In recent decades, there has been increasing attention toward the quality of life of breast cancer (BC) survivors. Meeting the growing expectations of fertility preservation and the generation of biological offspring remains a great challenge for these patients. Conventional strategies for fertility preservation such as oocyte and embryo cryopreservation are not suitable for prepubertal cancer patients or in patients who need immediate cancer therapy. Ovarian tissue cryopreservation (OTC) before anticancer therapy and autotransplantation is an alternative option for these specific indications but has a risk of retransplantation malignant cells. An emerging strategy to resolve these issues is by constructing an artificial ovary combined with stem cells, which can support follicle proliferation and ensure sex hormone secretion. This promising technique can meet both demands of improving the quality of life and meanwhile fulfilling their expectation of biological offspring without the risk of cancer recurrence.
Zusammenfassung Fragestellung: Die laparoskopische suprazervikale Hysterektomie (LASH) ist bei benignen, therapieresistenten uterinen Erkrankungen eine Alternative zur totalen Hysterektomie. Es gibt nur wenig Daten zur Methodik und Präparation, Technik, Komplikationen und postoperativem Befinden aus dem deutschen Sprachraum. Material und Methodik: In sechs vergleichbaren Tageskliniken des VAAO wurden zwischen dem 1. 4. 2003 und dem 31. 3. 2004 191 laparoskopische suprazervikale Hysterektomien (LASH) prospektiv erfasst. Prä-, intra-und postoperativ wurden relevante Daten in einem einheitlichen Fragebogen erhoben. Alle Patientinnen wurden sechs Monate nach der Operation nachbefragt. Ergebnisse: Das Alter der Patientinnen betrug im Mittel 43 Jahre. Die Hauptindikation zur Operation waren Blutungsstörungen und Dysmenorrhö (65%). Die durchschnittliche Operationszeit lag bei 119 Minuten. Das Durchschnittsgewicht der durch Morcellement extrahierten Korpusanteile betrug 239 g. Die Arteriae uterinae wurden überwiegend bipolar koaguliert (81%). Am häu-
AbstractStudy Objective: Laparoscopic supracervical hysterectomy (LASH) is an alternative to total hysterectomy for benign conditions in cases where conservative treatment options fail and hysterectomy is indicated. Only little data from German-speaking countries concerning surgical techniques, postoperative wellbeing and complications is available. Methods: The data of 191 patients scheduled for laparoscopic supracervical hysterectomy were prospectively registered between April 1, 2003 and March 31, 2004. A questionnaire was filled in by the physician recording data pre-, intra-and postoperatively. All patients were interviewed six months after surgery and asked about their well-being, possible complaints and their fitness to work by telephone. Results: The average age of the patients was 43 years. The main indications for the operation were abnormal uterine bleeding and dysmenorrhea (65%). The mean operation time was 119 minutes and the average weight of the uterus corpus was 239 g. The uterine arteries were coagulated with bipolar current in most
Uterine artery embolization (UAE) is a common minimally invasive treatment of different uterine pathologies, such as fibroids, adenomyosis, and menorrhagia. The procedure involves the injection of embolic agents into the uterine arteries, whereby various particles can be used, such as polyvinyl alcohol (PVA). Complication of UAE is the dispersion of polyvinyl alcohol (PVA) microsphere particles in the uterine body which can lead to a granular vaginal discharge. We report the management of complications of PVA microspheres dispersed from the uterine body causing postprocedural discomfort due to the vaginal passage of microspheres or because of an induced fibroid-size enlargement. The dispersion of the PVA microspheres is one example of a minor UAE complication, which nevertheless causes significant distress to the patient and eventfully requires further surgical interventions.
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