Cosmetic lateral canthoplasty has become popular among Asians in the last few decades, but few techniques have withstood the test of time to be accepted as both effective and noninvasive, with minimal complications. Novel techniques have been developed, but are not free from complications. Moreover, these methods often have limited indications and may require a rather long learning curve to master. Herein, the authors present their experiences performing a simple lateral canthoplasty procedure in 61 patients using a slightly modified V-Y advancement flap, previously known as the Uchida method.
Asian Continental Ancestry Group ; Blepharoplasty ; Cosmetic Techniques ; Humans ; Learning Curve ; Sterilization, Tubal

OBJECTIVE: Although previous research has suggested that risk for reoperation among hysteroscopic sterilization (HS) patients is more than ten times higher than for patients undergoing standard laparoscopic tubal ligation, little has been reported about these subsequent procedures. METHODS: This descriptive cohort study used a confidential online questionnaire to gather data from women (n=3,803) who volunteered information on HS followed by device removal surgery performed due to new symptoms developing after Essure placement. RESULTS: In this sample, mean age was 35.6 years and women undergoing hysterectomy after HS comprised 64.9% (n=2,468). Median interval between HS and hysterectomy was 3.7 (interquartile range, 3.9) years and mean age at hysterectomy was 36.3 years. Some patients (n=1,035) sought removal of HS devices and fallopian tubes only, while other miscellaneous gynecological procedures were also occasionally performed for Essure-associated symptoms. When data from all patients who had any post-Essure surgery besides hysterectomy were aggregated (e.g., device removal +“other” cases, n=1,335) and compared to those cases undergoing hysterectomy, mean age was significantly lower than for the hysterectomy group (34.4 vs. 36.3 years, respectively; P<0.01); uterus-conserving surgeries were also typically performed significantly earlier than hysterectomy (P<0.01). CONCLUSION: This investigation is the first to characterize specific gynecological operations after Essure, and suggests that the predominant surgical answer to HS complaints is hysterectomy for many women. Dissatisfaction with HS may represent an important indication for hysterectomy and additional study is needed to quantify this phenomenon.
Cohort Studies ; Contraception ; Device Removal ; Fallopian Tubes ; Female ; Humans ; Hysterectomy ; Reoperation ; Sterilization* ; Sterilization, Tubal

BACKGROUND: Epithelial ovarian carcinoma is the most lethal of the gynecologic malignancies. Recent theories on the etiopathogenesis of epithelial ovarian carcinoma supported the presence of occult, early stage neoplasms in the fimbriated end of the fallopian tube even before development of ovarian carcinoma. This study is interested in correlating opportunistic salpingectomy or tubal ligation as a possible effective prevention strategy in the occurrence of epithelial ovarian carcinoma.

OBJECTIVE: To determine the association between the occurrence of epithelial ovarian carcinoma and a previous history of tubal ligation and/ or salpingectomy

METHODS: This is a case-control study involving chart review of patients who underwent total hysterectomy with bilateral salpingoophorectomy with a histologically verified epithelial ovarian cancer (cases) and patients who underwent same surgical procedure for benign gynecologic conditions specifically myoma uteri and adenomyosis with normal ovaries on final histology report (controls). The association between the occurrence of epithelial ovarian carcinoma and previous tubal ligation and/or salpingectomy was determined using appropriate statistical methods.

RESULTS: A total of 558 patients were included in this review. They were divided into 158 post-surgical patients with histologically verified epithelial ovarian cancer (cases) and 400 post-surgical patients for benign gynecologic conditions with normal ovaries on final histology report (controls). Adjusted for age, parity and obesity the odds of developing epithelial ovarian carcinoma in subjects without previous tubal ligation and/or salpingectomy is 29%.

CONCLUSION: The result of the study showed that tubal ligation and/or salpingectomy reduces the risk of developing epithelial ovarian carcinoma hence for patients at average risk of ovarian cancer, risk-reducing salpingectomy should be discussed and at the time of abdominal or pelvic surgery. It must also be included in the counseling of women planning a hysterectomy for benign indications to conserve ovarian function and prevent ovarian epithelial carcinoma.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Pregnancy ; Salpingectomy ; Sterilization, Tubal ; Fallopian Tubes ; Adenomyosis ; Parity ; Hysterectomy ; Ovariectomy ; Ovarian Neoplasms ; Obesity ; Myoma

BACKGROUND: Epithelial ovarian carcinoma is the most lethal of the gynecologic malignancies. Recent theories on the etiopathogenesis of epithelial ovarian carcinoma supported the presence of occult, early stage neoplasms in the fimbriated end of the fallopian tube even before development of ovarian carcinoma. This study is interested in correlating opportunistic salpingectomy or tubal ligation as a possible effective prevention strategy in the occurrence of epithelial ovarian carcinoma.

OBJECTIVE: To determine the association between the occurrence of epithelial ovarian carcinoma and a previous history of tubal ligation and/ or salpingectomy

METHODS: This is a case-control study involving chart review of patients who underwent total hysterectomy with bilateral salpingoophorectomy with a histologically verified epithelial ovarian cancer (cases) and patients who underwent same surgical procedure for benign gynecologic conditions specifically myoma uteri and adenomyosis with normal ovaries on final histology report (controls). The association between the occurrence of epithelial ovarian carcinoma and previous tubal ligation and/or salpingectomy was determined using appropriate statistical methods.

RESULTS: A total of 558 patients were included in this review. They were divided into 158 post-surgical patients with histologically verified epithelial ovarian cancer (cases) and 400 post-surgical patients for benign gynecologic conditions with normal ovaries on final histology report (controls). Adjusted for age, parity and obesity the odds of developing epithelial ovarian carcinoma in subjects without previous tubal ligation and/or salpingectomy is 29%.

CONCLUSION: The result of the study showed that tubal ligation and/or salpingectomy reduces the risk of developing epithelial ovarian carcinoma hence for patients at average risk of ovarian cancer, risk-reducing salpingectomy should be discussed and at the time of abdominal or pelvic surgery. It must also be included in the counseling of women planning a hysterectomy for benign indications to conserve ovarian function and prevent ovarian epithelial carcinoma.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Pregnancy ; Salpingectomy ; Sterilization, Tubal ; Fallopian Tubes ; Adenomyosis ; Parity ; Hysterectomy ; Ovariectomy ; Ovarian Neoplasms ; Obesity ; Myoma

INTRODUCTIONThe study aimed to assess the level of awareness and knowledge of contraception among women in Singapore, and identify the factors that influence contraception choice.

METHODSWe conducted a cross-sectional survey of 259 female patients, aged 21-49 years, who attended the Obstetrics and Gynaecology Clinic at National University Hospital, Singapore. An original questionnaire on nine contraceptive methods was used. Respondents who had ≥ 2 correct answers for a method (out of four questions) were considered to have good knowledge of the method. Participants were asked to rate factors known to influence contraceptive choice as important or not important.

RESULTSAwareness of the following methods was high: condom (100.0%), oral contraception pill (89.2%), tubal ligation (73.0%) and copper intrauterine device (IUD) (72.2%). The women were least aware of hormonal IUD (24.3%). Women who were parous, had a previous abortion, had completed their family or used contraception previously were more likely to have a higher awareness of contraception. 89.2% of the women had good knowledge of the condom; among those aware of hormonal IUD, only 46.0% had good knowledge of it. Women who had used hormonal IUD and the condom were more likely to have good knowledge of them. Many rated efficacy (90.5%) and a healthcare professional's advice (90.1%) as important in contraceptive choice. Few considered peer influence (21.0%) and cultural practices (16.3%) to be important.

CONCLUSIONWomen in Singapore have poor awareness and knowledge of contraception, especially long-acting reversible methods. More effective ways are needed to educate women about contraceptive methods.

Abortion, Induced ; Adult ; Choice Behavior ; Condoms ; Contraception ; methods ; Contraceptives, Oral ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Intrauterine Devices ; Middle Aged ; Parity ; Patient Education as Topic ; Singapore ; Social Class ; Sterilization, Tubal ; Surveys and Questionnaires ; Young Adult

A metaplastic papillary tumor of the Fallopian tube is an extremely uncommon condition, with odd and confusing features that make it difficult to categorize as benign or borderline. Here, we summarize all the published cases to date and document the case of a 41-year-old woman diagnosed with this alteration after her last childbirth and ensuing tubal ligation. One of the tubes was bulky and filled with a caramel-like substance encircling a blurry spot. Light microscopy detailed a slender stalk covered by eosinophilic, columnar plump cells, showing atypical nuclei and focal budding. Mitotic figures were absent. The immunohistochemistry panel was positive for pan-cytokeratin, epithelial membrane antigen, cyclin D1, and hormone receptors. Additionally, a proliferation index of less than 5% was rated using Ki-67. The true nature of this tumor (reactive vs neoplastic) is uncertain. Nonetheless, its association with pregnancy suggests an adaptive change, likely similar to the atypical transdifferentiation proposed for Arias-Stella reaction.
Adult ; Cell Transdifferentiation ; Cyclin D1 ; Eosinophils ; Epithelium* ; Fallopian Tubes ; Female ; Humans ; Immunohistochemistry ; Microscopy ; Mucin-1 ; Parturition ; Pregnancy ; Sterilization, Tubal

No abstract available.
Cost-Benefit Analysis ; *Elective Surgical Procedures/economics/utilization ; Fallopian Tubes/surgery ; Female ; Humans ; Hysterectomy/economics/methods/utilization ; Incidence ; Ovarian Neoplasms/economics/epidemiology/*prevention & control ; *Risk Reduction Behavior ; Salpingectomy/economics/*utilization ; Sterilization, Tubal/economics/utilization

OBJECTIVE: To determine whether complications related to surgery increase with increasing number of cesarean sections (CSs) in upper segment placenta. To compare the complications in urgent and elective high order (4-6) repeat CSs. METHODS: A retrospective analysis of 519 women who underwent repeat CS was performed from January to December 2012. Women were divided into 3 groups: group 1 with previous 3 CS (n=325), group 2 with previous 4 CS (n=139), and group 3 with previous > or =5 CS (n=55). RESULTS: Statistically significant differences (P < 0.001) were observed among 3 groups, regarding mean gravidity, type of CS, midline incision and bilateral tubal ligation performed. The risks of severe intra-peritoneal adhesions, thin out lower uterine segment and bladder injury were significantly increased (P < 0.001) with increasing number of CS deliveries. Only one cesarean hysterectomy was done in group 1 due to post partum hemorrhage. No significant differences were found in blood loss, duration of surgery, post operative hospital stay as well as birth weight and Apgar scores of newborns. The elective and emergency CS groups of high order repeat CS had no remarkable differences in operative, post operative complications and fetal outcome. CONCLUSION: Women with repeat CS are at increased risk of having multiple intra-operative surgical complications which increase with each subsequent CS. Pregnant women must be informed of the related risks which may affect counselling regarding possible tubal ligation.Women with repeat CS are at increased risk of having multiple intra-operative surgical complications which increase with each subsequent CS. Pregnant women must be informed of the related risks which may affect counselling regarding possible tubal ligation.
Birth Weight ; Cesarean Section* ; Emergencies ; Female ; Gravidity ; Hemorrhage ; Humans ; Hysterectomy ; Infant, Newborn ; Length of Stay ; Placenta ; Pregnancy ; Pregnancy Outcome ; Pregnant Women ; Retrospective Studies ; Sterilization, Tubal ; Urinary Bladder

Women with tubal ectopic pregnancies have high levels of circulating interleukin 6 (IL-6). IL-6 treatment in vitro significantly reduces the ciliary activity of tubal epithelium. The effects of IL-6 on target cells occur via the formation of a high-affinity complex with its receptors IL-6Ralpha and glycoprotein 130 (Gp130). IL-6Ralpha is specifically expressed in the cilia of the epithelial cells. In this study, we performed a quantitative reverse transcriptase polymerase chain reaction to determine the mRNA expression of IL-6Ralpha and Gp130 in the fallopian tubes obtained from 12 women with ectopic pregnancies, 12 women with normal pregnancies, and 12 healthy nonpregnant women in the luteal phase of their menstrual cycle. Fallopian tubes were evaluated from specimens taken during tubal ligation in normal pregnancies and nonpregnant fertile women or during tubal surgery in ectopic pregnancies. We observed that IL-6Ralpha mRNA expression in fallopian tubes was increased in ectopic pregnancy compared with that in the midluteal phase. We also found that the Gp130 mRNA expression was significantly lower in fallopian tubes from ectopic pregnancies than in those from nonpregnant women during the midluteal phase of their menstrual cycle, although its expression was noticeably high in fallopian tubes in the midluteal phase, which suggests that high Gp130 levels may possibly contribute to embryo transport into the uterus.
Cilia ; Embryonic Structures ; Epithelial Cells ; Epithelium ; Fallopian Tubes ; Female ; Glycoproteins ; Humans ; Interleukin-6 ; Luteal Phase ; Menstrual Cycle ; Pregnancy ; Pregnancy, Ectopic ; Receptors, Interleukin-6 ; Reverse Transcriptase Polymerase Chain Reaction ; RNA, Messenger ; Sterilization, Tubal ; Ursidae ; Uterus

OBJECTIVE: Sterilization (tubal sterilization and vasectomy) is a widely applied contraceptive method worldwide. Although most studies have described sterilization as a safe method, there are reports of tubal ligation (TL) and vasectomy complications. The aim of this study was to evaluate the effects of TL and vasectomy on the serum oxidative stress, specifically prooxidant-antioxidant balance (PAB) and malondialdehyde (MDA) levels, over time. METHODS: Male and female rats were classified into vasectomy, sham-vasectomy, TL, and sham-TL groups, respectively. The PAB and MDA levels were measured on days 15 and 45 and months 3 and 6 after the intervention. For female rats, blood sampling was performed during the diestrous phase and estradiol and progesterone were also measured. RESULTS: Serum PAB and MDA increased after TL (p<0.05). Vasectomy increased serum MDA remarkably after 45 days, 3 months, and 6 months (p<0.05). After vasectomy, serum PAB also increased although not significantly. Serum estradiol and progesterone decreased remarkably in the TL group compared to the sham group (p<0.05). CONCLUSION: Bilateral TL and vasectomy both increase the serum oxidative stress; however the imbalance after TL was very noticeable. As for the TL, the reduction of serum estrogen levels can be involved in this imbalance. Complications followed by TL or vasectomy could be due to increased levels of oxidants. Thus, prescribing antioxidants during and or after surgery may be a solution.
Adult ; Animals ; Antioxidants ; Contraception ; Estradiol ; Estrogens ; Female ; Humans ; Male ; Malondialdehyde ; Oxidants ; Oxidative Stress ; Progesterone ; Rats ; Salicylamides ; Sterilization ; Sterilization, Tubal ; Vasectomy