Hematocolpos Secondary to Acquired Vaginal Scarring After Radiation Therapy for Colorectal Carcinoma

Size: px
Start display at page:

Download "Hematocolpos Secondary to Acquired Vaginal Scarring After Radiation Therapy for Colorectal Carcinoma"

Transcription

1 Case Report Hematocolpos Secondary to Acquired Vaginal Scarring After Radiation Therapy for Colorectal Carcinoma Sachit K. Verma, MD, Oksana H. Baltarowich, MD, Anna S. Lev-Toaff, MD, Donald. G. Mitchell, MD, Manisha Verma, MD, Frances Batzer, MD Hematocolpos in a postmenopausal woman is uncommon because most cases are due to a congenital anomaly and present during the neonatal or perimenarchal period. In older women, hematocolpos results from near or complete vaginal occlusion secondary to radiation therapy for cervical carcinoma or from scarring after surgical procedures such as cone biopsy. Rarely, vaginal obstruction may be due to postmenopausal atrophy, endometriosis, or vaginitis, leading to scarring or adhesions. 1 6 Hematocolpos after radiation therapy for colorectal carcinoma is a rare clinical entity. We report an unusual case of hematocolpos secondary to acquired vaginal scarring after radiation therapy for colorectal carcinoma in a postmenopausal woman who had dyspareunia and pelvic and lower back pain. Characteristics on 3-dimensional (3D) transvaginal sonography (TVS) and magnetic resonance imaging (MRI), as well as intraoperative sonographic guidance, are described, together with current management and a review of the literature. The diagnosis of vaginal scarring and associated hematocolpos was suggested by TVS and confirmed by intraoperative sonography. Case Report Abbreviations MRI, magnetic resonance imaging; 3D, 3-dimensional; TVS, transvaginal sonography Received February 3, 2009, from the Departments of Radiology (S.K.V., O.H.B., A.S.L.-T., D.G.M.), Medicine (M.V.), and Obstetrics and Gynecology (F.B.), Thomas Jefferson University Hospital, Philadelphia, Pennsylvania USA. Dr Lev-Toaff is currently with the Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania USA. Revision requested March 5, Revised manuscript accepted for publication March 9, Address correspondence to Sachit K. Verma, MD, Department of Radiology, Thomas Jefferson University, 132 S 10th St, Main Building, Philadelphia, PA USA. medskv@yahoo.com A 53-year-old woman, gravida 1, para 1, with a surgical history of resection for colorectal cancer followed by chemotherapy and radiation treatment underwent an evaluation for dyspareunia and pelvic and lower back pain 8 years after her cancer treatment. After treatment for cancer, she received hormone replacement therapy in the form of continuous combined oral conjugated estrogen and progestin for acute menopausal symptoms as well as for bone protection. Her gynecologic history included regular periods before the surgery and an uncomplicated pregnancy with a vaginal delivery. Her family history was notable for ovarian cancer in her mother. The physical examination revealed a healthyappearing woman in no apparent distress (height, 5 ft 6 in; weight, 116 lb; blood pressure, 110/70 mm Hg). A 2009 by the American Institute of Ultrasound in Medicine J Ultrasound Med 2009; 28: /09/$3.50

2 Hematocolpos After Radiation Therapy for Colorectal Carcinoma bimanual examination confirmed the presence of a soft midline mass possibly felt to be her uterus. The adnexa were not palpable, and the cervix could not be visualized on a speculum examination. No appreciable discharge was noted, and wet smear results were negative. Laboratory test results revealed a hemoglobin level of 12.4 g/dl, a hematocrit value of 0.38, a white blood cell count of /L, and a platelet count of /L. Serum creatinine, blood urea nitrogen, electrolyte, prothrombin time, and partial thromboplastin time values were normal. Magnetic resonance imaging performed 6 years after her cancer treatment to assess for signs of malignancy recurrence showed a large rounded encapsulated fluid collection measuring cm occupying the lower pelvis with high signal intensity on T1-weighted images (Figure 1A) and intermediate to slightly high signal intensity on T2-weighted images. The mass was surrounded by several T2-hyperintense foci and showed concentric rings at the periphery, indicating the presence of blood in various stages of evolution (Figure 1B) in the cervix and proximal vagina with an associated mass effect on the bladder. There was no enhancement after gadolinium contrast agent administration (Figure 1C). In the midsagittal plane (Figure 1B), MRI showed that the cervical canal was also distended and contiguous with the endometrial cavity, which mea- A Figure 1. A, Axial T1-weighted MRI. B, Fat-suppressed sagittal fast spin echo T2-weighted MRI. C, Fat-suppressed gadoliniumenhanced axial T1-weighted MRI. The images show a large hyperintense nonenhancing well-encapsulated hemorrhagic collection distending the upper vagina and extending into the cervical canal, consistent with hematocolpos (asterisks). Fluid in the distended part of the vagina is surrounded by several T2- hyperintense foci (B, center and right arrows) and a concentric ring (B, left arrow) at the periphery, consistent with the presence of blood in various stages of evolution. B C 950 J Ultrasound Med 2009; 28:

3 Verma et al sured 15 mm and contained hemorrhagic material. Vaginal stenosis secondary to prior radiation treatment was suggested as a cause of the accumulated blood. No further follow-up was performed at the time. The patient became symptomatic, and pelvic sonography was advised. A 3D TVS examination depicted a distended upper vagina containing diffuse low-level echoes measuring cm, consistent with blood known as hematocolpos (Figure 2). A thin hypoechoic diaphragm-like soft tissue structure measuring about 3 mm in thickness was seen crossing the vagina, consistent with an obstructing vaginal scar between the patent lower vagina and the hematocolpos (Figure 3). The lower vagina had a normal appearance with a length of approximately 3 cm; the appearance of the cervix was unremarkable. The uterus was normal with an endometrial thickness of 3 mm. Both ovaries were visualized as small with no cystic components. In contrast to the MRI, sonography showed that the uterus and cervical canal were not distended because this patient was no longer menstruating. In the operating room, under laryngeal mask anesthesia, successful intraoperative real-time transabdominal sonographic guidance was used to facilitate access to the hematocolpos via a blunt dilator, which resulted in the release of dark blood with complete evacuation of the fluid. The vaginal scarring was resected, with restoration of her normal vaginal length. Placement of a vaginal stent to prevent immediate closure was performed under continued sonographic guidance. The patient tolerated the procedure well. Endometrial biopsy confirmed an atrophic endometrium with chronic inflammation and old hemorrhage. Postoperatively, the patient continued to receive combined hormone replacement therapy with good resolution of her menopausal symptoms. Maintenance of an adequate vagina allowing for cervical visualization necessitated the continuous use of the vaginal stent, placed 3 nights per week with estrogen cream. A minimal constrictive ring at the site of previous scarring was still visible. The patient was advised that if she resumed vaginal intercourse, continued use of the vaginal stent may become unnecessary. Figure 2. Transperineal 3D multiplanar sonography shows sagittal (top left), axial (top right), and coronal (bottom left) views of a distended upper vagina filled with complex fluid containing diffuse low-level echoes most consistent with the hemorrhagic contents of the hematocolpos (asterisks). The lower vaginal walls are opposed to each other, creating the white line in the top left image. Discussion This report describes an unusual case of a midvaginal transverse scar acquired after radiation therapy that led to formation of hematocolpos due to obstruction of vaginal outflow. Hematocolpos is the term derived from the Greek words hematos, meaning blood, and kolpos, meaning vagina. 4 The obstruction may be primary (congenital), such as a müllerian defect of the lower female genital tract (eg, imperforate hymen, transverse vaginal septum, and partial vaginal agenesis), 7,8 or it may be acquired. 1 6 Acquired vaginal stenosis commonly occurs as a result of radiation treatment for gynecologic malignancies such as cervical, endometrial, vulvar, and vaginal carcinomas. 1,4,5 Rarely, it may also follow pelvic irradiation in patients with colorectal carcinoma. 5 Vaginal stenosis occurs after completion of radiation therapy as a result of denudation of the vaginal epithelium, leading to perivaginal fibrosis of the areas that were denuded. 1 Thinning of the vaginal mucosa and scarring result in shortening and narrowing of J Ultrasound Med 2009; 28:

4 Hematocolpos After Radiation Therapy for Colorectal Carcinoma A B Figure 3. A, Midsagittal 3D TVS shows a hypoechoic band of tissue (between arrows) that represents the scar between the patent lower vagina and the upper vaginal collection of blood constituting the hematocolpos (asterisk). B, Sagittal 3D TVS shows a 3-mm vaginal scar measured between the calipers and the hematocolpos (asterisk). the vagina. It is exaggerated by the frequent simultaneous onset of menopause and precipitated by radiation therapy with a resultant local estrogen deficiency. Clinical awareness of vaginal obstruction as a postradiotherapy complication is important because it impairs the quality of life and may lead to problems with sexual function, potential infection of the pelvic organs, and even sepsis. The diagnosis is usually made at the onset of symptoms. As with this patient, modes of presentation are commonly dyspareunia, pelvic pain, and back pain. 3,9 Obstructive symptoms such as urinary retention, dysuria, and constipation due to mechanical pressure on the bladder, urethra, and rectum by the accumulated menstrual blood are also common. 10,11 Management of hematocolpos and vaginal stenosis depends on the extent of the pelvic obstruction and the location. A definitive preoperative diagnosis is crucial for defining the best treatment strategy. In addition, other etiologies for a pelvic mass, including malignancy recurrence and a possible second malignancy, must be considered. To our knowledge, a case with sonographic and MRI findings of hematocolpos secondary to acquired vaginal scarring after radiation therapy for colorectal carcinoma has not been reported previously in the literature. Transperineal sonography and TVS have been used for diagnosing an obstructed vagina and consequent hematocolpos and for defining the anatomic defect. 12,13 These conventional methods may not allow for adequate angulation of a TVS probe to properly visualize the anatomic details of pelvic organs in the coronal plane. With the 3D TVS technique, it is possible to determine whether the obstruction is due to a vaginal septum or adhesion, its measurements, and its configuration, whether incomplete or complete, and define its relationship with adjacent pelvic structures. In this case, 3D TVS was performed because of increasing pelvic cramps, a persistent pelvic mass, a shortened vagina with nonvisualization of the cervix on the physical examination, and lack of an appreciable explanation on MRI. On sonography, hematocolpos manifests as a distended vagina containing fluid with low-level echoes, solid debris, or both. This case showed the classic appearance of old blood. The transversely oriented vaginal scar was seen as a thin hypoechoic band between the lower vagina and hematocolpos. Sonography is a simple, flexible, inexpensive, and noninvasive imaging modality that has an added advantage for guiding an invasive procedure for diagnostic and therapeutic purposes. In this case, 3D sonography confirmed the presence of hematocolpos, determined the 952 J Ultrasound Med 2009; 28:

5 Verma et al cause and level of the vaginal obstruction, and ruled out a urologic or gastrointestinal abnormality. Intraoperative sonographic guidance was essential for appropriate entry into the hematocolpos and subsequent evacuation. Correct placement of the vaginal stent was confirmed. Magnetic resonance imaging is highly sensitive in characterizing the components of large collections or masses with variable signal intensities on T1- and T2-weighted sequences and their enhancement patterns. 14 In this case, MRI revealed the large hyperintense fluid collection within the grossly distended vagina to be hemorrhagic contents with no solid components. Furthermore, MRI helped in excluding other possible etiologies, including a Nabothian cyst, a Gartner duct cyst, and a malignant lesion. Early diagnosis and management of hematocolpos are essential to relieve pressure and prevent hematometrium (accumulation of blood in the endometrial cavity), hematosalpinx (accumulation of blood in fallopian tube), and urinary tract obstruction. The mainstay of treatment is drainage and evacuation. 15 Vaginal dilation with the use of dilators and placement of a mechanical removable stent should be attempted for vaginal stenosis before surgical reconstruction is considered. 2,16 In this case, intraoperative sonography allowed complete evacuation of the hematocolpos and proper placement of a vaginal stent as a means of preventing restenosis. Because many of these patients become acutely menopausal after cancer treatment, local or systemic estrogen therapy to provide adequate epithelialization and perhaps prevent adhesion recurrence should be initiated simultaneously. In conclusion, pelvic 3D TVS was effective in confirming the diagnosis of hematocolpos and identifying the underlying cause. Intraoperative sonographic guidance during procedures is essential for safely approaching a vaginal collection and finding the point of stenosis. Both are important for an accurate preoperative diagnosis and effective surgical management. 2. Decruze SB, Guthrie D, Magnani R. Prevention of vaginal stenosis in patients following vaginal brachytherapy. Clin Oncol (R Coll Radiol) 1999; 11: Speas CK, Gallup DC, Gallup DG. Hematocolpos in elderly women. South Med J 1998; 6: Bruner DW, Lanciano R, Keegan M, Corn B, Martin E, Hanks GE. Vaginal stenosis and sexual function following intracavitary radiation for the treatment of cervical and endometrial carcinoma. Int J Radiat Oncol Biol Phys 1993; 27: Greven KM, Paunesku T. Radiation complications of the pelvis. Cancer Treat Res 2006; 128: Parmley TH, Woodruff JD. Complete vaginal occlusion in postmenopausal women. Obstet Gynecol 1975; 46: Yu TJ, Lin MC. Acute urinary retention in two patients with imperforate hymen. Scand J Urol Nephrol 1993; 27: Dickson CA, Saad S, Tesar JD. Imperforate hymen with hematocolpos. Ann Emerg Med 1985; 14: Harrison CS. Hematocolpos as a cause of low-back pain: a case report. Spine 1991; 16: Soloway MS, Rao MK, Kest L. Hematocolpos with urinary tract obstruction in an adult. J Urol 1977; 117: Ward A, Maher P. Haematocolpos: an unusual presentation. Br J Clin Pract 1979; 33: Meyer WR, McCoy MC, Fritz MA. Combined abdominalperineal sonography to assist in diagnosis of transverse vaginal septum. Obstet Gynecol 1995; 85: Sailer JF. Hematometra and hematocolpos: ultrasound findings AJR Am J Roentgenol 1979; 132: Griffin N, Grant LA, Sala E. Magnetic resonance imaging of vaginal and vulval pathology. Eur Radiol 2008; 18: Schneider K, Hong J, Fong J, Sanders CG. Hematocolpos as an easily overlooked diagnosis. Curr Opin Pediatr 1999; 11: Morley GW, DeLancey JO. Full-thickness skin graft vaginoplasty for treatment of the stenotic or foreshortened vagina. Obstet Gynecol 1991; 77: References 1. Hartman P, Diddle AW. Vaginal stenosis following irradiation therapy for carcinoma of the cervix uteri. Cancer 1972; 30: J Ultrasound Med 2009; 28:

Abnormal Uterine Bleeding FAQ Sheet

Abnormal Uterine Bleeding FAQ Sheet Abnormal Uterine Bleeding FAQ Sheet What is abnormal uterine bleeding? Under normal circumstances, a woman's uterus sheds a limited amount of blood during each menstrual period. Bleeding that occurs between

More information

Gynecology Abnormal Pelvic Anatomy and Physiology: Cervix. Cervix. Nabothian cysts. cervical polyps. leiomyomas. Cervical stenosis

Gynecology Abnormal Pelvic Anatomy and Physiology: Cervix. Cervix. Nabothian cysts. cervical polyps. leiomyomas. Cervical stenosis Gynecology Abnormal Pelvic Anatomy and Physiology: (Effective February 2007) pediatric, reproductive, and perimenopausal/postmenopausal (24-28 %) Cervix Nabothian cysts result from chronic cervicitis most

More information

Introduction Ovarian cysts are a very common female condition. An ovarian cyst is a fluid-filled sac on an ovary in the female reproductive system.

Introduction Ovarian cysts are a very common female condition. An ovarian cyst is a fluid-filled sac on an ovary in the female reproductive system. Ovarian Cysts Introduction Ovarian cysts are a very common female condition. An ovarian cyst is a fluid-filled sac on an ovary in the female reproductive system. Most women have ovarian cysts sometime

More information

OVARIAN CYSTS. Types of Ovarian Cysts There are many types of ovarian cysts and these can be categorized into functional and nonfunctional

OVARIAN CYSTS. Types of Ovarian Cysts There are many types of ovarian cysts and these can be categorized into functional and nonfunctional OVARIAN CYSTS Follicular Cyst Ovarian cysts are fluid-filled sacs that form within or on the ovary. The majority of these cysts are functional meaning they usually form during a normal menstrual cycle.

More information

Summa Health System. A Woman s Guide to Hysterectomy

Summa Health System. A Woman s Guide to Hysterectomy Summa Health System A Woman s Guide to Hysterectomy Hysterectomy A hysterectomy is a surgical procedure to remove a woman s uterus (womb). The uterus is the organ which shelters and nourishes a baby during

More information

About the Uterus. Hysterectomy may be done to treat conditions that affect the uterus. Some reasons a hysterectomy may be needed include:

About the Uterus. Hysterectomy may be done to treat conditions that affect the uterus. Some reasons a hysterectomy may be needed include: Hysterectomy removal of the uterus is a way of treating problems that affect the uterus. Many conditions can be cured with hysterectomy. Because it is major surgery, your doctor may suggest trying other

More information

CHAPTER 10 Uterine Synechiae

CHAPTER 10 Uterine Synechiae CHAPTER 10 Uterine Synechiae Uterine synechiae are intrauterine adhesions. They may involve small focal areas of the endometrium (Figures 10.1a e), or they can be so extensive that they obliterate the

More information

Beverly E Hashimoto, M.D. Virginia Mason Medical Center, Seattle, WA

Beverly E Hashimoto, M.D. Virginia Mason Medical Center, Seattle, WA Pelvic Floor Relaxation Beverly E Hashimoto, M.D. Virginia Mason Medical Center, Seattle, WA Disclosures Beverly Hashimoto: GE Medical Systems: research support and consultant (all fees given to Virginia

More information

Three-Dimensional Inversion Rendering

Three-Dimensional Inversion Rendering Image Presentation Three-Dimensional Inversion Rendering New Sonographic Technique and Its Use in Gynecology Ilan E. Timor-Tritsch, MD, RDMS, na Monteagudo, MD, RDMS, Tanya Tsymbal,, RDMS, Irina Strok,

More information

Ovarian Torsion: Sonographic Evaluation

Ovarian Torsion: Sonographic Evaluation J Clin Ultrasound 17:327-332, June 1989 Ovarian Torsion: Sonographic Evaluation Mark A. Helvie, MD,* and Terry M. Silver, MDI Abstract: The sonographic and clinical findings of 13 patients with surgically

More information

WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Endometriosis

WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Endometriosis Endometriosis WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 The lining of the uterus is called the endometrium. Sometimes, endometrial tissue grows elsewhere in the body. When this happens

More information

Frequently Asked Questions About Ovarian Cancer

Frequently Asked Questions About Ovarian Cancer Media Contact: Gerri Gomez Howard Cell: 303-748-3933 gerri@gomezhowardgroup.com Frequently Asked Questions About Ovarian Cancer What is ovarian cancer? Ovarian cancer is a cancer that forms in tissues

More information

Laparoscopy and Hysteroscopy

Laparoscopy and Hysteroscopy AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE Laparoscopy and Hysteroscopy A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of

More information

Glossary. amenorrhea, primary - from the beginning and lifelong; menstruation never begins at puberty.

Glossary. amenorrhea, primary - from the beginning and lifelong; menstruation never begins at puberty. Glossary amenorrhea - absence or cessation of menstrual periods. amenorrhea, primary - from the beginning and lifelong; menstruation never begins at puberty. A amenorrhea, secondary - due to some physical

More information

Ovarian Cystectomy / Oophorectomy

Ovarian Cystectomy / Oophorectomy Cystectomy and Ovarian Cysts Ovarian cysts are sacs filled with fluids or pockets located on or in an ovary. In some cases, these cysts need to be removed surgically. Types of Cysts Ovarian cysts are quite

More information

POSTMENOPAUSAL ASSESS AND WHAT TO DO

POSTMENOPAUSAL ASSESS AND WHAT TO DO POSTMENOPAUSAL OVARIAN CYSTS:HOW TO ASSESS AND WHAT TO DO Steven R. Goldstein, MD Professor of Obstetrics and Gynecology Director of Gynecologic Ultrasound Co-Director, Bone Densitometry New York University

More information

How To Treat A Uterine Sarcoma

How To Treat A Uterine Sarcoma EVERYONE S GUIDE FOR CANCER THERAPY Malin Dollinger, MD, Ernest H. Rosenbaum, MD, Margaret Tempero, MD, and Sean Mulvihill, MD 4 th Edition 2001 Uterus: Uterine Sarcomas Jeffrey L. Stern, MD Uterine sarcomas

More information

Cervical Cancer. Cervical smear test. The cervix. Dysplasia. Cervical cancer. The female reproductive system

Cervical Cancer. Cervical smear test. The cervix. Dysplasia. Cervical cancer. The female reproductive system INFORMATION SHEET Cervical Cancer This information sheet has been written to provide you with information about cervical cancer (cancer of the cervix). The sheet has information about the different types

More information

A Guide to Hysteroscopy. Patient Education

A Guide to Hysteroscopy. Patient Education A Guide to Hysteroscopy Patient Education QUESTIONS AND ANSWERS ABOUT HYSTEROSCOPY Your doctor has recommended that you have a procedure called a hysteroscopy. Naturally, you may have questions about

More information

A potential treatment for your abnormal uterine bleeding

A potential treatment for your abnormal uterine bleeding TRUCLEAR System A potential treatment for your abnormal uterine bleeding Do You Suffer from Abnormal Uterine Bleeding? What is a Hysteroscopy? What is the TRUCLEAR Procedure? What Happens Before Your

More information

Ovarian cysts Diagnosis and Management

Ovarian cysts Diagnosis and Management Ovarian cysts Diagnosis and Management Mr P K Athanasias MRCOG Consultant Gynaecologist St Anthony s Hospital pathanasias@gmail.com Introduction ovary is an ovum-producing reproductive organ located in

More information

Understanding Your Diagnosis of Endometrial Cancer A STEP-BY-STEP GUIDE

Understanding Your Diagnosis of Endometrial Cancer A STEP-BY-STEP GUIDE Understanding Your Diagnosis of Endometrial Cancer A STEP-BY-STEP GUIDE Introduction This guide is designed to help you clarify and understand the decisions that need to be made about your care for the

More information

Metastatic Cervical Cancer s/p Radiation Therapy, Radical Hysterectomy and Attempted Modified Internal Hemipelvectomy

Metastatic Cervical Cancer s/p Radiation Therapy, Radical Hysterectomy and Attempted Modified Internal Hemipelvectomy Metastatic Cervical Cancer s/p Radiation Therapy, Radical Hysterectomy and Attempted Modified Internal Hemipelvectomy Sarah Hutto,, MSIV Marc Underhill, M.D. January 27, 2009 Past History 45 yo female

More information

Hysterectomy. The time to take care of yourself

Hysterectomy. The time to take care of yourself Hysterectomy The time to take care of yourself The time to take care of yourself Women spend a lot of time taking care of others spouses, children, parents. We often overlook our own needs. But when our

More information

International Journal of Case Reports in Medicine

International Journal of Case Reports in Medicine International Journal of Case Reports in Medicine Vol. 2013 (2013), Article ID 340925, 18 minipages. DOI:10.5171/2013.340925 www.ibimapublishing.com Copyright 2013. Massinde Anthony. Distributed under

More information

Endometriosis: An Overview

Endometriosis: An Overview Endometriosis: An Overview www.bcwomens.ca Welcome to the BC Women s Centre for Pelvic Pain and Endometriosis. This handout will give you some basic information about endometriosis. It will also explain

More information

Ovarian Cyst. Homoeopathy Clinic. Introduction. Types of Ovarian Cysts. Contents. Case Reports. 21 August 2002

Ovarian Cyst. Homoeopathy Clinic. Introduction. Types of Ovarian Cysts. Contents. Case Reports. 21 August 2002 Case Reports 21 August 2002 Ovarian Cyst Homoeopathy Clinic Check Yourself If you have any of the following symptoms call your doctor. Sense of fullness or pressure or a dull ache in the abdomen Pain during

More information

Treating heavy menstrual bleeding caused by fibroids or polyps

Treating heavy menstrual bleeding caused by fibroids or polyps Treating heavy menstrual bleeding caused by fibroids or polyps With today s medical advances the outlook for successful treatment of fibroids and polyps has never been better. You don t have to live with

More information

Hysterectomy. What is a hysterectomy? Why is hysterectomy done? Are there alternatives to hysterectomy?

Hysterectomy. What is a hysterectomy? Why is hysterectomy done? Are there alternatives to hysterectomy? ROBERT LEVITT, MD JESSICA BERGER-WEISS, MD ADRIENNE POTTS, MD HARTAJ POWELL, MD, MPH COURTNEY LEVENSON, MD LAUREN BURNS, MSN, RN, WHNP OBGYNCWC.COM What is a hysterectomy? Hysterectomy Hysterectomy is

More information

WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Hormone Therapy

WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Hormone Therapy Hormone Therapy WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 At menopause, a woman's body makes less estrogen and she stops having menstrual periods. This is a natural stage in a woman's

More information

Facing a Hysterectomy? If you ve been diagnosed with early stage gynecologic cancer, learn about minimally invasive da Vinci Surgery

Facing a Hysterectomy? If you ve been diagnosed with early stage gynecologic cancer, learn about minimally invasive da Vinci Surgery Facing a Hysterectomy? If you ve been diagnosed with early stage gynecologic cancer, learn about minimally invasive da Vinci Surgery The Condition: Early Stage Gynecologic Cancer A variety of gynecologic

More information

Bard: Continence Therapy. Stress Urinary Incontinence. Regaining Control. Restoring Your Lifestyle.

Bard: Continence Therapy. Stress Urinary Incontinence. Regaining Control. Restoring Your Lifestyle. Bard: Continence Therapy Stress Urinary Incontinence Regaining Control. Restoring Your Lifestyle. Stress Urinary Incontinence Becoming knowledgeable about urinary incontinence Uterus Normal Pelvic Anatomy

More information

Get the Facts, Be Informed, Make YOUR Best Decision. Pelvic Organ Prolapse

Get the Facts, Be Informed, Make YOUR Best Decision. Pelvic Organ Prolapse Pelvic Organ Prolapse ETHICON Women s Health & Urology, a division of ETHICON, INC., a Johnson & Johnson company, is dedicated to providing innovative solutions for common women s health problems and to

More information

Cervical Cancer The Importance of Cervical Screening and Vaccination

Cervical Cancer The Importance of Cervical Screening and Vaccination Cervical Cancer The Importance of Cervical Screening and Vaccination Cancer Cells Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body. Sometimes, this

More information

The following chapter is called The Role of Endoscopy, Laparoscopy, and Hysteroscopy in Infertility.

The following chapter is called The Role of Endoscopy, Laparoscopy, and Hysteroscopy in Infertility. Welcome to Chapter 14. The following chapter is called The Role of Endoscopy, Laparoscopy, and Hysteroscopy in Infertility. The authors are Dr. Jose Remohi and Dr. Jaime Ferro. 1 There are several tools

More information

WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Ovarian Cysts

WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500. Ovarian Cysts Ovarian Cysts WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 The ovaries are two small organs located on either side of a woman s uterus. An ovarian cyst is a sac or pouch filled with fluid

More information

Considering Endometriosis Surgery? Learn about minimally invasive da Vinci Surgery

Considering Endometriosis Surgery? Learn about minimally invasive da Vinci Surgery Considering Endometriosis Surgery? Learn about minimally invasive da Vinci Surgery The Condition: Endometriosis Endometriosis is a condition in which the tissue that lines your uterus (the endometrium)

More information

Specialists In Reproductive Medicine & Surgery, P.A.

Specialists In Reproductive Medicine & Surgery, P.A. Specialists In Reproductive Medicine & Surgery, P.A. Craig R. Sweet, M.D. www.dreamababy.com Fertility@DreamABaby.com Excellence, Experience & Ethics Endometriosis Awareness Week/Month Common Questions

More information

Ultrasound and Hysteroscopy in Infertility

Ultrasound and Hysteroscopy in Infertility Ultrasound and Hysteroscopy in Infertility James M. Shwayder, M.D., J.D. Professor and Chair Department of Obstetrics and Gynecology University of Mississippi Medical Center Jackson, Mississippi Ultrasound

More information

Uterine fibroids (Leiomyoma)

Uterine fibroids (Leiomyoma) Uterine fibroids (Leiomyoma) What are uterine fibroids? Uterine fibroids are fairly common benign (not cancer) growths in the uterus. They occur in about 25 50% of all women. Many women who have fibroids

More information

Migration of an intrauterine contraceptive device to the sigmoid colon: a case report

Migration of an intrauterine contraceptive device to the sigmoid colon: a case report The European Journal of Contraception and Reproductive Health Care 2003;8:229 232 Case Report Migration of an intrauterine contraceptive device to the sigmoid colon: a case report Ü. S. nceboz, H. T. Özçakir,

More information

Cancer of the Cervix

Cancer of the Cervix Cancer of the Cervix WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 A woman's cervix (the opening of the uterus) is lined with cells. Cancer of the cervix occurs when those cells change,

More information

Carcinoma of the vagina is a relatively uncommon disease, affecting only about 2,000 women in

Carcinoma of the vagina is a relatively uncommon disease, affecting only about 2,000 women in EVERYONE S GUIDE FOR CANCER THERAPY Malin Dollinger, MD, Ernest H. Rosenbaum, MD, Margaret Tempero, MD, and Sean Mulvihill, MD 4 th Edition, 2001 Vagina Jeffrey L. Stern, MD Carcinoma of the vagina is

More information

Abnormal Uterine Bleeding

Abnormal Uterine Bleeding Abnormal Uterine Bleeding WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 Abnormal uterine bleeding is one of the most common reasons women see their doctors. It can occur at any age and has

More information

The menopausal transition usually has three parts:

The menopausal transition usually has three parts: The menopausal transition usually has three parts: Perimenopause begins several years before a woman s last menstrual period, when the ovaries gradually produce less estrogen. In the last 1-2 years of

More information

Patient. Frequently Asked Questions. Transvaginal Surgical Mesh for Pelvic Organ Prolapse

Patient. Frequently Asked Questions. Transvaginal Surgical Mesh for Pelvic Organ Prolapse Patient Frequently Asked Questions Transvaginal Surgical Mesh for Pelvic Organ Prolapse Frequently Asked Questions WHAT IS PELVIC ORGAN PROLAPSE AND HOW IS IT TREATED? Q: What is pelvic organ prolapse

More information

Endometriosis Obstetrics & Gynaecology Women and Children s Group

Endometriosis Obstetrics & Gynaecology Women and Children s Group Endometriosis Obstetrics & Gynaecology Women and Children s Group This leaflet has been designed to give you important information about your condition / procedure, and to answer some common queries that

More information

GYNECOLOGIC CANCERS Facts to Help Patients Make an Informed Decision

GYNECOLOGIC CANCERS Facts to Help Patients Make an Informed Decision RADIATION THERAPY FOR GYNECOLOGIC CANCERS Facts to Help Patients Make an Informed Decision TARGETING CANCER CARE AMERICAN SOCIETY FOR RADIATION ONCOLOGY FACTS ABOUT GYNECOLOGIC CANCERS Gynecologic cancers

More information

Saint Mary s Hospital. Ovarian Cysts. Information For Patients

Saint Mary s Hospital. Ovarian Cysts. Information For Patients Saint Mary s Hospital Ovarian Cysts Information For Patients 2 Contents Welcome 4 What are ovarian cysts? 4 How common are ovarian cysts? 6 Ovarian cysts and fertility 6 What are the symptoms of ovarian

More information

LAPAROSCOPIC OVARIAN CYSTECTOMY

LAPAROSCOPIC OVARIAN CYSTECTOMY LAPAROSCOPIC OVARIAN CYSTECTOMY Information Leaflet Your Health. Our Priority. Page 2 of 5 About this information This leaflet is for you if you have a cyst on one or both ovaries and are considering surgery.

More information

National Coverage Determination (NCD) for Tumor Antigen by Immunoassay - CA 125 (190.28)

National Coverage Determination (NCD) for Tumor Antigen by Immunoassay - CA 125 (190.28) National Coverage Determination (NCD) for Tumor Antigen by Immunoassay - CA 125 (190.28) Tracking Information Publication Number Manual Section Number 100-3 190.28 Manual Section Title Tumor Antigen by

More information

CERVICAL CANCER What every woman should know What is a cervix?

CERVICAL CANCER What every woman should know What is a cervix? CERVICAL CANCER What every woman should know What is a cervix? The cervix is the entrance to the womb from the vagina. It is the narrow, lower part of the uterus that is the passageway connecting the uterus

More information

Uterus myomatosus. 10-May-15. Clinical presentation. Incidence. Causes? 3 out of 4 women. Growth rate vary. Most common solid pelvic tumor in women

Uterus myomatosus. 10-May-15. Clinical presentation. Incidence. Causes? 3 out of 4 women. Growth rate vary. Most common solid pelvic tumor in women Uterus myomatosus A.J. Henriquez March 14, 2015 Uterus myomatosus Definition, incidence, clinical presentation and diagnosis. New FIGO classification for uterine leiomyomas Brief description on treatment

More information

Follow-Up Care for Breast Cancer

Follow-Up Care for Breast Cancer A Patient s Guide Follow-Up Care for Breast Cancer Recommendations of the American Society of Clinical Oncology The American Society of Clinical Oncology (ASCO) is a nonprofit organization which represents

More information

The main surgical options for treating early stage cervical cancer are:

The main surgical options for treating early stage cervical cancer are: INFORMATION LEAFLET ON TOTAL LAPAROSCOPIC RADICAL HYSTERECTOMY (TLRH) FOR EARLY STAGE CERVICAL CANCER (TREATING EARLY STAGE CERVICAL CANCER BY RADICAL HYSTERECTOMY THROUGH KEYHOLE SURGERY) Aim of the leaflet

More information

Women s Health Laparoscopy Information for patients

Women s Health Laparoscopy Information for patients Women s Health Laparoscopy Information for patients This leaflet is for women who have been advised to have a laparoscopy. It outlines the common reasons doctors recommend this operation, what will happen

More information

Uterine Fibroid Symptoms, Diagnosis and Treatment

Uterine Fibroid Symptoms, Diagnosis and Treatment Fibroids and IR Uterine Fibroid Symptoms, Diagnosis and Treatment Interventional radiologists use MRIs to determine if fibroids can be embolised, detect alternate causes for the symptoms and rule out misdiagnosis,

More information

Pap smears, cytology and CCHC lab work and follow up

Pap smears, cytology and CCHC lab work and follow up Pap smears, cytology and CCHC lab work and follow up What is a Pap Smear? A Pap smear (also known as the Pap test) is a medical procedure in which a sample of cells from a woman's cervix (the end of the

More information

Three-Dimensional Sonography of the Endometrium and Adjacent Myometrium

Three-Dimensional Sonography of the Endometrium and Adjacent Myometrium Technical dvance Three-Dimensional Sonography of the Endometrium and djacent Myometrium Preliminary Observations Rochelle F. ndreotti, MD, rthur C. Fleischer, MD, Lawrence E. Mason, Jr, MD Objective. y

More information

Why would you need a hysterectomy?

Why would you need a hysterectomy? Why would you need a hysterectomy? Removal of the uterus is performed to prevent, alleviate, or treat pain, pressure, bleeding, or cancer. Each reason is described in detail in the following pages. Benign

More information

Ovarian cancer. A guide for journalists on ovarian cancer and its treatment

Ovarian cancer. A guide for journalists on ovarian cancer and its treatment Ovarian cancer A guide for journalists on ovarian cancer and its treatment Contents Contents 2 3 Section 1: Ovarian Cancer 4 i. Types of ovarian cancer 4 ii. Causes and risk factors 5 iii. Symptoms and

More information

All you need to know about Endometriosis. Nordica Fertility Centre, Lagos, Asaba, Abuja

All you need to know about Endometriosis. Nordica Fertility Centre, Lagos, Asaba, Abuja All you need to know about Endometriosis October, 2015 About The Author Nordica Lagos Fertility Centre is one of Nigeria's leading centres for world class Assisted Reproductive Services, with comfort centres

More information

Kate O Hanlan, M. D. F. A. C. O. G., F. A. C. S.

Kate O Hanlan, M. D. F. A. C. O. G., F. A. C. S. Kate O Hanlan, M. D. F. A. C. O. G., F. A. C. S. Gynecologic Oncology, Surgery and Endoscopy 4370 Alpine Road Portola Valley, CA 94028-7523 Phone: (650)-851-6669 FAX: (650) 851-9747 Regarding Ovarian Cancer,

More information

Case Report. Central Neurocytoma. Fotis Souslian, MD; Dino Terzic, MD; Ramachandra Tummala, MD. Department of Neurosurgery, University of Minnesota

Case Report. Central Neurocytoma. Fotis Souslian, MD; Dino Terzic, MD; Ramachandra Tummala, MD. Department of Neurosurgery, University of Minnesota 1 Case Report Central Neurocytoma Fotis, MD; Dino Terzic, MD; Ramachandra Tummala, MD Department of Neurosurgery, University of Minnesota Case This is a previously healthy 20 year old female, with 3 months

More information

Uterine Cancer. Understanding your diagnosis

Uterine Cancer. Understanding your diagnosis Uterine Cancer Understanding your diagnosis Uterine Cancer Understanding your diagnosis When you first hear that you have cancer, you may feel alone and afraid. You may be overwhelmed by the large amount

More information

Female Urinary Disorders and Pelvic Organ Prolapse

Female Urinary Disorders and Pelvic Organ Prolapse Female Urinary Disorders and Pelvic Organ Prolapse Richard S. Bercik, M.D. Director, Division of Urogynecology & Reconstruction Pelvic Surgery Department of Obstetrics, Gynecology & Reproductive Sciences

More information

CASE REPORT Double Cervix and Vagina with Septate Uterus: An Uncommon Müllerian Malformation

CASE REPORT Double Cervix and Vagina with Septate Uterus: An Uncommon Müllerian Malformation CASE REPORT Double Cervix and Vagina with Septate Uterus: An Uncommon Müllerian Malformation Andrew F. Hundley, M.D., Julia R. Fielding, M.D.*, Lennox Hoyte, M.D. Departments of Obstetrics and Gynecology

More information

Ovarian Cysts Made Simple Michael East. Oxford Clinic

Ovarian Cysts Made Simple Michael East. Oxford Clinic Ovarian Cysts Made Simple Michael East Oxford Clinic Objectives of this talk To understand risk of malignancy and thus not fear it Practical advice for follow up of asymptomatic cysts Practical advice

More information

3 Summary of clinical applications and limitations of measurements

3 Summary of clinical applications and limitations of measurements CA125 (serum) 1 Name and description of analyte 1.1 Name of analyte Cancer Antigen 125 (CA125) 1.2 Alternative names Mucin 16 1.3 NLMC code To follow 1.4 Description of analyte CA125 is an antigenic determinant

More information

patient education Fact Sheet PFS003: Hormone Therapy APRIL 2015

patient education Fact Sheet PFS003: Hormone Therapy APRIL 2015 patient education Fact Sheet PFS003: Hormone Therapy APRIL 2015 Hormone Therapy Menopause is the time in a woman s life when she naturally stops having menstrual periods. Menopause marks the end of the

More information

Get the Facts About Gynecologic Cancer

Get the Facts About Gynecologic Cancer Get the Facts About Gynecologic Cancer Cervical Ovarian Uterine Vaginal Vulvar Get the Facts About Gynecologic Cancer U.S. Department of Health and Human Services Centers for Disease Control and Prevention

More information

OUTPATIENT HYSTEROSCOPY SERVICES JASMINE SUITE

OUTPATIENT HYSTEROSCOPY SERVICES JASMINE SUITE OUTPATIENT HYSTEROSCOPY SERVICES JASMINE SUITE Information Leaflet Your Health. Our Priority. Page 2 of 6 This information is for patients having a hysteroscopy (diagnostic or operative). It explains what

More information

AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE

AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE AMERICAN SOCIETY FOR REPRODUCTIVE MEDICINE UTERINE FIBROIDS A Guide for Patients PATIENT INFORMATION SERIES Published by the American Society for Reproductive Medicine under the direction of the Patient

More information

OVARIAN CANCER IS A MAJOR CAUSE OF MORBIDITY AND MORTALITY IN WOMEN. Name of Student HTHSCI 1110 WEBER STATE UNIVERSITY.

OVARIAN CANCER IS A MAJOR CAUSE OF MORBIDITY AND MORTALITY IN WOMEN. Name of Student HTHSCI 1110 WEBER STATE UNIVERSITY. Ovarian Cancer 2 OVARIAN CANCER IS A MAJOR CAUSE OF MORBIDITY AND MORTALITY IN WOMEN by Name of Student HTHSCI 1110 WEBER STATE UNIVERSITY Ogden, Utah Instructor s Name Date Ovarian Cancer 2 Background

More information

Ovarian Cancer. in Georgia, 1999-2003. Georgia Department of Human Resources Division of Public Health

Ovarian Cancer. in Georgia, 1999-2003. Georgia Department of Human Resources Division of Public Health Ovarian Cancer in Georgia, 1999-23 Georgia Department of Human Resources Division of Public Health Acknowledgments Georgia Department of Human Resources......B. J. Walker, Commissioner Division of Public

More information

COMPLICATIONS OF FISTULA REPAIR SURGERY. Sherif Mourad

COMPLICATIONS OF FISTULA REPAIR SURGERY. Sherif Mourad COMPLICATIONS OF FISTULA REPAIR SURGERY Sherif Mourad In the developing world, the true incidence of obstetric fistulas is unknown, as many patients with this condition suffer in silence and isolation.

More information

Are You at Risk for Ovarian Cancer?

Are You at Risk for Ovarian Cancer? Are You at Risk for Ovarian Cancer? A Woman s Guide Read this brochure to learn more about ovarian cancer symptoms, risk factors and what you can do to reduce your risk. ALL WOMEN HAVE SOME RISK OF OVARIAN

More information

worry When to Cervical Abnormalities CME Workshop What s the situation? What are the trends? By Dianne Miller, MD, FRCSC In this article:

worry When to Cervical Abnormalities CME Workshop What s the situation? What are the trends? By Dianne Miller, MD, FRCSC In this article: CME Workshop When to worry Cervical Abnormalities By Dianne Miller, MD, FRCSC What s the situation? Over 600,000 Papanicolaou s (Pap) smears were performed in British Columbia in 2000. Approximately 13,400

More information

GYNAECOLOGY. Ahmed Mohamed Abbas*, Mohamed Khalaf*, Abd El-Aziz E. Tammam**, Ahmed H. Abdellah**, Ahmed Mwafy**. Introduction ABSTRACT

GYNAECOLOGY. Ahmed Mohamed Abbas*, Mohamed Khalaf*, Abd El-Aziz E. Tammam**, Ahmed H. Abdellah**, Ahmed Mwafy**. Introduction ABSTRACT Thai Journal of Obstetrics and Gynaecology April 2015, Vol. 23, pp. 113-117 GYNAECOLOGY The Diagnostic Value of Saline Infusion Sonohysterography Versus Hysteroscopy in Evaluation of Uterine Cavity in

More information

K Raja/N Varol FPA 2013. FPA Sydney August 31 2013

K Raja/N Varol FPA 2013. FPA Sydney August 31 2013 FPA Sydney August 31 2013 Ms wilson 32 year old woman Presents with worsening, heavy menstrual and intermenstrual bleeding and pain for 6 months. Ms Wilson What is the differential diagnosis What are the

More information

Understanding Your Risk of Ovarian Cancer

Understanding Your Risk of Ovarian Cancer Understanding Your Risk of Ovarian Cancer A WOMAN S GUIDE This brochure is made possible through partnership support from Project Hope for Ovarian Cancer Research and Education. Project HOPE FOR OVARIAN

More information

2 of 6 10/17/2014 9:51 AM

2 of 6 10/17/2014 9:51 AM 1 of 6 10/17/2014 9:51 AM 010101 Free 14-Day Trial Tutorial Help Search by keyword or medical code User Name: Password: Directory Print Email Advanced Search Medical Disability Advisor > Cystocele Or Rectocele

More information

ProSono Copyright 2006. Ovarian Pathology

ProSono Copyright 2006. Ovarian Pathology Ovarian Pathology Physiologic cysts: Functional cysts Pathology: A simple cyst is a sac containing fluid or semi-solid material. Physiologic cysts are generic types of hormonally active cysts that result

More information

Implementation of hysteroscopy in an infertility clinic: The one-stop uterine diagnosis and treatment

Implementation of hysteroscopy in an infertility clinic: The one-stop uterine diagnosis and treatment Facts Views Vis Obgyn, 2014, 6 (4): 235-239 Short communication Implementation of hysteroscopy in an infertility clinic: The one-stop uterine diagnosis and treatment R. Campo 1,2,3, R. Meier,2, N. Dhont

More information

Understanding Endometriosis - Information Pack

Understanding Endometriosis - Information Pack What is endometriosis? Endometriosis (pronounced en- doh mee tree oh sis) is the name given to the condition where cells like the ones in the lining of the womb (uterus) are found elsewhere in the body.

More information

How To Perform Da Vinci Surgery

How To Perform Da Vinci Surgery Facing a Hysterectomy? If you ve been diagnosed with early stage gynecologic cancer, learn about minimally invasive da Vinci Surgery The Condition: Early Stage Gynecologic Cancer A variety of gynecologic

More information

Evaluation and Follow-up of Fetal Hydronephrosis

Evaluation and Follow-up of Fetal Hydronephrosis Evaluation and Follow-up of Fetal Hydronephrosis Deborah M. Feldman, MD, Marvalyn DeCambre, MD, Erin Kong, Adam Borgida, MD, Mujgan Jamil, MBBS, Patrick McKenna, MD, James F. X. Egan, MD Objective. To

More information

CMS Limitations Guide Mammograms and Bone Density Radiology Services

CMS Limitations Guide Mammograms and Bone Density Radiology Services CMS Limitations Guide Mammograms and Bone Density Radiology Services Starting July 1, 2008, CMS has placed numerous medical necessity limits on tests and procedures. This reference guide provides you with

More information

Benign Ovarian Masses

Benign Ovarian Masses Benign Ovarian Masses Anthony Hanbidge Learning Objectives Describe technique for assessment of ovarian masses Explain importance of transvaginal scan List the common benign masses Specify distinguishing

More information

Patient Information: Endometriosis Disease Process and Treatment

Patient Information: Endometriosis Disease Process and Treatment 1 William N. Burns, M. D. Associate Professor Department of Obstetrics & Gynecology Joan C. Edwards School of Medicine Marshall University Huntington, West Virginia, USA Patient Information: Endometriosis

More information

Lippes Loop intrauterine device left in the uterus for 50 years. Case report

Lippes Loop intrauterine device left in the uterus for 50 years. Case report 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Lippes Loop intrauterine device left in the uterus for 50 years Case report Background.The first Lippes Loop intrauterine device was distributed in 1962. It was a

More information

Hematometra An unusual cause of suprapubic pain in an adult.

Hematometra An unusual cause of suprapubic pain in an adult. Hematometra An unusual cause of suprapubic pain in an adult. Sam G Campbell MB BCh,* Rebecca Dobson MD FRCPC ^ * Samuel G Campbell: Department of Emergency Medicine, Dalhousie University Queen Elizabeth

More information

NovaSure: A Procedure for Heavy Menstrual Bleeding

NovaSure: A Procedure for Heavy Menstrual Bleeding NovaSure: A Procedure for Heavy Menstrual Bleeding The one-time, five-minute procedure Over a million women 1 have been treated with NovaSure. NovaSure Endometrial Ablation (EA) is the simple, one-time,

More information

Ovarian Cancer: A Case Report

Ovarian Cancer: A Case Report Ovarian Cancer: A Case Report Abstract Ovarian cancer is a very common cancer among women. It is an extremely diverse disease requiring several treatment options. Occasionally ovarian cancer is diagnosed

More information

FEMALE ANATOMY. the Functions of the Female Organs

FEMALE ANATOMY. the Functions of the Female Organs FEMALE ANATOMY the Functions of the Female Organs An educational video for every woman who is told she needs pelvic surgery, including exploratory surgery or removal of the uterus, fallopian tubes, or

More information

The position of hysteroscopy in current fertility practice is under debate.

The position of hysteroscopy in current fertility practice is under debate. The position of hysteroscopy in current fertility practice is under debate. The procedure is well tolerated. No consensus on effectiveness of HSC in improving prognosis of subfertile women. systematic

More information

Hysterosalpingography

Hysterosalpingography Scan for mobile link. Hysterosalpingography Hysterosalpingography uses a real-time form of x-ray called fluoroscopy to examine the uterus and fallopian tubes of a woman who is having difficulty becoming

More information

Timby/Smith: Introductory Medical-Surgical Nursing, 9/E

Timby/Smith: Introductory Medical-Surgical Nursing, 9/E Timby/Smith: Introductory Medical-Surgical Nursing, 9/E Chapter 59: Caring for Female Clients With Disorders of the Pelvic Reproductive Structures Slide 1 A Nurse s Role in All Reproductive Disorders Nurse

More information

Metastatic Renal Cell Carcinoma: Staging and Prognosis of Three Separate Cases.

Metastatic Renal Cell Carcinoma: Staging and Prognosis of Three Separate Cases. Metastatic Renal Cell Carcinoma: Staging and Prognosis of Three Separate Cases. Abstract This paper describes the staging, imaging, treatment, and prognosis of renal cell carcinoma. Three case studies

More information

Gynecologic Cancer in Women with Lynch Syndrome

Gynecologic Cancer in Women with Lynch Syndrome Gynecologic Cancer in Women with Lynch Syndrome Sarah E. Ferguson, MD FRCSC Division of Gynecologic Oncology, Princess Margaret Hospital, University of Toronto June 11, 2013 Objective 1. To review the

More information