Myoma of uterus has the highest incidence in gynecological tumors.The incidence rate is increasing year by year,which is the main indication for hysterectomy.Non-surgical treatment is often adopted for young patients ...Myoma of uterus has the highest incidence in gynecological tumors.The incidence rate is increasing year by year,which is the main indication for hysterectomy.Non-surgical treatment is often adopted for young patients with fertility requirements.The treatment methods for myoma of uterus are reviewed in this article.展开更多
Objective To study the effectiveness and acceptability of the medical termination of early pregnancy accompanied with myoma Methods A total of 92 early pregnant women with myoma were admitted. Every woman was administ...Objective To study the effectiveness and acceptability of the medical termination of early pregnancy accompanied with myoma Methods A total of 92 early pregnant women with myoma were admitted. Every woman was administrated mifepristone 150 mg in the first two days and Misoprostol 1 000 μg on d 3.Results The complete abortion rate was 89. 13%. The average bleeding duration was 11. 89± 6. 87 d. The expulsion time of gestational cyst was affected by the size of myoma. The bleeding duration and the expulsion time of gestational cyst were affected by the size of myoma and gestational cyst. The location and the number of myoma had no effect on the bleeding duration and the recovery of menses.Conclusion Mifepristone and Misoprostol could be safely and effectively used in the termination of early pregnancy with myoma.展开更多
BACKGROUND Uterine myomas are the most common benign gynecological soft tissue tumors in women but polycythemia associated with these tumors is rare.Polycythemia is significantly associated with risk of venous thrombo...BACKGROUND Uterine myomas are the most common benign gynecological soft tissue tumors in women but polycythemia associated with these tumors is rare.Polycythemia is significantly associated with risk of venous thromboembolism(VTE),which is further increased in case of a large pelvic mass and obesity.Here we report the surgical challenges in the case of an obese patient with a giant fibromatous uterus and associated polycythemia.CASE SUMMARY A 42-year-old obese woman was referred to our department for treatment for a huge fibromatous uterus.She suffered of pelvic pressure and abdominal distension and reported severe dyspnea from several months.Laboratory analyses including hemoglobin(Hb)19.2 g/dL and hematocrit(Hct)59.7%were indicative of polycythemia.Arterial blood gas analysis showed arterial oxygen pressure(pO2)of 81.5 mmHg.Abdominal computed tomography confirmed a giant fibromatous uterus measuring 28.2 cm×17 cm×25 cm.To reduce the thromboembolic risk,the patient underwent low molecular weight heparin,phlebotomy twice before surgery,and we opted for a laparoscopic hysterectomy.The uterus weighed 5400 g and the histology confirmed a diagnosis of leiomyoma.We did not find increased erythropoietin levels in the supernatant of the myomatous uterine tissue.There were no complications.On postoperative day 1,the Hb and the Hct levels normalized to 13.3 g/dL and 41.7%,respectively.Arterial blood gas analysis after surgery showed a pO2 of 144.7 mmHg.These results suggested the diagnosis of myomatous erythrocytosis syndrome.The patient was discharged on the second postoperative day in very good condition with no symptoms.CONCLUSION We believe this is the first reported laparoscopic hysterectomy in a patient with a giant uterus,polycythemia and obesity.Multiple VTE risk factors warranted a laparoscopic approach.展开更多
BACKGROUND Hypermenorrhea is characterized by excessive menstrual bleeding that causes severe anemia and interferes with everyday life.This condition can restrict women’s social activities and decrease their quality ...BACKGROUND Hypermenorrhea is characterized by excessive menstrual bleeding that causes severe anemia and interferes with everyday life.This condition can restrict women’s social activities and decrease their quality of life.Microwave endometrial ablation(MEA)using a 2.45-GHz energy source is a minimally invasive alternative to conventional hysterectomy for treating hypermenorrhea that is resistant to conservative treatment,triggered by systemic disease or medications,or caused by uterine myomas and fibrosis.The popularity of MEA has increased worldwide.Although MEA can safely and effectively treat submucous myomas,some patients may still experience recurrent hypermenorrhea postoperatively and may require additional treatment.AIM To investigate the efficacy of MEA combined with transcervical resection(TCR).METHODS Participants underwent cervical and endometrial evaluations.Magnetic resonance imaging and hysteroscopy were performed to evaluate the size and location of the myomas.TCR was performed before MEA using a hystero-resectoscope.MEA was performed using transabdominal ultrasound.The variables included operation time,number of ablation cycles,length of hospital stay,and visual analog scale cores for hypermenorrhea,dysmenorrhea,and treatment satisfaction at 3 and 6 mo postoperatively.The postoperative incidence of amenorrhea,changes in hemoglobin concentrations,and MEA-related complications were evaluated.RESULTS A total of 34 women underwent a combination of MEA and TCR during the study period.Two patients were excluded from the study as their histopathological tests identified uterine malignancies(uterine sarcoma and endometrial cancer).The 32 eligible women(6 nulliparous,26 multiparous)had a mean age of 45.2±4.3 years(range:36–52 years).Patients reported very severe hypermenorrhea(10/10 points on the visual analog scale)before the procedure.However,after the procedure,the hypermenorrhea scores decreased to 1.2±1.3 and 0.9±1.3 at 3 and 6 mo,respectively(P<0.001).The mean follow-up duration was 33.8±16.8 mo.Although 10 women(31.3%)developed amenorrhea during this period,none experienced a recurrence of hypermenorrhea.No surgical complications were observed.CONCLUSION Reducing the size of uterine myomas by combining MEA and TCR can safely and effectively treat hypermenorrhea in patients with submucous myomas.展开更多
基金Supported by Applied Basic Research Joint Special Fund Project of Yunnan Provincial Department of Science and Technology and Yunnan University of Traditional Chinese Medicine(2018FF001(-046))Key Laboratory of Dai and Yi Medicine in Yunnan Province(2017DG006)+1 种基金National Key Research Program of China(2017YFC1703901)Scientific Research Fund Project of Yunnan Provincial Department of Education(2017ZDX228)
文摘Myoma of uterus has the highest incidence in gynecological tumors.The incidence rate is increasing year by year,which is the main indication for hysterectomy.Non-surgical treatment is often adopted for young patients with fertility requirements.The treatment methods for myoma of uterus are reviewed in this article.
文摘Objective To study the effectiveness and acceptability of the medical termination of early pregnancy accompanied with myoma Methods A total of 92 early pregnant women with myoma were admitted. Every woman was administrated mifepristone 150 mg in the first two days and Misoprostol 1 000 μg on d 3.Results The complete abortion rate was 89. 13%. The average bleeding duration was 11. 89± 6. 87 d. The expulsion time of gestational cyst was affected by the size of myoma. The bleeding duration and the expulsion time of gestational cyst were affected by the size of myoma and gestational cyst. The location and the number of myoma had no effect on the bleeding duration and the recovery of menses.Conclusion Mifepristone and Misoprostol could be safely and effectively used in the termination of early pregnancy with myoma.
文摘BACKGROUND Uterine myomas are the most common benign gynecological soft tissue tumors in women but polycythemia associated with these tumors is rare.Polycythemia is significantly associated with risk of venous thromboembolism(VTE),which is further increased in case of a large pelvic mass and obesity.Here we report the surgical challenges in the case of an obese patient with a giant fibromatous uterus and associated polycythemia.CASE SUMMARY A 42-year-old obese woman was referred to our department for treatment for a huge fibromatous uterus.She suffered of pelvic pressure and abdominal distension and reported severe dyspnea from several months.Laboratory analyses including hemoglobin(Hb)19.2 g/dL and hematocrit(Hct)59.7%were indicative of polycythemia.Arterial blood gas analysis showed arterial oxygen pressure(pO2)of 81.5 mmHg.Abdominal computed tomography confirmed a giant fibromatous uterus measuring 28.2 cm×17 cm×25 cm.To reduce the thromboembolic risk,the patient underwent low molecular weight heparin,phlebotomy twice before surgery,and we opted for a laparoscopic hysterectomy.The uterus weighed 5400 g and the histology confirmed a diagnosis of leiomyoma.We did not find increased erythropoietin levels in the supernatant of the myomatous uterine tissue.There were no complications.On postoperative day 1,the Hb and the Hct levels normalized to 13.3 g/dL and 41.7%,respectively.Arterial blood gas analysis after surgery showed a pO2 of 144.7 mmHg.These results suggested the diagnosis of myomatous erythrocytosis syndrome.The patient was discharged on the second postoperative day in very good condition with no symptoms.CONCLUSION We believe this is the first reported laparoscopic hysterectomy in a patient with a giant uterus,polycythemia and obesity.Multiple VTE risk factors warranted a laparoscopic approach.
文摘BACKGROUND Hypermenorrhea is characterized by excessive menstrual bleeding that causes severe anemia and interferes with everyday life.This condition can restrict women’s social activities and decrease their quality of life.Microwave endometrial ablation(MEA)using a 2.45-GHz energy source is a minimally invasive alternative to conventional hysterectomy for treating hypermenorrhea that is resistant to conservative treatment,triggered by systemic disease or medications,or caused by uterine myomas and fibrosis.The popularity of MEA has increased worldwide.Although MEA can safely and effectively treat submucous myomas,some patients may still experience recurrent hypermenorrhea postoperatively and may require additional treatment.AIM To investigate the efficacy of MEA combined with transcervical resection(TCR).METHODS Participants underwent cervical and endometrial evaluations.Magnetic resonance imaging and hysteroscopy were performed to evaluate the size and location of the myomas.TCR was performed before MEA using a hystero-resectoscope.MEA was performed using transabdominal ultrasound.The variables included operation time,number of ablation cycles,length of hospital stay,and visual analog scale cores for hypermenorrhea,dysmenorrhea,and treatment satisfaction at 3 and 6 mo postoperatively.The postoperative incidence of amenorrhea,changes in hemoglobin concentrations,and MEA-related complications were evaluated.RESULTS A total of 34 women underwent a combination of MEA and TCR during the study period.Two patients were excluded from the study as their histopathological tests identified uterine malignancies(uterine sarcoma and endometrial cancer).The 32 eligible women(6 nulliparous,26 multiparous)had a mean age of 45.2±4.3 years(range:36–52 years).Patients reported very severe hypermenorrhea(10/10 points on the visual analog scale)before the procedure.However,after the procedure,the hypermenorrhea scores decreased to 1.2±1.3 and 0.9±1.3 at 3 and 6 mo,respectively(P<0.001).The mean follow-up duration was 33.8±16.8 mo.Although 10 women(31.3%)developed amenorrhea during this period,none experienced a recurrence of hypermenorrhea.No surgical complications were observed.CONCLUSION Reducing the size of uterine myomas by combining MEA and TCR can safely and effectively treat hypermenorrhea in patients with submucous myomas.
