Department of Obstetrics and Gynecology, Miller School of Medicine, University of Miami, Miami, FL, USA
|
|
- Leon Williamson
- 5 years ago
- Views:
Transcription
1 Ultrasound Obstet Gynecol 2007; 29: ublished online 14 December 2006 in Wiley InterScience ( DOI: /uog.3890 Comparison of CT- or ultrasound-guided with concomitant intravenous vs. intravenous alone in the management of tubo-ovarian abscesses N. GOHARKHAY, U. VERMA and F. MAGGIOROTTO Department of Obstetrics and Gynecology, Miller School of Medicine, University of Miami, Miami, FL, USA KEYWORDS: computed tomography; ; pelvic abscess; tubo-ovarian abscess; ultrasound-guided ABSTRACT Objective The purpose of this study was to compare the outcome of treatment of tubo-ovarian abscesses by imaging-guided and vs. intravenous alone. Methods A retrospective chart review of all patients hospitalized with a diagnosis of tubo-ovarian abscess was performed. atients were categorized into two groups. The first group consisted of subjects treated with intravenous alone. atients in the second group had primary image-guided with concomitant intravenous. Treatment failures in the primary group underwent salvage when feasible. The primary outcome of interest was complete response. Secondary outcomes included need for additional treatment, duration of resolution of fever, total length of hospital stay, and complication rates. We also evaluated the effectiveness of secondary in patients who failed primary antibiotic therapy alone. Results A total of 58 patients were included in the study. Fifty patients were treated primarily with intravenous ; eight patients had primary, which was guided by ultrasound in all cases. Complete response was noted in 29 (58%) patients treated with alone. All eight (100%) patients in the primary group responded to treatment. Of the 21 treatment failures with primary, two underwent surgery and 19 (90.5%) had salvage with either ultrasound or computed tomographic guidance; 18 of 19 salvage s led to complete recovery. Subjects in the primary group required shorter hospital stays and showed more rapid resolution of fever. No significant morbidity was noted as a consequence of procedures. A higher failure rate for secondary was noted in older patients, those with larger tubo-ovarian abscesses, and those with a history of pelvic inflammatory disease. Conclusion Drainage of tubo-ovarian abscesses with concomitant intravenous is an effective and safe treatment for the primary or secondary treatment of tubo-ovarian abscesses. Copyright 2006 ISUOG. ublished by John Wiley & Sons, Ltd. INTRODUCTION Tubo-ovarian abscesses (TOAs) are classically treated with intravenous followed by oral over a prolonged period 1. The response rate to antimicrobial treatment alone is about 70%. Failure of treatment is characterized by increase in the size of the TOA, persistently elevated temperature or signs of peritonitis 2.There is a high recurrence rate for TOAs after treatment with alone, requiring repeat hospital admissions in many cases. Surgical intervention becomes necessary in about 25% of all patients 2. Options for surgical procedures include laparoscopy or laparotomy with of abscess, unilateral or bilateral adnexectomy, or total hysterectomy with bilateral salpingo-ophorectomy as definitive treatment. The presence of infection and adhesions as well as friable inflammatory tissue makes the surgical approach difficult. An alternative method for the treatment of TOAs is under direct guidance by computed tomography Correspondence to: Assistant rofessor U. Verma, Department of Obstetrics and Gynecology (D-50), Miller School of Medicine, University of Miami,.O. Box , Miami, FL 33101, USA ( uverma@med.miami.edu) Accepted: 25 September 2006 Copyright 2006 ISUOG. ublished by John Wiley & Sons, Ltd. ORIGINAL AER
2 66 Goharkhay et al. (CT) or ultrasound, with or without antibiotic injection into the abscess cavity. This study was performed to compare the outcome of conservative management of TOAs using intravenous alone vs. under CT or ultrasound guidance with concomitant use of intravenous. MATERIALS AND METHODS We performed a retrospective analysis of all patients admitted to Jackson Memorial Hospital, University of Miami Medical Center, between April and September with a diagnosis of tubo-ovarian abscess. The cases were identified through a search of our computerized database, based on diagnostic coding. Clinical information was obtained from the electronic clinical database as well as through review of paper charts on all patients. Additional data were obtained by review of computerized reports available through the Division of Ultrasound, Department of Obstetrics and Gynecology. The primary outcome was the rate of complete response to the primary therapy without need for other interventions (such as surgery or secondary in the primary antibiotic group). Our secondary outcomes were the need for additional procedures, duration of resolution of fever, total length of hospital stay, and procedurerelated complications, such as bladder or bowel injury and sepsis. We further evaluated the effectiveness of secondary in patients who failed primary antibiotic therapy alone. The antibiotic regimen in all patients consisted of intravenous gentamicin and clindamycin as well as ampicillin (if not penicillin-allergic). A patient was assigned to the primary group when she underwent the procedure within 24 h of admission and no indication for such a procedure was evident from her medical records. The decision whether primary was performed was based on the attending physician s clinical judgment. The regimen for was the same for either primary or secondary (salvage). Direct guidance by either ultrasound or CT was utilized. In general, the ultrasound-guided procedures were performed by an obstetrician-gynecologist, whereas CT-guided s were done by an interventional radiologist. Both procedures aimed at draining all accessible cystic areas through a needle by the transvaginal or transabdominal approach. When using ultrasound guidance, a 900 mg dose of clindamycin suspended in 30 ml of saline was injected into the abscess at the end of the procedure. Statistical analyses were performed using SSS software for Windows (SSS Inc., Chicago, IL, USA). Statistical significance was determined by using an alpha level of 0.05 and two-sided tests. The Kolmogorov Smirnov procedure was used to evaluate the normal distribution of the variables. Categorical variables were compared with χ 2 or Fisher s exact tests; ANOVA was used to compare continuous variables if normally distributed. In case of non-normally distributed variables, Mann Whitney U and Wilcoxon tests were applied. RESULTS We identified a total of 58 subjects admitted to our institution with the diagnosis of tubo-ovarian abscess. The demographic data on all subjects together with clinical and initial diagnostic findings are shown in Table 1. Of the patients in this study, 50 subjects (86.2%) were treated primarily with and eight (13.8%) underwent primary. All primary s were performed under ultrasound guidance. Figure 1 shows ultrasound images of a TOA taken before and after imaging-guided. There were no significant differences in demographic features, clinical findings, or imaging characteristics of TOAs between the two study groups (Table 1). All patients with an intrauterine device (IUD) underwent primary antibiotic treatment, which likely reflects a bias on the side of the providers. The average total volume of the TOAs was calculated by the ellipsoid volume formula (volume = height width length 0.52). Of the 50 patients who received primary antibiotic therapy, 29 (58%) had a complete response and required no further treatment. All eight patients who underwent imaging-guided with concomitant experienced complete resolution of symptoms without Table 1 Demographics of patients and tubo-ovarian abscess (TOA) characteristics by study group All patients (n (%)) 58 (100) 50 (86.2) 8 (13.8) Age (years, mean (range)) 31.8 (16 61) 31.7 (16 61) 32.5 (18 44) arity (median (range)) 1 (0 5) 1 (0 5) 0.5 (0 4) History of ID (n (%)) 7 (12.1) 6 (12.0) 1 (12.6) IUD present (n (%)) 16 (27.6) 16 (32.0) 0 (0.0) HIV-positive (n (%)) 5 (8.6) 5 (10.0) 0 (0.0) Unilateral TOA (n (%)) 37 (63.8) 33 (66.0) 4 (50.0) Bilateral TOA (n (%)) 21 (36.2) 17 (34.0) 4 (50.0) volume (ml, mean (range)) ( ) (3 167) (21 160) IUD, intrauterine device; ID, pelvic inflammatory disease.
3 Management of tubo-ovarian abscesses 67 Table 2 Treatment outcome by study group All patients (n) 50 8 Treatment failure 21 (36.2) 21 (42.0) 0 (0.0) (n (%)) Surgery needed (n (%)) 3 (5.2) 3 (6.0) 0 (0.0) Hospital stay (days, median (range)) 7 (4 16) 7 (4 16) 4.5 (4 8) < subjects 50 primary 8 primary 29 resolved 2 TAH+ BSO 19 salvage All resolved 18 resolved 1 salpingectomy Figure 2 Flow chart of total patient population. BSO, bilateral salpingo-ophorectomy; TAH, total abdominal hysterectomy. Figure 1 Ultrasound images of a tubo-ovarian abscess before (a) and after (b) abscess. The complex has an approximate diameter of cm prior to. It measures cm after the procedure; 250 ml of pus were drained. any further interventions (Table 2). No major side effects were observed in any of the cases treated with abscess. The duration of hospital stay was significantly shorter for the primary group as compared to the primary group (Table 2). The 21 treatment failures in the primary group received further therapy as follows. Two subjects showed persistent severe symptoms requiring total abdominal hysterectomy with bilateral salpingoophorectomy. Nineteen patients (90.5% of treatment failures in group) were treated by salvage under imaging guidance (11 ultrasound-guided, eight CT-guided). In 18 of 19 patients (94.7%), salvage led to complete clinical response. One patient (5.3%) remained febrile and required a unilateral salpingo-ophorectomy, after which she achieved remission. Figure 2 represents a flow chart of all patients analyzed in our study. Several characteristics were significantly associated with treatment failure in our study population (Table 3). Nonresponders were on average older (36.4 ± 9.4 vs.28.0 ± Table 3 Characteristics of patients with failure to primary Antibiotic non-responders Antibiotic responders All patients on (n) Age (mean (range)) 31.7 (16 61) 36.4 (20 61) 28.0 (16 45) History of ID (n (%)) 6 (12.0) 5 (22.7) 1 (3.6) IUD present (n (%)) 16 (32.0) 8 (36.4) 8 (28.6) HIV-positive (n (%)) 5 (10.0) 4 (18.2) 1 (3.6) Bilateral TOA (n (%)) 17 (34.0) 6 (27.3) 11 (39.3) volume (ml, mean (range)) ( ) ( ) 99.5 ( ) < IUD, intrauterine device; ID, pelvic inflammatory disease; TOA, tubo-ovarian abscess.
4 68 Goharkhay et al. Table 4 Duration until fever resolution by study group atients with fever (n) Fever lasting < 24 h(n (%)) 6 (14.6) 2 (5.9) 4 (57.1) h (n (%)) 10 (24.4) 9 (26.5) 1 (14.3) h (n (%)) 21 (51.2) 19 (55.9) 2 (28.6) > 72 h(n (%)) 4 (9.8) 4 (11.8) 0 (0.0) 9.4 years (mean ± SEM), < 0.002). Furthermore, failure to respond to antibiotic therapy corresponded with total TOA volume (99 ± 58 vs. 200 ± 123 ml (mean ± SEM), < 0.001). In contrast, overall failure rates were similar for unilateral vs. bilateral lesions (40.5% vs. 33.9%, < 0.81). Women with a history of pelvic inflammatory disease were more likely to fail primary antibiotic therapy (3.6% of responders vs. 22.7% of non-responders), although this relationship was not statistically significant. At the time of presentation, 34 subjects (68.0%) in the primary antibiotic group and seven (87.5%) in the primary group were febrile ( < 0.001). We analyzed the duration of febrile illness in these patients by study group (Table 4). Overall, fever resolution was achieved faster in the primary group ( = 0.016). DISCUSSION One-third of women hospitalized with pelvic inflammatory disease have tubo-ovarian abscesses 3.Therearean estimated annual hospitalizations for TOA in the USA 4. The classical treatment of TOA in the past was hysterectomy and bilateral salpingo-ophorectomy, which, although it results in complete cure, has significant morbidity, leads to infertility, and can cause early menopause. In order to prevent such adverse effects in these mostly young patients, a more conservative approach is desirable. Success rates of 67 75% have been reported with prolonged use of intravenous alone 5,6. In patients with large adnexal masses, the success with intravenous antibiotic is low. It has been reported that patients with abscesses 10 cm required surgery more often (60%), while of those who had abscesses smaller than 5 cm, only 20% required surgery 7.8. More recently, minimally invasive approaches to abscess, such as laparoscopic and percutaneous methods, have become available 9. Drainage of abscesses with concomitant use of is another alternative. Using either ultrasound or CT guidance, several smaller and a large study have been reported, including a small randomized study Success rates for primary have been in the range of %, with the largest study by Gjelland et al. reporting 93.4% complete response 14. These reported outcomes are in accordance with the findings of the current investigation. Our study also demonstrates an excellent outcome for imaging-guided in cases of failed primary antibiotic treatment, with a success rate of 94.7%. Aboulgahr et al. reported improvement of symptoms in all patients after aspiration of abscesses and patients complete pain relief within 3 days of aspiration, which is similar to our experience 13. Gjelland et al. and Aboulgahr et al. reported faster fever resolution with abscess, which we also found in this study 13,14. In our population, more than 70% of febrile patients undergoing primary were afebrile by 48 h. We report a trend towards a shorter hospital stay in the group, in accordance with previous data 15,16. Larger TOAs failed medical management in our study to a larger proportion. An estimated total volume of 150 ml may be a relative indication for vs. expectant management if imaging-guided is not routinely available. We administered a dose of clindamycin into the abscess at the time of ultrasound-guided. Aboulgahr and his group have used cefotaxime in a similar setting 13. Injection of antibiotic into the abscess cavity after aspiration is simple and can be performed before removing the needle. This may improve treatment response and result in faster control of the infection. We did not find any significant morbidity associated with procedures, even in febrile patients with severe symptoms and potential for the presence of bacteremia. All evidence indicates that in experienced hands needle-guided is a safe procedure with minimal risk of complications. Drainage of abscesses is a highly successful technique, with minimal procedure-related complications despite the presence of infection 17,18. It may lead to significant cost savings, as suggested by our finding of reduced hospital stay. This mode of treatment is currently under-utilized in clinical practice. Our case series is the largest reported from the USA and confirms the results of the recent Norwegian study 14 as well as the relatively small randomized prospective study by erez-medina et al. 15. Limitations of the current study are the retrospective nature of data collection as well as the smaller sample size in the primary group. A larger prospective randomized trial to precisely quantify the benefit of primary and salvage of TOAs is encouraged. Based on the available data, primary of TOAs appears safe and effective as a first-line treatment and should be recommended wherever available. Furthermore, imaging-guided as secondary therapy is useful in most patients as an alternative to invasive surgical procedures. ACKNOWLEDGMENTS This study was supported by the Department of Obstetrics and Gynecology, University of Miami School of Medicine.
5 Management of tubo-ovarian abscesses 69 REFERENCES 1. McNeeley SG, Hendrix SL, Mazzoni MM, Kmak DC, Ransom SB. Medically sound, cost-effective treatment for pelvic inflammatory disease and tuboovarian abscess. Am J Obstet Gynecol 1998; 178: Mirhashemi R, Schoell WM, Estape R, Angioli R, Averette HE. Trends in the management of pelvic abscesses. J Am Coll Surg 1999; 188: Willson JR, Black JR III. Ovarian abscess. Am J Obstet Gynecol 1964; 90: Landers DV, Sweet RL. Current trends in the diagnosis and treatment of tuboovarian abscess. Am J Obstet Gynecol 1985; 151: Landers DV, Sweet RL. Tubo-ovarian abscess: contemporary approach to management. Rev Infect Dis 1983; 5: Sweet RL, Schachter J, Landers DV, Ohm-Smith M, Robbie MO. Treatment of hospitalized patients with acute pelvic inflammatory disease: comparison of cefotetan plus doxycycline and cefoxitin plus doxycycline. Am J Obstet Gynecol 1988; 158: Reed SD, Landers DV, Sweet RL. Antibiotic treatment of tuboovarian abscess: comparison of broad-spectrum betalactam agents versus clindamycin-containing regimens. Am J Obstet Gynecol 1991; 164: Ginsburg DS, Stern JL, Hamod KA, Genadry R, Spence MR. Tubo-ovarian abscess: a retrospective review. Am J Obstet Gynecol 1980; 138: Wiesenfeld HC, Sweet RL. rogress in the management of tuboovarian abscesses. Clin Obstet Gynecol 1993; 36: van Sonnenberg E, D Agostino HB, Casola G, Goodacre BW, Sanchez RB, Taylor B. US-guided transvaginal of pelvic abscesses and fluid collections. Radiology 1991; 181: icker RH, McLennan AC, Robertson RD, orter RN. Conservative management of pelvic abscess in recurrent pelvic inflammatory disease. Ultrasound Obstet Gynecol 1991; 1: Teisala K, Heinonen K, unnonen R. Transvaginal ultrasound in the diagnosis and treatment of tubo-ovarian abscess. Br J Obstet Gynaecol 1990; 97: Aboulghar MA, Mansour RT, Serour GI. Ultrasonographically guided transvaginal aspiration of tuboovarian abscesses and pyosalpinges: an optional treatment for acute pelvic inflammatory disease. Am J Obstet Gynecol 1995; 172: Gjelland K, Ekerhovd E, Granberg S. Transvaginal ultrasoundguided aspiration for treatment of tubo-ovarian abscess: a study of 302 cases. Am J Obstet Gynecol 2005; 193: erez-medina T, Huertas MA, Bajo JM. Early ultrasoundguided transvaginal of tubo-ovarian abscesses: a randomized study. Ultrasound Obstet Gynecol 1996; 7: Caspi B, Zalel Y, Or Y, Bar DY, Appelman Z, Katz Z. Sonographically guided aspiration: an alternative therapy for tuboovarian abscess. Ultrasound Obstet Gynecol 1996; 7: Fabiszewski NL, Sumkin JH, Johns CM. Contemporary radiologic percutaneous abscess in the pelvis. Clin Obstet Gynecol 1993; 36: Corsi J, Johnson SC, Gonik B, Hendrix SL, McNeeley SG Jr, Diamond M. Transvaginal ultrasound-guided aspiration of pelvic abscesses. Infect Dis Obstet Gynecol 1999; 7:
Clinical Study Tuboovarian Abscesses: Is Size Associated with Duration of Hospitalization & Complications?
Hindawi Publishing Corporation Obstetrics and Gynecology International Volume 2010, Article ID 847041, 5 pages doi:10.1155/2010/847041 Clinical Study Tuboovarian Abscesses: Is Size Associated with Duration
More informationPregnancies following ultrasound-guided drainage of tubo-ovarian abscess
ORIGINAL ARTICLES: FERTILITY PRESERVATION Pregnancies following ultrasound-guided drainage of tubo-ovarian abscess Knut Gjelland, M.D., a Seth Granberg, M.D., Ph.D., b Torvid Kiserud, M.D., Ph.D., a,c
More informationTransvaginal Ultrasound-Guided Aspiration of
Infectious Diseases in Obstetrics and Gynecology 7:216-221 (1999) (C) 1999 Wiley-Liss, Inc. Transvaginal Ultrasound-Guided Aspiration of Pelvic Abscesses P.J. Corsi, S.C. Johnson, z B. Gonik, 1 S.L. Hendrix,
More informationTransvaginal ultrasound-guided aspiration for treatment of tubo-ovarian abscess: A study of 302 cases
American Journal of Obstetrics and Gynecology (2005) 193, 1323 30 www.ajog.org GENERAL OBSTETRICS AND GYNECOLOGY: GYNECOLOGY Transvaginal ultrasound-guided aspiration for treatment of tubo-ovarian abscess:
More informationClinical Characteristics Associated with Antibiotic Treatment Failure for Tuboovarian Abscesses
Clinical Characteristics Associated with Antibiotic Treatment Failure for Tuboovarian Abscesses The Harvard community has made this article openly available. Please share how this access benefits you.
More informationCase Report A Tuboovarian Abscess Associated with a Ruptured Spleen
Case Reports in Emergency Medicine Volume 2016, Article ID 8796281, 4 pages http://dx.doi.org/10.1155/2016/8796281 Case Report A Tuboovarian Abscess Associated with a Ruptured Spleen Jennifer S. Li and
More informationUltrasound-guided transvaginal aspiration in the management of actinomyces pelvic abscess
Washington University School of Medicine Digital Commons@Becker Open Access Publications 1996 Ultrasound-guided transvaginal aspiration in the management of actinomyces pelvic abscess Eyal Y. Anteby Washington
More informationEarly View Article: Online published version of an accepted article before publication in the final form.
: Online published version of an accepted article before publication in the final form. Journal Name: International Journal of Case Reports and Images (IJCRI) Type of Article: Case Report Title: Sigmoid
More informationClinical Study Transvaginal Drainage of Pelvic Abscesses and Collections Using Transabdominal Ultrasound Guidance
Obstetrics and Gynecology International Volume 2015, Article ID 283576, 4 pages http://dx.doi.org/10.1155/2015/283576 Clinical Study Transvaginal Drainage of Pelvic Abscesses and Collections Using Transabdominal
More informationMANAGEMENT OF ACUTE PELVIC INFLAMMATORY DISEASE
WOMEN AND NEWBORN HEALTH SERVICE CLINICAL GUIDELINES SECTION C: GUIDELINES RELEVANT TO GYNAECOLOGY 6.1 ABDOMINAL / PELVIC PAIN 6.1 ACUTE PAIN Authorised by: OGCCU 6.1.3 TREATMENT 6.1.3.1 MANAGEMENT OF
More informationGynaecology. Pelvic inflammatory disesase
Gynaecology د.شيماءعبداألميرالجميلي Pelvic inflammatory disesase Pelvic inflammatory disease (PID) is usually the result of infection ascending from the endocervix causing endometritis, salpingitis, parametritis,
More informationClinical Study Laparoscopic Surgery in Elderly Patients Aged 65 Years and Older with Gynecologic Disease
International Scholarly Research Network ISRN Obstetrics and Gynecology Volume 2012, Article ID 678201, 4 pages doi:10.5402/2012/678201 Clinical Study Laparoscopic Surgery in Elderly Patients Aged 65 Years
More informationOUTCOMES OF ROBOTIC, LAPAROSCOPIC AND OPEN ABDOMINAL HYSTERECTOMY FOR BENING CONDITIONS IN OBESE PATIENTS
OUTCOMES OF ROBOTIC, LAPAROSCOPIC AND OPEN ABDOMINAL HYSTERECTOMY FOR BENING CONDITIONS IN OBESE PATIENTS Omer L. Tapisiz, Tufan Oge, Ibrahim Alanbay, Mostafa Borahay, Gokhan S. Kilic Department of Obstetrics
More informationABSTRACT. KEY WORDS antibiotics; prophylaxis; hysterectomy
Infectious Diseases in Obstetrics and Gynecology 8:230-234 (2000) (C) 2000 Wiley-Liss, Inc. Wound Infection in Gynecologic Surgery Aparna A. Kamat,* Leo Brancazio, and Mark Gibson Department of Obstetrics
More information7/2/15. Approach to imaging of pelvic pain. Acute pelvic pain. Chronic pelvic pain. Dysmenorrhea
I have no financial rela.onships to disclose. Approach to imaging of pelvic pain To emphasize the importance of ultrasound as the imaging modality of choice for the most commonly presen6ng diagnoses in
More informationLaparoscopic Surgical Management and Clinical Characteristics of Ovarian Fibromas
SCIENTIFIC PAPER Laparoscopic Surgical Management and Clinical Characteristics of Ovarian Fibromas Chang Eop Son, MD, Joong Sub Choi, MD, Jung Hun Lee, MD, Seung Wook Jeon, MD, Jin Hwa Hong, MD, Jong Woon
More informationDefinition Endometriosis is the presence of functioning endometrial tissue outside the cavity of the uterus.
Dept. of Obstetrics t and Gynecology Faculty of Medicine University of Sumatera Utara Endometriosis Definition Endometriosis is the presence of functioning endometrial tissue outside the cavity of the
More informationINTRAUTERINE DEVICES AND INFECTIONS. Tips for Evaluation and Management
INTRAUTERINE DEVICES AND INFECTIONS Tips for Evaluation and Management Objectives At the end of this presentation, the participant should be able to: 1. Diagnose infection after IUD placement 2. Provide
More informationPELVIC INFLAMMATORY. The Most Serious and Costly Bacterial Sexually BOB CARUTHERS, CST, PHD
PELVIC INFLAMMATORY The Most Serious and Costly Bacterial Sexually BOB CARUTHERS, CST, PHD CE Examination Category 3 DISEASE Transmitted Disease INTRODUCTION Pelvic inflammatory disease (PID) is a global
More informationPELVIC INFLAMMATORY. The Most Serious and Costly Bacterial Sexually BOB CARUTHERS, CST, PHD
PELVIC INFLAMMATORY The Most Serious and Costly Bacterial Sexually BOB CARUTHERS, CST, PHD CE Examination Category 3 DISEASE Transmitted Disease INTRODUCTION Pelvic inflammatory disease (PID) is a global
More informationSalpingitis : laparoscopy roles
Salpingitis : laparoscopy roles Dr AS AZUAR We need a relevant way to diagnose because Epidemiology Public health matter -130.000 cases / year - 15.000 cases of tubal infertility - Pb linked to complications/
More informationComparative Study Between Robotic Laparoscopic Myomectomy and Abdominal Myomectomy
Comparative Study Between Robotic Laparoscopic Myomectomy and Abdominal Myomectomy Magdi Hanafi, M.D., FACOG, FACS. Medical Director GYN & Fertility Specialists Emory Saint Joseph s Hospital Atlanta, Georgia.
More informationWhen should we operate for recurrent diverticulitis. Savvas Papagrigoriadis MD MSc FRCS Consultant Colorectal Surgeon King's College Hospital
When should we operate for recurrent diverticulitis Savvas Papagrigoriadis MD MSc FRCS Consultant Colorectal Surgeon King's College Hospital ASCRS Practice parameters for the Treatment of Acute Diverticulitis
More informationSudden/nocturnal onset of acute abdominal pain, lasting less than a day and accompanied by vomiting: a tell-tale sign of ovarian torsion
Gynecol Surg (2010) 7:297 301 DOI 10.1007/s10397-010-0557-4 ORIGINAL ARTICLE Sudden/nocturnal onset of acute abdominal pain, lasting less than a day and accompanied by vomiting: a tell-tale sign of ovarian
More informationThe impact of an assisted conception unit on the workload of a general gynaecology unit
BJOG: an International Journal of Obstetrics and Gynaecology February 2002, Vol. 109, pp. 207 211 The impact of an assisted conception unit on the workload of a general gynaecology unit Joanne McManus*,
More informationMANAGEMENT CHALLENGES OF PELVIC ABSCESS IN A TERTIARY HEALTH INSTITUTION IN NIGERIA. A.E. Ehigiegba, E.E Okosun
MANAGEMENT CHALLENGES OF PELVIC ABSCESS IN A TERTIARY HEALTH INSTITUTION IN NIGERIA. A.E. Ehigiegba, E.E Okosun Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City,
More informationAmerican Journal of Oral Medicine and Radiology
American Journal of Oral Medicine and Radiology e - ISSN - XXXX-XXXX ISSN - 2394-7721 Journal homepage: www.mcmed.us/journal/ajomr ULTRASONOGRAPHIC EVALUATION OF ADNEXAL MASSES Nageswar Rao* Professor,
More informationLaparoscopy as the primary modality for the treatment of women with endometrial carcinoma Eltabbakh G H, Shamonki M I, Moody J M, Garafano L L
Laparoscopy as the primary modality for the treatment of women with endometrial carcinoma Eltabbakh G H, Shamonki M I, Moody J M, Garafano L L Record Status This is a critical abstract of an economic evaluation
More informationNATIONAL CLINICAL GUIDELINE INVESTIGATION AND MANAGEMENT OVARIAN CYSTS IN POSTMENOPAUSAL WOMEN
NATIONAL CLINICAL GUIDELINE INVESTIGATION AND MANAGEMENT OF OVARIAN CYSTS IN POSTMENOPAUSAL WOMEN Institute of Obstetricians and Gynaecologists, Royal College of Physicians of Ireland and the Clinical
More informationFertility after ectopic pregnancy
Gynecology-endocrinol.ogy FERTILITY AND STERILITY Copyright 1993 The American Fertility Society Vol. 60. No.2, August 199:1 Printed on acid-free paper in U. S. A. Fertility after ectopic pregnancy Steven
More informationAbdominopelvic Actinomycosis: spectrum of Imaging Findings and common mimickers.
Abdominopelvic Actinomycosis: spectrum of Imaging Findings and common mimickers. Poster No.: C-1375 Congress: ECR 2011 Type: Educational Exhibit Authors: M. Giannila, A. J. Van Der Molen, P. Maniatis,
More informationHong Kong Medical Journal, 2007, v. 13 n. 1, p ; 香港醫學雜誌, 2007, v. 13 n. 1, p
Title Vaginal hysterectomies in patients without uterine prolapse: a local perspective; 本地對無呈現子宮脫垂的病人進行經陰道的子宮切除手術 Author(s) Pun, TC Citation Hong Kong Medical Journal, 2007, v. 13 n. 1, p. 27-30; 香港醫學雜誌,
More informationAn extremely rare case of tubo-ovarian abscesses involving corynebacterium striatum as causative agent
Yamamoto et al. BMC Infectious Diseases (2016) 16:527 DOI 10.1186/s12879-016-1860-0 CASE REPORT An extremely rare case of tubo-ovarian abscesses involving corynebacterium striatum as causative agent Open
More informationLAPAROSCOPY and OVARIAN CANCER
LAPAROSCOPY and OVARIAN CANCER J. DAUPLAT Clermont-Ferrand France UNIVERSITÉ D'AUVERGNE CLERMONT 1 1 - PROPHYLACTIC OOPHORECTOMY 2 - DIAGNOSIS 3 - EARLY STAGES : STAGING 4 - ADVANCED STAGES - ASSESSMENT
More informationAmpicillin/Sulbactam Vs. Cefoxitin for the Treatment
Infectious Diseases in Obstetrics and Gynecology 5:319-325 (1997) (C) 1998 Wiley-Liss, Inc. Ampicillin/Sulbactam Vs. Cefoxitin for the Treatment of Pelvic Inflammatory Disease Joseph G. Jemsek* and Frank
More informationUnexpected Gynecologic Findings at Laparotomy. Susan A. Davidson, MD University of Colorado, Denver School of Medicine
Unexpected Gynecologic Findings at Laparotomy Susan A. Davidson, MD University of Colorado, Denver School of Medicine Adnexal Mass: Gyn Etiologies Uterine Leiomyomas Pregnancy Malignancy Tubal Pregnancy
More informationComparison of outcome between total laparoscopic hysterectomy and vaginal hysterectomy in a nondescent uterus in a tertiary care hospital
2018; 4(12): 197-201 ISSN Print: 2394-7500 ISSN Online: 2394-5869 Impact Factor: 5.2 IJAR 2018; 4(12): 197-201 www.allresearchjournal.com Received: 25-10-2018 Accepted: 30-11-2018 Dr. Jhansi Aratipalli
More informationThe Role of Imaging for Gynecologic Emergencies
Objectives The Role of Imaging for Gynecologic Emergencies M. Jonathon Solnik, MD, FACOG FACS Associate Professor of Obstetrics & Gynaecology Head of Gynaecology & Minimally Invasive Surgery University
More informationAdnexectomy for benign pathology at vaginal hysterectomy without laparoscopic assistance
BJOG: an International Journal of Obstetrics and Gynaecology December 2002, Vol. 109, pp. 1401 1405 Adnexectomy for benign pathology at vaginal hysterectomy without laparoscopic assistance Shirish S. Sheth
More informationPercutaneous CT Scan-Guided Drainage vs. Antibiotherapy Alone for Hinchey II Diverticulitis: A Case-Control Study
Percutaneous CT Scan-Guided Drainage vs. Antibiotherapy Alone for Hinchey II Diverticulitis: A Case-Control Study D. Brandt, M.D., 1 P. Gervaz, M.D., 1 Y. Durmishi, M.D., 1 A. Platon, M.D., 2 Ph. Morel,
More informationSonographic features of tubo-ovarian abscess mimicking an endometrioma. adnexal masses
Sonographic features of tubo-ovarian abscess mimicking an endometrioma and review of cystic adnexal masses Artur Velcani 1*, Patrick Conklin 1, Neil Specht 1 1. Department of Radiology, St.Vincent's Medical
More informationPelvic Pain: Diagnosis and Management
Pelvic Pain: Diagnosis and Management Mr N Pisal Consultant Gynaecologist Advanced Laparoscopic Surgeon www.london-gynaecology.com History LMP Dysmenorrhoea / Dyspareunia Cyclical pain related to menstrual
More informationPrevention and Management of Hysterectomy-Related Infectious Morbidity DR. S. FOULEM BSC, MD, FRSCS
Prevention and Management of Hysterectomy-Related Infectious Morbidity DR. S. FOULEM BSC, MD, FRSCS Objectives Definition and epidemiology of surgical site infections (SSI) What are the most common infectious
More informationPregnancy With Huge Ovarian Cyst
BMH Med. J. 2018;5(3):74-78 Case Report Pregnancy With Huge Ovarian Cyst Suja Ann Ranji, Usha Payyodi, Ani Praveen, Rajesh MC, Jini Chandran Baby Memorial Hospital, Kozhikode 673004 Address for Correspondence:
More informationNo endogenous bacterial contamination Vagina entered. Clean-contaminated. Clean. Contaminated
Prophylactic Antibiotics in Obstetrics and Gynecology: A Current Benefit; A Future Curse? William J. Ledger, MD Wound Classification Guidelines of Surgical Wounds Provided by the American College of Surgeons
More informationHysterectomy for obese women with endometrial cancer: laparoscopy or laparotomy? Eltabbakh G H, Shamonki M I, Moody J M, Garafano L L
Hysterectomy for obese women with endometrial cancer: laparoscopy or laparotomy? Eltabbakh G H, Shamonki M I, Moody J M, Garafano L L Record Status This is a critical abstract of an economic evaluation
More informationTransabdominal pre peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair
Transabdominal pre peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair An inguinal hernia (hernia of the groin) is a weakness in the wall of the abdominal
More informationHysterectomy. What is a hysterectomy? Why is hysterectomy done? Are there alternatives to hysterectomy?
301.681.3400 OBGYNCWC.COM What is a hysterectomy? Hysterectomy Hysterectomy is surgery to remove the uterus. It is a very common type of surgery for women in the United States. Removing your uterus means
More informationTable 2: Outcomes measured. Table 1: Intrapleural alteplase instillation therapy protocol
ORIGINAL RESEARCH ARTICLE Intrapleural F brinolytic Therapy with Alteplase in Empyema Thoracis in Children conducted in the Department of Pediatric critical care and Pulmonology unit at our institution
More informationActinomycotic Inflammatory Disease and Misdiagnosis of Ovarian Cancer. A Case Report
Actinomycotic Inflammatory Disease and Misdiagnosis of Ovarian Cancer. A Case Report JALID SEHOULI 1, JENS H. STUPIN 1, ULRIKE SCHLIEPER 1, SHERKO KUEMMEL 1, WOLFGANG HENRICH 1, C. DENKERT 2, M. DIETEL
More informationA Practical Approach to Adnexal Masses
A Practical Approach to Adnexal Masses Darcy J. Wolfman, MD Section Chief of Genitourinary Imaging American Institute for Radiologic Pathology Clinical Associate Johns Hopkins Community Radiology Division
More informationHysterectomy Fact versus fiction. Richard Dover Specialist Gynaecologist
Hysterectomy Fact versus fiction Richard Dover Specialist Gynaecologist Disclaimer Disclaimer Hysterectomy An update? Myths busted? HYSTERECTOMY Retro-chic! HMB Important cause of morbidity Affects
More informationINTERVENTIONAL PROCEDURES PROGRAMME
NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedure overview of laparoscopic laser myomectomy Introduction This overview has been prepared to assist
More informationPelvic Inflammatory Disease (PID) Max Brinsmead PhD FRANZCOG July 2011
Pelvic Inflammatory Disease (PID) Max Brinsmead PhD FRANZCOG July 2011 This talk What is Pelvic Inflammatory Disease? Why it is important How it is spread Diagnosis Treatment Prevention What is PID? Inflammation
More informationChronic Pelvic Pain. AP099, December 2010
AP099, December 2010 Chronic Pelvic Pain Pain in the pelvic area that lasts for 6 months or longer is called chronic pelvic pain. An estimated 15 20% of women aged 18 50 years have chronic pelvic pain
More informationUterine-Sparing Treatment Options for Symptomatic Uterine Fibroids
Uterine-Sparing Treatment Options for Symptomatic Uterine Fibroids Developed in collaboration Learning Objective Upon completion, participants should be able to: Review uterine-sparing fibroid therapies
More informationAmpicillin/Sulbactam, Cefazolin, or Cefotetan in High-Risk Cesarean Section Patients
Infectious Diseases in Obstetrics and Gynecology 6:220-223 (1998) (C) 1998 Wiley-Liss, Inc. Incidence of Postpartum Endomyometritis Following Single-Dose Antibiotic Prophylaxis With Either Ampicillin/Sulbactam,
More informationWISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES
WISCONSIN DEPARTMENT OF SAFETY AND PROFESSIONAL SERVICES Wisconsin Department of Safety and Professional Services Access to the Public Records of the Reports of Decisions This Reports of Decisions document
More informationSurgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim s technique and comparison to laparotomy
Original Article Obstet Gynecol Sci 2017;60(2):178-186 https://doi.org/10.5468/ogs.2017.60.2.178 pissn 2287-8572 eissn 2287-8580 Surgical technique for single-port laparoscopy in huge ovarian tumors: SW
More informationDepartment of Radiology, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Jalan Yaacob Latiff, Cheras, Kuala Lumpur 56000, Malaysia.
Mini-invasive Surg 2017;1:143-7 DOI: 10.20517/2574-1225.2017.20 Original Article Mini-invasive Surgery www.misjournal.net Open Access The role of delayed laparoscopic suction for intra-abdominal collection
More informationC-0702 Conservative management of abdominal aortic stent-graft infection.
C-0702 Conservative management of abdominal aortic stent-graft infection. Aims and objectives. The treatment of abdominal aortic aneurism, availability and durability of stent-graft materials has revolutionized
More informationClear cell carcinoma arising from abdominal wall endometriosis: a unique case with bladder and lymph node metastasis
Liu et al. World Journal of Surgical Oncology 2014, 12:51 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Clear cell carcinoma arising from abdominal wall endometriosis: a unique case with bladder
More informationVaginal, Abdominal & Robotic Laparoscopic Hysterectomy: Comparative study including the clinical outcomes and the cost.
Vaginal, Abdominal & Robotic Laparoscopic Hysterectomy: Comparative study including the clinical outcomes and the cost. Magdi Hanafi, M.D., FACOG, FACS Medical Director Gyn & Fertility Specialists Emory
More informationHUGE PELVIC MASS, CUTANEOUS AND VAGINAL FISTULAS, AND BILATERAL HYDRONEPHROSIS: A RARE PRESENTATION OF ACTINOMYCOSIS
CASE REPORT HUGE PELVIC MASS, CUTANEOUS AND VAGINAL FISTULAS, AND BILATERAL HYDRONEPHROSIS: A RARE PRESENTATION OF ACTINOMYCOSIS WITH A GOOD RESPONSE TO CONSERVATIVE TREATMENT AND WITH LONG-TERM SEQUELAE
More informationPREGNANCY AND RECURRENCE RATES IN INFERTILE PATIENTS OPERATED FOR OVARIAN ENDOMETRIOSIS
Rev. Med. Chir. Soc. Med. Nat., Iaşi 2015 vol. 119, no. 1 SURGERY ORIGINAL PAPERS PREGNANCY AND RECURRENCE RATES IN INFERTILE PATIENTS OPERATED FOR OVARIAN ENDOMETRIOSIS Monica Holicov Luţuc 1, D. Nemescu
More informationCpt code for removal of pelvic mass
Cpt code for removal of pelvic mass Search Excision. Excess Skin, 15830. Tumor, Abdominal Wall, 22900. Exploration, 49000, 49002. Blood Vessel, 35840. Hernia Repair, 49495-49525, 49560-49587. Incision..
More informationA Prospective Study Of Comparison Of Efficacy Of Two Combination Treatment Regimens In Syndromic Treatment Of Pelvic Inflammatory Disease
ISPUB.COM The Internet Journal of Gynecology and Obstetrics Volume 5 Number 2 A Prospective Study Of Comparison Of Efficacy Of Two Combination Treatment Regimens In Syndromic Treatment Of Pelvic Inflammatory
More informationMetastatic Colonic Adenocarcinoma Simulating Primary Ovarian Neoplasm in Transvaginal Doppler Sonography
J Clin Ultrasound 22:121-125, February 1994 0 1994 by John Wiley & Sons, Inc. CCC 0091-2751/94/020121-05 Case Report Metastatic Colonic Adenocarcinoma Simulating Primary Ovarian Neoplasm in Transvaginal
More informationClinical Outcomes of Pediatric Patients With Acute Abdominal Pain and Incidental Findings of Free Intraperitoneal Fluid on Diagnostic Imaging
ORIGINAL RESEARCH Clinical Outcomes of Pediatric Patients With Acute Abdominal Pain and Incidental Findings of Free Intraperitoneal Fluid on Diagnostic Imaging Samantha Matz, DO, Mary Connell, MD, Madhumita
More informationAppendicitis. I. Background & Significance: Algorithm Definitions 1. CASE
I. Background & Significance: Appendicitis Appendicitis is one of the most common acquired surgical conditions of childhood. Diagnosis of appendicitis remains difficult. Much work has been done on validation
More informationAcoustic streaming: a new technique for assessing adnexal cysts
Ultrasound Obstet Gynecol 2003; 22: 74 78 Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/uog.156 Acoustic streaming: a new technique for assessing adnexal cysts A. EDWARDS,
More informationFDG-PET value in deep endometriosis
Gynecol Surg (2011) 8:305 309 DOI 10.1007/s10397-010-0652-6 ORIGINAL ARTICLE FDG-PET value in deep endometriosis A. Setubal & S. Maia & C. Lowenthal & Z. Sidiropoulou Received: 3 December 2010 / Accepted:
More informationTHE ROLES OF ENDOSCOPY IN ENDOMETRIAL CANCER
REVIEW ARTICLE THE ROLES OF ENDOSCOPY IN ENDOMETRIAL CANCER Chyi-Long Lee 1, Kuan-Gen Huang 1, Hsiu-Lin Chen 2, Chih-Feng Yen 1,3 * 1 Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital,
More informationLaparoscopic versus laparotomic surgery for adnexal masses: role in elderly
Pulcinelli et al. World Journal of Surgical Oncology (2016) 14:105 DOI 10.1186/s12957-016-0861-1 RESEARCH Open Access Laparoscopic versus laparotomic surgery for adnexal masses: role in elderly F. M. Pulcinelli
More informationInternational Federation of Gynecology and Obstetrics
International Federation of Gynecology and Obstetrics COMMITTEE FOR UROGYNAECOLOGY AND PELVIC FLOOR MEMBER: TSUNG-HSIEN (CHARLES) SU, CHAIR (TAIWAN) DAVID RICHMOND, CO-CHAIR (UK) CHITTARANJAN PURANDARE,
More informationTwo-thirds of the almost one-half million
Minimally Invasive Surgery New data and the guidance of our professional societies are bringing us closer to clarity in understanding the superiority of minimally invasive techniques of hysterectomy Amy
More informationDownloaded from Bilateral fetal head size endometriomas with deep infiltrating endometriosis in an adolescent girl.
Submitted on: May 2015 Accepted on: June 2015 For Correspondence Email ID: Medrech ISSN No. 2394-3971 BILATERAL FETAL HEAD SIZE ENDOMETRIOMAS WITH DEEP INFILTRATING ENDOMETRIOSIS IN AN ADOLESCENT GIRL
More informationPerformance of patients with a ''frozen pelvis" in an in vitro fertilization program
FERTILITY AND STERILITY Copyright 1987 The American Fertility Society Printed in U.8A. Performance of patients with a ''frozen pelvis" in an in vitro fertilization program David Molloy, F.R.A.C.O.G.*t
More informationMEMORANDUM. TO: Sandy Koufax FROM: Martin A. Ginsburg, BSN, RN SUBJECT: Merit Screen Johns DATE: 23SEP16. Mr. Koufax,
MEMORANDUM TO: Sandy Koufax FROM: Martin A. Ginsburg, BSN, RN SUBJECT: Merit Screen Johns DATE: 23SEP16 Mr. Koufax, Per your instructions and at your request, this memorandum is a summary of information
More informationConsent Advice No. XX (Joint with BSGE) Peer Review Draft Spring Morcellation for Laparoscopic Myomectomy or Hysterectomy
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 Consent Advice No. XX (Joint with BSGE) Peer Review Draft
More informationPelvic Inflammatory Disease
Pelvic Inflammatory Disease GRAND ROUNDS 03/07/18 HOLLY MONTGOMERY, MD Outline Pathogenesis Microbiology Risk Factors Clinical Manifestation Diagnosis Long Term Complications Treatment Review Pathogenesis
More informationREVIEW ARTICLE ABSTRACT
10.5005/jp-journals-10009-1273 Jesús Utrilla-Layna et al REVIEW ARTICLE Predicting Malignancy in Entirely Solid-appearing Adnexal Masses on Gray-Scale Ultrasound Based on Additional Ultrasound Findings,
More informationComparative Study of Outcomes of Early Versus Interval Laparoscopic Cholecystectomy in Acute Calculus Cholecystitis.
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 4 Ver. IX (April. 2017), PP 68-73 www.iosrjournals.org Comparative Study of Outcomes of Early
More informationAccreditation Council for Graduate Medical Education
Obstetrics And Gynecology Case Logs National Data Report Accreditation Council for Graduate Medical Education Prepared by: Department of Applications and Data Analysis I. National Resident Statistics Main
More informationRisk of Malignancy Index in the Preoperative Evaluation of Patients with Adnexal Masses among Women of Perimenopausal and Postmenopausal Age Group
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 17, Issue 9 Ver. 8 (September. 2018), PP 20-25 www.iosrjournals.org Risk of Malignancy Index in the Preoperative
More informationCLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION
Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 2/12/2011 Radiology Quiz of the Week # 7 Page 1 CLINICAL PRESENTATION AND RADIOLOGY QUIZ
More informationAMERICAN JOURNAL OF BIOLOGICAL AND PHARMACEUTICAL RESEARCH
AMERICAN JOURNAL OF BIOLOGICAL AND PHARMACEUTICAL RESEARCH e-issn - 2348-2184 Print ISSN - 2348-2176 Journal homepage: www.mcmed.us/journal/ajbpr ABDOMINAL ABSCESS A SEQUEL OF EXPLORATORY LAPAROTOMY FOR
More informationRichmond, Virginia. I ve have this terrible pain
Acute Pelvic Pain A Practical Approach Christine Isaacs, MD Associate Professor Department of Obstetrics & Gynecology Virginia Commonwealth University School of Medicine Richmond, VA Richmond, Virginia
More informationCase Report Genital Tuberculosis as the Cause of Tuboovarian Abscess in an Immunosuppressed Patient
Infectious Diseases in Obstetrics and Gynecology Volume 2009, Article ID 745060, 4 pages doi:10.1155/2009/745060 Case Report Genital Tuberculosis as the Cause of Tuboovarian Abscess in an Immunosuppressed
More informationCNGOF Guidelines for the Management of Endometriosis
CNGOF Guidelines for the Management of Endometriosis Anatomoclinical forms of endometriosis Definitions Endometriosis is defined as the presence of endometrial tissue containing both glands and stroma
More informationMANAGEMENT OF ACUTE PELVIC INFLAMMATORY DISEASE
Guideline No. 32 May 2003 MANAGEMENT OF ACUTE PELVIC INFLAMMATORY DISEASE 1. Purpose and scope Pelvic inflammatory disease (PID) is a common cause of morbidity and accounts for 1 in 60 GP consultations
More informationShunichiro Tsuji 1, Takashi Murakami 1, Fuminori Kimura 1,SatoshiTanimura 2, Masataka Kudo 3, Makio Shozu 4, Hisashi Narahara 5 and Norihiro Sugino 6
doi:10.1111/jog.12750 J. Obstet. Gynaecol. Res. Vol. 41, No. 9: 1305 1312, September 2015 Management of secondary infertility following cesarean section: Report from the Subcommittee of the Reproductive
More informationCHAPTER 13 Gynaecological Procedures
CHAPTER 13 Propunere noua clasificare proceduri folosind codificarea ICD-10-AM versiunea 3, 30 martie 2004 Gynaecological Procedures BLOCK 1240 Application, insertion or removal procedures on ovary 35518-00
More informationClinical and financial analyses of laparoscopically assisted vaginal hysterectomy versus abdominal hysterectomy Hidlebaugh D, O'Mara P, Conboy E
Clinical and financial analyses of laparoscopically assisted vaginal hysterectomy versus abdominal hysterectomy Hidlebaugh D, O'Mara P, Conboy E Record Status This is a critical abstract of an economic
More informationChronic Pelvic Pain. Bridget Kamen, MD Obstetrics and Gynecology, Confluence Health. I have no disclosures
Chronic Pelvic Pain Bridget Kamen, MD Obstetrics and Gynecology, Confluence Health I have no disclosures Objectives A little epidemiology Understand there are both gynecologic and non-gynecologic causes
More informationSCIENTIFIC PAPER ABSTRACT INTRODUCTION MATERIALS AND METHODS
SCIENTIFIC PAPER Vaginal Cuff Closure during Robotic-Assisted Total Laparoscopic Hysterectomy: Comparing Vicryl to Barbed Sutures A. Karim Nawfal, MD, David Eisenstein, MD, Evan Theoharis, MD, Marisa Dahlman,
More informationA NEW QUANTITATIVE METHOD TO EVALUATE ADNEXAL TUMORS
ORIGINAL ARTICLE A NEW QUANTITATIVE METHOD TO EVALUATE ADNEXAL TUMORS Chung-Yuan Lee, Ching-Cheng Tseng, Chen-Bin Wang, Yu-Hsiang Lin, Chun-Hung Chen, Ting-Hung Wun, Ying-Lun Sun, Chih-Jen Tseng* Department
More informationSetting Department of Gynecology and Obstetrics, Cleveland Clinic Foundation (tertiary care academic centre), USA.
Prospective randomized clinical trial of laparoscopically assisted vaginal hysterectomy versus total abdominal hysterectomy Falcone T, Paraiso M F, Mascha E Record Status This is a critical abstract of
More informationIsolated Torsion of the Distal Part of the Fallopian Tube in a Premenarcheal 12 Year Old Girl: A Case Report
Tohoku J. Exp. Med., 2004, Torsion 202, 239-243 of Fallopian Tube in a 12 Year Old Virgin Girl 239 Isolated Torsion of the Distal Part of the Fallopian Tube in a Premenarcheal 12 Year Old Girl: A Case
More informationSpecial Articles COSTS AND CHARGES ASSOCIATED WITH THREE ALTERNATIVE TECHNIQUES OF HYSTERECTOMY. The New England Journal of Medicine
Special Articles COSTS AND CHARGES ASSOCIATED WITH THREE ALTERNATIVE TECHNIQUES OF JAMES H. DORSEY, M.D., PATRICE M. HOLTZ, R.N., M.S., ROBERT I. GRIFFITHS, SC.D., MARGARET M. MCGRATH, M.S., AND EARL P.
More information