Online ISSN: 2515-8260

Keywords : hysterectomy


Histopathological correlation of hysterectomy specimens with clinical and other investigational findings

Dr. Killol Nathubhai Desai, Dr. Vidya Satapara, Dr. Alpeshkumar Maheshbhai Maru, Dr. Harshid L. Patel

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1040-1048

Context: Hysterectomy is the surgical removal of the uterus and is the most common major
gynaecological surgical procedure performed worldwide.
Aims: To study the incidence and distribution of various types of pathologies in the
hysterectomy specimens in the population studied.
Methods and Material: A total of 500 cases were studied. The study material was obtained
from patients’ hospitals that underwent hysterectomy and also specimens sent from nearby
private or government
Results: Among various significant pathologies, benign accounted for 95.7% of lesions while
malignant for 4.3% of lesions. Among benign lesions, adenomyosis was commonest with 203
(136 isolated + 67 with leiomyoma) cases and it was most common in 41-50 years age group.
Leiomyoma was next common with 183 (116 isolated + 67 with adenomyosis) cases and it
was also most common in 41-50 years age group. 67 (13.4%) cases had both leiomyoma and
adenomyosis. CIN1 or LSIL accounted for 15 cases, serous cystadenoma of ovary for 12
cases, endometrial polyp for 12 cases, mature cystic teratoma of ovary for 8 cases,
endocervical polyp for 9 cases, cervical leiomyoma for 6 cases, mucinous cystadenoma for 3
cases, placenta accreta for 3 cases, simple endometrial hyperplasia without atypia for 2 cases,
infected decidua for 2 cases, CIN2/CIN3 or HSIL for 2 cases, adult granulosa cell tumour for
2 cases, endometriosis of ovary for 2 cases, broad ligament leiomyoma for 2 cases, acute
salpingitis for 1 case, endometriosis of fallopian tube for 1 case, complete hydatidiform mole
for 1 case, invasive hydatidiform mole for 1 case and adenomatoid tumour of myometrium
for 1 case. Among malignant lesions, carcinoma of cervix was commonest with 11 cases,
followed by carcinoma of ovary with 7 cases and carcinoma of endometrium with 3 cases.

To study the efficacy and safety between use of BICLAMP (bipolar coagulation forceps) in vaginal hysterectomy and conventional vaginal hysterectomy: A prospective study at tertiary care center, Maharashtra

Dr. Neha Chandraprakash Agrawal, Dr. Priyanka Kunal Purohit, Dr. Gaurav Kumar J Desai and Dr. Chintan M Upadhyay

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 784-790

Background: Bipolar vessel sealing systems (BVSS) are accepted to be safe and efficacious
with possible advantages over conventional methods, namely fewer requirement of postoperative
analgesics, less blood loss, shorter operative time and minimum hospital stay.
Objectives: To compare the efficacy and safety between use of BiClamp (Bipolar
Coagulation Forceps) in Vaginal Hysterectomy and Conventional Vaginal Hysterectomy.
Materials and Methods: This prospective study was done among 80 cases indicating
hysterectomy for benign diseases admitted in OBGY unit were selected randomly out of
which 40 cases underwent Conventional Vaginal Hysterectomy and 40 cases underwent
BiClamp Vaginal Hysterectomy at department of obstetrics & Gynecology in Government
medical college and hospital, Latur during November 2012 to September 2014.
Results: Mean duration of hospital stay required for participants of cases and control group
was 2.6 days and 4.2 days respectively (p<0.05). Mean duration of operation of cases and
control group participants was 70.9 min and 75.5 min respectively (p<0.05). Mean blood loss
during operation noted among the cases and control group participants was 90.1 ml and 115.9
ml respectively (p<0.05). During operation, three suture material required in in 0.0%
participants of cases group and 82.5% of control group respectively (p<0.05). Post- op
complications like fever, bladder injury, bowel injury & hemorrhage noted only in
participants of control group.
Conclusion: BiClamp Vaginal Hysterectomy post-operative pain was less, intraoperative
blood loss was less, operative time was significantly shorter, duration of hospital stay was
less and BiClamp Vaginal Hysterectomy was more Cost effective than the Conventional
Vaginal Hysterectomy

STUDY OF FIBROID UTERUS

DR VIJAY Y KALYANKAR,2.DR BHAKTI VIJAY KALYANKAR, DR SRINIVAS N GADAPPA, DR REVATI RAMESHWAR GHAYAL, DR MEGHA CHAUHAN, DR SHIVANGI S VERMA .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 4974-4980

INTRODUCTION-uterine fibroids are common tumor of uterus, seen in reproductive age group. Fibroids during pregnancy produce special challenges during labour. Small fibroids with minimal symptoms treated with medical management, while large, multiple fibroids with pressure symptoms require surgical management. Fibroids during pregnancy produces special challenges during labour.
AIMS & OBJECTIVES –To study and analyse the Risk factors associated withfibroids, Clinical features according to different type offibroid, Different types of management of fibroid.
METHODOLOGY- fibroid cases were diagnosed clinically and with ultrasonography. Details of clinical examination findings, investigations and treatment modalities used were noted. Difficulties during surgery and methods to overcome were studied.
Histopathology details of specimen and other associated findings were studied.
RESULTS- Fibroids are Commonly seen in reproductive age group showing 45.5% cases. Majority cases are multipara seen in 79.35% cases and 5.14% cases are pregnant patients with fibroid. Intramural fibroid was seen in 60% and presented with menorrhagia (73%) and dysmenorrhea (50.5%). Fibroids presented with menstrual symptoms were seen in 96.15% cases. 61.7% cases underwent surgical management in that Total Abdominal Hysterectomy alone constitute 76.19%. neglected fibroids were common in rural areas making surgical management more common.
CONCLUSIONS- Pre-operative adequate preparations with general build-up for anesthesia and surgery, imaging studies, ureteric stenting where-ever required, use of GNRH analogues and following the principles of Fibroid surgery, made successful surgeries with no surgical morbidity and mortality. Caesarean section is common mode of delivery in fibroids in pregnancy with no complications.

Realities Of Time. Chronic Gender Inflammation And Pelvic Pain

Sitora Amirovna Tilyavova; Gulchehra Samatovna Karimova

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 2754-2766

One of the most pressing problems in modern gynecology is the problem of chronic inflammation of the appendages. Every obstetrician-gynecologist has to deal with a complaint of pain in the lower abdomen in women every day. About 39% of women experience pelvic pain caused by inflammation of the uterine appendages periodically, while 12% of patients experience pain for at least 5 days every month, and another 12% suffer from persistent pelvic pain [2]. Chronic pelvic pain occupies a special place among the variety of clinical manifestations of gynecological diseases and is considered by most researchers as one of the leading symptoms of inflammatory diseases of the pelvic organs: chronic salpingitis and oophoritis, pelvic peritoneal adhesions, chronic endometritis. However, the presence of a "routine" gynecological pathology cannot always explain the development of pain in the lower pelvis. Pelvic pain is an indication in 12% of all hysterectomies. For this reason, the aim of our study was to optimize the treatment of chronic inflammatory diseases of the uterine appendages to improve the quality of life and prevention of pelvic pain. The object of the study was 100 women with chronic salpingoophoritis complicated by pelvic pain, who were divided into three groups according to the method of treatment. During the study, we used, along with general clinical research methods and examination for sexually transmitted infections, special research methods, such as: studying the intensity of pain on the VAS scale, bacterioscopic and bacteriological examination of vaginal contents, ultrasound scanning and Doppler studies, estradiol, progesterone, testosterone, FSH, LH, DHEAS-S, TSH, prolactin and cortisol in the blood serum, the content of prostaglandins F2α, E2 and growth factors in the serum. In addition, the level of immunoglobulin A (IgA), the concentration of the main cytokines (IL 1β, IL6) in the blood serum were determined. The resulting material was subjected to automated statistical processing. After the examination, the patients received the necessary treatment, which included antibiotic-anti-inflammatory therapy (ceftriaxone, doxycycline, metronidazole), 20 procedures of pharmaco-physiotherapeutic intravaginal electrotherapy with the drug Glutoxim in an amount of 1 ml of 1% solution, intravaginal ultrasound therapy, synbiotic Bifiten. Based on the results of the data, the effectiveness of the use of the developed pharmaco-physiotherapeutic method (91%) was proved in comparison with intravaginal ultrasound therapy (74%) and, especially, drug therapy (40%).