- Email: [email protected]
Uterine artery embolization in the treatment of adenomyosis
Abstracts
for 2 weeks after surgery. Infection was suspected in one woman who was treated with antibiotics without sequelae. After a minimum of 6-30 weeks' follow-up, 41 (80%), 21 (78%), and 35 (95%), patients respectively, reported improvement in menorrhagia, dysmenorrhea, and pelvic pain. Two (3%) failed to report improvement. In one patient (1.61%), hysterectomy was performed for massive menometrorrhagia 4 months after ligation. Reductions in dominant myoma volume (average 54%) were seen on US. Conclusion. Laparoscopic ligation of uterine artery may be a minimally invasive method of treating myomarelated hypermenorrhea, pelvic pain, and possibly dysmenorrhea when performed by an experienced endoscopist.
Measurements and Main Results. In 240 women with clinical, biochemical, US, CT, and MRI diagnoses of benign dermoid cysts, the cysts were extracted by Endopouch (99 cases); puncture, irrigation, and extraction (69); colpotomy (35); and pouch bag (44). We analyzed irrigation amount, operating time, postoperative hospital stay, and complications for the four methods. Endopouch extraction required less irrigation fluid for cleaning the abdominal cavity and led to a shorter postoperative hospital stay (ANOVA, p = 0.0001). There were no significant differences in operating times among techniques. Four women had significant morbidity: three had fever (>38 ~ C) and one an intraabdominal abscess after puncture, irrigation, extraction. One incisional hernia occurred after pouch bag method. Conclusion. For minimal spillage in extracting dermoid cysts and careful irrigation of abdominal cavity to prevent potential risk of chemical peritonitis, we recommend Endopouch, pouch bag, and colpotomy, but not the puncture, irrigation, extraction method.
96. Uterine Artery Embolization in the Treatment of Adenomyosis WH Lee, TW Sunwoo, EH Lee, C Lee, SH Cha, JR Son, CS Ahn, CN Lee, KY Cha. Pundang CHA General Hospital, College of Medicine, Pochon CHA University, Sungnam City, Korea.
98. Transvaginal Ultrasonography of Adnexal Masses; What Is the Significance of Septation?
Objective. To assess the efficacy and safety of uterine artery embolization for treatment of uterine adenomyosis. Measurements" and Main Results. Nineteen women (age 32-54 yrs) with menorrhagia and/or severe dysmenorrhea underwent uterine artery embolization with digital subtraction angiography. Adenomyosis was evaluated by physical examination and confirmed by US and MR1. All patients were discharged 1 day after the procedure, except two in whom intractable pain persisted due to uterine ischemia. Symptomatic improvement of menorrhagia and/or dysmenorrhea was reported by 18 patients (94.73%) at next menstruation. One woman had hysterectomy because of recurrent symptoms. In 18 patients, reductions of mean volume of adenomyosis on MRI were 30.6% (range 2.7-74.2%). Mean changes in CA 125 were 74.2% in all patients except one. No intraprocedural complications occurred. Conclusion. Embolization is an effective alternative for women with symptomatic adenomyosis.
M Levie, RJ Klein, J Hochsztein, E Feldschreiber. Jack D. Weiler Hospital of the Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
Objective. To assess the significance of the presence, number, and thickness of septations within a cystic adnexal mass in predicting ovarian malignancy. Measurements and Main Results'. Sixty-six women underwent preoperative transvaginal ultrasonography within 6 weeks of laparotomy or laparoscopy for an adnexal mass. Patients were excluded if they were pregnant, had a history of pelvic malignancy, or had an endometrioma. Presence or absence of septations was documented. Septations were counted and their maximum thickness was measured. Eight patients (12%) had malignant or borderline ovarian neoplasms. Their mean age was 63.6 years, whereas mean age of those with a benign tumor was 41.7 years. There were four solid masses, one of which was malignant. Of 67 cystic masses, 80% contained at least one septation. Of 12 masses without septations, 1 was malignant. The presence or absence of septations did not prove predictive of malignancy (NS). Malignant ovarian neoplasms had a mean of 5.9 septations, whereas benign cysts had a mean of 2.5 septations (p <0.01). The mean thickness of the thickest septation in the
97. LaparoscopicManagement of Dermoid Cyst by Four Extraction Methods YS Lee, TH Lee, IK Kang, YR Cho, SSJeon. Kyungpook National University, Taegu Fatima Hospital, Teagu, Korea.
Objective. To compare results of four extraction methods in treatment of dermoid cysts. $28
for 2 weeks after surgery. Infection was suspected in one woman who was treated with antibiotics without sequelae. After a minimum of 6-30 weeks' follow-up, 41 (80%), 21 (78%), and 35 (95%), patients respectively, reported improvement in menorrhagia, dysmenorrhea, and pelvic pain. Two (3%) failed to report improvement. In one patient (1.61%), hysterectomy was performed for massive menometrorrhagia 4 months after ligation. Reductions in dominant myoma volume (average 54%) were seen on US. Conclusion. Laparoscopic ligation of uterine artery may be a minimally invasive method of treating myomarelated hypermenorrhea, pelvic pain, and possibly dysmenorrhea when performed by an experienced endoscopist.
Measurements and Main Results. In 240 women with clinical, biochemical, US, CT, and MRI diagnoses of benign dermoid cysts, the cysts were extracted by Endopouch (99 cases); puncture, irrigation, and extraction (69); colpotomy (35); and pouch bag (44). We analyzed irrigation amount, operating time, postoperative hospital stay, and complications for the four methods. Endopouch extraction required less irrigation fluid for cleaning the abdominal cavity and led to a shorter postoperative hospital stay (ANOVA, p = 0.0001). There were no significant differences in operating times among techniques. Four women had significant morbidity: three had fever (>38 ~ C) and one an intraabdominal abscess after puncture, irrigation, extraction. One incisional hernia occurred after pouch bag method. Conclusion. For minimal spillage in extracting dermoid cysts and careful irrigation of abdominal cavity to prevent potential risk of chemical peritonitis, we recommend Endopouch, pouch bag, and colpotomy, but not the puncture, irrigation, extraction method.
96. Uterine Artery Embolization in the Treatment of Adenomyosis WH Lee, TW Sunwoo, EH Lee, C Lee, SH Cha, JR Son, CS Ahn, CN Lee, KY Cha. Pundang CHA General Hospital, College of Medicine, Pochon CHA University, Sungnam City, Korea.
98. Transvaginal Ultrasonography of Adnexal Masses; What Is the Significance of Septation?
Objective. To assess the efficacy and safety of uterine artery embolization for treatment of uterine adenomyosis. Measurements" and Main Results. Nineteen women (age 32-54 yrs) with menorrhagia and/or severe dysmenorrhea underwent uterine artery embolization with digital subtraction angiography. Adenomyosis was evaluated by physical examination and confirmed by US and MR1. All patients were discharged 1 day after the procedure, except two in whom intractable pain persisted due to uterine ischemia. Symptomatic improvement of menorrhagia and/or dysmenorrhea was reported by 18 patients (94.73%) at next menstruation. One woman had hysterectomy because of recurrent symptoms. In 18 patients, reductions of mean volume of adenomyosis on MRI were 30.6% (range 2.7-74.2%). Mean changes in CA 125 were 74.2% in all patients except one. No intraprocedural complications occurred. Conclusion. Embolization is an effective alternative for women with symptomatic adenomyosis.
M Levie, RJ Klein, J Hochsztein, E Feldschreiber. Jack D. Weiler Hospital of the Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.
Objective. To assess the significance of the presence, number, and thickness of septations within a cystic adnexal mass in predicting ovarian malignancy. Measurements and Main Results'. Sixty-six women underwent preoperative transvaginal ultrasonography within 6 weeks of laparotomy or laparoscopy for an adnexal mass. Patients were excluded if they were pregnant, had a history of pelvic malignancy, or had an endometrioma. Presence or absence of septations was documented. Septations were counted and their maximum thickness was measured. Eight patients (12%) had malignant or borderline ovarian neoplasms. Their mean age was 63.6 years, whereas mean age of those with a benign tumor was 41.7 years. There were four solid masses, one of which was malignant. Of 67 cystic masses, 80% contained at least one septation. Of 12 masses without septations, 1 was malignant. The presence or absence of septations did not prove predictive of malignancy (NS). Malignant ovarian neoplasms had a mean of 5.9 septations, whereas benign cysts had a mean of 2.5 septations (p <0.01). The mean thickness of the thickest septation in the
97. LaparoscopicManagement of Dermoid Cyst by Four Extraction Methods YS Lee, TH Lee, IK Kang, YR Cho, SSJeon. Kyungpook National University, Taegu Fatima Hospital, Teagu, Korea.
Objective. To compare results of four extraction methods in treatment of dermoid cysts. $28