INTRODUCTION

Hysteroscopy is the gold standard procedure for the evaluation and diagnosis of intrauterine pathologies. The optimal time to do hysteroscopy is during the proliferative phase. However, for women with irregular bleeding, the optimal time is unpredictable. Besides pharmacological means, mechanical endometrial preparation could be done.

OBJECTIVE

The objective of this study was to determine the effect of suction curettage on visualization, operative time, fluid deficit, and histopathologic diagnosis among perimenopausal women with abnormal uterine bleeding (AUB) and unprepared endometrium prior to operative hysteroscopy.

METHODOLOGY

Thirty-four (34) perimenopausal women admitted for AUB with unprepared endometrium for operative hysteroscopy who consented to participate were recruited and randomly divided into two groups: 18 women had suction curettage done prior to operative hysteroscopy and 16 women had operative hysteroscopy done alone. The following data were obtained for each group: (1) improvement in clarity (i.e., visualization of fundus and both tubal ostia), (2) operative time from entry to withdrawal of the resectoscope (measured in minutes), (3) fluid deficit, and (4) final histopathological diagnosis. P 

RESULTS

Women who underwent suction curettage prior to operative hysteroscopy had improved visualization (72.2%, P < 0.001), shorter operative time (29.06 ± 7.06 min vs. 35.5 ± 7.2 min, P = 0.013), no difference in fluid deficit (P = 0.276), and the histopathologic diagnosis (P = 0.470).

CONCLUSION

Suction curettage prior to operative hysteroscopy among perimenopausal women with AUB and unprepared endometrium improved visualization and shortened operative time without affecting fluid deficit and histopathologic diagnosis.

Hysteroscopy ; Suction Curettage ; Vacuum Curettage

High gravidity hydatidiform mole (HM) without normal pregnancy is very rare. The challenge of managing such cases will dwell on the concern of having normal conception versus having another molar gestation and its neoplastic sequelae.

Presented in this paper is a case of a 32-year-old, gravida 5 para 0 (0040) who was admitted for the management of her fifth molar pregnancy. She underwent suction curettage and administration of methotrexate chemoprophylaxis. Genetic testing was done, which revealed a homozygous mutation in NLRP7, the gene implicated in recurrent molar gestations. This paper discusses the proper approach to determine the cause of recurrent molar pregnancies, as well as the management and prognosis of such cases.

Human ; Female ; Adult ; Gravidity ; Methotrexate ; Vacuum Curettage ; Hydatidiform Mole ; Homozygote ; Genetic Testing ; Mutation ; Prognosis ; Chemoprevention ; Molar

High gravidity hydatidiform mole (HM) without normal pregnancy is very rare. The challenge of managing such cases will dwell on the concern of having normal conception versus having another molar gestation and its neoplastic sequelae.

Presented in this paper is a case of a 32-year-old, gravida 5 para 0 (0040) who was admitted for the management of her fifth molar pregnancy. She underwent suction curettage and administration of methotrexate chemoprophylaxis. Genetic testing was done, which revealed a homozygous mutation in NLRP7, the gene implicated in recurrent molar gestations. This paper discusses the proper approach to determine the cause of recurrent molar pregnancies, as well as the management and prognosis of such cases.

Human ; Female ; Adult ; Gravidity ; Methotrexate ; Vacuum Curettage ; Hydatidiform Mole ; Homozygote ; Genetic Testing ; Mutation ; Prognosis ; Chemoprevention ; Molar

OBJECTIVETo observe the clinical efficacy of artificial skin combined with vacuum sealing drainage (VSD) in treating large-area skin defects.

METHODSTotally 18 patients with skin defects, treated with artificial skin combined with VSD from September 2008 to May 2009 in our hospital, were retrospectively analyzed in this study. There were 15 males and 3 females, aged 7-66 years, 34.3 years on average. Among them, 10 cases had skin laceration caused by traffic accidents (7 with open fractures), 1 mangled injury, 1 blast injury, 1 stump infection combined with skin defects after amputation and 5 heel ulcers.

RESULTSAll skin grafts in 16 cases survived after being controlled by VSD for one time. For the rest 2 patients, one with skin avulsion on the left foot was given median thickness skin grafts after three times of VSD, the other with open fractures in the left tibia and fibula caused by a traffic accident was given free flap transplantation. Skin grafts of both patients survived, with normal color and rich blood supply.

CONCLUSIONSkin grafting in conjunction with artificial skin and VSD is much more effective than traditional dressing treatment and worth wide application in clinic.

Adolescent ; Adult ; Aged ; Child ; Drainage ; methods ; Female ; Humans ; Lacerations ; surgery ; Male ; Middle Aged ; Postoperative Care ; Retrospective Studies ; Skin Transplantation ; Skin, Artificial ; Vacuum Curettage ; Wounds and Injuries ; surgery

Acute Disease ; Child ; Child, Preschool ; Empyema, Pleural ; therapy ; Female ; Humans ; Infant ; Male ; Therapeutic Irrigation ; Vacuum Curettage

Implantation of a pregnancy within the scar of previous cesarean section is the rarest form of ectopic pregnancy. Delayed diagnosis and treatment can lead to uterine rupture, hemorrhage and maternal morbidity. But diagnosed early by transvaginal sonography, treatment options are capable of preserving the uterus and subsequent fertility. Suction curettage, exploratory laparotomy, laparoscopic surgery, systemic or local injection of methotrexate is the treatment method currently performed. In this report, we treated a case of this patient by transvaginal hysterotomy. This is the first case report in the recent literature. By this surgery, we could successfully remove gestational sac from the implantation site and repair the defect by primary suture and preserve uterus.
Cesarean Section ; Cicatrix ; Delayed Diagnosis ; Female ; Fertility ; Gestational Sac ; Hemorrhage ; Humans ; Hysterotomy ; Laparoscopy ; Laparotomy ; Methotrexate ; Pregnancy ; Pregnancy, Ectopic ; Sutures ; Uterine Rupture ; Uterus ; Vacuum Curettage

PURPOSE: To evaluate the role of performing ultrasound (US)-guided vacuum-assisted breast biopsies for the treatment (mammotome excision) of gynecomastia. MATERIALS AND METHODS: Between November 2005 and December 2006, nine male patients underwent US-guided mammotome excision for eleven cases of true gynecomastia. The patient ages ranged from 14 to 55 years (mean age, 32.3 years). US-guided mammotome excision was performed with an 11-gauge needle in seven cases and an 8-gauge needle in four cases. After the procedure, the cigarette method using gauze packing was performed. The number of samples, procedure time and presence of complications were evaluated. Scheduled follow-up physical and US examinations were performed after three and six months. RESULTS: For 11 cases of US-guided mammotome excision of gynecomastia, the number of samples ranged from 12-126 (mean, 66) and the procedure time ranged from 10-42 minutes (mean time, 25.1 minutes). Clinical significant complications did not occur immediately after the procedure and complications were not seen after a follow-up examination in any of the cases. At the 3- and 6-month follow up examinations, all of the patients showed a normal male physical appearance on a physical examination and there was no evidence of hypoechoic glandular tissues as seen on ultrasonograms. CONCLUSION: US-guided mammotome excision is effective for the treatment of small, glandular true gynecomastia and is suggested as a new modality to replace the need for surgery or liposuction.
Biopsy ; Breast ; Follow-Up Studies ; Gynecomastia ; Humans ; Lipectomy ; Male ; Mammography ; Needles ; Physical Examination ; Tobacco Products ; Vacuum Curettage

Cervical pregnancy is an uncommon life threatening form of ectopic pregnancy. It is associated with the unexpected occurrence of uncontrollable hemorrhage from the cervix. This condition is usually treated with hysterectomy. And thus the patient loses her fertility potential. To avoid hysterectomy and to maintain fertility, several conservative methods of termination have been used. We report a case of cervical pregnancy treated conservatively without hysterectomy. Hemorrhage from the implantation site was controlled with an inflated Foley catheter balloon positioned within the cervical canal. Foley catheter ballooning after endocervical suction curettage seems to be a simple and effective treatment of cervical pregnancy as conservative treatment to maintain fertility.
Catheters ; Cervix Uteri ; Female ; Fertility ; Hemorrhage ; Humans ; Hysterectomy ; Pregnancy* ; Pregnancy, Ectopic ; Vacuum Curettage

Pregnancy in the previous Cesarean section scar is a very rare form of ectopic pregnancy. This ectopic pregnancy may cause grave complications such as severe vaginal bleeding or spontaneous uterine rupture. Suction curettage, exploratory laparotomy, or systemic or local injection of methotrexate is the treatment method currently performed. In this report, we treat a case of this patient by laparoscopic surgery. By this surgery, we could successfully remove gestational sac from the implantation site and repair the defect by primary suture and preserve uterus.
Cesarean Section* ; Cicatrix* ; Female ; Gestational Sac ; Humans ; Laparoscopy* ; Laparotomy ; Methotrexate ; Pregnancy ; Pregnancy, Ectopic* ; Sutures ; Uterine Hemorrhage ; Uterine Rupture ; Uterus ; Vacuum Curettage

Sir Run Run Shaw Hospital (SRRSH) has developed a form of laparoscopic hepatectomy, resecting by curettage and suction. Such resection has been carried out successfully in 6 patients who had liver tumors. The results are satisfactory. And after the operation, there is a very effective perioperative nursing ensuring the patient's recovery.
Adult ; Aged ; Female ; Health Education ; Humans ; Laparoscopy ; Liver ; surgery ; Male ; Middle Aged ; Perioperative Nursing ; Retrospective Studies ; Treatment Outcome ; Vacuum Curettage