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

â-thalassemia and gonadal axis: a cross-sectional, clinical study in a Greek population

ABSTRACT â-thalassemia (â-thal) is characterized by disturbances of the reproductive system. The aim of the present study was: 1) to assess the hypothalamic pituitary -gonadal axis in patients with â-thal in relation to their phenotype and 2) to determine prognostic features of current gonadal status. We studied 135 patients (67 males and 68 females) with â-thal through history, physical examination, spermiograms and GnRH test. These patients were divided into â-thal major (51 males and 62 females) and â-thal intermedia phenotypes (16 males and 6 females). Male patients with â-thal major were subdivided into three groups a) eugonadal (35%, Tanners stage V, normal testicular volume, normal spermiograms, normal basal and stimulated hormone values), b) patients with hypogonadotrophic hypogonadism (HH) of late onset (24%, Tanners stage II-V, low-normal testicular volume, abnormal spermiograms, normal basal gonadotrophin values and abnormal response to GnRH test) and c) patients with HH of early onset (41%, Tanners stage I, small testicular volume, abnormal spermiograms, abnormal basal and stimulated hormone values). Female patients with â-thal major were subdivided into: a) eugonadal (32%, Tanners stage V, regular menstruation, normal basal and stimulated hormone values), b) patients with hypogonadotrophic hypogonadism (HH) of late onset (34%, Tanners stage II-V, secondary amenorrhea, subnormal basal and stimulated gonadotrophin values) and c) patients with HH of early onset (34%, Tanners stage I, primary amenorrhea, subnormal basal and stimulated hormone values). Patients with â-thal intermedia were subdivided into eugonadal (75% of males -33% of females) and hypogonadal (25% of males -67% of females). Current gonadal status could not be predicted by means of transfusion or chelation parameters. In conclusion, â-thal patients could be eugonadal or develop early or late onset HH. â-thal intermedia patients have a more favorable profile than â-thal major individuals. Current gonadal status of â-thal patients cannot be predicted by means of history, clinical or laboratory parameters

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

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

Infertile men with varicocele alone and varicocele with coexistent non-obstructive azoospermia have completely different clinical, hormonal and sperm profiles

Objective: The aim of this study was to analyze the epidemiological, clinical, hormonal and sperm parameters in men with varicocele and to evaluate possible changes in sperm parameters after varicocelectomy.Patients and Methods: We accessed clinical, hormonal, sperm and cytological parameters from medical records of the men examined in the outpatient infertility clinic between 1991–2005. Inclusion criteria were either clinically apparent varicocele or a history of varicocelectomy (Study 1). In a subgroup of men, data were available before and after varicocelectomy (Study 2). In 64% of men varicocele was the only cause of infertility, whereas in 36% other additional causes were found. There were statistically significant differences between men with varicocele only and idiopathic non-obstructive azoospermia (INOA) plus varicocele, regarding testicular volume, Follicle Stimulating Hormone (FSH) levels and sperm parameters (Study 1). In men with varicocele only, Sperm Index was the only parameter that showed statistically significant increase after varicocelectomy (Study 2).Conclusions: Varicocele alone and INOA with coexistent varicocele have completely different clinical, hormonal and sperm profiles

Testicular fine needle aspiration biopsy in male infertility: A review of the indications, the advantages and the clinical applications

Τesticular Fine Needle Aspiration (FNA) biopsy is an integrated part of the diagnostic and the therapeutic approach of the infertile man. Apart from the cytological diagnosis, FNA makes possible sperm collection that can be subsequently used in Intra-Cytoplasmic Sperm Injection (ICSI). Compared to the traditional open testicular biopsy, FNA has significant advantages as it is a fast, low cost, less traumatic and minimally invasive technique. The combination of FNA with ICSI has revolutionized the management of male subfertilty. Infertile men with spermatogenesis defects can father their own children, whereas in the near past donor sperm or adoption were the only options available