Cavity Of Uterus Research Articles

Diagnostic abilities of hysteroscopy in patients with chronic endometritis

Hysteroscopy is an important diagnostic method in the gynecology practice. The visualization of the uterus cavity can detect a lot of abnormal changes, value the prevalence of the pathology process and eliminate of the abnormal tissues.

Cervimetry and ultrasonographic observations of the cervix regression in dairy cows during the first 10 days post partum.

The aim of this study was to describe the involution process of the bovine cervix during the first 10 days post partum by using an intracervically introduced gauge and transrectal ultrasonography. Twenty-five pluriparous Holstein Friesian cows were included, which were randomized into three groups: group 1 (n = 10): transrectal ultrasonographic presentation of the formation of cervical folds; group 2 (n = 10): measurement of the reduction of the canalis cervicalis using an intracervically introduced gauge. The examinations were performed directly after expulsion and 2, 4, 6, 8, 12, 16, 18 and 24 h post partum, and in intervals of 24 h up to the tenth day. The involution process can be divided into four phases: 1: fast reduction up to the sixth hour; 2: protracted reduction up to the second day without constant formation of folds; 3: protracted reduction up to the seventh day with constant formation of folds; 4: re-opening of the canalis cervicalis maintaining the structure of the folds. The reduction process (phase 1- phase 3) can be shown as the sum of two exponential functions with different grading coefficients: y = reduction 1 x e(-b1 x t) + reduction 2 x e(-b2 x t). Reduction 1 is reduction in cm during the first phase and reduction 2 is reduction in cm during the second and the third phase. Group 3 (n = 5): to exclude an influence of the high frequency of examinations on the involution process the cows were examined immediately after parturition and on the fifth and tenth day postpartum using the same method as in groups 1 and 2. In conclusion, the involution process of the bovine cervix guarantees a fast protection of the cavum uteri and a drainage of the lochia at the end of the early puerperium. The re-opening phase after the seventh day has not yet been described in any other species and can be interpreted as the adaptation to the exsudative puerperium in the cow.

Conservative treatment of ectopic pregnancy in a cesarean section scar with methotrexate: a case report

Ectopic pregnancies sited in dehiscent cesarean section scars have a high risk of rupture and bleeding. Attempts at operative therapy frequently end in loss of the uterus. A connection with the cavum uteri justifies an attempt at dilatation and curettage. We describes a patient with combined systemic and local intra-amniotic methotrexate (MTX). The uterus was preserved.

Three-dimensional dynamic MR hysterosalpingography: a preliminary report.

The aim of this study was to evaluate the feasibility of three-dimensional dynamic MR hysterosalpingography (3D MR HSG) for visualization of the cavum uteri and demonstration of bilateral fallopian tube patency as an alternative to conventional hysterosalpingography. Five infertile female patients underwent 3D dynamic MR HSG prior to conventional hysterosalpingography. The MR protocol consisted of axial T1-weighted spin-echo (SE), axial/coronal T2-weighted fast SE (FSE), and 3D MR angiography sequences before, during, and after injection of a diluted gadolinium solution into the cavum uteri via a balloon catheter. Positioning of the catheter was feasible in all patients. In one patient the catheter slipped out during MRI and in one patient the catheter was placed far in the cavum uteri. In three patients catheter position was optimal at the level of the cervical canal. Evaluation of pelvic anatomy, myometrium, and ovaries was possible in all patients on the basis of T1-weighted SE and T2-weighted FSE. Three-dimensional visualization of the dilated cavum uteri was possible in four patients. In these four patients 3D MR HSG also proved bilateral fallopian tube patency which was confirmed in each patient by conventional hysterosalpingography. Three-dimensional MR HSG is feasible and further research should be done to determine if this technique can evolve into an alternative technique to conventional hysterosalpingography with the advantages of no radiation and additional visualization of the uterus wall and ovaries.

Acute puerperal inversion of the uterus - treatment by a new abdominal uterus preserving approach

Objective. Inversion of the uterus is still a rare (1, 2) but serious and life-threatening obstetric complication. It is said to be complete when the fundus uteri protrudes through the cervix and into the vagina. Within minutes a state of shock is reached due to pulling forces on the peritoneum as well as blood loss. Methods. The vagina was entered by a longitudinal incision (3 m) below the contraction ring. Through this opening it was possible to advance two fingers (second and third finger of the left hand) into the vagina above the invaginated corpus uteri. The invaginated cavum uteri was loaded on these two fingers and, exerting counterpressure with the right hand, the inside was turned out. Conclusion. The present operative method guarantees easy reposition of the uterus in cases of failed vaginal manual repositioning. Furthermore, the cavum uteri remains intact and hysterectomy can be avoided.

P143Primary bilateral fallopian tube cancer – case report

IntroductionFallopian tube cancer is one of the rarest neoplasm of female reproductive tract. Primary, bilateral presence of the cancer is especially rare. Diagnostic difficulties cause, that it is often found in very advanced state. The authors have presented the case of primary bilateral cancer of the fallopian tube, qualified to surgical treatment on the base of sonographic examination.57 years‐old women was examined using transvaginal ultrasound due to increasing pain in the lower part of the abdomen and abnormal discharge out of the vagina. During the examination fluid in the uterus cavity and cystic, oblong, winding structures in both adnexa, looking like distended oviducts were found. Typical ovary tissue wasn't visible. On the base of history and examination laparotomy was ordered. During the surgery multiple adhesions in the pelvis and extended fluid filled fallopian tubes were found. The hysterectomy and bilateral adnexectomy was performed. Pathological examination revealed presence of bilateral papillary adenocarcinoma of the fallopian tubes. Out of the oviduct no neoplastic cells was found.ConclusionExtended fluid filled oviducts found during sonographic examination may be the first sign of fallopian tube cancer.

Tubaric pregnancy – an excellent idea?

Until now, the treatment in cases of tubal pregnancy has been focused on the patient and has not been concerned with saving the embryo. We consider a hypothetical operation: the transfer of the tube, the seat of developing pregnancy, with its vascularization, to the inside of the uterus cavity by an incision in the myometrium, and binding of the breach. In order to support this hypothesis, a review has been made of the literature on surgical treatments of transplantation of the ovary into the uterus at the beginning of the century.

Comparison of leiomyotic uterus cavity evaluation by transvaginalsonography (TVS), saline infusion sonography (SIS) and 3-d imaging with postoperative assessment

International Journal of Gynecology & ObstetricsVolume 70, Issue S1 p. A38-A38 Ultrasound in gynecology Comparison of leiomyotic uterus cavity evaluation by transvaginalsonography (TVS), saline infusion sonography (SIS) and 3-d imaging with postoperative assessment J. Suzin, J. SuzinSearch for more papers by this authorG. Surkont, G. SurkontSearch for more papers by this authorW. Tyliski, W. TyliskiSearch for more papers by this author J. Suzin, J. SuzinSearch for more papers by this authorG. Surkont, G. SurkontSearch for more papers by this authorW. Tyliski, W. TyliskiSearch for more papers by this author First published: 09 December 2003 https://doi.org/10.1016/S0020-7292(00)82086-XAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume70, IssueS12000Pages A38-A38 RelatedInformation

Entwicklungen in der operativen Gynäkologie

Im ausgearbeiteten Text der Abschiedsvorlesung wird die Entwicklung der operativen Gynäkologie anhand der Onkochirurgie, der Uterusexstirpation mit oder ohne Rekonstruktion des Beckenbodens sowie der Korrekturoperationen am Uterovaginalkanal abgehandelt. Es gibt keinen Zweifel, dass endoskopische Chirurgie insbesondere im Bereich der Adnexe und des Cavum uteri grosse Bedeutung gewonnen hat. Die Uterusexstirpation sollte weiterhin die Domäne des vaginalen Vorgehens bleiben. Die für den erfahrenen «Vaginalisten» fast immer überflüssige «laparoskopische Assistenz» sollte sich im Sinne einer Renaissance der vaginalen Technik auswirken. Starke Betonung muss von Seiten der Gynäkologie weiterhin auf die vaginale Rekonstruktion des lädierten Beckenbodens im Rahmen von Inkontinenzoperationen gelegt werden. Fehlbildungen des Uterus werden dank neuer diagnostischer Möglichkeiten häufiger entdeckt, eine Verfeinerung der Diagnostik erscheint unerlässlich, will man verhindern, dass hier ein weiteres Tummelfeld laparoskopischer Polypragmatik entsteht. Die nach Ansicht des Autors vor allem an Universitätskliniken stetig mehr im Argen liegende operative Ausbildung der Fachärzte wird diskutiert.

Analysis of different application systems and CT-controlled planning variants in treatment of primary endometrial carcinomas. Is brachytherapy treatment of the entire uterus technically possible?

Intracorporal brachytherapy is regarded as the definitive component of treatment for inoperable patients with endometrial carcinoma. Until now the whole uterus has been claimed to represent the target volume independent of individual tumor spread. The purpose of this work is to analyse the correlation between target volume and treated volume using different application- and planning procedures. In a consecutive series of 10 patients with primary irradiated endometrial carcinoma we analyzed the correlation between target volume and treated volume using either standard 1-channel applicators or individual Heyman-applicators. Application of the ovoids was followed by a planning CT scan for all patients. Based on this, target volume (uterus volume) was estimated on a 3D-planning system. According to the measurable length of the uterus cavity we determined the corresponding standard 1-channel applicator and calculated the respectively treated volume. Estimating the advantages of an optimized treatment planning strategy for individual Heyman-applications were compared the treated volumes, which result from a standardized and optimized treatment planning procedure. The mean uterus volume was 180 cm3 (range 57 to 316 cm3). Asymmetric uterus configurations with longitudinal or sagittal side differences exceeding 1 cm were found in 40% of the cases. Using standard 1-channel applicators on average 47% (range 25 to 89%) of the uterus volume were enclosed by the treated volume compared to 70% for Heyman-applications. Differentiating these individual applications according to the variable treatment modality values of mean 66% (range 36 to 110%) for the standardized and 73% (range 48 to 95%) for the optimized treatment planning strategy were found. Moreover optimized planning modalities led to an improved coverage of the target volume in 5 out of 10 cases with an increase in volume of 20% on average (range 11 to 32%). In 3 cases changes of less than 5% were noticed (no improvement). In order to protect organs at risk treated volume had to be decreased in 2 cases for 19% and 40% respectively. Intracavitary brachytherapy of primary endometrial carcinoma was improved by individualized application- and planning procedures, which led to better adaptations of the treated volumes to the target volumes. Nevertheless a complete coverage--corresponding to the primary intent--was not possible. Individualized and optimized brachy-therapy must be performed according to the individual tumor spread and uterus configuration. Therefore, different applicators are required.

A case of pregnancy in a woman with cloacal dysgenesis and a rudimentary uterine horn

Cloacal dysgenesis is frequently associated with uterine anomalies. We report a case of pregnancy which resulted in an abortion in a woman with a persistent cloaca. Presumptive diagnosis before operation was ectopic pregnancy of the left tube. Postoperatively, the site of implantation of the conceptus was found to be the cavity of a unicornuate uterus in association with a rudimentary horn, the presence of which misled us to diagnose an ectopic pregnancy.

Transplantations of Ectopic Pregnancy from Fallopian Tube to Cavity of Uterus

Transplantations of Ectopic Pregnancy from Fallopian Tube to Cavity of Uterus

Results of hysteroscopic method of foreign body removal out of uterus cavity

Recognition of foreign bodies in the uterine cavity is of great importance for successful treatment of secondary infertility: e.g. a piece of intrauterine contraceptive (after a removal failure), suture after cesarean section, or cylindrical and flat small bones after abortions. Sixty-nine foreign bodies were removed with a hysteroscope during 1992-93. Sixty-one of the foreign bodies were intrauterine devices. Twelve patients (19.7%) had had several unsuccessful removal attempts. The remaining eight women (11.9%) underwent fetal bone removals. Removal of ligatures in the area of scar on the uterus after cesarean section was carried out in two patients and both were done under hysteroscopic control. Hysteroscopy allows exact determination of foreign body position in uterus and for their atraumatic removal.

Experimental transfer of Paragonimus westermani from rodents to rodents following subcutaneous and intraperitoneal routes.

In order to investigate the experimental transfer of Paragonimus westermani from rodents to rodents following subcutaneous and intraperitoneal routes, 13 rats and 23 mice were inoculated with a total of 115 (1 mature and 114 immature) worms of P. westermani subcutaneously and intraperitoneally. The age of worms before transfer was 25-193 days. The transfer was performed immediately after worm collection from rodents which were killed at various intervals from 4 to 144 days after infection. The location, development and size of worms were recorded. An infection rate of 58% (or 21/36) was demonstrated in rodents after experimental transfer of P. westermani by intraperitoneal and subcutaneous routes. Twenty-seven worms were recovered, giving a worm recovery rate of 23.5%. The rate was significantly higher by the subcutaneous route (34.8%) than by the intraperitoneal route (20.7%) but no difference was found between mice (23.9%) and rats (23.0%). The sizes of worms in the abdominal cavity, pleural cavity and thoracic muscles of mice, and in the leg muscles of rats were much less than in the pleural cavity and lung cysts of rats. A mature worm (7 x 5 mm) and numerous eggs were found in the uterus and pleural cavity of one rat. It is evidence that these rodents are unfavourable definitive hosts of P. westermani, because the worm size, infectivity, maturation and egg production are usually very low. However, the worms are usually widely distributed in their rodent hosts and remain small in size for a long period. Therefore, these rodents are good paratenic hosts for P. westermani and can play an important role in infecting cats and dogs with P. westermani in the laboratory.

馬の分娩後初回排卵時の生殖器所見と受胎率

Ultrasonic monitoring was made on the uterus and ovaries of 14 mares from parturition to the first functional luteal stage. The conception rate was investigated about 7 mares mated at the first postpartum estrus. The foal heat appeared 7-12 days after parturition in 9 of 14 mares and ovulation was seen 9-15 days after parturition in 12 mares while 22 and 35 days after parturition in the remaining 2 mares. With the estrous signs the ultrasonic image of the uterus cavity revealed prominent endometerial foldings with star-like layering of the folds during 3-7 days, which disappeared 1-2 days before ovulation. There were 5.2 follicles (1-3 cm in diameter) on average 3-4 days after parturition, and 1 or 2 of them attained 4.3-5.2 cm in diameter at the ovulation. Out of 7 mares 4 and 3 mares were successfully mated during and after the presence of the starlike layering of the folds image, and 3 mares were fertilized.

Bacterial pathogen colonization of the uterus in puerperium

In a prospective study the spectrum of bacteriological organisms in the uterus was analysed within the first 3 days post partum. Smears were taken from the ectocervix and from the cavum uteri from 80 asymptomatic puerperae (70 had delivered spontaneously and 10 had had a vaginal-operative delivery). The smears were achieved using an endometrium catheter with a pilot cap. After the specialised sampling had been undertaken, in 47 of the 70 patients with spontaneous delivery and in 1 of the patients with operative delivery, no bacterial invasion was found in the cavum uteri. After prophylactic administration of antibiotics prenatally, bacterial organisms were found significantly less often (p < 0.05). On the other hand, intrauterine bacterial organisms were found significantly more frequently in patients who had had cervix priming with PGE2 and where foetal blood analysis had been performed sub partum (p < 0.05). Contrary to the smears from the cavum uteri, all ectocervical smears were positive. In 13 of 23 cases with positive proof of intrauterine bacterial organisms, a difference was found in the bacteriological spectrum compared with the parallel cervical smear taken. Further obstetrical factors play a role in influencing the bacterial invasion, however, there were no complications in any of the cases due to the smears being taken and no infections were observed during the rest of the lying-in period.

Die vaginalsonographische Kontrastdarstellung des Endometriums mit Gel

In many cases, the sonography of the endometrium requires an exact pre-therapeutical interpretation. Apart from a hysteroscopy, this can take place by means of an improved version of a contrast hysterosonography, i.e. the Gel-KHSG. The technique and examination results are described here. This simple examination method can--like hysteroscopy--precisely define or exclude anomalies of the endometrium, and, beyond that, it has the advantage of the sono-tomographic depiction of the uterine wall. Moreover, it can be taken assumed, that the vagino-sonomorphological diagnostics at the endometrium could--for instance, analogous to the colposcopy of the uterine portion--become part of a system of preventive diagnostics for the cavum uteri. However, such a system has not been set up to date.

Zytologische Endometrium-Diagnostik mit einem neuen Kombinationsgerät, dem Endoshave*

We report on 300 examinations with a new one-way instrument for taking cell material from the uterus for cytodiagnosis. A combination of shaving and aspiration and the technical form similar to the uterus guarantee a high probability of complete collection and excretion of cell material from all parts of the cavum uteri and the cervix. A regular screening of all women with high risk seems to be possible with this cell collector.

Fibronectin localization in the mouse embryo from the two cell stage to the morula stage.

Among the characters of fibronectin, the adhesiveness may play an important role in embryo implantation. It is concluded that, using the direct and indirect immunofluorescence techniques, fibronectin was not found on the zona pellucida, but on the embryo surface even from the two cell stage. The results imply that (i) fibronectin is not an initial differentiation marker for the stage of endoderm, which used to be postulated, (ii) the surface fibronectin which has been produced at least from the two cell stage is covered by the zona pellucida to mask its adhesiveness during the oviduct transport, and (iii) after hatching in the uterus cavity the surface fibronectin facilitates the embryo implantation.

Endometrial microbial flora of hysterectomy specimens

Microbiological and histopathological specimens were obtained from three levels (fundal, middle and cervical) of the endometrium immediately after removing the uterus. Hysterectomy indication was menometrorrhagia and uterine fibroids in eight cases and chronic pelvic pain in two cases. All cultures for C. trachomatis, N. gonorrhoeae, M. hominis, U. urealyticum, herpes simplex virus, anaerobic and facultative bacteria were negative. Histopathological examination showed few plasma cells in the endometrium in four cases with the presence of uterine fibroids and in one case with adenomyosis. These results suggest that the endometrial cavity of a nonpregnant uterus is sterile.