Unicornuate uterus is a very rare uterine anomaly caused by developmetal failure of Mullerian duct. This anomay is associated with various degrees of rudimentary horn, which is connected with fibrous band or firmly attached to unicornuate uterus. Different method of operation may be applied according to type of anatomical connection. The unicornuate uterus is commonly associated with severe dysmenorrhea, chronic pelvic pain, and pelvic mass. A case of noncommunicating rudimentary horn firmly attached to unicornuate uterus with severe dysmenorrhea was treated with laparoscopic excison of uterine horn and is presented with brief review of literature.
Animals ; Dysmenorrhea ; Female ; Horns ; Pelvic Pain ; Uterus

Superficial cervicovaginal myofibroblastoma (SCVM) is extremely rare mesenchymal tumor arising low genital tract. SCVM is characterized by asymptomatic polypoid or nodular mass within the lamina propria. It is difficult to distinguish SCVM from other genital mesenchymal tumors because of similar morphologic features, however SCVM has distinctive histological and immunohistochemical profiles. SCVM is considered benign tumor which can be treated with simple excision and shows rare recurrence. We experienced two cases of SCVM which was treated with simple excision. We present these cases, along with a review of the relevant literatures.
Mucous Membrane ; Neoplasms, Muscle Tissue ; Recurrence ; Vagina

OBJECTIVE: To document our experience of the vascular anomalies or variants in paraaortic region and intend to increase vigilance among the gynecological surgeons for presence of variable vascular anomalies or variants. METHODS: We conducted a retrospective chart review of 280 patients with various gynecologic malignancies who had undergone systemic laparotomic or laparoscopic paraaortic lymphadenectomy between November 2003 and July 2011. RESULTS: We discovered total nine patients of vascular anomalies during the surgery. Seven patients had an accessory polar renal artery. One patient had a duplicated inferior vena cava and the other had a right paravertebral vein. There were no vascular complications such as tearing, ligation or transection. CONCLUSION: It is not uncommon to encounter vascular anomalies in paraaortic region during the lymphadenectomy. Hence, the gynecological surgeons must be cognizant of various vascular anomalies occurring within this area to reduce the vascular accidents.
Humans ; Ligation ; Lymph Node Excision ; Renal Artery ; Retrospective Studies ; Veins ; Vena Cava, Inferior

OBJECTIVE: This study was conducted to compare the perioperative outcomes in patients with symptomatic uterine myoma who underwent laparoscopic (LM) or laparoscopically assisted myomectomy (LAM). METHODS: A total of 207 patients with myoma underwent LM or LAM in Samsung Medical Center between October 2006 and March 2010. Of them, 121 patients with LM and 50 with LAM met the inclusion criteria and were compared for the perioperative outcomes. RESULTS: The operation time was significantly shorter in the LAM group than in the LM group (111 min versus 139 min; p<.001, respectively). Estimated blood loss was significantly higher in the LAM group (p<.001). Intraoperative, early postoperative complications, hospitalization days and postoperative analgesics use were similar between the 2 study groups. CONCLUSION: LM and LAM is comparable in the perioperative outcomes in patients with symptomatic uterine myoma.
Analgesics ; Female ; Hospitalization ; Humans ; Laparoscopy ; Lipopolysaccharides ; Myoma ; Postoperative Complications

OBJECTIVE: The aim of the present study was to evaluate the impact of previous abdominal surgery on surgical outcomes of single-port access (SPA) total laparoscopic hysterectomy (TLH). METHODS: We reviewed the medical records of 111 women who underwent SPA-TLH at the Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University between January 2010 and December 2010. Women were classified according to their history of previous abdominal surgery. RESULTS: Of 111 women undergoing SPA-TLH, 74 women (66.7%) without history of previous abdominal surgery and 37 women (33.3%) with history of previous abdominal surgery were classified. There was no significant difference in surgical outcomes including operative time, estimated blood loss, change in hemoglobin, uterine weight, perioperative complications, transfusion, and additional port insertion between two groups. CONCLUSION: In our experience, previous abdominal surgery has no significant impact on SPA-TLH.
Female ; Gynecology ; Hemoglobins ; Humans ; Hysterectomy ; Laparoscopy ; Medical Records ; Obstetrics ; Operative Time

OBJECTIVE: The purpose of this study was to evaluate the pathologic outcomes of ovarian torsion and assess the safety of prompt surgical treatment thereof regardless of the age of patients and menopausal status. METHODS: A retrospective chart review was conducted in patients who were diagnosed with adnexal torsion postoperatively from 1999 through 2009 at Yonsei University Health System. Data pertaining to the patient's age at diagnosis, menopausal status, preoperative symptoms, surgical mode, surgical pathologic outcome, and postoperative treatment were obtained. RESULTS: A total of 129 patients (median age: 34.0 years, range: 7-79 years) were operatively proven with adnexal torsion. Among these patients, 10 were pathologically diagnosed to have malignant or borderline ovarian tumors (7.7%): six mucinous (4.6%), one serous borderline tumor (0.8%), one granulosa cell tumor (0.8%), and one dysgerminoma (0.8%), and one serous adenocarcinoma (0.8%). Four patients received further treatment with chemotherapy. None of these patients were in their menopause. CONCLUSION: Our study showed the low probability of ovarian malignancy in ovarian torsion. Therefore, when a patient is suspected with ovarian torsion, prompt surgical intervention should not be delayed for fears of malignancy regardless of the patient's menopausal status.
Adenocarcinoma ; Dysgerminoma ; Female ; Granulosa Cell Tumor ; Humans ; Mucins ; Ovarian Neoplasms ; Postmenopause ; Retrospective Studies ; Torsion Abnormality

OBJECTIVE: Fourteen cases of vaginal vault evisceration after total laparoscopic hysterectomy were presented. We review pertinent literature, discuss precipitating causes, clinical manifestations, and management that was performed. METHODS: We reviewed medical records of 14 women with vaginal vault evisceration after total laparoscopic hysterectectom between March 2000 and October 2012 at 4 hospitals of CHA University. RESULTS: Between March 2000 and March 2006, 1,887 women underwent total laparoscopic hysterectomy and 12 vaginal vault eviscerations (0.6%) were presented. Thereafter, only two new cases were presented. The precipitating event was coitus in nine cases (64%), sit-ups in two cases (14%), spontaneous (urine ascites), lymphatic ascites, and unknown in one case (7%) each. Prolapsed organs were small bowels, omentum, and salpinx. Common presenting symptoms were pain, bleeding, watery discharge, and protruded mass (bowels). Eleven women underwent transvaginal repair (79%) - two laparotomic (14%) and one laparoscopic (7%), and none have exhibited sequelae. CONCLUSION: Coitus was the triggering event in most cases. For vaginal vault evisceration following total laparoscopic hysterectomy, vaginal repair should be first considered.
Ascites ; Coitus ; Fallopian Tubes ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Medical Records ; Omentum

OBJECTIVE: To evaluated the result of laparoscopic surgery of adnexal tumors and removing excised tissue through Douglas pouch incision. METHODS: 110 patient who had visited Chosun University Hospital department of Obstetrics and Gynecology between January, 2011 to April, 2012 were involved in the study. Patient had laparoscopic surgery on the adnexal tumor and excised tissue was removed through Douglas pouch incision by single surgeon. RESULTS: The mean age of patients were 41.5 years. The size of the tumor varied from 3 cm to 27 cm in size using ultrasonography. The mean operation time was 61.3 minutes and the mean admission period was 4.2 days. 82 patient had salpingo-oophorectomy or oophorectomy, 19 had ovarian cystectomy, 2 had wedge resection and 4 had tumor enucleation. Histologic result reveal endometriosis in 23 patients (20.9%). teratoma in 21 (19%), serous cystadenoma in 14 (12.7%) and mucinous cystadenoma in 10 (9.1%). Other histologic finding includes hemorrhagic cyst, luteal cyst and paratubal cyst. There was no complication including bladder or rectal injury, suture site infection. CONCLUSION: Laparoscopic surgery of adnexal tumor and removal by Douglas pouch incision is a simple, safe and efficient method that could be considered as an alternative minimally invasive technique.
Cystadenoma, Mucinous ; Cystadenoma, Serous ; Cystectomy ; Douglas' Pouch ; Endometriosis ; Female ; Gynecology ; Hospital Departments ; Humans ; Laparoscopy ; Obstetrics ; Ovariectomy ; Parovarian Cyst ; Sutures ; Teratoma ; Urinary Bladder

OBJECTIVE: To analyze the clinical experiences of patients who treated with levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis associated with dysmenorrhea and/or menorrhagia. METHODS: The LNG-IUS was inserted into 103 patients who were diagnosed with adenomyosis on ultrasound examination and suffered from dysmenorrhea or menorrhagia at CHA Gangnam Medical Center between January 2009 and December 2009. Symptomatic changes of dysmenorrhea and menorrhagia, side effects, and failure rates were evaluated, retrospectively. RESULTS: During the follow-up periods, dysmenorrhea was improved in 91.4% and menorrhagia was improved in 90.4% of patients. Most common side effects were prolonged vaginal spotting in 41 (39.8%), and expulsion of LNG-IUS in 32 (31.1%) patients. Six (5.7%) patients were premature removal of LNG-IUS and 9 (8.5%) patients were underwent hysterectomy. Overall 77 (74.8%) patients continued to use of LNG-IUS. CONCLUSION: The LNG-IUS is effective treatment option for management of dysmenorrhea and menorrhagia for patients with clinical diagnosis of adenomyosis. It seemed to be an alternative treatment method before hysterectomy.
Adenomyosis ; Dysmenorrhea ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Menorrhagia ; Metrorrhagia

OBJECTIVE: To compare clinicopathologic characteristics and surgical outcomes of laparoscopic surgery in women with endometrial cancer according to body mass index (BMI). METHODS: From June 2009 to October 2010, prospective observational study without randomization of 159 patients treated by laparoscopic surgery from 10 hospitals nationwide. RESULTS: Patients were divided according to the WHO guidelines for Asia-Pacific populations and the distributions of BMI were as follows: 3 patients (1.9%) in underweight (BMI < 18.5 kg/m2), 50 patients (31.4%) in normal weight (BMI, 18.5-22.9 kg/m2), 45 patients (28.3%) in overweight (BMI, 23.0-24.9 kg/m2), 49 patients (30.8%) in obese (BMI, 25.0-29.9 kg/m2), and 12 patients (7.5%) in morbid obese (BMI > or = 30.0 kg/m2). Age, history of previous surgery, surgery extend, and history of previous surgery were not different between non-obese patients (BMI < 25.0 kg/m2) and obese patients (BMI > or = 25.0 kg/m2). Co-morbidities were more common in obese patients but marginally significant (23.5% vs. 37.7%, p=0.072). Four patients (2.5%) were converted to abdominal surgery because of severe adhesion. Regarding to surgical outcomes, operation time was significantly longer in obese patients (199 min vs. 235 min, p=0.013) but blood loss, lymph node yield, hospital stay, Foley removal, transfusion rate and peri-operative complication were not statistically significant. Regarding to pathologic results, there were no difference in terms of lymphovasucular space invasion, tumor grade, histologic type, lymph node metastasis and FIGO stage. CONCLUSION: Clinicopathologic characteristics and surgical outcomes does not seem to be significantly influenced by BMI except operation time. So the laparoscopic approach can be the alternative method for obese patients.
Body Mass Index ; Endometrial Neoplasms ; Female ; Humans ; Laparoscopy ; Length of Stay ; Lymph Nodes ; Neoplasm Metastasis ; Obesity ; Overweight ; Prospective Studies ; Random Allocation ; Thinness