Obstetrics and gynecology

BACKGROUND: Reproductive-aged women undergoing appendectomy for suspected appendicitis have twice the rate of negative histology as age-matched men. The reason for this discrepancy is unknown. CASES: Three patients with peritoneal endometr…

BACKGROUND: Malignant transformation of endometriosis in an episiotomy site is rare. CASE: A 42-year-old woman presented with a palpable mass, 2.5 cm in size, just inside the posterior commissure of the vagina, at the site of a previous ep…

BACKGROUND: Endometriosis, a major cause of pelvic pain in women, is driven by estrogen. Ovarian remnant irradiation may alleviate pelvic pain by eliminating estrogen production in appropriately selected women with endometriosis. CASE: Thr…

BACKGROUND: Visualization and biopsy of suspicious peritoneum can confirm endometriosis. Endoscopic India ink tattooing can lead to peritoneum that visually mimics endometriosis. CASE: A woman with chronic pelvic pain and a history of trea…

OBJECTIVE: To analyze the levels of circulating cell-free nuclear DNA and circulating cell-free mitochondrial DNA in patients with benign and malignant ovarian tumors using a gold-standard assay and to investigate whether quantitative alter…

BACKGROUND: Hormone changes are thought to influence the etiology and disease process of peritoneal inclusion cysts. The effects of fertility and pregnancy on preexisting cysts are unknown. CASE: A 29-year-old woman with recurrent peritone…

OBJECTIVE: To evaluate whether 6 months of raloxifene was effective in treatment of chronic pelvic pain in women with endometriosis. METHODS: Women with chronic pelvic pain and no endometriosis treatment for 6 months underwent laparoscopy …

OBJECTIVE: To investigate the need for further surgery after laparoscopic excision of endometriosis or hysterectomy. METHODS: In this retrospective study, women who had surgery for endometriosis-associated pain at the Cleveland Clinic were…

BACKGROUND: Endometriosis-associated chronic pelvic pain unresponsive to surgical menopause is a difficult clinical problem. CASE: A middle-aged woman presented with endometriosis and severe pelvic pain after hysterectomy and bilateral sal…

BACKGROUND: The development of a mass in association with a previous surgical scar can pose a diagnostic dilemma due to similarities in appearance to hernias, abscesses, hematomas, or desmoid tumors. Scar endometriosis is an uncommon cause …

OBJECTIVE: To identify risk factors for and the patterns of recurrence of endometrioma and of dysmenorrhea in women with ovarian endometrioma. METHODS: We evaluated 710 consecutive patients operated on for ovarian endometriomas who were fo…

OBJECTIVE: Urocortin is a neuropeptide, member of the corticotropin-releasing hormone family, that is produced by the human endometrium. Ovarian endometrioma is a prevalent gynecologic disorder still lacking specific serum markers. In the p…

BACKGROUND: The diagnosis of inguinal endometriosis can be complex, and patients are often first operated by a general surgeon for a hernia. We present five cases of inguinal endometriosis in which primary surgery resulted in recurrence and…

BACKGROUND: Endometriosis is rarely a cause of recurrent hemorrhagic ascites. This report draws attention to this uncommon condition, which could present a diagnostic dilemma. CASE: A young African-American woman who had experienced recurr…

The levonorgestrel intrauterine system, approved for contraceptive use for up to 5 years, also has noncontraceptive uses. It appears to reduce menstrual bleeding significantly in women with idiopathic menorrhagia. Current studies suggest th…

BACKGROUND: Adenosarcoma arising in inguinal endometriosis is a rare clinical entity. CASE: A 47-year-old nulligravida presented with a persistent and enlarged right groin mass. Sixteen years earlier she had undergone total abdominal hyste…

In Brief Imaging should be considered in adolescents with severe dysmenorrhea resistant to medical therapy because adenomyosis is a potential etiology in this age group.

Professor of Clinical Gynecology-Obstetrics, University at Buffalo, the State University of New York, Buffalo, New York Chief of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, New York Professor and Chairman, Department of Gy…

BACKGROUND: Endometriosis is commonly identified in the abdomen, specifically the ovaries, adnexa, and fallopian tubes, and sometimes in more distant areas; precoccygeal endometriosis is an extremely rare phenomenon. CASE: We present a cas…

BACKGROUND: The features of abdominal pain in this gravid patient mimicked more common diagnoses like preterm labor, chorioamnionitis, and appendicitis. CASE: A 40-year-old multipara presented at 30 weeks and 6 days with abdominal pain. Th…

BACKGROUND: Intestinal endometriosis may be complicated by bowel obstruction, colonic rupture, sepsis, and rarely, malignant transformation. Fistula formation is extremely rare. CASE: A 26-year-old woman presented at 16 weeks of gestation …

BACKGROUND: Spontaneous intraperitoneal hemorrhage during pregnancy or in the postpartum period is a rare but dangerous phenomenon. CASE: A 41-year-old gravida 3 para 1, 9 days postpartum, presented with lower abdominal pain and hypovolemi…

OBJECTIVE: To assess the ectopic pregnancy risk among women who conceived with assisted reproductive technology (ART) procedures. METHODS: The ectopic rate for ART pregnancies was calculated from population-based data of pregnancies concei…

OBJECTIVE: Although most women experience retrograde menses during their reproductive life, endometriosis develops only in a small percentage. We hypothesized that persistence of a fibrin matrix in peritoneal pockets, as a result of hypofib…