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Coexistence of myomas and endometriosis
August 2001, Vol. 8, No. 3 Supplement
The Journal of the American Association of Gynecologic Laparoscopists
Conclusion. Because of these very positive results, we are now routinely using the Plasma_kinetic TM electrosurgery system for our laparoscopic procedures.
Conclusion. Endometrial polyp growth in postmenopausal women correlates with the presence of c-erbB2 overexpression in these neoplasms.
128. Complications of Primary versus Repeat Endometrial Ablation
130. Insertion of Levonorgestrel I UD after Endometrial Resection H Maia, A Maltez, G Coelho, EM Coutinho. Endoscopy Unit, CEPARH, Salvador, Bahia, Brazil.
E MacLean-Fraser, D Penava, G Vilos. London Health Sciences Centre, London, Ontario, Canada; St. Joseph's Health Centre, London, Ontario, Canada.
Objective. To assess the efficacy of a levonorgestrel IUD (LVN-IUD) on the frequency of amenorrhea after hysteroscopic endometrial ablation. Measurements and Main Results. Seven women with menorrhagia and adenomyosis, eight with endometrial polyps, eight with dysfunctional endometrium, and two with endometrial hyperplasia were enrolled. An LVN-IUD was inserted at endometrial resection with no complications. Spotting was reported by approximately 40% of women at the end of the first month; however, after 6 months, all 25 reported amenorrhea. Conclusion. Inserting an LVN-IUD after endometrial resection is an effective way of inducing amenorrhea, at least in short-term follow-up.
Objective. To determine if the complication rate with repeat endometria1 ablation is higher than that with primary ablation. Measurements and Main Results. Subjects were 75 women who had repeat ablation and 800 who had primary ablation by the same surgeon for a diagnosis of menorrhagia and/or dysmenorrhea. Hysteroscopic ablation involved coagulation or resection of endometrium. Patients had repeat ablation after failure of the first. Serious complications were uterine perforation, hemorrhage, and excess fluid absorption. These occurred in 9.3% of repeat ablations compared with 2.05% of primary ablations (p <0.006). Conclusion. Repeat endometrial ablation has a significantly higher rate of serious complications than primary ablation.
131. Coexistence of Myomas and Endometriosis SF Malek. Lutheran Medical Center, Brooklyn, New York.
129. Comparison Between Hysteroscopic Findings and Immunohistochemistry in Evaluation of Endometrial Polyp Growth in Postmenopausal Women
Objective. To determine the frequency with which myomas and endometriosis coexist. Measurements and Main Results. Of 255 women (mean age 39 yrs), 144 (64%) had pain; other symptoms were bleeding, infertility, and palpable mass. All patients desired to preserve their uterus. Threepuncture laparoscopic myomectomy was performed, and during each procedure, regardless of the patient's symptoms, careful inspection of the pelvis was performed to examine the appearance of endometriosis, with vaginal, and rectal probes to identify hidden lesions. All endometriotic lesions were excised completely before myomectomy whenever possible. Histopathologic examination identified lesions as endometriosis or endometriosis-related tissue. Grossly, the lesions were black, red, white, or infilterating. Some were scarred or healed. Conclusion. The high frequency with which endometriosis coexists with myomas alerts surgeons to inspect the pelvis for those lesions during laparoscopic myomectomy, especially in patients with pain.
H Maia, Jr, A Maltez, EM Coutinho. Endoscopy Unit, CEPARH, Salvador, Bahia, Brazil.
Objective. To evaluate the frequency of c-erbB2 overexpression between atrophic and vascularized endometrial polyps removed by hysteroscopy. Measurements and Main Results. We studied the frequency of c-erbB2 overexpression and Ki-67 proliferation markers in endometrial polyps from 55 postmenopausal women that did or did not show signs of atrophy. Eight polyps showing signs of atrophy were negative for c-erbB2 overexpression and had low percentages of cell nuclei positive for Ki-67 proliferation markers. Ninety percent of vascularized polyps had c-erbB2 overexpression that was associated with higher percentages of cells showing positivity for Ki-67.
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The Journal of the American Association of Gynecologic Laparoscopists
Conclusion. Because of these very positive results, we are now routinely using the Plasma_kinetic TM electrosurgery system for our laparoscopic procedures.
Conclusion. Endometrial polyp growth in postmenopausal women correlates with the presence of c-erbB2 overexpression in these neoplasms.
128. Complications of Primary versus Repeat Endometrial Ablation
130. Insertion of Levonorgestrel I UD after Endometrial Resection H Maia, A Maltez, G Coelho, EM Coutinho. Endoscopy Unit, CEPARH, Salvador, Bahia, Brazil.
E MacLean-Fraser, D Penava, G Vilos. London Health Sciences Centre, London, Ontario, Canada; St. Joseph's Health Centre, London, Ontario, Canada.
Objective. To assess the efficacy of a levonorgestrel IUD (LVN-IUD) on the frequency of amenorrhea after hysteroscopic endometrial ablation. Measurements and Main Results. Seven women with menorrhagia and adenomyosis, eight with endometrial polyps, eight with dysfunctional endometrium, and two with endometrial hyperplasia were enrolled. An LVN-IUD was inserted at endometrial resection with no complications. Spotting was reported by approximately 40% of women at the end of the first month; however, after 6 months, all 25 reported amenorrhea. Conclusion. Inserting an LVN-IUD after endometrial resection is an effective way of inducing amenorrhea, at least in short-term follow-up.
Objective. To determine if the complication rate with repeat endometria1 ablation is higher than that with primary ablation. Measurements and Main Results. Subjects were 75 women who had repeat ablation and 800 who had primary ablation by the same surgeon for a diagnosis of menorrhagia and/or dysmenorrhea. Hysteroscopic ablation involved coagulation or resection of endometrium. Patients had repeat ablation after failure of the first. Serious complications were uterine perforation, hemorrhage, and excess fluid absorption. These occurred in 9.3% of repeat ablations compared with 2.05% of primary ablations (p <0.006). Conclusion. Repeat endometrial ablation has a significantly higher rate of serious complications than primary ablation.
131. Coexistence of Myomas and Endometriosis SF Malek. Lutheran Medical Center, Brooklyn, New York.
129. Comparison Between Hysteroscopic Findings and Immunohistochemistry in Evaluation of Endometrial Polyp Growth in Postmenopausal Women
Objective. To determine the frequency with which myomas and endometriosis coexist. Measurements and Main Results. Of 255 women (mean age 39 yrs), 144 (64%) had pain; other symptoms were bleeding, infertility, and palpable mass. All patients desired to preserve their uterus. Threepuncture laparoscopic myomectomy was performed, and during each procedure, regardless of the patient's symptoms, careful inspection of the pelvis was performed to examine the appearance of endometriosis, with vaginal, and rectal probes to identify hidden lesions. All endometriotic lesions were excised completely before myomectomy whenever possible. Histopathologic examination identified lesions as endometriosis or endometriosis-related tissue. Grossly, the lesions were black, red, white, or infilterating. Some were scarred or healed. Conclusion. The high frequency with which endometriosis coexists with myomas alerts surgeons to inspect the pelvis for those lesions during laparoscopic myomectomy, especially in patients with pain.
H Maia, Jr, A Maltez, EM Coutinho. Endoscopy Unit, CEPARH, Salvador, Bahia, Brazil.
Objective. To evaluate the frequency of c-erbB2 overexpression between atrophic and vascularized endometrial polyps removed by hysteroscopy. Measurements and Main Results. We studied the frequency of c-erbB2 overexpression and Ki-67 proliferation markers in endometrial polyps from 55 postmenopausal women that did or did not show signs of atrophy. Eight polyps showing signs of atrophy were negative for c-erbB2 overexpression and had low percentages of cell nuclei positive for Ki-67 proliferation markers. Ninety percent of vascularized polyps had c-erbB2 overexpression that was associated with higher percentages of cells showing positivity for Ki-67.
$39