Tubal Occlusion Research Articles

On the priority of V.S. Gruzdev in the experiment on in vitro fertilization

Among the many methods of teaching students, special attention is drawn to becoming a specialist through the implementation of scientific research. V.S.Gruzdev, having mastered under the guidance of Professor V.A.Manassein the first skills of scientific research, widely used them in his development as an obstetrician-gynecologist. Later he formed his own scientific school, which still exists today. One of his early works was the study of artificial insemination in mammals. This research, ahead of its time, marked the beginning of the study of in vitro fertilization. He revealed an important regularity in the development of a fertilized egg when it is planted in the oviduct. Other contemporary embryologists also spoke about this feature, mentioning that V.S.Gruzdev became the first scientist who described it. It is important that Viktorin Sergeevich proposed a plan to resolve the problem of infertile marriage, through his experiments as a result of his research, followers were able to significantly increase the number of pregnancies that occurred as a result of the treatment of obstruction of the fallopian tubes and identify problems associated with the pathology of spermatogenesis in men, and their role in an infertile marriage. Professor P.V.Manenkov, being a student and follower of V.S.Gruzdev, continued the work of his teacher and was also able to further participate in the development of a bill draft on heteronomous conception.

The effectiveness of chest T-tube drainage in uniportal video-assisted thoracic surgery.

Uniportal incision located at 4th or 5th intercostal space represents a problem for the correct drainage of distal areas of pleural cavity. The T-shaped tube can drain both the extremities of pleural space. In this study, we evaluated the effectiveness of T-chest tube compared to classic chest tube after uniportal video-assisted thoracic surgery. We compared the effectiveness of T-tube and classic 28 CH chest drainage after different surgical procedures in uniportal video-assisted thoracic surgery: lobectomies, wedge resections and pleural and mediastinal biopsies. As primary end points, drained effusion and evidence of pneumothorax at postoperative day 1, subcutaneous emphysema, tube kinking, obstruction and necessity of repositioning or postoperative thoracentesis were considered. Pain at 6 and 24 h after surgery, pain at tube removal and mean hospitalization were analysed as secondary end points. A total of 109 patients were selected for the study, 51 included to the T-tube group while the other 58 ones to the control group with classic drainage. Patients with T-tube showed a significantly lower rate of pneumothorax (29.4% vs 63.8%; P < 0.001), tube kinking (5.9% vs 27.6%; P = 0.003) and need of repositioning (2.0% vs 12.1%; P = 0.043). No significant results were obtained in subcutaneous emphysema (P = 0.26), tube obstruction (P = 0.32), drained effusion (P = 0.11) and need of postoperative thoracentesis (P = 0.18). Patients with T-tube complained of <6 h after surgery (P < 0.001). Conversely, T-tube removal was reported to be more painful (P < 0.001). Chest T-tube can achieve significantly lower rate of postoperative pneumothorax, kinking and repositioning with less pain 6 hours after surgery compared to classic tube.

Effectiveness of hyaluronic acid-based anti-adhesion gel for intraoperative prevention of postoperative adhesions in surgical correction of distal occlusion of the fallopian tubes: Prospective cohort study

Aim. To evaluate the effectiveness of hyaluronic acid anti-adhesion gel in surgical correction of distal tubal occlusion in restoring natural fertility in patients with infertility.&#x0D; Materials and methods. A prospective cohort study was conducted. The main group (group 1) included 54 women; the comparison group (group 2) included 58 women with tuboperitoneal infertility due to distal occlusion of the fallopian tubes. In group 1 patients, at the final stage of endoscopic reconstructive plastic surgery on the surface of the fallopian tubes, anti-adhesion barrier Anti-adhesion was applied (5 mL per each operated fallopian tube). Primary outcomes (patency of the fallopian tubes after 3 months) and secondary outcomes (onset of uterine pregnancy during the first year) were assessed. Statistical results were processed using the IBM SPSS Statistics version 25.0 software package.&#x0D; Results. Within 3 months after surgical treatment, the patency of the fallopian tubes was reported in 32 (59.3%) group 1 patients and 24 (41.4%) group 2 patients (2=3.445; p=0.064). The rate of uterine pregnancy in group 1 during the first year after surgical treatment was significantly higher than in group 2: 21 (38.9%) and 12 (20.7%) women, respectively (2=4.447; p=0.035).&#x0D; Conclusion. Endoscopic reconstructive plastic surgeries using hyaluronic acid-based anti-adhesion gel in patients with distal tubal occlusion slightly reduces the frequency of postoperative reocclusions of the fallopian tubes within 3 months after surgical treatment and significantly increase the rate of uterine pregnancy during the year after surgery mainly due to patients with grade IIIIV of adhesive process in the pelvis.

Evaluation of Radiofrequency Endometrial Ablation: A 17-year Canadian Experience

The purpose of this study was to better elucidate radiofrequency endometrial ablation (REA) durability by assessing the probability of failure as defined by need for postablation hysterectomy. Age at index REA, duration from REA until hysterectomy, and REA failure (REAF) risk factors were analyzed. A retrospective cohort study was conducted using patient data between April 1, 2002, and March 31, 2019. REAF cases were identified using operative procedure codes. Cox proportional hazard regression assessed the effect of age at index REA on time to postablation hysterectomy. Kaplan-Meier survival curve evaluated timing of postablation hysterectomy, stratified by age at index REA. This study was conducted at Regina General Hospital in Regina, Saskatchewan, Canada. Patient population included those who were 21 years of age or older, were premenopausal, and had a history of heavy menstrual bleeding at the time of REA. The intervention under investigation was REA. The overall probability of postablation hysterectomy was 22.6%. The probabilities of postablation hysterectomy were 36.1% for women younger than 30 years (n=128), 28% for women 30 to 34.9 years old (n=528), 29.6% for women 35 to 39.9 years old (n=1152), and 17.6% for women 40 years and older (n=2221). Characteristics associated with REAF included tubal occlusion, cesarean section, dysmenorrhea, and chronic pelvic pain (p <.01) among women younger than 40 years. Leiomyomas accounted for higher failure rates in women 40 years and older (p <.01). Postablation hysterectomy is more likely to occur in women younger than 40 years. REA can be considered in women aged 30 to 39.9 years old, who have no known REAF risk factors. Women younger than 40 years with REAF risk factors will experience higher rates of hysterectomy. Thus, the decision to proceed with REA should be individualized with careful consideration for the underlying causes of abnormal uterine bleeding, while respecting patient autonomy.

Legal medicine aspects of female sterilization: our experience.

The most frequent sterilization procedures include postpartum tubal ligation, laparoscopic tubal disruption or salpingectomy, and hysteroscopic tubal occlusion. It may be performed via laparoscopy, mini-laparotomy, or hysteroscopy. Safety, efficacy, short-term complications, long-term complications, and non-contraceptive benefits of sterilization are different for each procedure. Female sterilization has become an important professional liability problem in obstetrics and gynecology. We analyzed 6 cases of surgical sterilization that have been the subject of civil proceedings. We review indications, contraindications, and complications associated with each sterilization procedure. In our small number of cases, women who have undergone sterilization performed negligently are entitled to recover damages for wrongful conception, negligence, and wrongful birth. We also consider the issue of female sterilization of minors. Tubal sterilization can be performed with different techniques, chosen in light of the various situations involved, with the goal of reducing as many as possible any failures. Thorough and complete communication of information is of primary importance. Sterilization is the most widely used birth control method around the world. The procedure is generally safe and highly effective. As reported in the literature, the decision concerning method depends on the setting, the surgeon's experience, the country's economic development, and the woman's preference, but we think that some techniques present a greater risk of failure and expose the surgeon to malpractice litigation.

Management of Female Sterility Due to Tubal Obstruction during Laparoscopic Surgery at the Nianankoro Fomba Hospital in Segou

This is a prospective cross-sectional study which took place at Segou Hospital from 15 January 2019 to 15 January 2022 on the management of female infertility by tubal obstruction in laparoscopic surgery at Segou Hospital on 14 cases. 42.9% were between 31 and 35 years of age. The mean age was 20.3 years, with extremes ranging from 20 to 41 years. Civil servants were the most represented, with 42.9% in our series, followed by shopkeepers with 21.4%. All our patients were married. 78.6% had primary infertility, 21.4% had secondary infertility. The average duration of infertility was 1.9 years, with extremes of 2 and 10 years. Obstetrical outcome after catheterisation was favourable in four (4) of our patients, i.e. 28.6% had a pregnancy after recanalisation compared with 71.4% without pregnancy. Conclusion: The advent of laparoscopic surgery in our country has made it possible to improve care for women suffering from female infertility.

P-463 Data from 143,251 women indicates that black women access at-home fertility testing services later in life compared to white women in the United Kingdom

Abstract Study question Does ethnicity play a role in fertility assessment-seeking behaviour of Black women in the United Kingdom (UK)? Summary answer Black women approach an at-home reproductive health and fertility assessment service later in their fertility journey than White women. What is known already Evidence from the Human Fertilisation and Embryology Authority (HFEA) shows that Black patients access fertility care two years later than the national average in the United Kingdom (UK) (36.4 vs 34.6 years). Additionally, previous research has shown different prevalences of reproductive health conditions associated with infertility amongst Black women, such as fibroids and tubal occlusion. In combination with delayed access to fertility care, this may contribute to the lower live birth rates seen in Black patients in the UK. Study design, size, duration A retrospective observational study conducted on 143,251 Hertility Health users who completed a virtual health assessment between September 2020 and January 2023. The health assessment collected self-reported data on age, ethnicity, pre-existing diagnoses of reproductive health conditions, whether they were actively trying to conceive (TTC) and the length of time they had been actively TTC. Participants/materials, setting, methods A total of 25.9% users (n = 37,170) indicated they were TTC. The majority of those TTC self-identified as White (82.9%), followed by Asian (7.4%), Mixed (3.6%), Black (4.6%) and ‘Other’ (1.5%). Summary statistics (mean ± SD and %) regarding age and prevalence of pre-existing conditions of users TTC have been reported. Additional statistical analysis of the associations of time spent TTC between ethnicities was conducted via Chi-squared test (χ2); p values &amp;lt;0.05 were considered significant. Main results and the role of chance A significant relationship was observed between time spent TTC and ethnicity; the strongest association was observed between Black and White users χ2 (16, n = 34,706)=120, p &amp;lt; 0.0001). Comparison of time spent TTC, and average age showed that fewer Black women undertook the virtual health assessment at &amp;lt; 6 months of TTC than White women (29.3%, n = 469 vs 34.1%, n = 9820) at a moderately older age (31.3±6.5 years vs 29.8±5.7 years). A higher percentage of Black women were TTC for &amp;gt;5 years compared to White women (14.2%, n = 227 vs 8.8%, n = 2544). Additionally, Black women at this time point were approximately four years older than White women (36.9 years ± 6.0 years vs 33.0 ± 5.1 years). Secondary analysis of the prevalence of reproductive health conditions associated with infertility indicated that 20.1% (n = 133) and 22.5% (n = 149) of Black women had a preexisting condition at &amp;lt; 6 months and &amp;gt;5 years of TTC, respectively, vs 22.6% (n = 1363) and 19.2% (n = 1158) of White women in the corresponding TTC length groups. Limitations, reasons for caution As the virtual health assessment data was self-reported, there is a risk of recall bias and false reporting. Data was stratified via the main ethnicities and did not take the heterogeneity within ethnic groups or mixed ethnicities into account. Wider implications of the findings This data suggests that Black women approach fertility testing services later than White women, which may contribute to the disparities between pregnancy outcomes in the UK and cannot fully be accounted for by preexisting diagnoses associated with infertility. Further investigations are needed to outline the underlying reasons for this. Trial registration number not applicable

The Main Etiologies of the Infertility of the Couple at the Reference Health Center of Kalaban Coro, Koulikoro (MALI)

The aim was to evaluate the epidemiological and clinical aspects and the main etiologies of the couple's infertility. Materials and methods: This was a descriptive, cross-sectional, randomized and analytical study with prospective data collection from April 1, 2020 to March 31, 2021, a period of 12 months at the Kalaban-Coro reference health center. Result: The infertility of the couple remains a major problem with a prevalence of 19.99% and a predominance of the majority of patients were 21-25 years old, a frequency of 27.8%. The majority of spouses were housewives (60.9%), merchants were the most represented among spouses with a frequency of 23.5%. Patients were married 100% of the time and 73.9% were without a co-wife. Secondary infertility was the most prevalent at 64.3%. Palms accounted for 28.7% and nulliparous 48.7%. The history was dominated by hypertension and caesarean section, i.e. 3.5% each. The desire to have a child was found as a reason for consultation in 83.5% of cases and the most represented duration for infertility was between 12-24 months in 57.4% of cases. The patient participation rate was 97.4%. Percentage for spouses it was 13%. Female etiologies accounted for 20.9% (tubal obstruction 7%, PCOS 5.2%, endometriosis 6.2%, polymyomatous uterus 2.6%, uterine synechia 1.7% and anovulation 0.9%) and male etiologies accounted for 46.67% (13.33% azoospermia, oligospermia and asthenospermia, 6.67% asthenospermia). Conclusion: The problem of infertility affects a growing number of couples. It concerns all social strata with a prevalence of 19.99% and a conception of the population that thinks that the etiology is feminine.

FREQUENCY OF PELVIC PATHOLOGIES IN PRIMARY SUBFERTILITY ON DIAGNOSTIC LAPAROSCOPY

This study aimed to determine the frequency of pelvic pathologies in female primary subfertility by using diagnostic laparoscopy. A prospective study was conducted in the Department of Gynecology and Obstetrics of Nishtar Hospital, Multan, from April 2022- April 2023. A total of 100 women aged 20-40 years who were unable to get pregnant after unprotected sex for one year and had a normal pelvic examination and semen analysis of the husband were selected for the study. All the patients underwent laparoscopy. A tubal patency test was performed by using methylene blue dye. 50 patients (50%) had been subfertile for 1-5 years. Laparoscopy revealed that endometriosis was the most common cause of subfertility, as seen in 40% of patients. Tubal blockage was also observed in 8 patients (8%). Based on the results, it can be concluded that endometriosis followed and tubal occlusions are the most common causes of subfertility in women.

Contribution of Hysterosalpingography (HSG) in Female Infertility in Kati

Introduction: Female infertility is a frequent reason for consultation and is therefore a real public health problem. The objective is to study the contribution of HSG in the etiological research of this infertility. Materials and Method: This is a bicentric study carried out in the Medical Imaging Department of the Pr Bocar Sidy SALL University Hospital and at the "Amitié" Medical Clinic (CMA) of Kati over a period of two years (from 01 January 2020 to 31 December 2021). The examinations were largely performed by radiologists in the first part of the cycle, after menstruation and outside of any infectious context. The variables studied were sociodemographic, clinical and radiographic data. The readings of the images were made by the radiologists. The GE PRESTILIX 1600X remote-controlled table was used for examinations in each centre. Results: At the end of our study, we collected 421 files: 223 cases at the CHU and 198 at the CMA. These examinations were requested by gynecologists in 70% of cases, the average age of our patients was 31.4 years and the 25-34 years age group was in the majority (50.4%). The most recovered clinical information was sterility with 40.6% (21.4% for secondary sterility and 19.2% for primary sterility) and desire for children (17.6%). Examinations were done by radiologists (47%) and medical assistants (40%). The result was normal in 58% of cases and pathological in 42% of cases; Among the pathologies, tubal abnormality was the majority (71.2%) dominated by tubal obstruction in 59.5% of cases, followed by hydrosalpinx in 35.7% of cases. Uterine pathologies were dominated by myomas (25.5%) followed by uterine synechia (21.6%). Conclusion: Female infertility is common, affecting young women. The HSG allowed us to detect certain lesions, largely tubal and uterine abnormalities. It is the examination of choice in the search for tubal abnormality in our country.

Successful laparoscopic resection of fallopian tube abscess caused by Escherichia coli in a 12-year-old adolescent virgin:a case report and review of the literature

BackgroundUpstream infection with vaginal flora can develop into tubal endothelial damage and tubal edema, which can lead to tubal obstruction and fallopian tube abscess if left untreated. Fallopian tube abscess in adolescent virgins is very rare, it may lead to long-term or even lifelong complications once it occurred.Case presentationA 12-year-old adolescent virgin with no history of sexual intercourse and previous physical fitness who presented with lower abdominal pain with nausea and vomiting for 22 h, body temperature up to 39.2 °C. Laparoscopic surgery revealed an abscess in the left fallopian tube, the left fallopian tube was surgically removed, successfully treated, and the pus was cultured for escherichia coli.ConclusionIt is important to consider possibility of tubal infection in young.

Treatment of Proximal Tubal Occlusion by Transcervical Fluoroscopic Guide Wire Mediated Fallopian Tube Recanalization in Female Infertility

Treatment of Proximal Tubal Occlusion by Transcervical Fluoroscopic Guide Wire Mediated Fallopian Tube Recanalization in Female Infertility

Tubal Blockage Surgery: A Retrospective Cohort Study on Clinical Characteristics and Reproductive Outcomes Within Six Years.

Introduction and objectives This research undertakes a comprehensive evaluation of demographic information and medical antecedents, in addition to intraoperative observations, for patients diagnosed with tubal obstruction. Furthermore, we delineate the therapeutic procedures implemented to achieve bilateral tubal patency. The overarching objective of this study is to ascertain the efficacy of the aforementioned therapeutic procedures and to establish an optimal timeframe before the necessity for exogenous intervention becomes apparent. Material and methods This study conducted a retrospective analysis of patients diagnosed with infertility due to tubal obstruction at the Oradea County Clinical Hospital, spanning a six-year period from 2017 through 2022. We evaluated numerous factors, including demographic data of the patients, intraoperative observations, and the exact site of the obstruction within the fallopian tubes. Additionally, we monitored patients post-procedure to assess their potential for fertility following the intervention. Our study involved a comprehensive examination of 360 patients in total. The primary objectives of our research were to provide clinicians with significant insights regarding the likelihood of spontaneous conception subsequent to surgical interventions and to propose guidelines on establishing an adequate waiting period prior to recommending other interventions. We employed a mix of descriptive and inferential statistical methods to analyze the data amassed. Results This study encompassed an initial patient population of 360 included in the study following specific exclusion criteria; the remaining 218 patients constituted the study cohort. The mean±SD age of the patients was 27.9±4.4. Out of the entire cohort, 47 patients presented with minimal adhesions, while 117 patients exhibited blockages in one fallopian tube. A total of 54 patients were diagnosed with bilateral tubal defects. Post-intervention, patients were monitored and it was noted that 63 patients achieved pregnancy. The correlation analysis indicated the significant impact of tubal defect characteristics and patient age on fertility outcomes. The most favorable fertility outcomes were observed to be influenced by factors such as patient age and blockage location, while a higher body mass index (BMI) was found to exert a negative impact on fertility. Temporal analysis revealed that 52 patients conceived within the initial six months post-intervention, whereas only 11 patients became pregnant in the subsequent months. Conclusions Our research indicates that age, parity, and tubal damage severity predict tubal intervention success. Fimbriolysis was the most successful, while outcomes for salpingotomy varied. Conception significantly declined12 months post-intervention, suggesting this is a reasonable waiting limit for a successful pregnancy.

Impact of a quality improvement programme on the preparation and administration of medications via a nasoenteral feeding tube: 2014–2019 intervention study

AimsEvaluate the impact of a quality improvement programme on the reduction of feeding tube obstruction frequencies, analyse the predictive variables of this safety incident, and estimate the economic costs related...

Tubarial Salivary Gland – The New Member of Nasopharynx

Tubarial Salivary Gland – The New Member of Nasopharynx

Use of prostaglandin E1 analog (misoprostol) to aid cervical dilation in birth induction (a case report)

The cervix is a barrier between the environment and the uterus, composed of longitudinal folds that continue along the uterine folds. Cervical dilation is associated with increased synthesis of prostaglandin E2 (PGE2). Dilatation may fail due to congenital malformations or adhesions of the cervix caused, for example, by previous dystocia or by failure of any mechanisms that regulate cervical relaxation including a reduction in collagen and glycosaminoglycans and an increase in water content and metalloproteinases. Labor induction often requires the ripening of the cervix mechanically or pharmacologically. Oxytocin success may be reduced if the cervix is not favorable or responsive. Misoprostol, a synthetic prostaglandin E1 analog, is widely used in reproduction in cases of oviduct obstruction. It also promotes cervical softening by the dissolution of extracellular collagen. A 17-year-old mixed-breed mare from a private farm in the Middle East presented with abdominal discomfort and signs of imminent delivery, 10th months after embryo transfer. A slight thickening of the uterus-placental junction (7.12mm) was observed during transrectal ultrasound evaluation, but there was no placental detachment. On transabdominal imaging, the absence of a fetal heartbeat, fetal movements, and torsion of the umbilical cord were observed. Imaging evaluations were performed with an ultrasound machine DCS - MyLab™25 GOLD, 5Hzfrequency. Hematological analysis of the mare showed results within normal ranges. Flunixin Meglumine (10mL i.v., Finadyne, 50mg/mL, MSD) was administered before the abortion procedure. After confirmation of fetal death and dystocia in the mare, the cervix dilation process began with a local application of 1mg of misoprostol 200mcg diluted in lubricating gel and mechanical massage. Then, intravenous oxytocin (Syntocin, 10UI/mL, Illium) was started gradually every 5 minutes (5IU, 5IU, 10IU, 10IU). Mild sedation and analgesia was achieved with detomidine (0.6mL i.v., Dormiun V, 10mg/mL, Agener Uniao) and butorphanol (1mL i.v., Torbugesic, 14,58mg/mL, Zoetis). The mare showed signs of delivery before the mechanical rupture of the allantochorion. The position of the fetus (head back and right shoulder flexion) was corrected transvaginally by mechanical maneuver. After removing the fetus, 5 mg of dinoprost (i.m., Lutalyse, 6.71mg/mL, Zoetis) was administered to aid uterine contractility and clearance. The placenta did not have macroscopic changes. The fetus showed an absence of the right posterior limb's first, second, and third phalanges. During fetal necropsy, no other changes were observed. Uterine lavage was performed 24h and 48h after the procedure, using Ringer Lactate Solution (LRS), with 10% iodine (20mL/5L LRS) followed by 20IU oxytocin every eight hours for two consecutive days.

A Unique Case of Foreign Body Acquired by Stabbing and Retained for 7 Years in the Sigmoid Colon

The ingestion of foreign bodies is a common cause for presentation in the emergency department by pediatric, adult, or elderly psychiatric patients. Swallowed foreign bodies sometimes represent a great challenge for surgeons due to the obstruction or perforation of the digestive tube’s upper or lower segments. Occasionally, the foreign bodies detected in the lower parts of the digestive tube (colon and rectum) could be introduced through the anal route with the risk of perforation of the rectum or sigmoid colon. In this report, we describe a unique case of a foreign body located in the sigmoid colon, where it arrived due to backstabbing and was retained for 7 years without acute symptoms. The 43-year-old male patient came to the emergency department with pain in the left iliac fossa. Before his presentation, a computerized tomography (CT) scan examination had suggested a foreign body. A surgical approach was decided. The surgery started as an exploratory laparoscopy and was converted to a xiphoid-pubic incision to extract the foreign body (a piece of glass about 8 cm long) through a sigmoid colotomy followed by a double-layer sigmoidorrhaphy. The postoperative evolution of the patient was uneventful. As far as we know, this is the first case of a patient with a foreign glass body positioned in the sigmoid colon that got there by stabbing and not by ingestion or introduced per anum. In conclusion, we suggest that aggressive behavior and abdominal wall penetration by different sharp objects should be considered when foreign bodies are detected in the abdomen.

Pregnancy outcomes of intrauterine insemination without ovarian stimulation in couples affected by unilateral tubal occlusion and male infertility

BackgroundInformation available to date regarding the pregnancy outcomes of intrauterine insemination (IUI) without ovarian stimulation (OS) in infertile patients with unilateral tubal occlusion remains scarce. The objectives of this study were to investigate for couples affected by unilateral tubal occlusion (diagnosed via hysterosalpingography (HSG)/transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (TVS RT-3D-HyCoSy)) and male infertility: (1) whether significant differences exist in pregnancy outcomes between IUI with or without OS cycles, and (2) whether the pregnancy outcomes of IUI without OS in women with unilateral tubal occlusion were similar to those of women with bilateral patent tubes.Methods258 couples affected by male infertility completed 399 IUI cycles. The cycles were divided into three groups: group A, IUI without OS in women with unilateral tubal occlusion; group B, IUI with OS in women with unilateral tubal occlusion; and group C, IUI without OS in women with bilateral patent tubes. The main outcome measures, including clinical pregnancy rate (CPR), live birth rate (LBR), and first trimester miscarriage rate, were compared between either groups A and B or groups A and C.ResultsAlthough the number of dominant follicles > 16 mm were significantly higher in group B than that in group A (group B vs. group A: 1.6 ± 0.6 vs. 1.0 ± 0.2, P < 0.001), the CPR, LBR, and first trimester miscarriage rate were comparable between these two groups. When comparing group C to group A, the duration of infertility was significantly longer in group C than that in group A (group A vs. group C: 2.3 ± 1.2 (year) vs. 2.9 ± 2.1 (year), P = 0.017). Except for the first trimester miscarriage rate, which was significantly higher in group A (42.9%, 3/7) than that in group C (7.1%, 2/28) (P = 0.044), no significant differences were observed in the CPR and LBR in these two groups. After adjusting for female age, body mass index, and the duration of infertility, similar results were obtained between groups A and C.ConclusionsIn couples affected by unilateral tubal occlusion (diagnosed via HSG/TVS RT-3D-HyCoSy) and male infertility, IUI without OS might be an alternative treatment strategy. However, when compared to patients with bilateral patent tubes, the patients with unilateral tubal occlusion showed a higher first trimester miscarriage rate following IUI without OS cycles. Further studies are warranted to clarify this relationship.

Clinical Characteristics Associated With Re-Insertion and Postoperative Complication of Ventilation Tube Insertion in Pediatric Patients

Background and Objectives Otitis media with effusion is a common disease in the pediatric population. When medical treatment fails, ventilation tube insertion (VTI) is the best treatment choice. In this article, we aimed to analyze complications following VTI and evaluate clinical characteristics that increase the possibility of reoperation.Subjects and Method This study retrospective reviewed the medical charts of 287 pediatric patients who underwent VTI in our institute from May 2015 to June 2020. Patients were classified into two groups: the single VTI group, who were operated on once, and the multiple VTI group, who were operated on at least twice. We studied the differences between the two groups regarding patient demographics, the operative method, operative-related data, treatment outcomes, and complications.Results Our study included 181 patients (308 ears), consisting of 114 males (63.0%) and 67 females (37.0%). Among the patients, 141 patients (237 ears) were included in the single VTI group, and 40 patients (71 ears) were included in the multiple VTI group. There was a higher tendency of re-operation for patients whose age was younger at the first operation than for older patients and for those who had underlying diseases such as genetic diseases, developmental delay or language delay. We also found that the retraction state of the tympanic membrane after tube extrusion and earlier extrusion or obstruction of the ventilation tube was statistically significant factors associated with reoperation.Conclusion Our study identified factors affecting the possibility of reoperation. Regular follow-ups are necessary if these factors are present.

Anesthetic Complications in Children Undergoing Mehta Spine Casting: A Case Series.

Elongation-derotation flexion casting, commonly referred to as Mehta casting, is a relatively new treatment for infantile idiopathic scoliosis. Surgeons have noted remarkable, sustained improvement in scoliosis following treatment with serial Mehta plaster casts. There is scant literature regarding anesthetic complications during Mehta cast placement. This case series examines 4 children who underwent Mehta casting at a single tertiary institution. Complications included endotracheal tube obstruction, hypothermia, pressure point injuries, and prolonged exposure to general anesthesia (GA) that potentially increases the risk of long-term neurodevelopmental delay.