No abstract

No abstract

FMC levels could identify pregnancy-related abnormalities requiring compression ultrasonography examination, without changing the cut-off values for non-pregnant individuals. Thus, this marker may be used to screen for VTE.

In the presence of the uterus, it is rare that vaginal intraepithelial neoplasia (VAIN) alone exists. We described our experience with a case in which VAIN3 was found in the vaginal fornix without lesions in the uterine cervix. She had cervical intraepithelial neoplasm (CIN) 1 several years ago. After that, it disappeared. However, high-grade squamous intraepithelial lesion persisted cytologically. After hysterectomy was performed, VAIN3 was found in the vaginal fornix. CIN was not found in the cervix. We are apt to suspect endocervical lesions when Papanicolau (Pap) smear shows abnormalities and colposcopy fails to identify columnar epithelium. However, we need to keep in mind that the vaginal fornix may have a lesion. It may be difficult to assess the vaginal fornix in young women because of a large cervix. The presence of VAIN should also be considered when cytological abnormalities persist on Pap smears.

Submucosal myomas often become pedunculated and pass through the cervix, resulting in episodes of major genital hemorrhage. We attempted the removal of prolapsed uterine myomas in an outpatient, using a loop ligator device (ENDOLOOP PDS II ETHICON ®). Here, we report our experience with successful removal of multiple transvaginal uterine myomas by ligation of the stem. A 52-year-old patient (gravida 3, para 2) presented with severe anemia secondary to hypermenorrhea. Colposcopic examination, transvaginal ultrasonography, and pelvic magnetic resonance imaging led to the diagnosis of a prolapsed uterine myoma. For personal reasons, the patient requested outpatient management and underwent treatment with loop ligation. Following ligation, the hypermenorrhea improved, without exacerbation of anemia or signs of infection. The submucosal myoma gradually receded due to the decreased blood flow caused by ligation. At 41 months after initial evaluation, myoma resection was performed using hysteroscopy. The uterine myoma was suspended by a thick stem; therefore, several ligation treatments were performed over an extended period. Ligation was aimed at cutting off the blood flow to the prolapsed uterine myoma. Even if blood flow could not be completely cut off, ligation was expected to decrease the uterine myoma size by decreasing blood flow.