Spontaneous discharge from Gartner’s duct cyst in a perimenopausal woman: a rare case

Gartner’s duct cyst which arises from the remnants of the distal part of Wolffian duct is rare, especially in a perimenopausal woman. Hereby, presenting a case of huge Gartner’s duct cyst with spontaneous discharge in a perimenopausal woman. A 40 year old woman, who is having mass descending per vaginum for the past 2 years and discharge  from the mass for the past one week, is diagnosed to have a Gartner’s duct cyst in the right lateral vaginal wall. There was mucous discharge from the cyst through a pin hole opening in the vaginal wall covering the cyst. Under antibiotic cover, the cyst was excised completely. The patient was advised follow up.

Acute abdomen in early pregnancy caused by torsion of bilateral huge multiloculated ovarian cysts

The association of pregnancy and torsion of bilateral huge benign ovarian cyst is rare. We report a case of multigravida at 13 weeks of pregnancy presenting with acute onset of lower abdominal pain. Ultrasound revealed bilateral multiloculated ovarian cysts of size 10x10 cm on right side and 15x10cm on left side with evidence of torsion and a single live intrauterine fetus of gestational age 13 weeks 4 days. Emergency laparotomy was done with vaginal susten 200 mg as perioperative tocolysis. Intra operatively, uterus was enlarged to 14 weeks size. Both ovaries were replaced with multiloculated cysts of size 15x10 cm on left side and 10x10 cm on right side. Ovarian pedicle was found to be twisted once on right side and twice on left side. On right side, untwisting of pedicle was done and the ovarian cyst was punctured at multiple sites to drain the clear fluid. Biopsy was taken from the right ovarian cyst wall. On left side, ovariotomy was done. Histopathology revealed mucinous cyst adenoma of left ovary and multiple corpus luteum in right ovarian biopsy specimen. The patient was followed up with regular antenatal check-ups and ultrasound to rule out the recurrence of ovarian cyst on right side. The patient successfully delivered a term male baby at 39 weeks

Comparison of vaginal hysterectomy and laparoscopically assisted vaginal hysterectomy in women with benign uterine disease: a retrospective study

Background: Nowadays, there is a trend in favour of (laparoscopically assisted vaginal hysterectomy) LAVH even for patients in whom (vaginal hysterectomy) VH is feasible. Hence, this study is undertaken to compare the efficacy of LAVH and the traditional vaginal hysterectomy for the treatment of benign uterine disease and also to find out the advantage of LAVH over VH.Methods: The study population consists of patients who had undergone hysterectomy for benign uterine disease excluding prolapse of uterus. Medical records of patients who had undergone vaginal hysterectomy (50) and LAVH (50) without any medical illness and without previous surgical history (except sterilisation) were collected. Age, parity, indication for hysterectomy, operative time, intra operative and postoperative complications and duration of hospital stay were noted and compared between the two groups.Results: The mean operative time was significantly shorter in the VH group (83.7min) than in the LAVH group (128.7 min) and the difference was statistically significant (p<0.000). Total hospital stay was significantly longer in the VH group (7.1days) when compared to the LAVH group (4.9days) and the difference was found to be statistically significant (p<0.000). There were no intraoperative complications noted in both the groups. There was no significant difference in the minor postoperative complications (fever and spotting per vaginum) between the two groups.Conclusions: This study shows lesser operative time in VH group when compared to LAVH group and there is no added advantage in performing LAVH other than shorter hospital stay. Hence it is concluded that whenever feasible VH should be the preferred route of hysterectomy