Chapters authored
Bleeding and Hysteroscopy in Uterine Myomatosis
Uterine leiomyomas are one of the most common diseases in women. However, there is still much about them we do not know. These tumours, also known as fibroids or myomas, affect women mainly during their reproductive years, and they are diagnosed in up to 70% to 80% of women during their lives. The most relevant part of this disease is the profound impact in the quality of life of women, in the provision of health services, and on the costs all around the world. Even though, the majority of women with fibroids are asymptomatic, approximately 30% of them will present severe symptoms, with a broad range of problems such as: abnormal uterine bleeding, infertility, and obstetric complications. There are multiple factors involved in the biology of fibroids: genetic, epigenetic, hormonal, proinflammatory, angiogenic and growth factors, growth factors that are capable of inducing and promoting de development of fibroids. The leiomyoma is surrounded by a pseudocapsule generated by compression and ischaemia of the tumour towards the myometrium and is composed by multiple elements that that promote healing and tissue repair of the myometrium after myomectomy. Therefore, its conservation in the myometrium is essential, regardless of the surgical technique used. Resection by hysteroscopy can be performed in an office or in an operating room, depending on the characteristics of the fibroid, it is required a good diagnosis and experience.
Part of the book: Fibroids
Endoscopic Approach to Ectopic Pregnancy
Minimally invasive surgery is an option in the management of ectopic pregnancy, it may be rupture, not rupture, or complement of medical treatment. In addition to the known advantages of endoscopic surgery in the field of obstetrics, it allows better conservative management of the fallopian tube and ovaries, allowing a better reproductive prognosis. The surgical technique to be performed of the clinical findings, the hemodynamic status, and the anatomical location of the ectopic pregnancy. Salpingectomy is performed in the ruptured ectopic pregnancy, assessing the integrity of the contralateral salpinge. Linear salpingostomy is performed on unbroken ectopic pregnancy preserving the fallopian tube, in the literature, this technique has reported maintenance of the fertility rate. In case of a cervical or niche ectopic pregnancy, resectoscopy is recommended.
Part of the book: Ectopic Pregnancy and Prenatal Diagnosis