes of abnormal uterine bleeding in perimenopausal women and to correlate their clinical evaluation with ultrasonographic and histopathological examination.Method : This is a retrospective study of 100 perimenopausal women with complaint of abnormal bleeding in the age group ranging from 40 years till 1 year within the menopause, who underwent hysterectomy at Lok Nayak Hospital. The age, parity, menstrual complaints of these patients were noted & clinical diagnosis and ultrasonography were analysed. Finally, histopathology report of the hysterectomy specimen was correlated with the clinical profile of the patient and ultrasonographic findings.Results : Maximum frequency of abnormal uterine bleeding was seen in the age group 40– 45 years. Most of the patients were para 3. Menorrhagia was the commonest complaint & fibroid uterus was responsible for abnormal uterine bleeding in 53% of women. Out of 42 women labelled clinically as dysfunctional uterine bleeding, 9 patients were diagnosed with fibroid uterus on ultrasound, 3 with malignancy, 1 with adenomyosis & in rest of the 30 patients, no organic cause was found. Out of these 30 patients, 6 patients were diagnosed to have adenomyosis on histopathology & in rest 24 patients, no gross pathology was detected. Suspected malignancy in all the 3 patients was confirmed on histopathology. Simple endometrial hyperplasia without atypia was present in 24% patients.Conclusion : Clinical, radiological & pathological evaluation correlated well to diagnose fibroids, however clinically as well as ultrasound proved to be of little help in diagnosing adenomyosis.

  12. Utility of the broccoli sign in the distinction of prolapsed uterine tumor from cervical tumor

    International Nuclear Information System (INIS)

    Objective: To describe the utility, histopathological basis, and clinical correlates of the broccoli sign. Methods: The committee on human research approved this HIPAA compliant study and waived written informed consent. Based on the records of the senior author and our multidisciplinary Gynecologic Oncology Tumor Board, we retrospectively identified thirteen women (mean age of 48.8 years; range, 34–74) with a cervical mass seen at MR imaging (n = 13) or CT (n = 5) that demonstrated the previously reported broccoli sign (i.e., a soft tissue stalk connecting the cervical mass to the uterine cavity) on one or other modality. All available clinical, imaging, and histopathological records were reviewed, with particular emphasis on initially suspected diagnosis, final proven diagnosis, and outcome. Results: Cervical cancer was the initial clinically suspected diagnosis in 6 of 13 patients. Surgical resection demonstrated prolapsed uterine tumor in all patients, consisting of endometrioid adenocarcinoma (n = 7), carcinosarcoma (n = 2), adenosarcoma (n = 1), and leiomyoma (n = 3). Excluding the three patients with leiomyomas, currently, 7 patients with malignant tumors are disease free after a mean interval of 15 months (range, 3–45) and 3 patients have been lost to follow-up. Conclusion: A stalk connecting an apparent cervical mass seen at CT or MR imaging to the endometrial cavity (“broccoli sign”) favors the diagnosis of a prolapsed uterine tumor; these prolapsed uterine tumors can often be malignant but appear to have a good prognosis.

  13. The Ultrasound and MRI Findings of Uterine Adenofibroma: A Case Report

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    Kim, Hyun Jung; Rha, Sung Eun; Byun, Jae Young; Lee, Ah Won [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2011-09-15

    Adenofibroma is an extremely rare benign m'ullerian mixed tumor composed of epithelium and mesenchymal cells. Most uterine adenofibromas occur in the endometrium, but they rarely protrude into the vagina. To date, only a few such cases with the imaging findings have been reported. Therefore, we report here on the sonographic and magnetic resonance (MR) imaging findings of a case of endometrial adenofibroma protruding into the vaginal cavity in a 28-year-old woman. The uterine adenofibroma appeared as a large intracavitary echogenic mass containing multiple small internal cysts, and it was distending the vaginal cavity on transrectal sonography. T2- weighted MR images showed a large intracavitary mass with heterogeneous high signal intensity protruding into the vaginal cavity. On gadolinium-enhanced T1-weighted MR images, heterogeneous septa-like enhancement was noted in the mass. Although uterine adenofibroma is extremely rare, adenofibroma can be suggested as a possible diagnosis when an intracavitary uterine mass, with multiple internal small cystic components and enhancing septa-like structures, is protruding into the vaginal cavity on imaging

  14. Pregnancy recognition in cattle: effects of conceptus products on uterine prostaglandin production

    International Nuclear Information System (INIS)

    In cattle, continued progesterone (P4) production by the corpus luteum (CL) is required if pregnancy is to persist. Identification of putative conceptus-derived signals and evaluation of their biological roles relative to CL maintenance during early pregnancy were goals of this research endeavor. Using various chromatography systems, bovine conceptuses (days 19 to 23) exhibited extensive metabolism of tritiated P4 (90-98%), in vitro. A majority of conceptus metabolites were 5?-reduced pregnanes. A major conceptus metabolite was 5?-pregnan-3?-ol-20-one (5?-P). Conversely, endometrial explant cultures metabolized 40 to 50% of P4 substrate to primarily 5?-reduced steroid products. An in vivo test system to evaluate uterine PGF/sub 2?/ production capacity was characterized in experiment two. Exogenous estradiol-17? (E2; 3 mg I.V.) stimulated uterine blood flow, and PGF/sub 2?/ production and metabolism. In experiment three, CL function, interestrous interval, and spontaneous uterine PGF/sub 2?/ production were evaluated in cyclic cows following intrauterine administration of 5?-P, conceptus secretory proteins (CSP) or homologous serum proteins (Control). Results support a role for CSP in suppression of uterine PGF/sub 2?/ production during early pregnancy in cattle

  15. Cesarean Section followed by myomectomy in a pregnancy complicated by left intraligamentous myoma

    OpenAIRE

    Arifuddin Djuanna

    2004-01-01

    A 20-year-old primigravida with 38th weeks of gestation complicated with a left large solid intraligamentous uterine tumor. The operation started with lower segment cesarean section to delivere the fetus. Intramural uterotonica was given and the uterus contracted well; intra- and up to 24 hours post-operatively oxytocin infusion was administered. Double circle stitching technique was performed on lateral side of the mioma before starting myomectomy. No blood transfusion was given. The histopa...

  16. The Role of Adjuvant Radiation in Uterine Sarcomas

    International Nuclear Information System (INIS)

    Purpose: To determine clinical and pathological factors significant for overall survival (OS) and local-regional failure-free survival (LRFFS) in uterine sarcoma as they relate to adjuvant radiotherapy (AR). Methods and Materials: A retrospective analysis of 3,650 patients with uterine sarcoma was conducted using the National Oncology Database, a proprietary database of aggregated tumor registries owned by Impac Medical Systems (Sunnyvale, CA). Adjuvant radiotherapy was defined as postoperative external beam radiation to the pelvis, with or without brachytherapy. Prognostic factors were identified by multivariate analysis (MVA) using the Cox proportional hazards model. The Kaplan-Meier method was used to estimate survival, with significant differences (p < 0.05) determined using the log-rank test. Results: The median follow-up time was 59 months, with a 5-year OS of 37%. Significant prognostic factors for OS were stage, race/ethnicity, grade, age, histology, lymph node status, and surgical treatment (p < 0.01 for all factors). Use of AR was not predictive for OS. For nonmetastatic cancer patients receiving definitive surgery (n = 2,206), the 5-year LRFFS was 87%. In this group, stage, grade, histology, and AR were prognostic for LRFFS (p < 0.05), with AR associated with improved outcome compared with surgery alone (hazard ratio = 0.4, p < 0.001). Patients with carcinosarcoma, endometrial stromal sarcoma, leiomyosarcoma, poorly differentiated tumors, and negative lymph differentiated tumors, and negative lymph nodes had reduced local-regional failure (LRF) with AR (log-rank, p < 0.05 for all). Conclusion: In the largest retrospective analysis of uterine sarcoma published thus far, AR conferred a 53% reduction in the risk of LRF at 5 years. Use of AR may have broader indications than what are currently accepted in clinical practice.

  17. Uterine Artery Anatomy Relevant to Uterine Leiomyomata Embolization

    International Nuclear Information System (INIS)

    To categorize the anatomic variants of uterine arteries, and determine the incidence of menopausal symptoms where the tubo-ovarian branches were seen prior to embolization. Between July 1997 and June 2000, 257 (n = 257) uterine fibroid embolizations were performed at our institution. Arteriograms were retrospectively evaluated. Uterine arteries were classified into groups: type I (the uterine artery as first branch of the inferior gluteal artery), type II (the uterine artery as second or third branch of the inferior gluteal artery), type III (the uterine artery, the inferior gluteal and the superior gluteal arteries arising as a trifurcation), type IV (the uterine artery as first branch of the hypogastric artery), inconclusive, or not studied. Tubo-ovarian branches were recorded if visualized prior to and/or after embolization. Menopausal symptoms were recorded (n = 175 at 3 months, n = 139 at 6 months, n = 98 at 1 year, n = 22 at 2 years) using written questionnaires. Five hundred and fourteen uterine arteries (n = 514) were evaluated. There were 38% classifiable types, 23% inconclusive, and 39% not studied. Classification was as follows: type I, 45%; type II, 6%; type III, 43%; type IV, 6%. Among 256 patients, tubo-ovarian arteries were seen in 36 prior to embolization, but not afterwards. In this group, 25 patients reported transient menopausal symptoms (hot flashes, amenorrhea). Five patients did not report any menopausal symptoms. Six patients did not answer the symptoms. Six patients did not answer the questionnaires. Type I is the most common type of anatomy, followed by type III. The tubo-ovarian arteries may be visualized prior to and/or after embolization. The embolization was monitored to avoid embolization of the tubo-ovarian branches. Menopausal symptoms were transient all patients when the tubo-ovarian branches were seen prior to embolization

  18. Hormonally active doses of isoflavone aglycones promote mammary and endometrial carcinogenesis and alter the molecular tumor environment in Donryu rats.

    Science.gov (United States)

    Kakehashi, Anna; Tago, Yoshiyuki; Yoshida, Midori; Sokuza, Yui; Wei, Min; Fukushima, Shoji; Wanibuchi, Hideki

    2012-03-01

    Our research is focused on modifying effects of an isoflavone aglycones (IAs)-rich extract at a hormonally active dose of 150 mg/kg body weight/day on mammary and endometrial carcinogenesis in female Donryu rats. IA administered for 2 weeks in a phytoestrogen-low diet exerted estrogenic activity and induced cell proliferation in the uterus of ovariectomized rats. Furthermore, administration for 4 weeks resulted in elevation of cell proliferation in the mammary glands of 7,12-dimethylbenz[a]anthracene (DMBA)-treated animals. Forty weeks of postpubertal administration of IA to 5-week-old rats after initiation of mammary and endometrial carcinogenesis with DMBA and N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) caused significant increase of incidence and multiplicity of mammary adenocarcinoma, multiplicities of endometrial atypical hyperplasia, adenomatous polyps, and an increased trend of uterine adenocarcinomas. Liquid chromatography with tandem mass spectrometry and immunohistochemical analyses revealed significant elevation of tumorigenesis-related proteins such as S100 calcium-binding protein A8, kininogen 1, and annexins 1 and 2 in mammary adenocarcinomas and cadherin EGF LAG seven-pass G-type receptor 2, DEAD box polypeptide 1, and cysteine- and glycine-rich protein 1 in uterine proliferative lesions of IA-treated animals. Those changes are likely to be related to modulation of estrogen receptor (ER), AP1, nuclear factor-kappa B, and actin signaling pathways. Our results indicate that the postpubertal exposure of Donryu rats to IA at an estrogenic dose results in promotion of mammary and uterine carcinogenesis induced by DMBA and ENNG, which might be related to the activation of ER-dependent signaling and alteration of the molecular tumor environment in the mammary gland and endometrium. PMID:22248470

  19. Proteomics of the human endometrial glandular epithelium and stroma from the proliferative and secretory phases of the menstrual cycle.

    Science.gov (United States)

    Hood, Brian L; Liu, Baoquan; Alkhas, Addie; Shoji, Yutaka; Challa, Rusheeswar; Wang, Guisong; Ferguson, Susan; Oliver, Julie; Mitchell, Dave; Bateman, Nicholas W; Zahn, Christopher M; Hamilton, Chad A; Payson, Mark; Lessey, Bruce; Fazleabas, Asgerally T; Maxwell, G Larry; Conrads, Thomas P; Risinger, John I

    2015-04-01

    Despite its importance in reproductive biology and women's health, a detailed molecular-level understanding of the human endometrium is lacking. Indeed, no comprehensive studies have been undertaken to elucidate the important protein expression differences between the endometrial glandular epithelium and surrounding stroma during the proliferative and midsecretory phases of the menstrual cycle. We utilized laser microdissection to harvest epithelial cells and stromal compartments from proliferative and secretory premenopausal endometrial tissue and performed a global, quantitative mass spectrometry-based proteomics analysis. This analysis identified 1224 total proteins from epithelial cells, among which 318 were differentially abundant between the proliferative and secretory phases (q < 0.05), and 1005 proteins from the stromal compartments, 19 of which were differentially abundant between the phases (q < 0.05). Several proteins were chosen for validation by immunohistochemistry in an independent set of uterine tissues, including carboxypeptidase M, tenascin C, neprilysin, and ectonucleotide pyrophosphatase/phosphodiesterase family member 3 (ENPP3). ENPP3, which was elevated in epithelial glandular cells in the secretory phase, was confirmed to be elevated in midsecretory-phase baboon uterine lavage samples and also observed to have an N-linked glycosylated form that was not observed in the proliferative phase. This study provides a detailed view into the global proteomic alterations of the epithelial cells and stromal compartments of the cycling premenopausal endometrium. These proteomic alterations during endometrial remodeling provide a basis for numerous follow-up investigations on the function of these differentially regulated proteins and their role in reproductive biology and endometrial pathologies. PMID:25695723

  20. Histerossonografia: avaliação da cavidade uterina com sangramento anormal / Hysterosonography: evaluation of the uterine cavity in women with abnormal uterine bleeding

    Scientific Electronic Library Online (English)

    Luiz Guilherme Trevisan de, Albuquerque; Ellen, Hardy; Luis, Bahamondes.

    2006-08-01

    Full Text Available OBJETIVO: Comparar a acurácia da histerossonografia com as da histeroscopia e da USG no diagnóstico das alterações uterinas em mulheres com sangramento uterino anormal. MÉTODOS: Foram incluídas 53 pacientes que estavam agendadas para realização de histeroscopia no Setor de Histeroscopia do CAISM/UNI [...] CAMP. Comparou-se a sensibilidade e especificidade dos três métodos propedêuticos utilizando a histologia como padrão ouro. RESULTADOS: A sensibilidade da histerossonografia e da histeroscopia foi de 94% e a da USG 83%. A especificidade da histerossonografia foi de 77%, da histeroscopia de 91% e da USG 69%. As diferenças entre as sensibilidades dos três métodos não foram estatisticamente significativas, no entanto observou-se diferença significativa entre a especificidade da USG e da histeroscopia. A histerossonografia mostrou maior capacidade que a ultra-sonografia de identificar pólipos endometriais. CONCLUSÃO: A histerossonografia pode ser utilizada como método complementar à USG e substituto da histeroscopia para o diagnóstico de alterações que levam ao sangramento uterino anormal. Abstract in english OBJECTIVE: To compare the diagnostic accuracy of sonohysterography with that of hysteroscopy and ultrasonography for the diagnosis of uterine alterations with abnormal uterine bleeding. METHODS: Fifty three patients scheduled for hysteroscopy at the Hysteroscopy Sector of the Women's Hospital (CAISM [...] ) at the "Universidade Estadual de Campinas" (Brazil) were included in the study. Sensitivity and specificity of the three propaedeutic methods were compared using histology as the gold standard. RESULTS: Sensitivity of sonohysterography and of hysteroscopy was 94% and that of ultrasonography 83%. The specificity of sonohysterography was 77%, of hysteroscopy 91% and of ultrasonography 69%. There were no significant differences between sensitivities of the three methods. However, a significant difference was found between the specificity of ultrasonography and hysteroscopy. Sonohysterography demonstrated a much greater capability than ultrasonography to identify endometrial polyps. CONCLUSION: Sonohysterography may be used to complement ultrasonography and to substitute hysteroscopy, for the diagnosis of alterations that result in abnormal uterine bleeding.

  1. Genistein promotes DNA demethylation of the steroidogenic factor 1 (SF-1) promoter in endometrial stromal cells

    International Nuclear Information System (INIS)

    Highlights: ? Genistein (GEN) is a phytoestrogen found in soy products. ? GEN demethylated/unsilenced the steroidogenic factor 1 gene in endometrial tissue. ? GEN thus altered mRNA expression in uteri of ovariectomized (OVX) mice. ? A high-resolution melting assay was used to screen for epigenetic change. ? We isolated an endometrial cell clone that was epigenetically modulated by GEN. -- Abstract: It has recently been demonstrated that genistein (GEN), a phytoestrogen in soy products, is an epigenetic modulator in various types of cells; but its effect on endometrium has not yet been determined. We investigated the effects of GEN on mouse uterine cells, in vivo and in vitro. Oral administration of GEN for 1 week induced mild proliferation of the endometrium in ovariectomized (OVX) mice, which was accompanied by the induction of steroidogenic factor 1 (SF-1) gene expression. GEN administration induced demethylation of multiple CpG sites in the SF-1 promoter; these sites are extensively methylated and thus silenced in normal endometrium. The GEN-mediated promoter demethylation occurred predominantly on the luminal side, as opposed to myometrium side, indicating that the epigenetic change was mainly shown in regenerated cells. Primary cultures of endometrial stromal cell colonies were screened for GEN-mediated alterations of DNA methylation by a high-resolution melting (HRM) method. One out of 20 colony-forming cell clones showed GEN-induced demethylation of SF-1. This clone exhibited a high proliferation capacity with continuous colony formation activity through multiple serial clonings. We propose that only a portion of endometrial cells are capable of receiving epigenetic modulation by GEN.

  2. Correlation between Endometrial Parameters in Doppler Sonography and Success Rate of Implantation in Assisted Reproductive Programs

    Directory of Open Access Journals (Sweden)

    Firoozeh Ahmadi

    2007-01-01

    Full Text Available Background: A good blood supply towards the endometrium is usually considered to be an essential requirement for implantation. Evaluating the role of endometrial and sub-endometrial blood flows detected by color Doppler sonography at the day of embryo transfer, as a predictor of pregnancy rate during IVF/ICSI programs was our main goal in this study.Materials and Methods: Seventy three infertile patients aged <38 years with basal serum FSH level<12 mIU/ml who had less than two failed attempts of ART cycles were prospectively evaluated. The cases with more than two failed IVF cycle and uterine disorders were excluded. All procedures were performed by one expert and two good quality embryos were transferred. Vaginal power color Doppler sonography was performed at the day of embryo transfer and endometrial characteristics including endometrial vascularization, area of vascularization distribution and pulsatility index were registered. Then pregnant and non-pregnant groups were compared for ultrasonographic parameters of endometrium.Results: Pregnancy occurred in 28 patients. Mean age, duration and etiology of infertility, baseline mean FSH and estradiol level at the day of Human chorionic gonadotropin (HCG injection, amount of drug administered, number of retrieved oocytes and embryos, also number and quality of transferred embryos in the pregnant and non-pregnant groups showed no statistically significant difference .On the other hand, none of the sonographic parameters reported in two groups indicated a statistically significant difference.Conclusion: Doppler ultrasonographic indices at the day of embryo transfer are not considered appropriate criteria for prediction of success rate or failure of embryo implantation.

  3. Global endometrial transcriptomic profiling: transient immune activation precedes tissue proliferation and repair in healthy beef cows

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    Foley Cathriona

    2012-09-01

    Full Text Available Abstract Background All cows experience bacterial contamination and tissue injury in the uterus postpartum, instigating a local inflammatory immune response. However mechanisms that control inflammation and achieve a physiologically functioning endometrium, while avoiding disease in the postpartum cow are not succinctly defined. This study aimed to identify novel candidate genes indicative of inflammation resolution during involution in healthy beef cows. Previous histological analysis of the endometrium revealed elevated inflammation 15?days postpartum (DPP which was significantly decreased by 30 DPP. The current study generated a genome-wide transcriptomic profile of endometrial biopsies from these cows at both time points using mRNA-Seq. The pathway analysis tool GoSeq identified KEGG pathways enriched by significantly differentially expressed genes at both time points. Novel candidate genes associated with inflammatory resolution were subsequently validated in additional postpartum animals using quantitative real-time PCR (qRT-PCR. Results mRNA-Seq revealed 1,107 significantly differentially expressed genes, 73 of which were increased 15 DPP and 1,034 were increased 30 DPP. Early postpartum, enriched immune pathways (adjusted P?P?SAA1/2, GATA2, IGF1, SHC2, and SERPINA14 genes were significantly elevated 30 DPP and are functionally associated with tissue repair and the restoration of uterine homeostasis postpartum. Conclusions The results of this study reveal an early activation of the immune response which undergoes a temporal functional change toward tissue proliferation and regeneration during endometrial involution in healthy postpartum cows. These molecular changes mirror the activation and resolution of endometrial inflammation during involution previously classified by the degree of neutrophil infiltration. SAA1/2, GATA2, IGF1, SHC2, and SERPINA14 genes may become potential markers for resolution of endometrial inflammation in the postpartum cow.

  4. EPAC2-mediated calreticulin regulates LIF and COX2 expression in human endometrial glandular cells.

    Science.gov (United States)

    Kusama, Kazuya; Yoshie, Mikihiro; Tamura, Kazuhiro; Imakawa, Kazuhiko; Tachikawa, Eiichi

    2015-02-01

    The proper production of the implantation-related factors, leukemia inhibitory factor (LIF), cyclooxygenase 2 (COX2, PTGS2), and prostaglandin E2 (PGE2) in the uterine glands is essential for embryo implantation and the establishment of endometrial receptivity. It has been shown that cAMP-mediated protein kinase A (PKA) signaling regulates the production of these factors. We have previously reported that exchange protein directly activated by cAMP 2 (EPAC2, RAPGEF4), another cAMP mediator, is involved in the differentiation of endometrial stromal cells through the regulation of the expression of calreticulin (CALR). To address whether EPAC2-CALR signaling is involved in the expression of implantation-related factors, we examined the effect of EPAC2 and CALR knockdown on their expression in cultured human endometrial glandular epithelial EM1 cells, treated with forskolin, an adenylyl cyclase activator, an EPAC-selective cAMP analog (8-(4-chlorophenylthio)-2'-O-methyl cAMP (CPT)), or a PKA-selective cAMP analog (N(6)-phenyl-cAMP (Phe)). In addition, the status of cell senescence was examined. EPAC2 knockdown suppressed the expression of CALR protein and mRNA in EM1 cells. Forskolin- or Phe-, but not CPT-, induced expression of LIF or PTGS2 and secretion of PGE2 was inhibited in EPAC2- or CALR-silenced EM1 cells. In addition, knockdown of EPAC2 or CALR increased senescence-associated beta galactosidase activity and expression of p21 but decreased expression of p53. These findings indicate that expression of CALR regulated by EPAC2 in endometrial glandular epithelial cells is critical for the expression of LIF and PTGS2-mediated production of PGE2 through cAMP signaling. Furthermore, EPAC2 and CALR could play a role in the maintenance of gland function. PMID:25378661

  5. Utility of immunohistochemistry method in expression of thyroid transcription factor-1 in endometrial and endocervical adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Janbazvatan A

    2011-02-01

    Full Text Available "nBackground: Thyroid transcription factor-1 (TTF-1 is widely used in the diagnosis of lung and thyroid carcinomas. Although there have been reports of TTF-1 immunoreactivity in tumors other than those originating from the lung or thyroid, endocervical and endometrial adenocarcinomas have not been studied in large numbers in this regard."n "nMethods: Thirteen endocervical adenocarcinomas, 39 endometrioid endometrial adenocarcinomas and four uterine serous carcinomas which had no neuroendocrine component were retrieved, stained by TTF-1 and examined. A semiquantitative grading system was used to evaluate the distribution of TTF-1 staining (0= negative, 1+ ? 5%, 2+= 5% to 25%, 3+= 26% to 50%, 4+= 51% to 75% and 5+ ? 75%. A qualitative system was also used to evaluate the intensity of TTF-1 staining (weak, moderate and strong."n "nResults: TTF-1 expression was seen in 1 out of 13 (7.7% endocervical adenocarcinoma samples, showing 1+ distribution rate and weak intensity. The positive sample was moderately differentiated. TTF-1 expression was present in 2 out of 39 (5.1% endometrioid adenocarcinoma samples (one grade I and the other grade II with 1+ distribution rate and weak intensity. There was no apparent correlation between the degree of differentiation and TTF-1 positivity in the studied adenocarcinomas. None of the four endometrial serous carcinomas were positive for TTF-1."n "nConclusion: Although some recent studies cast doubt about the specificity of TTF-1 for lung and thyroid carcinoma, our study showed that TTF-1 was negative in endocervical and endometrial adenocarcinomas and established the specificity of TTF-1 for lung and thyroid carcinomas.

  6. Radiological appearances of uterine fibroids

    OpenAIRE

    Sue, Wilde; Sarah, Scott-barrett

    2009-01-01

    Uterine fibroids, also known as leiomyomas, are the commonest uterine neoplasms. Although benign, they can be associated with significant morbidity and are the commonest indication for hysterectomy. They are often discovered incidentally when performing imaging for other reasons. Usually first identified with USG, they can be further characterized with MRI. They are usually easily recognizable, but degenerate fibroids can have unusual appearances. In this article, we describe the appearances ...

  7. Medical Treatment of Uterine Leiomyoma

    OpenAIRE

    Sabry, Mohamed; Al-hendy, Ayman

    2012-01-01

    Uterine leiomyomas (also called myomata or fibroids) are the most common gynecologic tumors in the United States. The prevalence of leiomyomas is at least 3 to 4 times higher among African American women than in white women. Pathologically, uterine leiomyomas are benign tumors that arise in any part of the uterus under the influence of local growth factors and sex hormones, such as estrogen and progesterone. These common tumors cause significant morbidity for women and they are considered to ...

  8. Hereditary factors in endometrial cancer

    OpenAIRE

    Tzortzatos, Gerasimos

    2015-01-01

    Endometrial carcinoma (EC) is the most common gynecological malignancy in Sweden and accounts for about 6 % of all female malignancies. The risk of EC increases with age and the majority of cases are diagnosed between age 50 and 60. Ninety percent of cases occur in women older than age 50. About 2% of EC may have a familial association related to Lynch syndrome (LS). About 80% of women with Cowden syndrome have the PTEN mutation, which increases their lifetime risk of developing EC. The benef...

  9. [Surgical approaches for endometrial cancer? ].

    Science.gov (United States)

    Narducci, Fabrice; Jean-Laurent, Mehdi; Lambaudie, Eric; Coutty, Nadège; Leblanc, Eric

    2012-01-01

    The recommendations of the Institut national du cancer and of the Société francaise d'oncologie gynécologique in endometrial carcinoma (2010) reported that laparoscopy is the standard surgical approach for patients with apparent stage FIGO I in preoperative outcomes including MRI (www.e-cancer.fr). For patients with stage FIGO greater than I, laparotomy is the standard surgical approach. In case of lymph nodes or peritoneal restaging, the laparoscopy could be a good option especially by extraperitoneal route in patients with recent first surgery. PMID:22192868

  10. ZEB1 Expression in Endometrial Biopsy Predicts Lymph Node Metastases in Patient with Endometrial Cancer

    OpenAIRE

    Feng, Gang; Wang, Xiangming; Cao, Xiaozhi; Shen, Lijuan; Zhu, Jiansheng

    2014-01-01

    Purpose. The purpose of this study was to analyze the expression of zinc-finger E-box-binding homeobox 1 (ZEB1) in endometrial biopsy and its correlation with preoperative characteristics, including lymph node metastases in patient with endometrial cancer. Methods. Using quantitative RT-PCR, ZEB1 expressions in endometrial biopsy from 452 patients were measured. The relationship between ZEB1 expression and preoperative characteristics was analyzed. Results. ZEB1 expressions were significantly...

  11. Surgical removal of multiple mesenteric fibroids (Kg 4,500) by abdominal spread of previous laparoscopic uterine myomectomy

    Science.gov (United States)

    LEANZA, V.; GULINO, F.A.; LEANZA, G.; ZARBO, G.

    2015-01-01

    Introduction Huge and multiple mesenteric fibroids (4,500 Kg weight) are very unusual. In many cases they are mistaken for subserosal fibroids of the womb due to the proximity with uterine walls. When they have a rapid growth, the risk of becoming malignant (sarcoma) has not to be underestimated. Surgery is challenging to remove abdominal nodes. Case report A case of a 40-year old woman, admitted to the hospital with abdominal masses occupying the entire cavity was reported. Both computerized tomography (CT) and ultrasounds (US) were not diriment for belonging of tumours. Clinical history of patient reports a laparoscopic removal of uterine fibroids, using the morcellator. Laparoscopy was performed four years before. Open surgery by means of a large transversal suprapubic laparotomy according to Pfannestiel was carried out. Multiple and huge mesenteric, peritoneal and intestinal tumours spread in the whole abdominal cavity were found, removed and examined by frozen section histology; in addition a series of small conglomerated myomas in the site of previous laparoscopic transumbilical route was taken away as well (the largest fibroid weighed Kg 3.500 and the all tumors removed 4,500 Kg); the result was benign (fibroids) and genital apparatus was preserved. Operation was challenging. Postoperative course was uneventful; after five days patient was discharged. Conclusions This case is very interesting for many factors: A) many extra-uterine fibroids spread throughout abdominal cavity; B) considerable weight of the masses C) intraoperative and postoperative danger. Finally, due to involvement of previous laparoscopic transumbilical incision together with other findings, the hypothesis of post laparoscopic dissemination has to be considered. A case of so large extragenital abdominal fibroids following laparoscopic uterine myomectomy has never been published so far. PMID:25827668

  12. Uterine sarcoma incidental in infertile women: experience in a tropical hospital

    International Nuclear Information System (INIS)

    Uterine sarcoma is an uncommon gynaecological malignancy. Diagnosis in its early stage and management is challenging especially in a resource poor setting. The objective of the study is to evaluate the clinico-pathologic presentation of uterine sarcoma in 9 subfertile patients that underwent surgery for seemingly benign uterine diseases. Nine consecutive infertile women with intra-operative diagnosis of uterine sarcoma were reviewed over a period of 5.5 years. The nine patients were pre-operatively misdiagnosed with uterine fibroid in 7 (77.8%) patients and adenomyosis uteri in 2 (22.2%) patients. The patients mean age was 39.2 years with a range of 36 to 47 years. Parity ranged from para 0 to para 3. Of the nine patients, 7 (77.8%) presented with secondary infertility and two (22.2%) patients with primary infertility. Clinical presentations were mainly abdomino - pelvic mass (100%), pelvic pain (77.8%) and abnormal uterine bleeding in (77.8%) of patients. Three (33.3%) of the 9 patients had history of myomectomy. Pre-operative hysterosalpingogram revealed that six (66.7%) patients had bilateral tubal blockage, two (22.2%) patients had unilateral tubal blockage and one (11.1%) patient had bilateral patent fallopian tubes. Six (66.7%) patients had hydrosalpinges. Clinical staging of malignancy was stage Ic in seven patients, stage IIa and IIb in the remaining two patients. Histologic classifications were leiomyosarcoma in six patients and endometrial stromal sarcoma inatients and endometrial stromal sarcoma in three patients. Treatments offered were surgery alone in six (66.7%) patients, surgery with adjuvant chemotherapy for 2 (22.2%) patients and one (11.1%) patient had surgery with adjuvant radiotherapy. Case fatality was 77.8% with a year of diagnosis. In a resource constrained setting, due to limitations in making diagnosis in the early stage of the disease, a high index of suspicion is needed in all elderly infertile women presenting with seemingly benign abdomino pelvic mass. (author)

  13. Rabdomiosarcoma Embrionario Uterino: Aspectos Morfológicos e Inmunohistoquímicos / Embryonal Rhabdomyosarcoma of the Corpus Uterine: Morphological and Immunohistochemical Characteristics

    Scientific Electronic Library Online (English)

    Oscar, Tapia E.

    1126-11-01

    Full Text Available Los sarcomas uterinos son relativamente raros. El tipo histológico más frecuente es el leiomiosarcoma, seguido por el sarcoma del estroma endometrial. Los rabdomiosarcomas (RMS) son neoplasias malignas con diferenciación muscular esquelética. El rabdomiosarcoma embrionario (RMSE) tipo botrioide es e [...] l sarcoma más común de la infancia; con escasos reportes en adultos, afectando la región de cabeza y cuello, tracto genitourinario y extremidades más frecuentemente. En el tracto genitourinario, la vagina es la localización mas frecuente, comprometiendo en raras ocasiones el cuello o fondo uterino. Se presentan las características clínicas y morfológicas de un caso de RMSE uterino tipo botrioide diagnosticado en una paciente de 58 años en la Unidad de Anatomía Patológica del Hospital Hernán Henríquez Aravena de Temuco. Abstract in english Uterine sarcomas are relatively rare. The most common histological type is leiomyosarcoma, followed by endometrial stromal sarcoma. The rhabdomyosarcoma (RMS) are malignant neoplasms with skeletal muscle differentiation. Embryonal rhabdomyosarcoma (RMSE) type botryoides is the most common in childho [...] od, with few reports in adults, affecting the head and neck region, genitourinary tract and extremities more frequently. In the genitourinary tract, the vagina is the most common location, rarely involving cervix and fundus uterine. Clinical and morphological characteristics are presented of a case of uterine RMSE diagnosed in a 58 year-old woman in the Pathology Unit of the Hernán Henríquez Aravena Hospital in Temuco.

  14. Molecular mechanisms in uterine epithelium during trophoblast binding: the role of small GTPase RhoA in human uterine Ishikawa cells

    Science.gov (United States)

    Heneweer, Carola; Schmidt, Martina; Denker, Hans-Werner; Thie, Michael

    2005-01-01

    Background Embryo implantation requires that uterine epithelium develops competence to bind trophoblast to its apical (free) poles. This essential element of uterine receptivity seems to depend on a destabilisation of the apico-basal polarity of endometrial epithelium. Accordingly, a reorganisation of the actin cytoskeleton regulated by the small GTPase RhoA plays an important role in human uterine epithelial RL95-2 cells for binding of human trophoblastoid JAR cells. We now obtained new insight into trophoblast binding using human uterine epithelial Ishikawa cells. Methods Polarity of Ishikawa cells was investigated by electron microscopy, apical adhesiveness was tested by adhesion assay. Analyses of subcellular distribution of filamentous actin (F-actin) and RhoA in apical and basal cell poles were performed by confocal laser scanning microscopy (CLSM) with and without binding of JAR spheroids as well as with and without inhibition of small Rho GTPases by Clostridium difficile toxin A (toxin A). In the latter case, subcellular distribution of RhoA was additionally investigated by Western blotting. Results Ishikawa cells express apical adhesiveness for JAR spheroids and moderate apico-basal polarity. Without contact to JAR spheroids, significantly higher signalling intensities of F-actin and RhoA were found at the basal as compared to the apical poles in Ishikawa cells. RhoA was equally distributed between the membrane fraction and the cytosol fraction. Levels of F-actin and RhoA signals became equalised in the apical and basal regions upon contact to JAR spheroids. After inhibition of Rho GTPases, Ishikawa cells remained adhesive for JAR spheroids, the gradient of fluorescence signals of F-actin and RhoA was maintained while the amount of RhoA was reduced in the cytosolic fraction with a comparable increase in the membrane fraction. Conclusion Ishikawa cells respond to JAR contact as well as to treatment with toxin A with rearrangement of F-actin and small GTPase RhoA but seem to be able to modify signalling pathways in a way not elucidated so far in endometrial cells. This ability may be linked to the degree of polar organisation observed in Ishikawa cells indicating an essential role of cell phenotype modification in apical adhesiveness of uterine epithelium for trophoblast in vivo. PMID:15757515

  15. Disposition of ampicillin trihydrate in plasma, uterine tissue, lochial fluid, and milk of postpartum dairy cattle.

    Science.gov (United States)

    Credille, B C; Giguère, S; Vickroy, T W; Fishman, H J; Jones, A L; Mason, M E; DiPietro, R O; Ensley, D T

    2015-08-01

    The objective of this study was to determine the disposition of ampicillin in plasma, uterine tissue, lochial fluid, and milk of postpartum dairy cattle. Ampicillin trihydrate was administered by intramuscular (i.m.) injection at a dose of 11 mg/kg of body weight every 24 h (n = 6, total of 3 doses) or every 12 h (n = 6, total of 5 doses) for 3 days. Concentrations of ampicillin were measured in plasma, uterine tissue, lochial fluid, and milk using HPLC with ultraviolet absorption. Quantifiable ampicillin concentrations were found in plasma, milk, and lochial fluid of all cattle within 30 min, 4 h, and 4 h of administration of ampicillin trihydrate, respectively. There was no significant effect of dosing interval (every 12 vs. every 24 h) and no significant interactions between dosing interval and sampling site on the pharmacokinetic variable measured or calculated. Median peak ampicillin concentration at steady-state was significantly higher in lochial fluid (5.27 ?g/mL after q 24 h dosing) than other body fluids or tissues and significantly higher in plasma (3.11 ?g/mL) compared to milk (0.49 ?g/mL) or endometrial tissue (1.55 ?g/mL). Ampicillin trihydrate administered once daily by the i.m. route at the label dose of 11 mg/kg of body weight achieves therapeutic concentrations in the milk, lochial fluid, and endometrial tissue of healthy postpartum dairy cattle. PMID:25376083

  16. Abnormal uterine bleeding: a study of menstrual patterns and histopathological patterns in perimenopausal females

    Directory of Open Access Journals (Sweden)

    Mahima Jain

    2015-02-01

    Full Text Available Background: In gynecology out-patient department there is a large group of patients especially in perimenopausal age group who present with various menstrual disorders. These can be as such caused due to various etiologies, which need to be investigated as line of management is thereupon decided. This study is undertaken to know the various abnormal uterine bleeding in perimenopausal women, and their histopathological pattern. Methods: This study is done at PDU medical college hospital, Rajkot, Gujarat which is a tertiary care centre. A retrospective analysis of 268 cases clinically presenting with abnormal uterine bleeding is done. They are further posted for dilatation and curettage after thorough investigation to rule out other pathologies. The endometrial samplings from the D and C material are collected and sent for histopathological assessment. The data is recorded and further analysed. Women between 40-55 years age group are included in this study. Women with diagnosed pelvic pathology, endocrinal cause and bleeding tendencies are excluded from the study. Results: In our study almost all menstrual disorders are found, commonest being menorrhagia in 42.16%. Other patterns reported are metrorrhagia in 3.35%, oligomenorrhea in 14.80%, polymenorrhea and polymenorrhagia in 5.22% and 5.59% cases. Post-menopausal bleeding is found in one case. The histopathological diagnoses reported in this study are proliferative and secretory phase in 26.49% and 19.77% respectively. Other endometrial hyperplasias reported are Swiss cheese in 1.86%, simple cystic hyperplasia in 12.31%, complex hyperplasia with or without atypia in 7% and 4.10% respectively. Malignancy is found in 2 cases. Conclusions: From this study it is well established that endometrial sampling from D and C material still remains the gold standard in diagnosis of various endometrial pathologies in low resource set-up. Thereby the further line of management can also be decided for a rational approach in the treatment of perimenopausal women with abnormal uterine bleeding. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 109-112

  17. Miomatosis uterina e infertilidad: indicaciones de tratamiento convencional / Conventional treatment for uterine myomatosis - induced infertility

    Scientific Electronic Library Online (English)

    Jaime, Saavedra.

    2003-06-01

    Full Text Available Los fibromas son relativamente comunes en las pacientes en edad reproductiva y son exclusivamente responsables de infertilidad y abortos en una pequeña (5%) pero significante proporción de pacientes. Aproximadamente el 50% de las mujeres con infertilidad y miomas uterinos se embarazan después de mio [...] mectomía. Una proporción relativamente alta de mujeres con historia de abortos recurrentes se embaraza después miomectomía. Lo más importante, hay una disminución significativa en la tasa de abortos en el primer y segundo trimestre. La evidencia sugiere que la mayoría de mujeres que desean embarazarse son capaces de hacerlo en el primer año, con una caída de estas tasas en forma aguda después de este tiempo. Esto se puede atribuir a la recurrencia de los fibromas. Por tanto, la cirugía se debería realizar cuando la mujer esté lista para iniciar una familia. El sitio, número y tamaño de los miomas así como la experiencia del cirujano junto con la preferencia de la paciente puede influenciar la opción del manejo. Son indicaciones para realizar cirugía en una mujer que esté considerando la posibilidad de embarazo por los métodos naturales o por reproducción asistida la presencia de un mioma submucoso o un mioma intramural que distorsione la cavidad uterina, fibromas mayores de 5 centímetros y múltiples fibromas. Para fibromas intramurales menores de 5 centímetros y múltiples fibromas. Para fibromas intramurales menores de 5 centímetros y fibromas subserosos la historia reproductiva debe ser una consideración importante en la determinación en lo tocante a la necesidad de una intervención quirúrgica. Abstract in english Fibroids are a fairly frequent occurrence in the reproductive age group and exclusively responsible for both infertility and pregnancy wastage in a small (5%) but significant proportion of patients. Approximately 50% of women with infertility and uterine myomas conceive after myomectomy. A slightly [...] higher proportion of women with history of recurrent pregnancy loss conceive following myomectomy. More importantly, there is highly significant reduction in early and mid trimester miscarriage rates. Evidence suggests that most women wish to conceive are able to do so in the first year, with pregnancy rates dropping sharply after this time. This may be attributed to recurrence of fibroids. If possible, therefore, the surgery should be timed to take place when the woman is ready to start a family. The site, number and size of the myomas as well as the expertise of the surgeon along with patient preference may all influence the management option. A submucous fibroid or an intramural fibroid distorting the uterine cavity, fibroids > 5 cm and multiple fibroids are all indications for surgery in woman considering a pregnancy. For relatively small (

  18. Miomatosis uterina e infertilidad: indicaciones de tratamiento convencional Conventional treatment for uterine myomatosis - induced infertility

    Directory of Open Access Journals (Sweden)

    Jaime Saavedra

    2003-06-01

    Full Text Available Los fibromas son relativamente comunes en las pacientes en edad reproductiva y son exclusivamente responsables de infertilidad y abortos en una pequeña (5% pero significante proporción de pacientes. Aproximadamente el 50% de las mujeres con infertilidad y miomas uterinos se embarazan después de miomectomía. Una proporción relativamente alta de mujeres con historia de abortos recurrentes se embaraza después miomectomía. Lo más importante, hay una disminución significativa en la tasa de abortos en el primer y segundo trimestre. La evidencia sugiere que la mayoría de mujeres que desean embarazarse son capaces de hacerlo en el primer año, con una caída de estas tasas en forma aguda después de este tiempo. Esto se puede atribuir a la recurrencia de los fibromas. Por tanto, la cirugía se debería realizar cuando la mujer esté lista para iniciar una familia. El sitio, número y tamaño de los miomas así como la experiencia del cirujano junto con la preferencia de la paciente puede influenciar la opción del manejo. Son indicaciones para realizar cirugía en una mujer que esté considerando la posibilidad de embarazo por los métodos naturales o por reproducción asistida la presencia de un mioma submucoso o un mioma intramural que distorsione la cavidad uterina, fibromas mayores de 5 centímetros y múltiples fibromas. Para fibromas intramurales menores de 5 centímetros y múltiples fibromas. Para fibromas intramurales menores de 5 centímetros y fibromas subserosos la historia reproductiva debe ser una consideración importante en la determinación en lo tocante a la necesidad de una intervención quirúrgica.Fibroids are a fairly frequent occurrence in the reproductive age group and exclusively responsible for both infertility and pregnancy wastage in a small (5% but significant proportion of patients. Approximately 50% of women with infertility and uterine myomas conceive after myomectomy. A slightly higher proportion of women with history of recurrent pregnancy loss conceive following myomectomy. More importantly, there is highly significant reduction in early and mid trimester miscarriage rates. Evidence suggests that most women wish to conceive are able to do so in the first year, with pregnancy rates dropping sharply after this time. This may be attributed to recurrence of fibroids. If possible, therefore, the surgery should be timed to take place when the woman is ready to start a family. The site, number and size of the myomas as well as the expertise of the surgeon along with patient preference may all influence the management option. A submucous fibroid or an intramural fibroid distorting the uterine cavity, fibroids > 5 cm and multiple fibroids are all indications for surgery in woman considering a pregnancy. For relatively small (< 5 cm intramural or subserosal fibroids, reproductive history is an important consideration in counseling the patient regarding the need for surgical intervention.

  19. Clinicopathologic study in uterine cancer.

    Science.gov (United States)

    Vandenput, I

    2011-01-01

    Patients with primary advanced or recurrent endometrial cancer are relatively uncommon and deserve better treatment options. Current treatment options are surgery, radiotherapy, and systemic therapy. Since the outcome is still poor, there is a need to improve our knowledge on molecular markers in order to personalize treatment. In addition, we need to continue the search for new treatment strategies with a better balance between efficacy and toxicity. In this doctoral thesis, we documented that among molecular and histological markers, blood vessel space involvement and chemotherapy induced regressive changes are new prognostic markers in endometrial cancer. We demonstrated that the tumour biology changes during tumour evolution. The optimal moment to decide on tumour biology is therefore the recurrent setting. A biopsy of the recurrent tumour is the best guarantee to characterize the tumour correctly. Furthermore, this study showed that neoadjuvant chemotherapy followed by interval debulking is a valuable treatment option for endometrial cancer with transperitoneal spread since optimal cytoreduction was achieved in 78% with a low morbidity. Future studies should look into new biomarkers that predict antitumoral activity and should search for mutations in endometrial cancer and analyse which mutation is sensitive for therapy. PMID:24753865

  20. Integral transform solution to the endometrial ablation problem

    Directory of Open Access Journals (Sweden)

    A. V. Presgrave

    2009-06-01

    Full Text Available Menorrhagia is an ailment experienced by a significant number of women during their reproductive years. This condition is associated to heavy menstrual bleeding and while medical treatments are possible, its effects are quite limited. Surgical procedures often employ a hysterectomy but the total removal of the uterus involves high costs and also sometimes a moderate health hazard. Less invasive treatments were devised, and over the years a technique called endometrial ablation has become increasingly popular especially in the United States and in Europe. This treatment removes the endometrium by inserting a latex balloon filled with a solution at a high temperature inside the uterine cavity. Therefore, in order to assess the effectiveness of this treatment, accurate predictions of the temperature field are needed. The present contribution addresses this thermal problem and adopts the Pennes' bioheat transfer equation to mathematically determine the transient temperature distribution across the uterus wall by employing finite integral transforms. Special focus is given to situations in which the temperature of the fluid inside the balloon is no longer constant and may impair the effectiveness of the treatment. On general terms, it was found that the temperature distribution is strongly dependent on the perfusion coefficient and is also significantly affected by the rate of the decay of the fluid temperature inside the balloon.

  1. Integral transform solution to the endometrial ablation problem

    Scientific Electronic Library Online (English)

    A. V., Presgrave; R. O. C., Guedes; F., Scofano Neto.

    2009-06-01

    Full Text Available Menorrhagia is an ailment experienced by a significant number of women during their reproductive years. This condition is associated to heavy menstrual bleeding and while medical treatments are possible, its effects are quite limited. Surgical procedures often employ a hysterectomy but the total rem [...] oval of the uterus involves high costs and also sometimes a moderate health hazard. Less invasive treatments were devised, and over the years a technique called endometrial ablation has become increasingly popular especially in the United States and in Europe. This treatment removes the endometrium by inserting a latex balloon filled with a solution at a high temperature inside the uterine cavity. Therefore, in order to assess the effectiveness of this treatment, accurate predictions of the temperature field are needed. The present contribution addresses this thermal problem and adopts the Pennes' bioheat transfer equation to mathematically determine the transient temperature distribution across the uterus wall by employing finite integral transforms. Special focus is given to situations in which the temperature of the fluid inside the balloon is no longer constant and may impair the effectiveness of the treatment. On general terms, it was found that the temperature distribution is strongly dependent on the perfusion coefficient and is also significantly affected by the rate of the decay of the fluid temperature inside the balloon.

  2. An analysis of DSA in uterine arteriography in uterine fibroids

    International Nuclear Information System (INIS)

    Objective: The appearances of 152 cases on DSA were analyzed to evaluate the features of blood supply and the bifurcation angle between the uterine artery and inner iliac artery for providing an interventional management guidance. Methods: All 152 cases were diagnosed by ultrasound, CT and MRI including 74 cases with tumor site in muscle layer, 32 beneath the mucosa and 46 with both of the formers. All cases were performed aortography, of them, 91 cases underwent rotational DSA. The bifurcation angle between the uterine artery and inner iliac artery was measured. The bilateral appearances of various phases on DSA and predominant types of blood supply were analyzed and compared. Results: The successful rate of catheterization with DSA was 100%. There were 81 cases (53.3%) with bifurcation angle less than 30 degree, 52 cases (34.2%) between 30 degree and 60 degree, 19 cases larger than 60 degree (12.5%). 112 cases(73.7%) revealed unilateral dominated blood supply, 98 cases with a sign of tumors wrapped by small arteries. The tumor staining signs were seen in 124 cases (81.6%). The bifurcation morphology was clearly displayed in 89 cases (97.8%). Conclusion: The uterine arteries are commonly enlarged asymmetrically in uterine fibroid with rich blood supply demonstrating contrast stain in later phase. Some of the uterine arteries having a large bifurcation angle with the iliac artery, more attention should be taken during the interventional treatment. (authors)rventional treatment. (authors)

  3. DNA damage and apoptosis of endometrial cells cause loss of the early embryo in mice exposed to carbon disulfide

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Bingzhen [Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan (China); Shen, Chunzi [Centers for Disease Control and Prevention, Zibo (China); Yang, Liu; Li, Chunhui; Yi, Anji [Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan (China); Wang, Zhiping, E-mail: zhipingw@sdu.edu.cn [Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan (China)

    2013-12-01

    Carbon disulfide (CS{sub 2}) may lead to spontaneous abortion and very early pregnancy loss in women exposed in the workplace, but the mechanism remains unclear. We designed an animal model in which gestating Kunming strain mice were exposed to CS{sub 2} via i.p. on gestational day 4 (GD4). We found that the number of implanted blastocysts on GD8 was significantly reduced by each dose of 0.1 LD{sub 50} (157.85 mg/kg), 0.2 LD{sub 50} (315.7 mg/kg) and 0.4 LD{sub 50} (631.4 mg/kg). In addition, both the level of DNA damage and apoptosis rates of endometrial cells on GD4.5 were increased, showed definite dose–response relationships, and inversely related to the number of implanted blastocysts. The expressions of mRNA and protein for the Bax and caspase-3 genes in the uterine tissues on GD4.5 were up-regulated, while the expressions of mRNA and protein for the Bcl-2 gene were dose-dependently down-regulated. Our results indicated that DNA damage and apoptosis of endometrial cells were important reasons for the loss of implanted blastocysts induced by CS{sub 2}. - Highlights: • We built an animal model of CS2 exposure during blastocyst implantation. • Endometrial cells were used in the comet assay to detect DNA damage. • CS2 exposure caused DNA damage and endometrial cell apoptosis. • DNA damage and endometrial cell apoptosis were responsible for embryo loss.

  4. DNA damage and apoptosis of endometrial cells cause loss of the early embryo in mice exposed to carbon disulfide

    International Nuclear Information System (INIS)

    Carbon disulfide (CS2) may lead to spontaneous abortion and very early pregnancy loss in women exposed in the workplace, but the mechanism remains unclear. We designed an animal model in which gestating Kunming strain mice were exposed to CS2 via i.p. on gestational day 4 (GD4). We found that the number of implanted blastocysts on GD8 was significantly reduced by each dose of 0.1 LD50 (157.85 mg/kg), 0.2 LD50 (315.7 mg/kg) and 0.4 LD50 (631.4 mg/kg). In addition, both the level of DNA damage and apoptosis rates of endometrial cells on GD4.5 were increased, showed definite dose–response relationships, and inversely related to the number of implanted blastocysts. The expressions of mRNA and protein for the Bax and caspase-3 genes in the uterine tissues on GD4.5 were up-regulated, while the expressions of mRNA and protein for the Bcl-2 gene were dose-dependently down-regulated. Our results indicated that DNA damage and apoptosis of endometrial cells were important reasons for the loss of implanted blastocysts induced by CS2. - Highlights: • We built an animal model of CS2 exposure during blastocyst implantation. • Endometrial cells were used in the comet assay to detect DNA damage. • CS2 exposure caused DNA damage and endometrial cell apoptosis. • DNA damage and endometrial cell apoptosis were responsible for embryo loss

  5. Uterine Fibroids - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Here: Home ? Multiple Languages ? All Health Topics ? Uterine Fibroids URL of this page: http://www.nlm.nih. ... W XYZ List of All Topics All Uterine Fibroids - Multiple Languages To use the sharing features on ...

  6. What Are the Symptoms of Uterine Fibroids?

    Science.gov (United States)

    ... and Publications What are the symptoms of uterine fibroids? Skip sharing on social media links Share this: Page Content ?Uterine fibroids can cause uncomfortable or sometimes painful symptoms, such ...

  7. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... lymphectomy, and hysterectomy. Just to put it in perspective, endometrial cancer will affect about 40,000 women ... we’re doing in essence is microsurgery. For perspective for the viewers, the scissors that we’re ...

  8. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... dissection regarding complications of the robotic endometrial cancer stage, he says, compared to our laparoscopic ones. In ... ovarian cancer? Do you think you can adequately stage an ovarian cancer patient with this system? 00: ...

  9. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... improved access to reach the deep pelvis. These advantages can be particularly helpful in staging endometrial cancer ... blood loss. And that’s one of the major advantages that we’ve found with this system, because ...

  10. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... has to do with the length between their pubic bone and their xiphoid, meaning how much room is ... here while we’re watching the dissection regarding complications of the robotic endometrial cancer stage, he says, ...

  11. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... Good afternoon and welcome, everybody, to our live webcast from UNC-Chapel Hill. Today we’re going to be performing a live webcast using the daVinci S system to perform an endometrial ...

  12. Robotic-Assisted Hysterectomy for Endometrial Cancer

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    Full Text Available ... perspective, endometrial cancer will affect about 40,000 women in the United States every year, making it ... the webcast. We are going to treat a woman in her 50s today who has a grade- ...

  13. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... pelvic, periaortic lymphectomy, and hysterectomy. Just to put it in perspective, endometrial cancer will affect about 40, ... women in the United States every year, making it the most common gynecologic malignancy. A significant portion ...

  14. Robotic-Assisted Hysterectomy for Endometrial Cancer

    Medline Plus

    Full Text Available ... duodenum, or small, retroperitoneal portion of the small intestine which traverses the inferior vena cava and aorta. ... some questions from how robotics has changed referral patterns. And I think, potentially, I think endometrial cancer ...