Effect of myomectomy on endometrial cavity: A prospective study of 51 cases

Bhandari, Shilpa; Ganguly, Ishita; Agarwal, Pallavi; Singh, Aparna; Gupta, Nitika

doi:10.4103/0974-1208.183509

Cited by 23 publications

(24 citation statements)

References 21 publications

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“…One patient developed a broad ligament hematoma, two developed postoperative fever, and one underwent open subtotal hysterectomy 9 hours after surgery for dilutional coagulopathy. Authors concluded that myomectomy for very large fibroids by laparoscopy is a safe alternative to laparotomy for very large myomas [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

Prevention and Management of Complications in Laparoscopic Myomectomy

Tanos

Berry

Frist

et al. 2018

BioMed Research International

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Myomectomy aims to preserve fertility, treat abnormal uterine bleeding, and alleviate pain. It should cause minimal damage to the endometrium, while being tolerable and durable, and reduce the incidence of myoma recurrence and complications including bleeding, hematoma, adhesions, and gravid uterus perforation. Training and experience are crucial to reduce complications. The surgical strategy depends on imaging information on the myomas. The position of the optical and secondary ports will determine the degree of ergonomic surgery performance, time and difficulty of myoma enucleation, and the suturing quality. Appropriate hysterotomy length relative to myoma size can decrease bleeding, coagulation, and suturing times. Bipolar coagulation of large vessels, while avoiding carbonization and myometrium gaps after suturing, may decrease the risk of myometrial hematoma. Quality surgery and the use of antiadhesive barriers may reduce the risk of postoperative adhesions. Slow rotation of the beveled morcellator and good control of the bag could reduce de novo myoma and endometriosis. Low intra-abdominal CO2 pressure may reduce the risk of benign and malignant cell dissemination. The benefits a patient gains from laparoscopic myomectomy are greater than the complication risks of laparoscopic morcellation. Recent publications on laparoscopic myomectomies demonstrate reduced hospitalization stays, postoperative pain, blood loss, and recovery compared to open surgery.

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Section: Methodsmentioning

confidence: 99%

Prevention and Management of Complications in Laparoscopic Myomectomy

Tanos

Berry

Frist

et al. 2018

BioMed Research International

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“…In addition, Bhandari et al [13] reported that, most of the participants [72.55%] were cases of primary infertility.…”

Section: Discussionmentioning

confidence: 99%

“…Bhandari et al [13] reported that, of the 50 patients underwent myomectomy, intrauterine adhesions were observed in consequent hysteroscopy in 11 cases [21.57%]. They added, of these 11 adhesion cases, mild adhesions were noted in seven cases, while moderate adhesions were present in three cases.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of intrauterine adhesions after hysteroscopic myomectomy by integrated Bigatti Shaver (IBS)

Awad¹,

Anter

Ayad

2019

International Journal of Medical Arts

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Background: Myomectomy is the best procedure for treatment of uterine fibroids. However, post-myomectomy adhesions represent a major problem. The introduction of hysteroscopic myomectomy thought to reduce these adhesions. However, the incidence is not determined after different shavers. Aim of the work: To assess the prevalence of adhesions in women undergoing IBS-myomectomy for uterine fibroids. Patients and methods: The study included 70 women indicated for IBS myomectomy. Eligible females were submitted to full history taking, clinical examination and routine laboratory investigations. In addition, all patients underwent transvaginal ultrasonography. Fibroid grade was defined and hysteroscopic myomectomy. Then office hysteroscopy was done after 3 months of the procedure, and any pathology especially intrauterine adhesions was reported. Patients were classified into two groups; with adhesions and without adhesions. Results: The incidence of adhesions was 5.7%. The development of adhesion was usually associated with multiple myomas present in posterior position who need long resection time and usually the resection is incomplete. The adhesions were usually mild [75%] and there was no complications were reported after hysteroscopic myomectomy. Conclusion: The incidence of intrauterine adhesion after the hysteroscopic myomectomy by IBS is low

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“…Myomectomy would result in uterine scarring and synechiae further worsening the subfertility. This can be ruled out through hysteroscopy which is useful for diagnosis and treatment of the intrauterine adhesions [15]. One of our clients had undergone two previous myomectomies and was found to have an endometrial polyp which was hysteroscopically resected after which she was able to conceive through ART.…”

Section: Discussionmentioning

confidence: 99%

Childbearing at very advanced maternal age, the challenges and complications: A report of two cases

Oindi¹,

Sequeira²,

Mutiso³

2017

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. The desire for childbearing at very advanced maternal age (maternal age ≥45 years at the time of delivery) is becoming increasingly common. This has resulted in increased demand and utilization of assisted reproductive technologies to counteract the declining fecundity associated with the advanced maternal age. However, the older gravidas are at increased risk of having various medical conditions with potential adverse impact on their pregnancies making such pregnancies be considered as high risk pregnancies. Case Report: We present two cases of very advanced maternal age pregnancies (54-year-old and 49-year-old), both conceived through assisted reproductive technology, we successfully managed through their pregnancies outlining the conception challenges, pregnancy complications and the subsequent management and outcomes. We further undertake a literature review to assess the challenges and outcomes of pregnancies at very advanced maternal age. Conclusion: Childbearing at very advanced maternal age is challenging from conception to delivery. Owing to the age related decline in fertility, most of these women require assisted reproductive technology (ART). Moreover, they are more likely to have adverse pregnancy outcomes principally stemming from preterm births with a resultant greater maternal and perinatal mortality and morbidity. With the increasing trend towards delayed child bearing, and owing to the anticipated adverse pregnancy outcomes, the hospitals and physicians needs to equip themselves for the increased demand for ART and the need for sophisticated prenatal, perinatal and postpartum care. IJCRI publishes

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Effect of myomectomy on endometrial cavity: A prospective study of 51 cases

Cited by 23 publications

References 21 publications

Prevention and Management of Complications in Laparoscopic Myomectomy

Prevention and Management of Complications in Laparoscopic Myomectomy

Prevalence of intrauterine adhesions after hysteroscopic myomectomy by integrated Bigatti Shaver (IBS)

Childbearing at very advanced maternal age, the challenges and complications: A report of two cases

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