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CASE REPORT
Meenu Agarwal, Sandhya Meshram

Laparoscopic Management of Cesarean Section Scar Ectopic Pregnancy

[Year:2018] [Month:January-March] [Volumn:2 ] [Number:1] [Pages:41] [Pages No:38-41][No of Hits : 185]


ABSTRACT

Cesarean scar pregnancy (CSP) is defined as an implantation of pregnancy in a fibrous tissue scar of a previous cesarean section. It is considered as one of the rarest forms of ectopic pregnancy and can be life threatening. The incidence of CSP is steadily rising in view of increasing cesarean section rates. A very high index of clinical suspicion is required for the diagnosis and further management. Through this case report, we demonstrate the laparoscopic management of a previous failed methotrexate (MTX) therapy in a CSP.

Keywords: Caesarean scar ectopic, Ectopic pregnancy, Laparoscopy.

How to cite this article: Agarwal M, Meshram S. Laparoscopic Management of Cesarean Section Scar Ectopic Pregnancy. Int J Gynecol Endsc 2018;2(1):38-41.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL RESEARCH
Nutan Jain, Vandana Jain, Sonil Srivastav, Kriti Agarwal

Endoscopic Findings of Female Genital Tract Tuberculosis: A 3-year Analysis at a Referral Center

[Year:2018] [Month:January-March] [Volumn:2 ] [Number:1] [Pages:41] [Pages No:1-3][No of Hits : 169]


ABSTRACT

Objective: To study the laparoscopic and hysteroscopic appearances of female genital tract tuberculosis (FGTB).

Study design: This is a hospital-based prospective observational study.

Materials and methods: The study was conducted in the Department of Obstetrics and Gynecology, Vardhman Laparoscopy Centre, from July 1, 2014 to June 31, 2017. A total of 2,200 patients presenting with infertility were subjected to endoscopic evaluation, and the findings suggestive of TB were recorded.

Results: Out of total 2,200 patients who underwent endoscopic evaluation for infertility, 33 and 21.5% had findings suggestive of TB on laparoscopy and hysteroscopy respectively, and 59.5 and 55.6% of these patients had laparoscopic and hysteroscopic findings of early-stage disease respectively.

Conclusion: Endoscopic evaluation of unexplained infertility is an indispensable tool for early diagnosis of FGTB and providing antitubercular treatment, while it is in the reversible stage.

Keywords: Female, Genital, Hysteroscopy, Laparoscopy, Tuberculosis.

How to cite this article: Jain N, Jain V, Srivastav S, Agarwal K. Endoscopic Findings of Female Genital Tract Tuberculosis: A 3-year Analysis at a Referral Center. Int J Gynecol Endsc 2018;2(1):1-3.

Source of support: Nil

Conflict of interest: None


 
Editorial
Prof Dr Liselotte Mettler, Priv Doz Dr Ibrahim Alkatout

Editorial

[Year:2018] [Month:January-March] [Volumn:2 ] [Number:1] [Pages:41] [Pages No:iv-v][No of Hits : 159]


ABSTRACT

With great pleasure, we are introducing the first issue of International Journal of Gynecological Endoscopy (IJGE), an official publication of Kiel School of Gynecological Endoscopy. In cooperation with our Indian Editors and Jaypee Brothers Medical Publishers (P) Limited, we come out with a new clinical Journal covering medical and surgical procedures focusing on comprehensive care for women with conditions such as, abnormal uterine bleedings, pelvic pain, cervical incompetence, and ovarian cysts.


 
ORIGINAL RESEARCH
Sanket Pisat

Pisat's Visual Vasopressor Injection Needle: A New Instrument for enhancing Patient Safety in Laparoscopic Myomectomy

[Year:2018] [Month:January-March] [Volumn:2 ] [Number:1] [Pages:41] [Pages No:4-5][No of Hits : 157]


ABSTRACT

The use of vasoconstrictor agents like vasopressin during laparoscopic myomectomy reduces blood loss during surgery and reduces operative time. However, certain side effects related to the cardiovascular system have also been reported with its use. These side effects could possibly be due to inadvertent intravascular injection of the drug. The author aims to describe a new design of an injection needle, Pisat’s Visual Vasopressor Injection Needle (VVIN) that can be used during laparoscopic myomectomy to reduce the likelihood of an inadvertent intravascular injection of a vasoconstrictor solution.

Keywords: Fibroid, Laparoscopy, Myomectomy, Vasopressin.

How to cite this article: Pisat S. Pisat’s Visual Vasopressor Injection Needle: A New Instrument for enhancing Patient Safety in Laparoscopic Myomectomy. Int J Gynecol Endsc 2018;2(1):4-5.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Nutan Jain, Vandana Jain, Parima Jain

Submucous Myoma: Laparoscopic Myomectomy

[Year:2018] [Month:January-March] [Volumn:2 ] [Number:1] [Pages:41] [Pages No:35-37][No of Hits : 155]


ABSTRACT

A 24-year-old nullipara presented to our outpatient department with severe menorrhagia and infertility with a 20 weeks size uterus. The sonography showed a large submucous myoma. Diagnostic hysteroscopy showed an obliterated endometrial cavity. Laparoscopic myomectomy was done leaving behind an intact endometrium.

Keywords: Big myoma, Laparoscopy, Submucous.

How to cite this article: Jain N, Jain V, Jain P. Submucous Myoma: Laparoscopic Myomectomy. Int J Gynecol Endsc 2018;2(1):35-37.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Liselotte Mettler, Ibrahim Alkatout

Laparoscopic Subtotal Hysterectomy: Does It Still have a Stand?

[Year:2018] [Month:January-March] [Volumn:2 ] [Number:1] [Pages:41] [Pages No:22-28][No of Hits : 154]


ABSTRACT

Classic intrafascial subtotal hysterectomy (CISH) technique is one method of intrafascial supracervical or subtotal hysterectomy that was performed by laparoscopy in Kiel, Germany, from 1989 until 2005 and has then been replaced by laparoscopic subtotal hysterectomy (LASH) or (LSH) technique, we intend to give in this article a review on both valuable technologies. Many clinicians do not like subtotal hysterectomy at all; however, in our time of understanding that less might be more effective than more for some patients, we are happy to stress the fact of this surgical technology and are giving the background of its development.

Keywords: Classic intrafascial subtotal hysterectomy, Laparoscopic subtotal hysterectomy.

How to cite this article: Mettler L, Alkatout I. Laparoscopic Subtotal Hysterectomy: Does It Still have a Stand? Int J Gynecol Endsc 2018;2(1):22-28.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Nutan Jain, Vandana Jain, Anshu Agarwal, Kaustubh Srivastava

Temporary Ovarian Suspension: An Overview

[Year:2018] [Month:January-March] [Volumn:2 ] [Number:1] [Pages:41] [Pages No:29-34][No of Hits : 154]


ABSTRACT

Objective: To assess the efficacy of temporary ovarian suspension following laparoscopic surgery for severe pelvic endometriosis in the prevention of postoperative ovarian adhesions and its correlation with the pregnancy outcome.

Study design: Prospective double-blind randomized controlled trial.

Materials and methods: The study was conducted in the Department of Obstetrics and Gynaecology, Vardhman Laparoscopy Centre from January 1, 2011 to September 30, 2017 on 100 endometriotic patients.

Results: On ultrasonographic follow-up, the study group showed significantly lesser incidence of readhesions compared with control group (20% vs 65%). Of these, 28 conceived (56%): 4 delivered, 22 pregnancy continues (85%), and 2 woman had an ectopic pregnancy. Five patients had a second-look laparoscopy out of which in 4 cases (80%), we found no evidence of recurrent adhesions. Only 1 patient had minimal adhesions.

Conclusion: The study suggests that temporary ovarian suspension could be an effective and feasible surgical technique, which might actually help reduce postoperative adhesion.

Keywords: Adhesions, Endometriosis, Temporary ovarian suspension.

How to cite this article: Jain N, Jain V, Agarwal A, Srivastava K. Temporary Ovarian Suspension: An Overview. Int J Gynecol Endsc 2018;2(1):29-34.

Source of support: Nil

Conflict of interest: None


 
REVIEW ARTICLE
Liselotte Mettler, Ibrahim Alkatout

Prerequisites for Laparoscopic Hysterectomies

[Year:2018] [Month:January-March] [Volumn:2 ] [Number:1] [Pages:41] [Pages No:6-21][No of Hits : 144]


ABSTRACT

Let us start with the question, if instruments make good surgeon? Instruments and apparatuses for laparoscopic hysterectomies have been developed over the last 40 years for interventions with multiple ports as well as for single-port surgery. A good surgeon bases his surgical plan on his knowledge of anatomy, recognizing the presented disease, his intuitiveness, and on optimal instruments and coagulation systems. With this issue, we are dealing in three parts:
1. History
2. General systems for adhesion prevention, mesh, stitching and knotting techniques, staples, glue, drains, rinsing solutions, and suction
3. Instruments and apparatuses for laparoscopic hysterectomies
Instrument trolleys gather all equipment used in gynecological and general laparoscopic surgery. These smart carts are available as rolling carts or on special platforms hanging down from the ceiling. Operating room settings, like OR1TM Neo (Karl Storz GmbH, Tuttlingen, Germany) or the Endoalpha or Visera Elite of Olympus or the Stryker unit with SDC Ultra as digital documentation system, form the basis to position the necessary equipment for easy use of the surgeon.
The idea of warming and humidifying the CO2 gas to avoid peritoneal damage has been well described by Philippe Konincks and Douglas Ott. The HumiGardTM of Fisher and Paykel Health care (Auckland, New Zealand) provides heated, filtered, and humidified gas for abdominal insufflation with a predetermined temperature.
Today, every CO2 pneu automatic provides up to 37°C heated CO2 gas, which is controlled by a pressure regulator within the machine by applying the Quatro-test. In the Quatrotest, the volume of gas flowing through the Veress needle during insufflation, intra-abdominal pressure, total volume, and preset filling pressure are measured. Cold light provided by xenon lamps is already substituted by light-emitting diode light. Video camera setup with three-chip cameras is substituted recently by HC camera systems and can be used for laparoscopy as well as in hysteroscopy. High-resolution video with video monitors guarantees optimal picture quality. The technological development allows the use of larger monitors in high-definition quality that facilitates a relaxed working atmosphere for the surgeon. A realistic, nearly true to life three-dimensional (3D) picture is possible due to various technological elements, such as digital simulation, a second camera system, or the use of shutter lens. Digital devices for the video camera control the picture quality and facilitate automatic white balancing. The Karl Storz Company already offers the TRICAM 3D imaging system that allows the surgeon to view crisp, clear image through a pair of lightweight polarizing glasses. The ENDOCAMELEON laparoscope provides a viewing angle that can be adjusted continuously between 0 and 120.

Keywords: Laparoscopic hysterectomies, Technical features.

How to cite this article: Mettler L, Alkatout I. Prerequisites for Laparoscopic Hysterectomies. Int J Gynecol Endsc 2018;2(1):6-21.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Liselotte Mettler, Khulkar Abdusattarova

Tissue Extraction and Morcellation: The Menace of Unexpected Malignancy

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:1-4][No of Hits : 474]


ABSTRACT

Uterine fibroids are a common indication for hysterectomy or myomectomy. Even with optimal preoperative imaging, unexpected uterine sarcoma can be detected in histopathology after uterine fibroid surgery. In case of inadvertent morcellation of an unexpected uterine sarcoma the clinical outcomes, due to the rapid intraperitoneal dissemination of malignant tissue during the procedure can be negatively influenced. The purpose of this study was to determine the prevalence of uterine sarcoma in women undergoing hysterectomy or myomectomy for benign uterine fibroids. We performed retrospective study (2003-2014 years). The total number of women operated for uterine fibroids was 2297. Of this, 938 (42.5%) women had myomectomies and 1269 (57.5%) women had hysterectomies. In myomectomies the most frequently used surgical method was laparoscopic myomectomy in 591(63%) cases, followed by hysteroscopy myomectomy in 306 (32.62%) cases, and laparotomic myomectomy only in 41 (4.37%) cases. In hysterectomies, laparoscopic approaches significantly dominated in 1163 (61.1%) cases, showing laparotomic approaches in 491(25.82%) cases and vaginal approaches in 247 (12.99) cases. Only one patient with endometrial stromal sarcoma (ESS) was not preoperatively diagnosed and treated as symptomatic uterine fibroid; this patient underwent laparoscopic supracervical hysterectomy. In the post-operative histopathological examination ESS was detected. Thus, our incidence of sarcomas among women who underwent benign uterine fibroid surgery is 1/2297 (0,043%). Laparoscopic power morcellation should be performed only in cases with no suspicion of malignancy Patients, who undergo laparoscopic surgery with power morcellation should be informed about the possible risks of morcellation in cases of rare not suspected malignant disease.

Keywords: Hysterectomy, Myomectomy, Uterine fibroids, Uterine sarcomas.

How to cite this article: Mettler L, Abdusattarova K. Tissue Extraction and Morcellation: The Menace of Unexpected Malignancy. Int J Gynecol Endsc 2017;1(1):1-4.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
BS Jodha, Preeti Chawla

Study of Combined Laparoscopic and Hysteroscopic Findings in 100 Cases of Infertility

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:5-10][No of Hits : 464]


ABSTRACT

Objectives:
• To study the role of combined diagnostic laparoscopy and hysteroscopy in evaluation of female infertility.
• To find out different factors associated with infertility.
• To provide concurrent therapeutic management.

Materials and methods: A total of 100 women underwent combined diagnostic laparoscopy and simultaneous diagnostic hysteroscopy during the period from January 2015 to December 2015 in the Obstetrics and Gynecology Department, Umaid Hospital, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India.

Results: Age ranged from 21 to 38 years, and mean age was 25.98 years. Abnormal laparoscopic findings were noted in 41% cases, abnormal hysteroscopy seen in 24% cases, and 17% cases showed abnormality in both. Bilateral tubal patency was demonstrated in 81% cases. Tubal blockage was bilateral in 5% and unilateral in 9% cases. In 2% cases, bilateral block with beaded appearance found suggestive of tuberculosis. Of total 100 cases, 12% cases were found to have endometriosis, 8% had polycystic ovarian syndrome (PCOS), chocolate cyst was found in 5% cases, and 7% had functional cyst of ovary. Pelvic adhesions were found in 15% patients. Myomas were found in 8% cases. Endometrial polyps were revealed in 5% and Asherman’s syndrome in 6% patients. Combined laparoscopy and hysteroscopy was diagnostic in 17% of cases, 41% were diagnosed through laparoscopy alone, 24% through hysteroscopy alone, while in 18% cases findings were normal. In our study, tuboperitoneal factors were responsible for infertility in 40% cases, ovarian factors in 26% cases, and PCOS in 8% cases.

Conclusion: In our study, 74% of the cases had some form of tubo-ovarian pathology, which makes laparoscopy an essential tool of infertility workup. Although hysteroscopy alone was diagnostic in 30% of cases, its simultaneous use with laparoscopy provides cost-effective, comprehensive, and single setup diagnostic aid in these kinds of patients.

How to cite this article: Jodha BS, Chawla P. Study of Combined Laparoscopic and Hysteroscopic Findings in 100 Cases of Infertility. Int J Gynecol Endsc 2017;1(1):5-10.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
CS Beeresh, Divyasree Doopadapalli, KR Vimala, Krishna Lingegowda

Laparoscopic Management of Large Ovarian Cysts

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:18-21][No of Hits : 407]


ABSTRACT

Introduction: Large ovarian cysts are conventionally managed by laparotomy. This study was undertaken to assess the feasibility and outcome of laparoscopic surgery for the management of large ovarian cysts.

Settings and design: Rural teaching hospital - prospective study.

Materials and methods: Thirty-eight patients from January 2014 to December 2016 presumed to be with large ovarian cyst were managed laparoscopically. Preliminary evaluation suggestive to be of benign ovarian cyst by history, clinical examination, sonographic imaging, and basic serum marker were only included in this study. The cysts were aspirated initially, followed by cystectomy, oophorectomy, or total hysterectomy depending on age, parity, coexisting pathology, and desire for future fertility.

Results: Out of 38 cases, 6 were nonovarian adnexal masses. Eight of the 32 cases who presented with pain due to torsion were managed on emergency basis; rest of the cases were operated electively. Mean operating time was 90 minutes. Mean size of the cyst was 16 cm. One case of borderline malignancy was detected and the rest showed benign pathology. Six of the cases required minilaparotomy for specimen removal. Most women were successfully treated laparoscopically without any complications, and conversion to laparotomy was required in three cases.

Conclusion: With proper patient selection and exclusion of malignancy, laparoscopic management of large ovarian cyst by gynecologist is feasible.

Keywords: Benign ovarian cyst, Laparoscopy, Large ovarian cysts.

How to cite this article: Beeresh CS, Doopadapalli D, Vimala KR, Lingegowda K. Laparoscopic Management of Large Ovarian Cysts. Int J Gynecol Endsc 2017;1(1):18-21.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Nutan Jain, Swati Varshney

Ectopic Pregnancy in Isthmocele: A Report of Unrecognized Case

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:40-43][No of Hits : 402]


ABSTRACT

Cesarean scar pregnancy (CSP) is one of the rarest forms of ectopic pregnancy. Little is known about its incidence and natural history. The diagnosis and treatment of CSP is challenging. The authors report a case of CSP with heavy bleeding per vagina, who underwent suction and evacuation after abortion; patient underwent hysterolaparoscopy with resection of ectopic mass. The patient was discharged from the hospital without any complications. The CSP should be diagnosed and treated as soon as possible to prevent severe complications and spare fertility.

Keywords: Cesarean scar defect, Ectopic pregnancy, Isthmocele.

How to cite this article: Jain N, Varshney S. Ectopic Pregnancy in Isthmocele: A Report of Unrecognized Case. Int J Gynecol Endsc 2017;1(1):40-43.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Nutan Jain, Mohsina Hakim

Cystic Degeneration of Fibroid following Mifepristone

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:46-49][No of Hits : 393]


ABSTRACT

Uterine leiomyomas are common uterine tumors and often altered by degenerative changes, which can cause difficulty and confusion in their clinical diagnosis. Several agents exist for the medical management of uterine fibroids through symptom control, reduction in fibroid volume, and reduction in menstrual blood loss. In our patient, Tab. mifepristone 25 mg was used for 9 months. In follow-up, size of fibroid tripled over 9 months. Patient started developing pressure symptoms. Surgery was difficult to perform because of cystic degeneration. Further long-term study is needed to exactly understand the long-term effect of these medicines.

Keywords: Cystic degeneration, Leiomyoma, Mifepristone.

How to cite this article: Jain N, Hakim M. Cystic Degeneration of Fibroid following Mifepristone. Int J Gynecol Endsc 2017;1(1):46-49.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Meenu Agarwal, Madhuri Kashyap, Sandhya Meshram

A Case of Laparoscopically Managed Myometrial Scar Ectopic Pregnancy

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:28-31][No of Hits : 388]


ABSTRACT

Intramural pregnancy, an ectopic gestation completely surrounded by the myometrium located within the uterine wall with separation from the uterine cavity, is an extremely unusual form of pregnancy. Complications resulting from intramural pregnancy include inevitable uterine rupture with resultant hemorrhage and possible hysterectomy if the diagnosis is not made early and treatment is not initiated. A patient presented with missed abortion, suction curettage was done but no placental villi were seen in the products. She had a previous history of laparoscopic myomectomy 6 months ago. A provisional diagnosis of myometrial scar pregnancy was made and was confirmed with Doppler and magnetic resonance imaging. Laparoscopic enucleation of ectopic sac was done against medical management with methotrexate. The patient conceived successfully through intracytoplasmic sperm injection for male factor and delivered twins by lower (uterine) segment cesarean section at term.

Keywords: Ectopic, Intramural, Laparoscopy, Myomectomy.

How to cite this article: Agarwal M, Kashyap M, Meshram S. A Case of Laparoscopically Managed Myometrial Scar Ectopic Pregnancy. Int J Gynecol Endsc 2017;1(1):28-31.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Poonam Raikwar, Vijeta Jain, Ramsharan Raikwar

Ruptured Ovarian Ectopic Pregnancy after Interval of Tubal Ligation

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:44-45][No of Hits : 382]


ABSTRACT

We report a case of a woman presenting in a state of shock with classic symptoms of rupture ectopic pregnancy. She had a history of tubal ligation done two years back. Laparoscopic surgery was done and a diagnosis of ruptured ectopic ovarian pregnancy was made.

Keywords: Ectopic post, Ovarian pregnancy, Tubal ligation

How to cite this article: Raikwar P, Jain V, Raikwar R. Ruptured Ovarian Ectopic Pregnancy after Interval of Tubal Ligation. Int J Gynecol Endsc 2017;1(1):44-45.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Nutan Jain, Sonam Singh

Multiple-layer Closure of Myoma Bed in Laparoscopic Myomectomy

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:22-27][No of Hits : 379]


ABSTRACT

Objective: To assess the feasibility and outcome of laparoscopic myomectomy and multiple-layer closure of myoma bed for management of myomas at a tertiary care hospital.

Materials and methods: Five hundred and ten patients from January 2011 to January 2017 with large and moderate size myomas were managed by laparoscopic myomectomy. Indications were subfertility, menorrhagia, and abdominal mass. Preoperative evaluation included history, clinical examination, and sonographic mapping. Myomas were enucleated and retrieved laparoscopically. Myoma beds were sutured in multiple layers by endoscopic intracorporeal suturing. Fluid as adhesion barrier was used.

Results: Three hundred and eighty two patients presented with subfertility, 69 with menorrhagia, and 59 with abdominal mass. The average maximum diameter of myoma was 9.1 cm. The mean duration of surgery was 90 minutes. The mean postoperative stay was 24 hours. No intraoperative complication occurred and the hospital course was uncomplicated. In seven cases, minilap incision was given for retrieval of myoma and suturing of the bed. Two patients had minor delayed wound healing of the morcellator port site. The patients did not report any complaints during follow-up except one patient who developed omental hernia at morcellator port site. There was no rupture of scar and very low adhesion scores in subsequent cesarean sections or second look scopies.

Conclusion: With proper multilayer closure of the myoma bed, laparoscopic myomectomy is feasible for moderate and even large myomas and has good outcomes in terms of fertility and alleviation of symptoms.

Keywords: Better reproductive outcome, Laparoscopic myomectomy, Large myomas, Multilayer closure.

How to cite this article: Jain N, Singh S. Multiple-layer Closure of Myoma Bed in Laparoscopic Myomectomy. Int J Gynecol Endsc 2017;1(1):22-27.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Steffi V Rodrigues, MK Swamy, Namrata Jadhav

A Randomized Controlled Trial of Extra-amniotic Saline Infusion vs Intracervical Dinoprostone Gel for Induction of Labor

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:11-17][No of Hits : 369]


ABSTRACT

Background: Success of induction depends largely on cervical ripening and increases the likelihood of vaginal delivery. This study compared the outcomes for induction of labor using extraamniotic saline infusion (EASI) vs intracervical dinoprostone gel.

Objective:
Primary: To compare improvement between pre- and postinduction Bishop’s scores in both the groups.
Secondary: To compare induction to delivery interval, mode of delivery, and neonatal outcome in both the groups.

Materials and methods: A randomized controlled trial of 1 year was conducted in the Department of Obstetrics and Gynaecology, Karnataka Lingayat Education University Dr Prabhakar Kore Hospital and Medical Research Centre, Belagavi, Karnataka, India, on 82 pregnant women from January 2014 to December 2014. The selected women were divided into two groups of 41 each as group I (induced with dinoprostone) and group II (induced with EASI using Foley’s catheter).

Results: Significantly higher number of women had postinduction Bishop’s scores between 9 and 12 in the dinoprostone group (70.73%; p < 0.001). The mean Bishop’s scores were significantly high in the dinoprostone gel (9.27 ± 3.07) vs EASI (8.22 ± 2.34; p = 0.086). Cervical ripening based on cut-off score of ≥6 was noted in a significantly higher number of women (92.68%) in EASI (p = 0.241). The mean time for cervical ripening was significantly high in dinoprostone gel group compared with EASI (15.44 ± 8.41 vs 3.88 ± 3.67; p < 0.001), but mean induction to delivery time was comparable (p = 0.086). Significantly higher numbers of vaginal deliveries were noted in dinoprostone group (91.43%; p = 0.001). The neonatal outcomes, i.e., birth weight, mean birth weight, appearance, pulse, grimace, activity, and respiration score at 1 and 5 minutes, and neonatal intensive care unit admission, were comparable (p = 0.570).

Conclusion: Dinoprostone gel and EASI using Foley’s catheter appear to be effective methods for cervical ripening and labor induction, but dinoprostone gel yielded significantly higher rate of vaginal delivery.

Keywords: Cervical ripening, Dinoprostone gel, Extra-amniotic saline infusion, Foley’s catheter.

How to cite this article: Rodrigues SV, Swamy MK, Jadhav N. A Randomized Controlled Trial of Extra-amniotic Saline Infusion vs Intracervical Dinoprostone Gel for Induction of Labor. Int J Gynecol Endsc 2017;1(1):11-17

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Sonal Kotdawala, Utkrant Patel, Balkrishna Tanna, Parul Kotdawala

Ovary in Inguinal Hernia

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:53-55][No of Hits : 361]


ABSTRACT

Inguinal hernia is a very common condition. Ovary in inguinal hernia is a common condition for a pediatrician as the pain symptoms will necessitate an early visit to health facility in young childhood. Ovarian and fallopian tube inguinal hernias are commonly associated with defects in genital tract development.

Keywords: Hernia, Inguinal, Post-inflammatory implant.

How to cite this article: Kotdawala S, Patel U, Tanna B, Kotdawala P. Ovary in Inguinal Hernia. Int J Gynecol Endsc 2017;1(1):53-55.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Puspal De, Sudipa Chakravarty, Amit Chakravarty

Invasive Pre- and Postnatal Genetic Evaluation reduces the Reproductive Risk in the Era of Noninvasive or Minimally Invasive Prenatal Screening Method

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:35-39][No of Hits : 311]


ABSTRACT

Introduction: Spontaneous abortion has been reported in 15 to 20% of all diagnosed pregnancies. The most common cause of spontaneous abortion is chromosomal abnormalities of the embryo. Robertsonian translocation is one of the major chromosomal rearrangements with a prevalence rate of 0.1% of the general population and 1% of the infertile population. Robertsonian translocation carriers especially 21,14 are the most common balanced rearrangements among the carrier couples with a history of spontaneous abortion.

Materials and methods: Cytogenetic evaluation of both the partners and the child revealed that the child had translocated Down’s syndrome and the mother was carrier of balanced Robertsonian translocation of 14q;21q. Amniocentesis of the next pregnancy and detection of chromosomal abnormality in the fetus were done by fluorescence in situ hybridization (FISH) analysis of the amniotic cells with 13,18,21,X,Y probe mix.

Conclusion: The present case study shows that genetic counseling, cytogenetic evaluation, prenatal diagnosis by amniocentesis, and FISH together help couples with nonhomologous RT and history with syndromic child and repeated abortions to get normal offspring.

Keywords: Balanced chromosomal rearrangement, Chromosomal abnormality, Genetic counselling, Robertsonian translocation, Spontaneous abortion,.

How to cite this article: De P, Chakravarty S, Chakravarty A. Invasive Pre- and Postnatal Genetic Evaluation reduces the Reproductive Risk in the Era of Noninvasive or Minimally Invasive Prenatal Screening Method. Int J Gynecol Endsc 2017;1(1):35-39.

Source of support: This research received no specific grant from any funding agency in the public, commercial or not-forprofit sectors. All the research work was done by the affiliated institutions’ funding.

Conflict of interest: None


 
CASE REPORT
Meenu Agarwal, Sujay Hegde, Naina Sawapure

Leiomyosarcoma in a Posthysterectomy Patient

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:50-52][No of Hits : 290]


ABSTRACT

Leiomyosarcoma is an aggressive soft tissue sarcoma derived from smooth muscle cells. Uterus is the commonest location for a leiomyosarcoma. They may either arise de novo from uterine musculature or the connective tissue of uterine blood vessels, or in a pre-existing benign leiomyoma and are associated with poor outcome. A 45 year patient presented with mass per abdomen. She had under gone laparoscopic hysterectomy three years back for menorrhagia. A provisional diagnosis of ovarian neoplasm was made based on the ultrasonography and CT scan report, but tumour markers were negative. Staging laparotomy was done, mass removed in toto, infracolic omentectomy, appendectomy and bilateral ureteric dissection was done. Post operatively, patient recovered well. Histopathological analysis was suggestive of leiomyosarcoma FNCLCC grade 3. Patient was advised radiation and is on regular follow up with the oncosurgeon.

Keywords: Hysterectomy, Laparoscopy, Leiomyosarcoma.

How to cite this article: Agarwal M, Hegde S, Sawapure N. Leiomyosarcoma in a Posthysterectomy Patient. Int J Gynecol Endsc 2017;1(1):50-52.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Nutan Jain, Sonam Singh

Bartholin Gland Endometriosis

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:32-34][No of Hits : 275]


ABSTRACT

Endometriosis is a commonly encountered benign gynecological disease, involving extrauterine growth of both endometrial glands and elements of endometrial stroma. Like ectopic endometrial tissue, these ectopic foci are susceptive to cyclic hormonal changes. A case of endometriosis infiltrating the Bartholin gland is presented. The initial diagnosis was a Bartholin gland cyst. The clinical diagnosis was made during the operation when chocolate-colored material poured into operation field, and histopathologic examination confirmed the presence of endometriosis. Bartholin gland endometriosis should be kept in mind when women of reproductive age have a diagnosis of Bartholin cyst. It is a rare case and only few cases are reported in the literature.

Keywords: Bartholin cyst, Bartholin gland, Endometriosis, Total laparoscopic hysterectomy in Bartholin cyst.

How to cite this article: Jain N, Singh S. Bartholin Gland Endometriosis. Int J Gynecol Endsc 2017;1(1):32-34.

Source of support: Nil

Conflict of interest: None


 
Obituary
Nutan Jain

Obituary

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:vii][No of Hits : 224]


ABSTRACT

Dr. Rakesh Sinha—A renowned Laparoscopic Surgeon, Past president of the Indian Association of Gynecological Endoscopy (IAGE) and a board member of the International Society for Gynaecological Endoscopists started his endoscopy career having trained at Kiel with Prof. Semm followed by a post doctorate fellowship at the Royal Free Hospital, London with Adam Magos.


 
EDITORIAL
Liselotte Mettler

How does Endometriosis affect Women’s Life, focusing on Endometriomas?

[Year:2017] [Month:April-June] [Volumn:1 ] [Number:2] [Pages:38] [Pages No:57-59][No of Hits : 192]


ABSTRACT

Endometriosis is one of the frequent female diseases that can be better diagnosed today by the help of laparoscopy and hysteroscopy than ever before.

How to cite this article: Mettler L. How does Endometriosis affect Women’s Life, focusing on Endometriomas? Int J Gynecol Endsc 2017;1(2):57-59.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Vineet Mishra, Tanvir Singh, Rohina Aggarwal, Sumesh Choudhary, Preeti Goyal

Liberal Use of Intraoperative Cystoscopy in Routine Major Gynecological Surgeries

[Year:2017] [Month:April-June] [Volumn:1 ] [Number:2] [Pages:38] [Pages No:60-64][No of Hits : 192]


ABSTRACT

Aim: The purpose of this study is to determine the (1) importance of liberal use of intraoperative cystoscopy in routine gynecological surgeries for detection of urinary tract injuries, (2) time taken for intraoperative cystoscopy, and (3) complications associated with cystoscopy.

Materials and methods: The study was started in March 2015 that enrolled 170 patients up to June 2016 with a follow-up period of 12 months.

Settings and design: Prospective study in a tertiary care center. Patients undergoing all gynecological and urogynecological surgeries were included in the study. Malignancy was excluded. Cystourethroscopy was performed following gynecological surgery using a 20 F 30° telescope. A study pro forma was prepared to record case information.

Results: Three bladder injuries were diagnosed by intraoperative cystoscopy during antiincontinence surgery [tension-free vaginal tape (TVT)] and hysterectomy. Following total laparoscopic hysterectomy (TLH) with normal cystoscopy, one patient returned 1 month postoperatively with right ureteric injury. Three patients had immediate postoperative urinary tract infection. One patient complained of flank pain with fever 48 hours following surgery. Further investigation with computed tomography intravenous pyelogram (CT IVP) was negative for urinary tract injury. She was treated conservatively.

Conclusion: Obstetricians/gynecologists (OB-GYNs) should have a low threshold to perform intraoperative cystoscopy during gynecological surgeries for early detection of urinary tract injuries.

Clinical significance: Early recognition and repair of urinary tract injuries lead to decreased morbidity for the patient, with successful outcome of repair at the time of detection. This is possible by performing an intraoperative cystoscopy during gynecological surgeries.

Keywords: Gynecological surgeries, Intraoperative cystoscopy, Urinary tract injuries.

How to cite this article: Mishra V, Singh T, Aggarwal R, Choudhary S, Goyal P. Liberal Use of Intraoperative Cystoscopy in Routine Major Gynecological Surgeries. Int J Gynecol Endsc 2017;1(2):60-64.

Source of support: Nil

Conflict of interest: None


 
EDITORIAL
Liselotte Mettler, Ibrahim Alkatout, Kurt Semm, Thoralf Schollmeyer, Rakesh Sinha

Editorial

[Year:2017] [Month:April-June] [Volumn:1 ] [Number:2] [Pages:38] [Pages No:iv-v][No of Hits : 188]


ABSTRACT

With great pleasure, we are introducing the second issue of International Journal of Gynecological Endoscopy (IJGE), an official publication of Kiel School of Gynecological Endoscopy. In cooperation with our Indian Editors and Jaypee Brothers Medical Publishers (P) Limited, we come out with a new clinical Journal covering medical and surgical procedures focusing on comprehensive care for women with conditions such as, abnormal uterine bleedings, pelvic pain, cervical incompetence, and ovarian cysts. In addition to these, the journal also covers procedures followed for uterine fibroids, adhesions, hysterectomies, different types of cancer surgeries; combined gynecological, general surgical and urological procedures along with related cosmetic and uro-gynecological procedures. We particularly invite young researchers to present their topics. Do not be shy but express what you are thinking and put it out for discussion.


 
Editorial 2
Nutan Jain

Editorial 2

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:vi][No of Hits : 187]


ABSTRACT

The idea of bringing forth this journal is to fulfil the need of meaningful research articles in the field of minimally invasive surgery.
As the surgical trends now weighs heavily toward smaller incision, it is imperative to bring out this journal updating the readers about the latest trends.


 
Editorial 1
Liselotte Mettler, Ibrahim Alkatout

Editorial 1

[Year:2017] [Month:January-March] [Volumn:1 ] [Number:1] [Pages:55] [Pages No:iv-v][No of Hits : 186]


ABSTRACT

With great pleasure, we are introducing the first issue of International Journal of Gynecological Endoscopy (IJGE), an official publication of Kiel School of Gynecological Endoscopy. In cooperation with our Indian Editors and Jaypee Brothers Medical Publishers (P) Limited, we come out with a new clinical Journal covering medical and surgical procedures focusing on comprehensive care for women with conditions such as, abnormal uterine bleedings, pelvic pain, cervical incompetence, and ovarian cysts.


 
RESEARCH ARTICLE
Liselotte Mettler, Ibrahim Alkatout

Laparoscopic Tubectomy, Oophorectomy, Adnexectomy: Indications at Hysterectomy

[Year:2017] [Month:April-June] [Volumn:1 ] [Number:2] [Pages:38] [Pages No:69-74][No of Hits : 177]


ABSTRACT

At hysterectomies in patients beyond the age of 45 years, we have to decide on concomitant adnexectomies, tubectomies, or oophorectomies as ovarian or tubal cancer prevention. Ovarian conservation should be considered in many women having pelvic surgery as oophorectomy runs with decreased long-term health outcomes. Oophorectomy is indicated for women with an adnexal mass, i.e., suspicious for malignancy or for a mass that increases in size or complexity when monitored with serial sonography. Adnexal torsion can usually be treated with detorsion rather than adnexectomy. Oophorectomy decreases the likelihood of repeat surgery in women with severe, symptomatic endometriosis, but ovarian conservation should be considered in those women who are younger than age 40, since conservation avoids early surgical menopause. Tubectomy or salpingectomy with hysterectomies, however, is considered today as good standard care at hysterectomies for adnexal cancer prevention.

Keywords: Adnexectomy, Hysterectomies, Oophorectomy, Tubectomy

How to cite this article: Mettler L, Alkatout I. Laparoscopic Tubectomy, Oophorectomy, Adnexectomy: Indications at Hysterectomy. Int J Gynecol Endsc 2017;1(2):69-74.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Vaishali Chavan, Neha Sanghvi

Choriocarcinoma: Rupture from Uterus with Lung Metastasis—A Rare Entity

[Year:2017] [Month:April-June] [Volumn:1 ] [Number:2] [Pages:38] [Pages No:85-87][No of Hits : 171]


ABSTRACT

Choriocarcinoma is a highly malignant epithelial tumor arising from the trophoblastic tissue. It commonly occurs in women of reproductive age.
Persistent gestational trophoblastic disease (GTD) following molar pregnancy is a potentially fatal complication that must be recognized early and treated aggressively for both immediate and long-term recovery. While complete molar pregnancies are rare, they are associated with a host of potential complications that include invasive gestational trophoblastic neoplasia. In this study, we report the case of a 21-year-old young woman who presented 1.5 months after evacuation of a molar pregnancy. She had invasive and metastatic gestational neoplasia (GTN) complicated by uterine rupture and hemoperitoneum. This was successfully managed by exploratory laparotomy and hysterectomy.

Keywords: Choriocarcinoma, Gestational neoplasia, Hysterectomy and metastatic, Uterine rupture

How to cite this article: Chavan V, Sanghvi N. Choriocarcinoma: Rupture from Uterus with Lung Metastasis—A Rare Entity. Int J Gynecol Endsc 2017;1(2):85-87.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Vandana Jain, Nutan Jain

Cesarean Section Scar Endometriosis

[Year:2017] [Month:April-June] [Volumn:1 ] [Number:2] [Pages:38] [Pages No:88-92][No of Hits : 167]


ABSTRACT

Scar endometriosis is an infrequent type of extrapelvic endometriosis. Scar endometriosis is an infrequent type of extra pelvic endometriosis. Diagnosis can be difficult due to its presentation as abdominal lump. Histopathology yields confirmative diagnosis.

In this case report we will discuss abdominal wall endometriosis following caesarean section. We shall evaluate the incidence, pathophysiology, course, diagnosis, treatment and prevention of this condition

Keywords: Cesarean scar, Endometriosis, Extrapelvic, Painful scar, Scar endometriosis.

How to cite this article: Jain V, Jain N. Cesarean Section Scar Endometriosis. Int J Gynecol Endsc 2017;1(2):88-92.

Source of support: Nil

Conflict of interest: None


 
ORIGINAL ARTICLE
Vinita Sarbhai, Mohini Paul, Sangita N Ajmani

Importance of Colposcopy for screening of Premalignant Lesions of Cervix: An Experience of Tertiary Public Health Hospital in India

[Year:2017] [Month:April-June] [Volumn:1 ] [Number:2] [Pages:38] [Pages No:65-68][No of Hits : 167]


ABSTRACT

Aim: The aim of this article is to correlate the clinical, cytological, and colposcopic findings for detection of premalignant lesions of cervix.

Materials and methods: A total of 100 nonpregnant females attending the gynecology outpatient department (OPD) in Kasturba Hospital, New Delhi, India, were enrolled in the study. Papanicolaou (Pap) smear was done in first OPD visit. Colposcopy was done in these patients and patients with satisfactory colposcopy were subjected to biopsy if any abnormal finding was detected; in those with unsatisfactory colposcopy, endocervical curettage and conization were done. Samples were sent for histopathology examination and findings were correlated.

Results: The Pap smear was evaluated according to Bethesda system, which showed 70 patients had inflammatory smear, 6 had inflammatory with definitive organism, and 14 were abnormal. Out of 14 abnormal smears, 5 cases of atypical squamous cells of uncertain significance (ASCUS), 8 cases of low-grade squamous intraepithelial lesion (LSIL), and 1 case of squamous cell carcinoma (SCC) were noted. Sensitivity of Pap smear for detecting all grades of cervical intraepithelial neoplasia (CIN) was found to be 50%.
On colposcopy, 30% had normal appearance and 38% had miscellaneous findings; 28 patients with abnormal colposcopy finding were graded according to Reid’s colposcopy index, and findings showed 26 abnormal and 2 suspected of invasive cancer. Biopsy was done in 32 patients, including abnormal and unsatisfactory colposcopy.
Sensitivity of colposcopy for detecting all grades of CIN and SCC was found to be 92.85%. After combining both Pap smear and colposcopy, detection rate was 100%. Conclusion: Colposcopy and Pap smear should be done together for early detection of premalignant cervical intraepithelial lesions to reduce the burden of cervical cancer and its associated morbidity and mortality.

Keywords: Colposcopy, Papanicolaou smear, Premalignant lesions of cervix, Screening.

How to cite this article: Sarbhai V, Paul M, Ajmani SN. Importance of Colposcopy for screening of Premalignant Lesions of Cervix: An Experience of Tertiary Public Health Hospital in India. Int J Gynecol Endsc 2017;1(2):65-68.

Source of support: Nil

Conflict of interest: None


 
RESEARCH ARTICLE
Geetika G Syal, Kartik Syal, Chitra Chaudhary, Avinash Goyal

Airway changes in Laboring Patient

[Year:2017] [Month:April-June] [Volumn:1 ] [Number:2] [Pages:38] [Pages No:75-77][No of Hits : 162]


ABSTRACT

Introduction: Airway management is difficult in pregnant patients due to various factors; we in this study undertake changes in airway related to endotracheal intubation during active labour through Mallampati Score

Materials and methods: Study was conducted in 100 pregnant females by noting Mallampati Score before start of labour, at second stage of labour and after 15 minutes of delivery.

Conclusion: Airway difficulty increases with duration of labour and is reflected through Mallampati scores.

Keywords: Airway assessment, Laboring patient, Mallampati.

How to cite this article: Syal GG, Syal K, Chaudhary C, Goyal A. Airway changes in Laboring Patient. Int J Gynecol Endsc 2017;1(2):75-77.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Vineet Mishra, Suwa R Saini, Priyankur Roy, Rohina Aggarwal, Sakshi Nanda

Cervicovaginal Agenesis: Hysterectomy or Uterovaginal Anastomosis?

[Year:2017] [Month:April-June] [Volumn:1 ] [Number:2] [Pages:38] [Pages No:78-82][No of Hits : 159]


ABSTRACT

Cervicovaginal agenesis is one of the rarest müllerian anomalies, whose true incidence is still unknown. It is characterized by the absence of cervix and vagina, along with functioning endometrium and normal tubes and ovaries. It clinically presents as a case of primary amenorrhea along with cyclical lower abdominal pain. It can be associated with other anomalies like skeletal and renal anomalies. Earlier, hysterectomy was considered as a definitive surgery for this condition; however, it has been replaced with more conservative approach, like uterovaginal anastomosis with creation of neovagina. In the literature, successful pregnancy has been reported in those patients who underwent conservative surgery.

Keywords: Cervicovaginal agenesis, Conservative surgery, Hysterectomy, Uterovaginal anastomosis.

How to cite this article: Mishra V, Saini SR, Roy P, Aggarwal R, Nanda S. Cervicovaginal Agenesis: Hysterectomy or Uterovaginal Anastomosis? Int J Gynecol Endsc 2017;1(2):78-82.

Source of support: Nil

Conflict of interest: None


 
CASE REPORT
Khuspreet Kaur, Balwinder Kaur, Arvinder Kaur, Ramiti Gupta

Transverse Vaginal Septum: A Rare Case diagnosed during Labor

[Year:2017] [Month:April-June] [Volumn:1 ] [Number:2] [Pages:38] [Pages No:83-84][No of Hits : 157]


ABSTRACT

Transverse vaginal septum is a developmental defect in vaginal embryogenesis that leads to incomplete fusion between müllerian duct component and urogenital sinus component of vagina. Septum may be complete but usually has laterally placed tiny hole giving an impression of vaginal vault without cervix. We describe a case of untreated transverse vaginal septum with small tiny aperture diagnosed during labor and confirmed during lower segment cesarean section.

Keywords: Cesarean section, Congenital malformations, Müllerian ducts, Transverse vaginal septum.

How to cite this article: Kaur K, Kaur B, Kaur A, Gupta R. Transverse Vaginal Septum: A Rare Case diagnosed during Labor. Int J Gynecol Endsc 2017;1(2):83-84.

Source of support: Nil

Conflict of interest: None.


 
CASE REPORT
Meenu Agarwal, S Borkar, V Agarwal

Mayer Rokitansky Küster Hauser Syndrome

[Year:2017] [Month:April-June] [Volumn:1 ] [Number:2] [Pages:38] [Pages No:93-95][No of Hits : 151]


ABSTRACT

Purpose: The purpose of the article is to know how to progress ovum pick up (OPU) in cases where the ovaries are superiorly placed and are difficult to approach vaginally.

Material and methods: We performed OPU in cases where the ovaries are superiorly placed and are difficult to approach vaginally. This is a case study of eight patients where the ovaries were not approachable: four cases of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, three cases of endometriosis, and one case of pelvic inflammatory disease (PID) over a period of 2 years from December 2014 till December 2016. There were four cases of MRKH syndrome out of which in two the vagina was only about 2 to 3 cm in depth. It was very difficult to even insert the vaginal probe. In two cases of MRKH syndrome the ovaries were superiorly placed and were not approachable by the routine OPU needle through the guide of transvaginal probe; in two cases of endometriosis, endometrioma was 4 to 5 cm in size. There was one case of endometriosis and one case of PID.

Discussion: A laparoscopic approach for OPU may be the answer in cases of superiorly placed ovaries in cases of MRKH syndrome going in for surrogacy and also in some cases of severe endometriosis and PID where it may be difficult to approach the ovaries. In all these cases, OPU could be completed with the transvaginal ultrasound probe kept suprapubically and the OPU needle was guided through the guide and all the follicles could be aspirated without the need for laparoscopy. Limitations, reasons for caution: The procedure should be carefully done in very obese women. The anatomical location of the inferior epigastric vessels should also be known to avoid any bleeding from these vessels at the time of the procedure. Wider implications of the findings: Can be done by a routine in vitro fertilization specialist. It removes the need of calling a laparoscopic surgeon in such difficult cases.

Results: It is noninvasive with just a needle puncture on the lower abdomen and all the follicles can be retrieved.

Conclusion: This novel method of using the transvaginal probe abdominally for OPU in cases of superiorly placed ovaries can avoid

Keywords: Amenorrhea, Mayer rokitansky küster hauser syndrome, Müllerian duct.

How to cite this article: Agarwal M, Borkar S, Agarwal V. Mayer Rokitansky Küster Hauser Syndrome. Int J Gynecol Endsc 2017;1(2):93-95.

Source of support: Nil

Conflict of interest: None



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