Mrs. Blumenthal*, a 40-year-old G1P1, had young twins at home and was also a full-time student. She delivered her twins in 1992 by C-section after conceiving through IVF. The patient had long-standing endometriosis, treated previously by three abdominal procedures (one laparotomy and two laparoscopies).
In late 1996 Mrs. Martin contacted our office and reported concern over the fact that her periods were occurring every 2 weeks. During the office visit, she stated that she was experiencing heavy bleeding with the passage of clots that lasted approximately 7 days, requiring the use of 10 or more pads per day. The problem was very upsetting to her and was interfering with daily life at home and at work.
One of the most effective treatments for bleeding is to stop the blood supply to the area that is bleeding by blocking the vessels from the inside, this is known as “embolization”. Embolization of the arteries to the uterus has been used as a treatment for severe uterine bleeding after surgery or childbirth since at least the late 1970s, and is used as a treatment for uterine fibroids.
afe abdominal entry and prevention of retroperitoneal vascular injuries during laparoscopic surgery are the ultimate goals of any laparoscopic surgeon. Dr. Linda Nicoll and colleagues very capably have been able to describe a new technique and technology that prevent almost all retroperitoneal vascular injuries during laparoscopic entry.
Laparoscopy is one of the most common surgical procedures performed in the United States today. It is the modality of choice for many physicians for removal of ectopic pregnancy, bilateral tubal sterilization, treatment of endometriosis, lysis of adhesions, cholecystectomy, appendectomy, splenectomy, prostatectomy, etc. It is becoming increasingly popular for more complex procedures, including laparoscopic hysterectomy and myomectomy.
Fibroids are non-cancerous (benign) growths of the muscle wall of the uterus. They are probably responsible for more unnecessary gynecologic surgery than any other condition. Every year a staggering 600,000 American women have a hysterectomy. And about 30 percent of those hysterectomies, 180,000 in all, are performed because of fibroids.
Hysterectomy is no longer the only treatment for uterine fibroids. Now, GnRH agonists and laparoscopic coagulation with lasers and bipolar needles are treatment options.
Obesity: to treat, or not to treat: that is the question? Recently I read a column in the Florida Sun Sentinel in which some ob/gyns in South Florida reported that they turned away obese patients-15 practices of the 105 polled stated that they had established a weight “cut-off” starting at 200 pounds. In the interest of transparency I must admit that I would have problems finding a doctor under these circumstances as I am 5′ 10.5″ and over these physicians’ set weight limit.
Transvaginal Ultrasonography, Sonohysterography, Hysterosalpingography And Operative Hysteroscopy In Predicting Endometrial Hyperplasia
Reproductive endocrinology, a relatively new subspecialty of obstetrics and Gynecology, came of age during the 1980s. The discipline has benefited greatly from substantial recent advances in reproductive biology and allied fields and technologic improvements in computers, ultrasonography, and surgical instrumentation. All of these developments have been applied to clinical practice at an unprecedented rate.
Fibroids may be felt during a pelvic exam, but many times myomas that are causing symptoms can be missed if the examiner relies just on the examination. Also, other conditions such as adenomyosis or ovarian cysts may be mistaken for fibroids. For this reason, I routinely do an Ultrasound of fibroid in endometrial cavity ultrasound examination at the time of the first visit when a woman has symptoms of abnormal bleeding or cramping, or if I feel an abnormality on examination.
The Air Force has a program, the Education and Training Technology Application Program (ETTAP), specifically geared to introduce new technology into the training environment. This program funds initiatives to incorporate the latest advances in technology into the training setting.
Confusion about whether to use "ultrasound" or "sonogram," "sonographer" or "ultrasound tech", has done the profession a disservice. The following is the unedited version of the manuscript submitted, including references. The version referenced above was edited.
This overview describes and illustrates the clinical applications of three-dimensional transvaginal sonography in reproductive medicine. Its main applications include assessment of uterine anomalies, intrauterine pathology, tubal patency, polycystic ovaries, ovarian follicular monitoring and endometrial receptivity. It is also useful for detailed evaluation of failed and/or ectopic pregnancy. Three-dimensional color Doppler sonography provides enhanced depiction of uterine, endometrial, and ovarian vascularity.
The visual combination of different modalities is essential for many medical imaging applications in the field of Computer-Assisted medical Diagnosis (CAD) to enhance the clinical information content. Clinically, incontinence is a diagnosis with high clinical prevalence and morbidity rate.
The Relationship Between Transvaginal Sonogram and Hysteroscopy Findings in the Assessment of Endometrial Lesions in Postmenopausal Bleeding: A Case Study
The aim of this study was to evaluate the role of TV-SH in the assessment of tubal patency and to compare these results with those obtained using HSG and laparoscopy.
Test your ob/gyn knowledge in our DailyDx.
Urge urinary incontinence (UUI) can be a troublesome symptom following surgery for stress incontinence and may be most likely to occur in women with a history of preoperative UUI. Meanwhile, the number of these procedures has grown, mostly due to the availability of the less invasive midurethral sling procedure
Breast cancer causes more than 40,000 deaths annually and is only second to lung cancer in cause of cancer deaths in women in the United States. Since early identification is key to prompt treatment and the best prognosis, it is crucial to identify women at risk.
The author of the letter addresses the contradiction of Dr. Charles Lockwood's recommendation of 17OHP to treat prior preterm birth patients.
Arguing that a relentlessly rising volume of care driven by our discounted fee-for-service payment system is exacerbating both cost inflation and suboptimal care, the Centers for Medicare and Medicaid Services has decided to adopt value-based purchasing.
New findings indicate that the cutoff level for Hybrid capture 2 test for primary screening for high-grade cervical intraepithelial neoplasia can be increased to reduce the burden on women while still meeting international sensitivity recommendations.
Bilateral oophorectomy at the time of hysterectomy for benign disease has been commonly recommended to women over the age of 40 or 45 years to prevent development of ovarian cancer.
Like many other specialties in medicine, the field of obstetrics and gynecology faces numerous workforce challenges.
A Florida woman underwent a hysterectomy performed by her gynecologist in 2007. Three months later the patient returned with abdominal pain and was diagnosed with appendicitis.
A survey of 247 women reveals that 89% think that women in their forties should continue to receive yearly mammograms.
The number of indications for ultrasound examination during pregnancy is rising.
Since World War II, evidence-based medicine has rapidly replaced custom and lore. Proliferation of imaging and laboratory studies has improved diagnostic accuracy.