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TEMPLATE DESIGN © Do we still need to resect ? A six year review and patient satisfaction survey Dr Uma Mahesha Arava, Dr Dimitrios Koleskas, Dr Mark Roberts, Dr Tony Chalhoub Royal Victoria Infirmary, Queen Victoria Road, Newcastle, NE1 4LP, England Introduction Transcervical resection of fibroids(TCRF) has traditionally been used to hysteroscopically resect submucous fibroids that cause menstrual problems or that may be interfering with the ability to conceive has been combined with transcervical resection of the endometrium(TCRE) to treat menorrhagia. It has been considered the gold standard for the treatment of symptomatic submucous fibroids. 1 However with the advent of newer endometrial ablation techniques that are less user dependent, there seems to be a gradual reduction in the use of resection techniques with the potential for loss of skill among the newer generation gynaecologists. TCRF and TCRE is a core component of hysteroscopic surgery and training should be directed to achieve and maintain this key skill, lest it be consigned to history. Methods This was a prospective study over a six year period from evaluating the effectiveness of TCRE/F and a retrospective one year study assessing patient satisfaction rates. Data regarding resection was collected prospectively on an ongoing basis and information about satisfaction was obtained using a patient satisfaction questionnaire. 73 patients who underwent TCRF with or without TCRE were included of whom 49 patients responded with information regarding bleeding pattern and satisfaction. Results Conclusions References OPTIONAL LOGO HERE 1. Cravello L, Agostini A, Beerli M, Roger V, Bretelle F, Blanc B. Results of hysteroscopic myomectomy. Gynecol Obstet Fertil Sep: 32(9): Agdi M, Tulandi T. Endoscpic management of uterine fibroids. Best Prac Res Clin Obstet Gynaecol Mar 4. (Abstract). Objectives To evaluate the treatment effect of Transcervical resection of fibroid and Transcervical resection of endometrium at the Royal Victoria Infirmary, Newcastle and to assess patient satisfaction. endometrium(TCRE) at the Royal Victoria Infirmary, Newcastle and to assess patient satisfaction Results Menorrhagia was the commonest indication for the procedure. 65 (89%) of patients had submucous fibroids on pre-op ultrasound scan. The majority of submucous fibroids resected were grade 1 Most of the submucous fibroids measured 1-5 cms in size. Fluid overload of greater than 1 litre was the most frequent complication. Of the 49 women who were followed up at 1 year, 21 women had amenorrhoea and 23 women had light bleeding giving a success rate of 90%. success rate of 90%. Patient satisfaction was high at 90%. Transcervical resection of fibroids is an established surgical procedure for women with submucosal fibroids and excessive uterine bleeding, infertility or repeated miscarriages. 2 TCRM/E is an effective treatment for menorrhagia particularly in the presence of submucous fibroids and is associated with high levels of patient satisfaction. Efforts should be made to provide continous training in acquiring and maintaining resection techniques to prevent loss of skill particularly in the backdrop of emerging ablation techniques.
Abnormal Uterine Bleeding Dr Helen Barnes GPSI September 2014.
TEMPLATE DESIGN © Objectives Methods This was a retrospective cohort data analysis of all women who presented with menorrhagia.
By Dr. Sushma Chawla MD.(PGI) Chawla Nursing Home & Maternity Hospital. 9, Lajpat Nagar, Link Road, Jalandhar.
TEMPLATE DESIGN © Major surgery in a minor way Sin WT, Woldman S, Attilia B, Gauthaman N, Karpouzis H, Patwardhan M South.
MENORRHAGIA – AN OVERVIEW Dr. MUKESH CHANDRA M.S;FICOG;FICMU,FICMCH,Dip.Lap.Surg (Germany);Dip.Ultrasound (New Zealand) ASSOCIATE PROFESSOR, Dept.of OB/GYN,
Uterine Fibroid Embolization Renan Uflacker, M.D. Interventional Radiology Medical University of South Carolina Charleston, SC.
A BNORMAL M ENSTRUATION Matthew Beaumont. H EAVY / A BNORMAL M ENSTRUAL B LEEDING Menorrhagia Excessive bleeding in normal cycle Clinical definition:
HYSTEROCOPIC SURGERY AND SUCCESS OF IVF/ICSI Prof.dr. Tomaž Tomaževič Ljubljana, Slovenia Brioni, 5-8 september 2013.
TEMPLATE DESIGN © Prevalence of endometrial cancer in symptamatic women with thickened endometrium Dr Maheswari SRINIVASAN.
TEMPLATE DESIGN © Outcome of trial of instrumental delivery in theatre Dr Uma Mahesha Arava, Dr Toli S Onon University.
Uterine Fibroids Max Brinsmead PhD FRANZCOG January 2010.
TEMPLATE DESIGN © Laparoscopic Ovarian Drilling For Polycystic Ovary Syndrome(PCOS) – Are We Wasting Women’s Time? Chima.
VAGINAL MYOMECTOMY IN TREATMENT OF UTERINE FIBROIDS. K.V. Mekoshvili, E.B. Troik, S.V. Vardanyan, B.L. Tsivyan. Department of Obstetrics and Gynecology,
Role of Ultrasound Imaging and Management option for Caesarean scar Ectopic Pregnancy Shah. Fatima, Vaithilingam. N Queen Alexandra Hospital, Southwick.
Asymptomatic Endometrial Thickening in Postmenopausal Patient Dr.Yousefi Professor OF Mashhad University of Medical Sciences Gynecologist Oncologist Society.
Dr Edward Sang, Fellow, Gynaecologic Oncology. Definitions Preoperative care: the patient management period during which time gynaecologic pathology,
Limits, Effectivity and Efficasy in ART Yücel Karaman MD. Prof. IVF and Endoscopic Surgery Center Brussel’s Women’s Health & Infertility Center
MYOMECTOMY USING LASER IN A PRIVATE PRACTISE Akinwuntan AL, Osinowo OS, Olutayo AA, Iwuh UE, Olaleye A Premier Specialists Medical Center, Victoria Island,
David blair toub, m.d. David Blair Toub, M.D. Department of Obstetrics and Gynecology Pennsylvania Hospital, Philadelphia, PA Hysterectomy: A Reappraisal.
Bilgin GURATES, M.D.. Abnormal Uterine Bleeding Causes of abnormal uterine bleeding.
Hysteroscopic myomectomy. Hysteroscopic myomectomy is performed for intracavitary fibroids, ie, submucosal and some intramural leiomyomas for which most.
Heavy Menstrual Bleeding. Also called menorrhagia Excessive menstrual bleeding which interferes with a woman’s physical, social, emotional or material.
Role of Hysteroscopy in Diagnosis and Treatment of Infertility Factors M.E.Parsanezhad M.D Professor and chair Department of Gynecology & Obstetrics Head.
ABNORMAL UTERINE BLEEDING Dr Rooma Sinha, MD, DNB Senior Consultant Gynecologist & Laparoscopic Surgeon Apollo Health City; HYDERABAD
TEMPLATE DESIGN © One Year study evaluating symptomatic relief of patients undergoing trans-obturator tape procedure Dr.
PREGNANCY AFTER UTERINE FIBROID EMBOLIZATION (UFE) João Martins Pisco, MD, PhD Interventional Radiologist Marisa Duarte, MD –Interventional Radiologist.
Uterine Fibroid Embolisation. The FEMME Trial! Anna-Maria Belli EBIR.
ROBOTIC MYOMECTOMY Dr Rooma Sinha, MD, DNB Senior Consultant Gynecologist & Laparoscopic Surgeon Apollo Health City; HYDERABAD
Abnormal uterine bleeding Dr. Abdalla H. Elsadig MD.
METHODS This evidenced-based literature review compares the use of GnRHa therapy and laparoscopic ablation with respect to symptom relief, recurrence of.
Management of Heavy Menstrual Bleeding Dr Sana’a Sabri GP ST1 14/12/2010.
8th Edition APGO Objectives for Medical Students Uterine leiomyomas.
Myomectomy in infertile patients Prof. Abbas Aflatoonian 14 th International Congress on Obstetrics and Gynecology October 14-17, Tehran - Iran.
It is benign uterine tumour consist of smooth muscles,it can present anywhere in the uterine wall.it could be intrmural,subserosal, Submucosal,cervical.
Enhanced MR guided Focused Ultrasound Surgery (MRgFUS) Guidelines Demonstrates Improved Efficacy and Durability for the Treatment of Uterine Myoma Phyllis.
ABNORMAL UTERINE BLEEDING TONY HOANG, MD. ABNORMAL UTERINE BLEEDING AUB accounts for approx. 70% of all gyn visits in the peri-menopause & post-menopausal.
TEMPLATE DESIGN © How well do we counsel women prior to laparoscopic procedures? Khaund A, Jamieson R South and North.
UTERINE FIBROIDS Hazem Al-Mandeel, M.D Course 481 Obstetrics and Gynecology Rotation.
‘Let’s get it right - Referral for suspected Cancer’ Dr Banchhita Sahu Consultant O&G Mr Nick Reed MDT lead, Consultant O&G.
Uterine Fibroids for Undergraduates Max Brinsmead MB BS PhD September 2012.
The National Mastectomy and Breast Reconstruction Audit Key findings of the Third Annual Report Slides produced by the MBR Project Team. © The National.
Endometrial Ablation for Heavy bleeding “A new treatment for an old problem”
DR MANAL IDRIS menorrhagia. Introduction Menorrhagia is one of the commenest gynaecological complaints seen in practice and accounts for approximately.
DYSFUNCTIONAL UTERINE BLEEDING AHMED ABDULWAHAB. Definition. Definition. It is abnormal vaginal bleeding in the child bearing period where no organic.
Obesity Case Study. What is your history with weight gain and weight loss? Would you like to manage your weight differently? If so, how? What do you think.
TEMPLATE DESIGN © Loo CY, S. Balakrishnan, M. Rouse, Department of O&G, Penang Hospital, Penang 1.Bemelmans BL, Chapple.
1.Royal College of Obstetricians and Gynaecologists. The Green Top Guidelines Number 21: The management of tubal pregnancy. (Online). Available from:
Post-menopausal bleeding Definition –Any vaginal bleeding after a period of amenorrhoea of 6 months or more in the perimenopausal age group –Menstruation.
Abnormal Uterine Bleeding Peter J. Chen, M.D. Clinical Assistant Professor Department of Obstetrics and Gynecology Hospital of the University of Pennsylvania.
Manual Vacuum Aspirator- A Safe and Cost Effective Tool for Decentralization of Post Abortion Care N Tasnim, G Mahmud, S Fatima Maternal and Child Health.
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