OBJECTIVE: Some vaginal procedures may be safer, easier and more successful if they could be done under direct sonographic vision of the object. METHODS: All the procedures were done under the guidance of transrectal sonography. Suction curettage, after using curved plastic Karman's cannula, additional curettage was done only when there was probable remaining conceptal tissue seen on sonography. If additional curettage was needed curved metal cannula made in the same form as plastic Karman's cannula is used first and then usual metal curette if the former did not work. A high frequency cautery unit was used for myolysis. Insertion of the flexible curved cautery tip into the myoma mass was done through the uterine cavity and coagulation of the myoma tissue was performed. Myoma biopsies were done with thin loop high frequency cautery tip through laparoscopy and the vagina. RESULTS: Suction curettage in 156 cases of early pregnancy and 2 cases of previous cesarean incision site pregnancy, D&C in 11 cases, chorionic villus sampling in 13 cases, polypectomy in 1 case, myolysis in 1 case and myoma biopsy in 2 cases were done. CONCLUSION: Performing some vaginal procedures under the guidance of transrectal sonography may be better.
Biopsy ; Catheters ; Cautery ; Chorionic Villi Sampling ; Curettage ; Dilatation and Curettage ; Female ; Laparoscopy ; Myoma ; Plastics ; Pregnancy ; Ultrasonography* ; Vacuum Curettage ; Vagina

Idiopathic hypertrophic subaortic stenosis (IHSS) is characterized by asymmetric septal hypertrophy, wherein the upper portion of interventricular septum, and dynamic left ventricular outflow tract obstruction due to narrowing the subaortic area usually resulting from the middiastolic apposition of the mitral anterior leaflet against the hypertrophied septum. The goals of anesthetic management for IHSS are to prevent the development of dynamic obstruction to left ventricular ejection and to optimize ventricular filling by maintaining the heart in normal sinus rhythm. Spinal and epidural anesthesia decrease in the preload and afterload secondary to peripheral venous pooling and sympathetic blockade could act to increase the left ventricular outlet obstruction. We experienced the case of the epidural anesthesia for the dilatation and curettage of the uterus with IHSS, and there is no adverse effects of epidural anesthesia.
Anesthesia, Epidural* ; Cardiomyopathy, Hypertrophic* ; Dilatation and Curettage ; Female ; Heart ; Humans ; Uterus

OBJECTIVE: To evaluate of safety and effectiveness of conservative treatment of previous cesarean section scar pregnancy. METHODS: Ten patients with previous cesarean section scar pregnancy were treated systemic methotrexate or intra-amnionic methotrexate injection. After treatment, patients were measured for the levels of serum beta-hCG and underwent ultrasound. According to the results, additional dose of methotrexate or curettage were done. Serum beta-hCG and ultrasound were checked several times until the level of serum beta-hCG and the finding of ultrasound had been normalized. RESULTS: Two patients showed normal serum beta-hCG levels and ultrasound findings after intra-amnionic methotrexate injection only. Two patients showed normal serum beta-hCG levels and ultrasound findings after systemic methotrexate/folinic acid therapy followed by dilatation and curettage. Six patients showed normal serum beta-hCG levels and ultrasound findings after intra-amnionic methotrexate injection followed dilatation and curettage. Two patients were transfused due to massive bleeding and other patients were not experienced severe complications. CONCLUSION: These results suggest that systemic or intra-amnionic methotrexate therapy with or without dilatation and curettage is safe and effective as a primary therapy for intramural pregnancy implanting in the cesarean section scar.
Cesarean Section* ; Cicatrix* ; Curettage ; Dilatation and Curettage ; Female ; Hemorrhage ; Humans ; Methotrexate ; Pregnancy* ; Pregnancy, Ectopic ; Ultrasonography

The endometrial osseous metaplasia is one of a rare conditions which gynecologist experience clinically. Clinical presentation may include irregular menstration, abnormal uterine bleeding, discharge, dysmenorrhea, pelvic pain, and secondary infertility. However the etiology and treatment about this disease are unclear. Recently, ultrasound-guided management of ectopic bone in uterus was suggested more potentially safer based on reported multi-patients women, a large majority was successfully treated. We have experienced a case of endometrial osseous metaplasia diagnosed and treated by ultrasound-guided dilatation and curettage. Which is presented with a brief review of literatures.
Dilatation and Curettage* ; Dilatation* ; Dysmenorrhea ; Female ; Humans ; Infertility ; Metaplasia ; Pelvic Pain ; Uterine Hemorrhage ; Uterus

Cervical pregnancy is one of the most rare and dangerous forms of ectopic pregnancy. It can complicate with massive bleeding and result in life-threatening condition. With the advance of USG technique, we can make an earlier diagnosis and a more conservative management to preserve the fertility potential. We report a case of cervical pregnancy which had high beta-hCG level & fetal heart tone and successfully been treated with dilatation and curettage (D & C) after using color Doppler and local methotrexate (MTX) injection.
Diagnosis ; Dilatation and Curettage* ; Dilatation* ; Female ; Fertility ; Fetal Heart ; Hemorrhage ; Methotrexate* ; Pregnancy* ; Pregnancy, Ectopic

Vesicouterine fistula is a rare condition, and almost of them result from surgical obstetric procedures. We have experienced two cases of vesicouterine fistulas, one of which developed menouria. Herein these two cases of vesicouterine fistulas have been presented. Case 1; A 29_year_old housewife had underwent dilatation and curettage at local clinic. Afterwards she has been noticed urinary leakage from the vagina and menturia. Cystoscopic examination revealed a small fistula at midportion of the retrotrigone and hysterosalpingography showed a fistula between the bladder and the uterus. Transperitoneal closure of the fistula was performed with excellent result. Case 2; A 32-year-old housewife had. gross hematuria after bugination and curettage for interruption of midtrimester pregnancy and noticed urinary leakage from the vagina a few days later. A fistula between the bladder and the uterus was identified with cystoscopic examination, cystography and hysterosalpingography. A 24 Fr. silastic Foley catheter has been indwelt in the bladder for 4 weeks, but resulted in failure. Transperitoneal closure of the fistula resulted in cure.
Adult ; Catheters ; Curettage ; Dilatation and Curettage ; Female ; Fistula* ; Hematuria ; Humans ; Hysterosalpingography ; Pregnancy ; Pregnancy Trimester, Second ; Urinary Bladder ; Uterus ; Vagina

OBJECTIVE: In Korea, approximately 600 thousand artificial abortions are done officially during the course of a year, and dilatation and curettage is commonly used as a method for selective abortion. In addition, because of the increasing use of hormone replacement therapy for treating postmenopausal syndrome and for the diagnostic purposes for postmenopausal bleeding, the importance of dilatation and curettage is emphasized more and more. Our objective was to verify the effects of delayed time between paracervical block and the procedure of dilatation and curettage on pain and patient satisfaction. METHODS: 92 women who underwent dilatation and curettage were picked and divided into 2 groups randomly. In group A there was no transit delay time between paracervical block and the procedure, and in group B, there was 5 minutes delay time. We used the VAS (Visual Analogue Scale) to measure numerical value of pain and patient satisfaction during uterine cervical dilatation, the actual procedure of curettage, and 30-45 minutes after the procedure. RESULTS: There was no statistically meaningful difference on the pain value and patient satisfaction between group A and group B measured during uterine cervix dilatation, curettage, and 30-45 minutes after the procedure. CONCLUSION: The transit delay time between paracervial anesthesia and dilatation and curettage had no specific effects on the pain or patient satisfaction of the procedure. Therefore, the main role of paracervical anesthesia is not to block the peripheral nerve, but instead to dilatate the tissue mechanically.
Abortion, Eugenic ; Anesthesia ; Anesthesia, Obstetrical* ; Cervix Uteri ; Curettage ; Dilatation and Curettage* ; Dilatation* ; Female ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Korea ; Labor Stage, First ; Patient Satisfaction ; Peripheral Nerves ; Pregnancy

Uterine arteriovenous vascular malformation (UAVM) is a disease that causes excessive bleeding. The symptoms do not subside without proper treatment and this can lead to life-threatening situations. The correct diagnosis of UAVM can be complicated if the patient's uterus did not completely discharge everything during abortion (in broader terms, retaining remnants of the products of conception). In this case, Doppler ultrasonography and computed tomography angiography with 3-dimensional rendering were used to analyze the cause of bleeding and provide proper treatment of this patient. Then, uterine artery embolization, dilatation, and curettage were performed safely and successfully. The patient no longer had symptoms of vaginal spotting during the planned follow up care. UAVM is uncommon; however, if reproductive-age women show repeated abnormal vaginal bleeding after dilatation and curettage, a diagnosis of UAVM must be considered based on the medical history and examination.
Angiography ; Arteriovenous Malformations ; Curettage ; Diagnosis ; Dilatation and Curettage ; Dilatation ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Metrorrhagia ; Ultrasonography ; Ultrasonography, Doppler ; Uterine Artery ; Uterine Artery Embolization ; Uterine Hemorrhage ; Uterus ; Vascular Malformations

Abdominal pregnancies are classified as primary and secondary. The incidence varies from one in 372 to one in 9714 live birth. When this occurs, perinatal morbidity and mort-ality are high, usually as a result of growth restriction and congenital anomalies such as fetal pulmonary hypoplasia, pressure deformities, facial and limb asymmetry. Omental pregnancy is an extremely rare form of abdominal pregnancy that may cause life-threatening massive hemorrhage in case of rupture. A case of this rare entity is prese- nted after dilatation and curettage in which gestational tissue was found to arise from the edge of greater omentum, requiring partial omentectomy. The diagnosis of omental pregnancy is hardly ever made prior to laparotomy. This case of omental pregnancy, believed to be secondary, was recently experienced and it is reported here with a brief review of the literature.
Congenital Abnormalities ; Diagnosis ; Dilatation and Curettage* ; Dilatation* ; Extremities ; Female ; Hemorrhage ; Incidence ; Laparotomy ; Live Birth ; Omentum ; Pregnancy* ; Pregnancy, Abdominal ; Rupture

For more than 20 years, many cytologic techniques have been developed for endometrial sampling such as Gravlee jet aspirator, Isaacs cell sampler, Vabra aspirator, Pipelle, etc. But none of the techniques received general acceptanee as a replacement for dilatation and curettage. Hence dilatation and curettage is still used to evaluate women at high risk for endometrial cancer and infertility, to manage abnormal uterine bleeding and to follow womeh on hormone replacement therapy, But biopsy methods produce enough pain to lower patients acceptance, Z-sarnpler is a new simple plastic endornetrial suction curette that provides a histologic diagnosis like Pippelle, This study compared the clinical usability of the Z-sampler to that of endometrial biopsy by dilatation and eurettage. The Z-sampler obtained sufficient tissues for histologic diagnosis in 45 cases(45/50, 90.0%), it was lower than that of end.ometrial biopsy(49/50, 98,0%), But the accuracy of tissue diagnosis was almost equal to that of endometrial biopsy. In addition. Z-sempler cau less pain(94.1%) and the duration of this procdure was shorter than that of endometrial biopsy by dilatation and curettage. These results suggest that the Z-sampler may be efficieot technique in endometrial tissue diagnosi, like dilatation and curettage and it has greater patient acceptability due to less pain, less bleeding and shorter duration of procedure.
Biopsy ; Diagnosis ; Dilatation and Curettage* ; Dilatation* ; Endometrial Neoplasms ; Female ; Hemorrhage ; Hormone Replacement Therapy ; Humans ; Infertility ; Plastics ; Suction ; Uterine Hemorrhage