Laparoscopic management of a large torted ovarian cyst in an adolescent virgin: a case report

We report a case of a torted mature cystic teratoma in a 23-year-old, sexually inactive, virgin female which necessitated immediate laparoscopy. The patient and her family stressed that the integrity of the hymen must be maintained at any cost, for cultural reasons. We opted out of our routine intravaginal preparation for laparoscopic surgery to honor the patient’s request to maintain the integrity of the hymen. Left salpingo-oophorectomy was accomplished, and the specimen was removed using a large nephrectomy endobag. Here, we describe techniques that are useful for this procedure, including the use of gauze attached to ovum forceps to manipulate the uterus through the rectum, and a review of the literature

Sildenafil citrate for the management of asymmetrical intrauterine growth restriction and its effect on umbilical artery Doppler

Background: Asymmetrical intrauterine growth restriction IUGR occurs when there is uteroplacental insufficiency. Sildenafil citrate phosphodiasterase-5 inhibito is a potent vasodilator, which selectively inhibits phosphodiesterase-5 and, as a consequence, enhances the action of cyclic guanosine monophosphate which is the second messenger of NO. Hence, the trial was used for improving uteroplacental perfusion through enhancing vasodilatation of myometrial small arteries boosting flow within uteroplacental bed. The aim was to evaluate the efficacy of adding sildenafil citrate to low dose aspirin in treatment of asymmetrical IUGR through its effect on uteroplacental blood flow guided by Doppler ultrasound.Methods: Our study was a prospective double-blinded, randomized, controlled trial. Recruitment of participating women was from the obstetric outpatient clinic of Aswan university hospital. 100 patients included in the study and randomized in two groups. The first group was 50 patients assigned sildenafil with low dose aspirin and the second group was 50 patients assigned placebo with low dose aspirin.Results: As regard the outcomes, the study demonstrated that using of SC and LDA were effective in increasing estimated fetal weight and in improvement of umbilical artery umbilical artery Doppler (UAD) indices RI and PI for pregnancy complicated with IUGR compared with the control group.Conclusions: Sildenafil citrate is a promising treatment for IUGR fetuses with prolongation of pregnancy and improvement of fetal birth weight, umblical Doppler indices UDI, decreases days needed in PCU

Opportunistic salpingectomy during hysterectomy for benign indications in women at low and high risk for ovarian cancer: a cross-sectional study

Objective Our study aims to evaluate the role of pathology evaluation of fallopian tubesduring hysterectomy for benign indications for the purpose ofearly detection of serous tubal intraepithelial carcinoma (STIC) in women at high and low risk for ovarian cancer. Material and methods This cross-sectional study was conducted at Minia Maternity University Hospital, Egypt, between June 2015 and December 2017. Our study included all women undergoing hysterectomy for benign conditions in the genital tract. Appropriate histories were taken, as well as physical exams, and laboratory and ultrasound evaluations were done prior to scheduling surgery. Abdominal hysterectomies including opportunistic salpingectomies were performed and the whole specimens including the tubal fimbria were sent to the pathology lab for histo-pathological examination. Results A total of 526 patients met inclusion criteria for this study. The mean age of the study participants was 49.75±8.95 years, the mean parity was 3.91±1.62 and the mean BMI was 24.21±2.38 Kg/m2. The most common surgical indications for hysterectomy were postmenopausal bleeding (34.6%), a clinically benign adnexal/pelvic mass (31.7%), and menorrhagia (24.7%). The fallopian tubes were found to have either no pathology or benign conditions in 500 out of the 526 patients. Among these patients, 56% had no pathologic abnormality. The most common benign conditions were paratubal cysts (25%), endometriosis (9%), torsion (2%) and hydrosalpinx (1%). STIC was identified in the fallopian tubes of 8 out of 526 patients. Conclusions Microscopic examination of the entire fimbriae from all patients regardless of the clinical context represents a novel method of early detection of sporadic tubal carcinoma, a putative precursor to advanced-stage pelvic cancer

The Use of Green Tea in the Treatment of Symptomatic Uterine Fibroids

Background: Green tea is a natural product, commonly used by women for multiple purposes. Epigallocatechin gallate (EGCG), the major catechin in green tea, exhibits several useful biological effects, including anti-inflammatory, antiproliferative, and antioxidant effects. A study conducted by the US Department of Agriculture reported that green tea has potent anticancer effects against a wide range of human cancer cells. Green tea's polyphenols are considered responsible for these positive effects, and most notably EGCG has been shown to inhibit key pathways of tumor growth. Objective: Aim of the work was to study the effects of epigallocatechin gallate (EGCG), an extract of green tea on human leiomyoma and quality of life in women with symptomatic uterine fibroids. Patients and methods: A Prospective, sealed envelopes, randomized control trial was conducted including 75 reproductive-age women with symptomatic uterine fibroids (UF) were recruited for this study. All subjects had at least one fibroid lesion ≥ 2 cm³, as confirmed by transvaginal ultrasonography. The subjects had been randomized by SNOSE (Sequentially Numbered Opaque Sealed Envelopes); to oral daily treatment with either 900 mg of green tea extract or only symptomatic treatment for 4 months. The duration of study was about 3 years

Two Dimension Versus Three Dimension Ultrasound Assessment of Caesarean Section Scars

Background: Ultrasound (US) is now used as an imaging modality for the evaluation of lower uterine segment (LUS). A number of reports of sonographic evaluation of LUS have appeared in literature. It has been speculated that thickness of the LUS is related to the quality of wound healing. There is strong correlation between the anatomic status of scarred LUS as assessed by USG and its functional status which is tested during labour. Objective: The aim of this work was to investigate the accuracy of two-dimensional and three-dimensional ultrasound in measurement of Caesarean section scar thickness. Patients and methods: This study was cross sectional study, conducted in Aswan University Hospital. The ultrasound examinations were conducted in the Obstetrics and Gynecology department between June 2017 and September 2021. The study included 150 pregnant females with previous one or two cesarean sections (CS) (aged 20-41y; mean 32.5y), underwent TA 2D and 3D US for assessment of the LUS thickness at 37-39 gestational weeks, before planning