OC22.01: Who is at risk of endometrial cavity breach at laparoscopic myomectomy?

Rajah, K.; Kriedt, Kathiuska; Balachandren, Neerujah; Moghazy, M.; Burt, Elizabeth; Mavrelos, D.

doi:10.1002/uog.19354

Cited by 2 publications

(2 citation statements)

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“…Preoperative ultrasound variables able to predict the risk for endometrial cavity breach in laparoscopic myomectomy have been analyzed in a recent retrospective study, and the protrusion ratio was the best predictor for cavity breach (OR 1.22). Compared to women who did not have the intraoperative uterine cavity opening, it appears that the risk was higher in women with smaller fibroids, closer to the cavity, with a greater intracavity surface area and smaller extra-cavity size [24]. Type and size of the largest myoma, number of fibroids removed, and previous surgery have also been identified in our study as factors univariately associated ( p < 0.2) with the presence of intrauterine adhesions after myomectomy along with breach of the cavity and laparotomic surgery.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Intrauterine Adhesions after Myomectomy: A Prospective Multicenter Observational Study

Laganà¹,

Garzon²,

Dababou³

et al. 2022

Gynecol Obstet Invest

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Objectives: To evaluate intrauterine adhesion formation after laparoscopic and laparotomic myomectomy. Design: Prospective, multicenter, observational study (ClinicalTrials.gov ID: NCT04030273). Methods: We included patients after laparotomic and laparoscopic myomectomy. All patients underwent post-surgical diagnostic hysteroscopy, after three months. The intrauterine adhesion rate and associated factors were investigated. Results: Between January 2020 and December 2020, 38 and 24 consecutive patients underwent laparoscopic and laparotomic myomectomy, respectively. All diagnostic hysteroscopies were performed in the office setting without complications. Intrauterine adhesions were identified in 19.4% of women (95% CI of 9 – 29%). Factors univariately associated (p <0.2) with the presence of intrauterine adhesions after myomectomy were previous uterine surgery, the surgical approach (laparoscopic or laparotomic), the number of removed fibroids, the type and diameter of the largest myoma, and the opening of the uterine cavity. In the multivariable analysis, only the opening of the uterine cavity (OR 51.99; 95% CI, 4.53 – 596.28) and the laparotomic approach (OR, 16.19; 95% CI, 1.66 – 158.35) were independently associated with the identification of intrauterine adhesions after myomectomy. Limitations: One of the main limitations of our study is that we used uterine manipulator only in laparoscopic group; in addition, we did not perform a pre-operative hysteroscopy to evaluate the rate of intrauterine adhesions potentially present even before the myomectomy. Conclusions: The prevalence of intrauterine adhesions after three months from surgery was significantly associated with the opening of the uterine cavity and the laparotomic approach.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Intrauterine Adhesions after Myomectomy: A Prospective Multicenter Observational Study

Laganà¹,

Garzon²,

Dababou³

et al. 2022

Gynecol Obstet Invest

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“…Patients with IUA may present with a high rate of infertility, recurrent miscarriage, abnormal menstruation and cyclic pain (2,3). IUA can be induced by various risk factors including miscarriage curettage, postpartum curettage, gynecologic surgeries, and infection, among which miscarriage curettage was the dominating predisposing factor accounting for 66.7% (4,5). However, the true prevalence of IUA is difficult to determine, as a large number of patients are asymptomatic (6).…”

Section: Introductionmentioning

confidence: 99%

Extracellular Vesicles Derived from Mesenchymal Stem Cells as Cell-Free Therapy for Intrauterine Adhesion

2023

Int J Stem Cells

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Intrauterine adhesion (IUA) can occur after trauma to the basal layer of the endometrium, contributing to severe complications in females, such as infertility and amenorrhea. To date, the proposed therapeutic strategies are targeted to relieve IUA, such as hysteroscopic adhesiolysis, Foley catheter balloon, and hyaluronic acid injection have been applied in the clinic. However, these approaches showed limited effects in alleviating endometrial fibrosis and thin endometrium. Mesenchymal stem cells (MSCs) can offer the potential for endometrium regeneration owing to reduce inflammation and release growth factors. On this basis, MSCs have been proposed as promising methods to treat intrauterine adhesion. However, due to the drawbacks of cell therapy, the possible therapeutic use of extracellular vesicles released by stem cells is raising increasing interest. The paracrine effect, mediated by MSCs derived extracellular vehicles (MSC-EVs), has recently been suggested as a mechanism for their therapeutic properties. Here, we summarizes the main pathological mechanisms involved in intrauterine adhesion, the biogenesis and characteristics of extracellular vesicles, explaining how these vesicles could provide new opportunities for MSCs.

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OC22.01: Who is at risk of endometrial cavity breach at laparoscopic myomectomy?

Cited by 2 publications

References 0 publications

Prevalence of Intrauterine Adhesions after Myomectomy: A Prospective Multicenter Observational Study

Prevalence of Intrauterine Adhesions after Myomectomy: A Prospective Multicenter Observational Study

Extracellular Vesicles Derived from Mesenchymal Stem Cells as Cell-Free Therapy for Intrauterine Adhesion

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