Ultrasound and MR-imaging in preoperative evaluation of two rare cases of scar endometriosis

Scar or incisional endometriosis is a rare, often misdiagnosed, pathologic condition of the abdominal wall. Two cases of incisional endometriosis are presented. Both patients presented with atypical cyclic pain and palpable nodules on scars of previous cesarean sections. In both cases, the mass was totally excised, after accurate preoperative evaluation with 2-D ultrasound, power Doppler and MRI. Microscopic examination confirmed the preoperatively presumed diagnosis of cutaneous endometriosis. In cases of suspected scar endometriosis, preoperative diagnostic imaging is valuable in determining the extent of disease, thus enhancing accurate and total excision

Placenta abruption in a woman with Wilson’s disease: a case report

Wilson’s disease is a rare genetic disorder of copper metabolism that causes primary hepatic cirrhosis, secondary menstrual abnormalities and infertility. Following the appropriate therapy patients are asymptomatic and pregnancy may be achieved. We present a case of placental abruption in a pregnant woman with Wilson’s disease and we review the management dilemmas and treatment options of pregnant women with Wilson’s disease

Embryo with XYY syndrome presenting with clubfoot: a case report

Talipes equinovarus (clubfoot) is a skeletal anomaly of the embryo’s legs, with a frequency of 1-3:1000 living born babies. It may occur as an independent anomaly, or as part of a syndrome with concomitant chromosomal abnormalities

Complete uterine inversion during caesarean section: A case report

Inversion of the uterus through the uterine lower segment incision during a caesarean section is an extremely rare obstetric incident. It consists, though, an emergency complication that is potentially life-threatening, especially in cases of prolonged inversion, because haemodynamic instability and shock may occur. Prompt diagnosis and immediate uterine reversion are the key actions in the management of this serious complication

Laparoscopic management of mesenteric cyst: a case report

Mesenteric cysts are rare intra-abdominal lesions with variable clinical symptoms and signs that make pre-operative diagnosis difficult. Optimal treatment is surgical excision of the cyst with laparotomy or laparoscopy. We present a case of mesenteric cyst that was misdiagnosed as para-ovarian cyst and managed laparoscopically by gynaecologists

Novasure impedance control system versus microwave endometrial ablation for the treatment of dysfunctional uterine bleeding: a double-blind, randomized controlled trial

Novasure impedance control system versus Microwave EndometrialAblation for the treatment of dysfunctional uterine bleeding: a double-blind,randomized controlled trialAim: To compare the efficacy and safety of two different second generationablation devices, Novasure impedance control system and Microwave Endometrial Ablation, in cases of abnormal uterine bleeding.Methods: This is a randomized controlled trial that took place in a single Gynecological Department of a University Hospital. Sixty six women with dysfunctional uterine bleeding, unresponsive to medical treatment, were included in the trial. The ratio of women allocated to bipolar radio-frequency ablation o rmicrowave endometrial ablation was 1:1. Follow-up assessments were carried out at 3 and 12 months post-ablation. Our main outcome measure was amenorrhea rates 12-months post-treatment.Results: The rate of amenorrhea at 12-months post-ablation was significantlyhigher in women treated by Novasure (25/33; 75.8%) as compared to thosetreated by MEA (8/33; 24.2%) (rate difference: +51.5%, 95% CI: +27.8 to +67.7).Conclusions: In women with dysfunctional uterine bleeding, endometrial ablation with Novasure bipolar radiofrequency impedance-controlled system is associated with increased rates of amenorrhea at 12-months post-treatment as compared to the microwave endometrial ablation method.Αντιμετώπιση δυσλειτουργικών αιμορραγιών μήτρας με μεθόδους καταστροφής του ενδομητρίου 2ης γενιάς: Διπολική διαθερμία ραδιοκυμάτων (Novasure) vs Microwave Endometrial Ablation (MEA): μια τυχαιοποιημένη κλινική δοκιμή.Σκοπός: Σκοπός της παρούσας τυχαιοποιημένης κλινικής δομικής είναι να συγκριθεί η αποτελεσματικότητα της διπολικής διαθερμίας υπερήχων (Novasure)με αυτή της καταστροφής ενδομητρίου με μικροκύματα (ΜΕΑ), σε περιπτώσεις δυσλειτουργικών αιμορραγιών μήτρας.Υλικό-Μέθοδος: Με βάση τον αρχικό υπολογισμό δείγματος, 66 προ εμμηνοπαυσιακές γυναίκες αποτέλεσαν το δείγμα αυτής της μελέτης. Η κατανομή τους σε δύο ομάδες (Novasure: n=33 – MEA: n=33) έγινε με χρήση λίστας τυχαίων αριθμών. Η καταστροφή του ενδομητρίου σε κάθε ασθενή έγινε σύμφωνα με τις οδηγίες του κατασκευαστή κάθε συσκευής. Στη συνέχεια οι ασθενείς παρακολουθήθηκαν για χρονικό διάστημα διάρκειας ενός έτους. Κύρια έκβαση της μελέτης, αποτέλεσε η αμηνόρροια στους 12 μήνες μετά την εφαρμογή της μεθόδου.Αποτελέσματα: Οι ασθενείς που υποβλήθηκαν σε καταστροφή του ενδομήτριου με Novasure παρουσίασαν σημαντικά αυξημένη πιθανότητα αμηνόρροιας 12μήνες μετά την εφαρμογή της μεθόδου (75.8%), σε σχέση με τις ασθενείς στις οποίες έγινε χρήση του MEA (24.2%) για τον ίδιο σκοπό (ποσοστιαία διαφορά:+51.5%, 95% CI: +27.8 to +67.7; NNT~2).Συμπεράσματα: Με βάση τα αποτελέσματα της πρώτης σχετικής τυχαιοποιημένης μελέτης, η καταστροφή του ενδομητρίου με τη χρήση Novasure παρουσιάζει σημαντικά μεγαλύτερη πιθανότητα αμηνόρροιας στους 12 μήνες μετά την εφαρμογή της μεθόδου σε σχέση με τη χρήση MEA