جستجوی مقالات مرتبط با کلیدواژه « ovarian cysts » در نشریات گروه « پزشکی »

Management of hemoperitoneum due to ruptured ovarian cyst in patients on anticoagulation is a dilemma. Low threshold of surgery intervention may increase the risk of some events operatively. There is a trend for less invasive treatment in highly selected patients. We present two cases   of massive hemoperitoneum due to ruptured ovarian cyst that were on anticoagulation. Successful conservative management was done in both of them and one patient, due to refractory abdominal pain, required interventional radiologic drainage, instead of surgery approach with good outcome. Ovulation suppression was started in both of them with regular uneventful follow up heretofore. Less invasive management is preferred in carefully selected patients of hemoperitoneum in women on anticoagulation. Ovulation suppression to avoid recurrence must be emphasized.

Ovarian torsion (OT) is a common gynecological emergency. Clinical presentation is nonspecific, and diagnosis is based on a high index of suspicion. Current recommendations strongly are based on ovarian support.

To assess clinical findings and therapeutic approach of patients diagnosed with OT.

In this retrospective study 104 patients with confirmed OT in surgery were investigated. Clinical symptoms, laboratory indices, ultrasonography finding, and therapeutic approach were collected from hospital records of patients from 2001 to 2021.

The mean age of patients was 34.7±14.1 years old. The mean duration from hospitalization to surgery was 6.4±3 hours. The most common symptom in patients was abdominal pain (100%) followed by nausea and vomiting (76.9%). Ovarian cyst (71.2%) was the most gynecologic etiology of OT. Local tenderness (92.3%) and rebound tenderness (46.2%) were the most prevalent sign in physical examination. Necrotic ovary was found in 60 patents (57.7%) at surgery. Detorsion was possible in only 26 patients (25%).

 This study revealed that most objective findings in patients were nondifferential. The majority of patients with OT were in the reproductive ages, but just one fourth of them treated with conservative management.

Since endometriosis is an estrogen-dependent disease; therefore, combined oral contraceptives (COCs) may not be the best choice for the treatment of endometriosis. The objective of the present study was to investigate the effects of ethinyl estradiol (EE) and desogestrel (DSG) in COCs on cell proliferation and apoptosis in ectopic endometrial tissue as compared to DSG alone.

Forty-five women of reproductive age with at least one endometriotic cyst were recruited into this single-blind randomized controlled trial study and randomly divided equally into three groups. EE-DSG and DSG groups received EE (0.03 mg) and DSG (0.15 mg) or DSG alone daily for 28-35 days before surgery. The control group was prescribed nothing. Endometriotic cyst tissues were collected during ovarian cystectomy for immunohistochemistry.

Levels of Ki-67 positive cells in the ectopic endometrial tissue of the EE-DSG group were significantly higher than the DSG group (median [IQR]; 1.4[1.2] vs 0.6 [0.7], P <0.016). There were significantly more TUNEL-positive cells in the EE-DSG group compared to the DSG group (median [IQR]; 2.8[0.7] vs 1.8[1.4], P < 0.016, respectively). Moreover, the number of TUNEL-positive cells in the EE-DSG and DSG groups were significantly higher than the control (median [IQR]; 2.8[0.7] vs 0.2[0.2] and 1.8[1.4] vs 0.2[0.2], P <0.016). The levels of cells that positively stained for Bcl2 were not different among all groups.

Progestin alone increased cell apoptosis in ectopic endometria. However, concurrent EE in COCs enhanced proliferation and promoted a greater apoptotic effect in ectopic endometria compared to progestin alone.