10 research outputs found
Retroperitoneal endometriosis causing cyclical ureteral obstruction
We report a case of retroperitoneal endometriosis involving the
periureteral tissues of the left ureter. The patient suffered from
cyclical symptoms of left ureteral obstruction during menstruation.
Endometriosis of the ureter is not common and in this case the
preoperative diagnosis presented difficulties due to the absence of any
pathological findings during the clinicolaboratory evaluation of the
patient before or after menstruation. The patient was managed with
surgical resection of the affected ureteral segment and subsequent
end-to-end anastomosis of the left meter. A brief review of the subject
is also presented
Tubo-ovarian abscesses in postmenopausal women: gynecological malignancy until proven otherwise?
Objective: To investigate the incidence of gynecological malignancy in
menopausal women who develop tubo-ovarian abscesses (TOAs), and to
address the differences in presentation and underlying pathology between
premenopausal and postmenopausal women with TOAs. Study design: In a
retrospective study we included 93 patients with a diagnosis of a TOA
and compared a premenopausal group (group 1) with a postmenopausal group
(group 2). Results: Group 1 included 76 (82%), and group 2 17 (18%)
patients. Abdominal pain and pyrexia >38 degreesC were present in 93 and
74% cases of group 1, and in 71 and 41% cases of group 2 (P = 0.016
and 0.019, respectively). Irregular vaginal bleeding and gross ascites
were significantly more frequent in group 2. With respect to benign
additional pathology we found no differences between the two groups. On
the contrary a significant association between TOAs in menopause and
malignancy was established. In 8 (47%) postmenopausal cases a
concomitant gynecological malignancy was found including a variety of
cancers. Conclusion: Postmenopausal women presenting with TOAs, should
be thoroughly investigated to exclude a concomitant pelvic malignancy.
Conservative treatment of TOAs has no place during the menopause. (C)
2003 Elsevier Ireland Ltd. All rights reserved
Management of ureteric injuries during gynecological operations: 10 years experience
Objective(s): To present our 10 years. experience in the management of
ureteric injuries occurring during gynecological surgery. Study design:
Seventy-six patients had a variety of injuries. In 29 cases, the
ureteric damage was diagnosed intraoperatively. Management of
early-diagnosed injuries included suturing, ligature removal, end-to-end
anastomosis, and reimplantation of the ureter. In 47 cases, the injury
was diagnosed postoperatively. Ureteric catheterization was attempted in
all cases presenting with obstruction. Catheterization failures were
managed with ureterolysis, and reimplantation. Small ureteric fistula
were managed with catheterization, and large communications with
reimplantation. Two cases with urinomas were treated with surgical
evacuation and anastomoses. Results: Management of early-diagnosed
injuries was relatively easy in most cases. Postoperatively-diagnosed
injuries were more difficult to treat. Catheterization failed in 28/44
(65.9%) ureters and surgical re-exploration was necessary. Long-term
morbidity was minimal and no relapses occurred. Conclusion(s): Early
recognition of a ureteric injury is the key to a complications-free
repair. Unrecognized injuries cause prolonged morbidity, and their
management can be difficult. Treatment of these injuries by experienced
teams may minimize longterm consequences. (C) 2002 Elsevier Science
Ireland Ltd. All rights reserved