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15 October 2014, Volume 41 Issue 5
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The Application of Minimally Invasive Surgery Personalization and Humanization XIA En-lan 2014, 41 (5):  481-482.  Abstract ( 1061 )   PDF (342KB) ( 4814 )   Minimally invasive surgery began in the 1980. Laparoscopy, hysteroscopy, vaginal surgery, ultrasonic and radioactive interventional surgery, as well as smaller incision are the representatives of minimally invasive surgery in gynecology. Their characteristics are with no incision, small incision, no cut off the muscles. However minimally invasive surgery can also cause massive trauma or death. To recognize minimally invasive should be to use a kind of operation with minimal trauma to achieve the best treatment effect. All surgery should be done under this guidance and this concept should be always carry out in any operations. Minimally invasive surgery should also carry out personalized and humanized principle to achieve the ideal therapeutic effect. Minimally invasive surgery should be strictly prevent, avoid and reduce the occurrence of complications. Related Articles | Metrics

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Innovative Thinking and Human Nature of Gynecologists LING Bin;LANG Jing-he 2014, 41 (5):  483-486.  Abstract ( 1087 )   PDF (577KB) ( 4757 )   The methods which are different from traditional medical behaviors and more conductive to patients′ physical and psychological rehabilitation are meaningful innovation. It contains not only historical heritage and affirmation, but also the betrayal of history and negation. In essence, it is the betrayal of traditional thinking and behavior. Although all the new things in clinical medicine come from clinical innovative ideas, the innovation result is not necessarily in line with the science and the humanities spirit. Everything new needs to go through clinical practice and to be superb. Clinical innovative researches are to discover clinical problems, and use proper scientific wisdom to solve the problems cleverly, that is to establish bridges of new ideas between clinical problems and the ideal solutions. The process of research is the process of bridge construction that requires scientific methods and hard practice, which leads to success. The starting point of innovation must be the liberation of thought and humanistic care. Human nature, the coexistence of good and evil, is the basic spirit attributes of human beings and the most basic and powerful motive power to dominate behaviors. Human nature should not be indulged. If free, we′ll have no way to restrict humanity evil. On the contrary, humanity should not be depressed persistently, if completely bound, creativity will be bondaged. Related Articles | Metrics

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Soil and Seed LI Tin-chiu;XIAO Yu 2014, 41 (5):  487-490.  Abstract ( 1059 )   PDF (712KB) ( 4805 )   The process of implantation in humans involves a complex interaction between the embryo and the endometrium, very similar to the case of the seed and the soil. Both the quality of the embryo （seed） and the endometrium （soil） are important determinants of successful implantation. There are many studies on how to select good quality embryos to improve implantation rate but relatively few ones on how to assess and improve endometrial quality. This review focuses on the endometrium, including the available methods used to assess the endometrium and strategies to improve the endometrium to achieve a higher implantation rate. Specifically, the role of endometrial scratch, a novel treatment recently introduced to improve the implantation and pregnancy rate in women who previously had recurrent IVF failure will be discussed. Finally, recommendations on how to protect or avoid inadvertent damage to the endometrium during various gynaecology procedures will also be discussed. Related Articles | Metrics

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Progress of Minimally Invasive Surgery for Reproductive Related Tubal Diseases ZHANG Song-ying;LIN Xiao-na;XU Wen-zhi 2014, 41 (5):  491-494.  Abstract ( 1181 )   PDF (735KB) ( 4816 )   The goal of infertile couples are to achieve pregnancy via exploring all reasonable attempts. The infertile couples who are due to tubal disease, account for more than 20% of all infertile couples, have two options to achieve this goal: minimally invasive tubal surgery and in vitro fertilization（IVF）. In most cases, the decision-making process requires detailed and effective discussion on the curative effect, side effect and cost of the procedures. The available evidence shows that tubal surgery can be more effective for cases of tubal adhesions, mild distal tubal occlusion, proximal obstruction and ectopic pregnancy. A successful tubal reconstructive surgery can not only make infertile couples to avoid further treatment, but also obtain the psychological advantage to conceive naturally. Before or during IVF treatment, individualized minimally invasive surgery treatment which according to tubal pathological changes, can improve the curative effect of IVF, intrauterine pregnancy rate and live birth rates. The incidence of ectopic pregnancy（EP） in IVF cycle is higher than that of natural population, minimally invasive surgery treatment for EP not only less trauma, but also can reduce the impact on subsequent IVF as far as possible. Now the most pragmatic viewpoint is to consider reproductive surgery and in vitro fertilization as complementary options that are directed towards increasing the overall probability of achieving a pregnancy in the most efficient manner. Related Articles | Metrics

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The Protection of Ovarian Function in Laparoscopic Surgery XIA Xiao-meng;FANG Xiao-ling 2014, 41 (5):  495-499.  Abstract ( 1254 )   PDF (768KB) ( 4911 )   Laparoscopic surgery has gradually replaced most of the traditional surgeries because of its advantages，such as good curative effect, rapid postoperative recovery, leaving almost no abdominal scar. It has become one of the minimal invasive surgeries which are most widely used and have promising developing prospect in gynecological operations. In recent years, it has become a concern that whether the various types of surgical manipulations in gynecological laparoscopic procedure can lead to the decrease of ovarian reserve function or even premature ovarian failure. Correct understanding and use of laparoscopic energy device can help improve a healthy development of laparoscopy. This paper focuses on different aspects, including the anatomy of ovary, the detection of ovarian reserve function, the impacts of laparoscopic surgery on the ovarian function, the protection measures for the ovarian function during the laparoscopic surgery and so on. It has been concluded that grasping the correct operation indication, choosing the appropriate operative procedures, and mastering skilled surgical techniques have important significance for protecting the ovarian function. Related Articles | Metrics

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Laparoscopic Surgery in Diagnosis and Treatment of Ovarian Cancer WANG Gang;CHEN Yang-ping 2014, 41 (5):  500-504.  Abstract ( 1086 )   PDF (716KB) ( 4805 )   Laparoscopic surgery has been controversial for a long time since it was applied to diagnosis and treatment of ovarian cancer. With the continual intensification of minimally invasive concept and development of minimally invasive surgical technology, laparoscopic staging surgery for ovarian cancer has been recognized and inthroned gradually in academia. Laparoscopic predictive model for optimal cytoreduction in advanced ovarian carcinoma is attracting widespread interest and active attempt. But there are continuous disputes on the feasibility, effectivity and safety of laparoscopic cytoreductive surgery. Clinical practice indicated that under the condition of well-selected cases and well-applied technology, lots of patients with advanced ovarian cancers can be benefited from minimally invasive surgical technology such as laparoscopy. Laparoscopic cytoreductive surgery for advanced ovarian carcinoma is worthy of further research. Related Articles | Metrics

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Laparoscopic Surgery in Treatment of the Cesarean Scar Pregnancy ZHAO Shao-jie;LUO Xiao-ping;YANG Wei-min 2014, 41 (5):  505-508.  Abstract ( 1041 )   PDF (748KB) ( 4828 )   The incidence rate of cesarean scar pregnancy（CSP） after cesarean section increases rapidly in recent years due to the increase of cesarean delivery. The CSP is caused by poor healing of lower uterine segment of cesarean section scar. Although with the progress in transvaginal ultrasonography, the diagnosis of these conditions is not the challenge for clinical doctor anymore, but the standardized management of CSP is not well established and the patient′s condition with CSP is various when visit the hospital, the treatment must be individualized as well. The main problem we face now is there has no standardized criteria for the selection of individualized treatment. The current opinion is that, for the patients with operation indications, operation can remove lesions as soon as possible could not only avoid life-threatening complications such as uterine rupture, hemorrhage, especially hysterectomy and loss of fertility, but also could repair the uterine scar defects and reduce the risk of CSP again. Laparoscopy had been widely used in China and many hospitals have the appropriate equipments and techniques, it is no doubt for operation safety and feasibility. In this review, we summarized the recent clinical researches about laparoscopic treatment cesarean scar pregnancy. The conclusion is that laparoscopic operation should be the first line treatment of CSP with operation indications, which had the lowest effect on the patient′s life quality after operation. However, there had several points needs to be fully evaluated, the operation should be done by skilled surgeon, always be ready for heavy hemorrhage in the operation and change to hysterectomy anytime necessary, injury of bladder should be carefully checked before the operation ends. Related Articles | Metrics

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The Effect of miR-200c Over Expression on OVCAR-3 Epithelial Ovarian Cancer Biological Functions WU Hai-tian;ZHANG Yue;LIN Qi-de;ZHANG Shu 2014, 41 (5):  509-512.  Abstract ( 1046 )   PDF (882KB) ( 4758 )   Objective： To investigate the effect of the miR-200c over-expression on the ability of proliferation, migration and invasion in OVCAR-3 ovarian cancer cells. Methods：Constructed retrovirus expression vector pMSCVpuro-miR-200c and transfected OVCAR-3 cells to overexpress miR-200c. By using CCK8 and Transwell methods to detect the ability of OVCAR-3 cells in proliferation and metastasis. Different expression genes involved in OVCAR-3 cells were detected by using gene chip before and after transfected with pMSCVpuro-miR-200c. Results：Compared with untransfected cells, the ability of proliferation, migration and invasion in pMSCVpuro-miR-200c transfected OVCAR-3 cell are significantly decreased（P＜0.01）. 190 up-regulated genes and 166 down-regulated genes were detected in OVCAR-3 cells after over-expressed miR-200c. Conclusions：As a tumor suppression gene，overexpression of miR-200c could inhibit the proliferation，migration and invasion of ovarian cancer cells. Related Articles | Metrics

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Analysis of the Reproductive Outcome of Intra-uterine Adhesiolysis for Asherman′s Syndrome Following UAE--a Report of 26 Cases SONG Dong-mei;XIA En-lan;LI Tin-chiu;LIU Yu-huan;XIAO Yu 2014, 41 (5):  513-517.  Abstract ( 1530 )   PDF (966KB) ( 4924 )   Objective：To evaluate the reproductive outcome of hysteroscopic adhesiolysis in women who had Asherman′s syndrome following uterine artery embolization （UAE）. Methods：Hysteroscopic adhesiolysis （HA） was performed in 26 women with Asherman′s syndrome following UAE from May 2008 to March 2014. The changes in AFS score and menstrual pattern and reproductive outcome were analysed. Results：38.5% of women experienced improvement in menstruation defined as subjective increase in menstrual flow after surgery. The reduction of AFS score after HA was 88.5%. The spontaneous conception rate was 7.7%（2/26）, one of which experienced miscarriage in the first trimester. Another present symptom of threatened abortion at the last following up. Conclusions：The poorer outcome of hysteroscopic adhesiolysis in women with Asherman′s syndrome following UAE may be a consequence of compromised vascular supply to the endometrium adversely affecting regeneration after surgery. Related Articles | Metrics

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Predictive Value of Endometriosis Fertility Index in Treatment of Intrauterine Insemination for Endometriosis Complicated with Infertility SU Ning;ZENG Yan-hua;WANG Wei;XIA Wei 2014, 41 (5):  518-521.  Abstract ( 1053 )   PDF (892KB) ( 4827 )   Objective： To study the predictive value of the endometriosis fertility index （EFI） for the clinical pregnancy rate in intrauterine insemination （IUI） treatment cycles for endometriosis patients complicated with infertility. Methods：The clinical data of 75 endometriosis patients complicated with infertility after laparoscopic surgery undergoing 125 IUI cycles were analyzed. EFI score was calculated according to the endometriosis fertility index system, the ROC curve was used to assess the predictive value of EFI for the clinical pregnancy rate of IUI. Results：The areas under ROC curve of EFI and r-AFS were 0.708±0.059 （P＜0.05） and 0.375±0.065 （P＞0.05） respectively. The best point for diagnosis by EFI was 7, the sensitivity was 0.737 and the specificity was 0.613. The clinical pregnancy rate of EFI≤6, 7, 8, 9, 10 was 3.1%, 10.5%, 21.1%, 27.8%, 27.8% respectively. Compare to the group of EFI≤6, the clinical pregnancy rate of EFI=8, 9 and 10 was significantly higher （P＜0.05）. Conclusions：EFI can be used as a good and effective tool to predict pregnancy outcome in the endometriosis-associated infertile patients attempted to IUI after laparoscopic surgery, the clinical pregnancy rate was obviously increased among EFI≥8, which can provide an important basis for assisted reproductive technology treatment. Related Articles | Metrics

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The Comparative Study between Transcervical Resection of Myoma and Laparoscopic Myomectomy of Intramural Uterine Myoma HEN Ai-rong;ZOU Shun-hong 2014, 41 (5):  522-525.  Abstract ( 1113 )   PDF (820KB) ( 4873 )   Objective：To compare the clinic value between the transcervical resection of myoma （TCRM） and laparoscopic myomectomy （LM）, and investigate the favourable surgical approaches in women with intramural uterine myomas. Methods：From January 1, 2007 to December 31, 2011, 236 women undergoing TCRM （hysteroscopy group） and 392 women undergoing LM （laparoscope group） were studied retrospectively in The Third Affiliated Hospital of Zhengzhou University. The patients′ general information, peri-operative characteristics, postoperative muscle healing, and pregnancy outcome were compared and analyzed. Results：The average operation time, the average intraoperative blood loss and the reduce perioperative hemoglobin level of hysteroscopic group and laparoscopic group were compared respectively, the difference had statistical significance （P＜0.05）. The transfer laparotomy operation rate, postoperative fever rate and menstrual period rate of hysteroscopic group and laparoscopic group were compared. There was no significant difference （P＞0.05）. In the follow-up of 181 cases of hysteroscopy group and 336 cases of laparoscopic group of patients, the muscular complete healing rate of postoperative 1 month, 3 months, 6 months were respectively comparison, the difference had statistical significance （P＜0.05）. The muscular complete healing rate of postoperative 12 months was no statistically significant difference （P=0.709）. The postoperative pregnancy from fibroids weed out of time for the first time of hysteroscopic group and laparoscopic group was statistically significant difference （P＜0.05）. All patients with postoperative pregnancy appeared no pregnant uterine rupture. Conclusions：For intramural myoma, two kinds of operation modes are safe and reliable. The intraoperative bleeding and postoperative recovery by TCRM is better than the patientes treated by LM, so hysteroscopy surgery is superior to the laparoscopic surgery for the patients with intramural uterine myoma. Related Articles | Metrics

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A Clinical Study of the Second-generation Endometrial Ablation Treatment NovaSure on 70 Cases MA Ning;XIA En-lan;ZHAO Yu-ting;GUO Yan 2014, 41 (5):  526-530.  Abstract ( 1440 )   PDF (877KB) ( 4836 )   Objective：A 3-year follow-up evaluation of the safety, efficacy and outcome analysis of the second generation of endometrial ablation using the NovaSure system. Methods：A study of 70 women with menorrhagia secondary to abnormal uterine bleeding （AUB） who underwent endometrial ablation using the NovaSure system at hysteroscopic center, Fuxing Hospital, Capital Medical University, from January 2011 to December 2013. General condition of these patients, treatment time, complications, hemoglobin and endometrial thickness before and after the operation and rate of surgical re-interventions were recorded. Results：①Patient: The patient age in this cohort ranged from 28-54 years with a median age of （43.5±5.5） years. 27.1%（19/70） had serious medical complications. The mean sounding length was （9.17±1.12） cm. The time of energy delivery was （122.00±19.73） s, range from 55-179 s. All patients reported small amount of bleeding, less than 10 mL. No complications occurred. ②At 3-year follow-up, 97.1%（68/70） experienced a successful reduction in bleeding, 54.3%（38/70） of patients reported amenorrhea. Two of 70 had additional surgery during the follow-up period. 28.6%（20/70） of patients reported fluid accumulation in the uterine cavity. ③Hemoglobin and endometrial thickness before and after the operation has a very significant difference （P=0.000）, 98.56 g/L vs. 115.27 g/L, 9.2 mm vs. 3.4 mm, respectively. ④Menorrhagia with and without adenomyosis group, amenorhea rate has a very significant difference （χ2=6.860，P=0.013）. Conclusions：Clinical result indicate that the NovaSure system is safe and effective method for treatment of women with menorrhagia. Adenomyosis may be one of factors influencing curative effects. Related Articles | Metrics

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Reproductive Outcomes after Laparoscopic Radical Trachelectomy for Early-stage Cervical Cancer ZHU Ding-jun;ZHANG Wei;LYU Qiong-ying;ZHANG Juan;LI Fei;ZHENG Wen-jing 2014, 41 (5):  531-533.  Abstract ( 1050 )   PDF (860KB) ( 4736 )   Objective： The objective of this study was to estimate the reproductive outcome of young women with early-stage cervical cancer who underwent fertility-sparing laparoscopic radical trachelectomy（LRT）. Methods：We performed a retrospective review of the medical records of patients with early-stage cervical cancer who underwent LRT from April 2006 to December 2013. Clinicopathological data were obtained from patient medical records，and reproductive outcome data were obtained from patient medical records and telephone interviews. Results：Twenty-two patients who underwent successful LRT were included in this study. The median age of patients was 32 years （range，22 to 40 years），and the median follow-up time after LRT was 28 months （range，3 to 82 months）. Menstruation resumed in all patients after LRT，with twenty patients（90.9%） and two patients （9.1%） reporting regular and irregular menstruation，respectively. Five patients（22.7%） presented with cervical stenosis，which was manifested by regular but decreased menstrual flow and newly-developed dysmenorrhea. These patients underwent cervical cannulation and dilatation. Eleven pregnancies（including 3 missed abortions，6 preterm births and 2 full-term births） occurred in 7 patients after LRT. Seven out of 12 patients gave birth to 6 healthy babies. The pregnancy rate after LRT was 58.3%（7/12）. The spontaneous abortion rate and live birth rate were 27.3%（3/11） and 72.7%（8/11），respectively. The preterm birth rate was 54.5%（6/11）. Conclusions：Pregnancy and live birth rates after LRT were promising; however，the preterm birth rate was relatively high. Cervical stenosis also occurred in a small percentage of patients. Related Articles | Metrics

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The Understanding of Air or Gas Embolism in Hysteroscopy ZHAO Shuo;FENG Li-min 2014, 41 (5):  537-541.  Abstract ( 1297 )   PDF (813KB) ( 4947 )   Because of safety and minimally invasion, hysteroscopic surgery has gotten popularity and has become the routine for diagnostic and therapeutic interventions of intrauterine pathology. Advantages consist of short operating time, rapid postoperative recovery and low morbidity. However, during hysteroscopic surgery there are concerns about potential complications such as venous air and gas embolism. These are rare but hazardous complications, which can occur in all surgical procedures. In hysteroscopic surgery, large uterine veins may be exposed and are, therefore, entries for gas or air. A number of fatal cases have been described as case reports. Although awareness for air and gas embolism is raised this way, proper guidelines how to reduce the risk of venous gas or air embolism are lacking. The pathophysiologic difference between gas and air embolism is described herein because composition of the gases differs with their different physiologic effects. Signs and symptoms of patients are described, as early detection and intervention are crucial for survival. Furthermore, we provide guidelines for operating department personnel, surgeons, and anesthesiologists to reduce the risk of venous gas or air embolism during hysteroscopic procedures. Potential complications of these procedures may be prevented by this way. Related Articles | Metrics

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Evaluation and Treatment Outcomes of Hysteroscopy on Common Intrauterine Factors in IVF XUE Xiang;ZHAO Jin-yan 2014, 41 (5):  542-544.  Abstract ( 1024 )   PDF (745KB) ( 4747 )   Infertility not only refers to the inability to conceive offspring primarily, but also refers to the state of a woman who is unable to carry a pregnancy to full term, which is a great problem for many families. Prevalence of infertility varies depending on the definition, there are many reasons causing infertility. While uterine cavity abnormality is one of the common reasons interfering embryo implantation for infertility patients, so the assessment of abnormal uterine lesions is becoming a core part of the evaluation of infertility. As hysteroscopy is considered to be the most accurate diagnosis of intrauterine lesions, in order to optimize fertility treatment, the examination is increasingly performed before IVF as a common treatment and the abnormal uterine lesions found during the hysteroscopic examination can be resected simultaneously which improve the pregnancy outcomes. This article mainly focuses on assessment on several mostly common intrauterine factors before undergoing IVF cycle by hysteroscopy and impact on pregnancy outcomes in IVF after hysteroscopic resection. Related Articles | Metrics

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The Use of a Hysteroscope in Diagnosing and Establishing Therapeutic Management of Pediatric and Adolescent Patients with Gynecological Problems ZHU Ke-an;Jolinda Johary;XU Da-bao 2014, 41 (5):  545-549.  Abstract ( 1492 )   PDF (810KB) ( 4841 )   The diagnosis and treatment of gynecological problems in pediatric and adolescent patients were challenging in the past. Due to its physiological and anatomical characteristics, a vaginal approach for the assessment of gynecological problems in these patients has always been a problem. Furthermore, when vaginal examination is needed, virginity might be a significant obstacle for the gynecologist in diagnosing and establishing the management. Recent advance in gynecological endoscopic procedure has made hysteroscopy a promising option in assessing gynecological disorders in these patients. Hysteroscope is a useful substitute for vaginoscopy and/or hysteroscopy in the exploration of the immature genital tract. It is a safe procedure because it can always be performed under visual control. The scope of the hysteroscope is advanced into the vagina without a speculum or tenaculum, so it can facilitate diagnosis and treatment of gynecological disorders in pediatric and adolescent patients with intact hymens, limited vaginal access, narrow vaginas. Recent studies have used a hysteroscope for vaginoscopy and hysteroscopy to diagnose and establish therapeutic management of pediatric and adolescent patients with gynecological problems without injury of the hymen in recent years, but most of these studies are limited in case report and small scale clinical research. This article evaluated the effectiveness and feasibility of the use of a hysteroscope for vaginoscopy and hysteroscopy in diagnosing and establishing therapeutic management of pediatric and adolescent patients with gynecological problems. Related Articles | Metrics

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Recent Progress of Minimally Invasive Surgery in Gynecology CUI Guang-xing;KONG Xian-chao 2014, 41 (5):  550-554.  Abstract ( 1018 )   PDF (825KB) ( 4762 )   Minimally invasive surgery has made rapid development in recent years and has become one of the most hot fields in procedural medicine. As science and medical technology have been improved, it has also made great progress in applications of gynecology. Although traditional open surgery is still has an important role in gynecology, minimally invasive surgery are attracting more and more attentions from researchers. As a representative of minimally invasive surgery, traditional laparoscopy has been a standard minimally invasive approach for gynecological diseases, which also can treat gynecological malignancies. Since traditional laparoscopy has been proven a mature technology, in this article, two evolving minimally invasive surgeries, endoscopic surgery through natural channels and robotic-assisted laparoscopic surgery are respectively reviewed. We review the main advances of these minimally invasive surgeries and their recent applications in gynecological treatments. Related Articles | Metrics

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Laparoscopy in the Diagnosis and Treatment of Pelvic Inflammatory Disease WANG Dan-dan;BI Fang-fang;YANG Qing 2014, 41 (5):  555-557.  Abstract ( 1041 )   PDF (774KB) ( 4872 )   Pelvic inflammatory disease （PID） is a polymicrobial asending infection that causes inflammation of the upper genital tract, including endometritis, salpingitis, tubo-ovarian abscess and pelvic peritonitis. PID has various clinical manifestation but low accuracy rate of diagnosis. Failed to get the correct diagnosis and treatment in time, PID can cause serious sequelae including infertility, ectopic pregnancy, chronic pelvic pain and repeated attacks of inflammation, which impacts women′s physical and mental health. Laparoscopic evaluation is considered to be golden standard for PID, especially for acute PID, which is not only can help to confirm the diagnosis and obtain the pathogenic microorganism testing samples, but also at the same time can supply surgical treatment for pelvic lesions accordingly. Related Articles | Metrics

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Piwi Protein and Gene Expression Regulation and Its Role in Cancer ZHANG Hong-li;LING Bin;FENG Ding-qing 2014, 41 (5):  558-561.  Abstract ( 1251 )   PDF (546KB) ( 4750 )   The Piwi proteins, a class of Argonaute protein family, are predominantly present in different species of the male testes. It can associate with a novel class of small RNAs known as Piwi-interacting RNAs （piRNAs）, lead to transposon gene repression, so that to protect genome integrity and functions of germline stem cell, these plays an important role in self-renewal of germline stem cell, gametogenesis and embryo development. In addition, Piwi proteins was reported to be expressed in various types of human tumor tissue including breast, gastrointestinal and cervical cancer, especially, it is stably expressed in cancer stem cell. Inhibiting its expression can suppress tumor cell proliferation and apoptosis through a variety of different mechanisms, indicating that it might play an important role in tumor initiation and progression. Here is to make a review of the mechanism of Piwi proteins regulate gene expression and its relations with tumorigenesis. Related Articles | Metrics

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Conservative Treatment of Adenomyosis GE Jun;HAN Yao-wei;ZHOU Li-jun 2014, 41 (5):  562-565.  Abstract ( 1271 )   PDF (1024KB) ( 4772 )   In recent years, the incidence of adenomyosis has shown a rising trend year by year and diversified clinical manifestations have been observed. Treatments for adenomyosis include high intensity focused ultrasound drug therapy, hysterectomy, uterine artery embolization, levonorgestrel releasing intrauterine system (LNG-IUS), endometrial stripping technique, etc. Recently, the effect of drug treatment is obvious, but it is easy to relapse after drug withdrawal. Removal of the uterus often leads to the loss of fertility. Uterine artery embolization is difficult to operate with a lot of factors influencing the curative effect; LNG-IUS had the characteristics of surgery-free and good compliance, but some patients may have the problems such as bleeding, etc.; Endometrial stripping operation has confirmable effect, but the side effect is also relatively bigger; therefore, various treatment methods all have some limitations. The conservative method to be employed in women with adenomyosis has become the topic that clinicians generally care about. With the increasingly high expectation of patients on saving their uterus, there have been many cases of conservative method for adenomyosis in clinical practices. Review on the conservative treatment methods of adenomyosis. Related Articles | Metrics

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Interpretation on Complication of Hysteroscopic Surgery--Transurethral Resection of Prostate Syndrome HUANG Xiao-wu;XIA En-lan 2014, 41 (5):  566-569.  Abstract ( 2412 )   PDF (879KB) ( 4943 )   Transurethral resection of prostate （TURP） syndrome during hysteroscopic surgery is a severe complication due to the absorption of irrigating fluids and pressure in uterine cavity, fluid overload and/or dilution hyponatremia cause a series of clinical symptoms. It can be a dread complication if it is not timely diagnosed and treated. The relevant pathophysiology of TURP syndrome was discussed through the analysis on four typical cases, the relative major factors include high-pressure perfusion and venous sinuses open during the surgery. The principles of preventive measures and treatments of this complication were discussed in order to strengthen the safety awareness of doctors, to reduce the incidence of this complication. Related Articles | Metrics

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A New Era of Diagnosis and Treatment of Uterine Malformation XIA En-lan 2014, 41 (5):  570-574.  Abstract ( 1498 )   PDF (848KB) ( 4883 )   Laparoscopic combined with hysteroscopy examination is the confirmed diagnostic method for uterine malformation. Most uterine malformation metroplasty can be done by hysteroscopic surgery. But combing with laparoscopy can not only help to understand the shape of uterus, reconfirm the classifications of uterine anomaly, identify the uterus didelphys, such as: bicornuate uterus, septate uterus, T-shaped uterus, Robert′s uterus, arcuate uterus, unicornuate uterus with non-communicating/communicating rudimentary uterine horn, etc, but also can help to monitor the operation process which can improve the safety of operation and help to diagnose and treat other lesions in pelvis and do dye test of fallopian simultaneously. The traditional laparotomy metroplasty for malformation uterus has be reasonable replaced by hysteroscopy and laparoscopy which is minimally invasive, effective and safe surgery. Related Articles | Metrics