Hellow guys, Welcome to my website, and you are watching SHARING THE EXPERIENCES ON SEVER ADENOMYOSIS.. and this vIdeo is uploaded by Dr Some Gowda, MD, Obstetrics and Gynecology at 2024-10-26T07:25:52-07:00. We are pramote this video only for entertainment and educational perpose only. So, I hop you like our website.
| Name | SHARING THE EXPERIENCES ON SEVER ADENOMYOSIS. |
| Video Uploader | Video From Dr Some Gowda, MD, Obstetrics and Gynecology |
| Upload Date | This Video Uploaded At 26-10-2024 14:25:52 |
| Video Discription | I don’t how many consultants truely experienced the clinical course and its managment. In my forty two yrs experience I operated on teen age group to peri menopausal patients it is very difficult take a decision with the SEVERE ADENOMYOSIS WITH ? Chocolate cyst in teen age, nulliparous or uniparous pt since it is certainly going to reccure soon after whatever the skills and techniques one use without the relief of clinical symptoms , signs and her fertility managment including SURROGACY BECAUSE POOR QUALITY EGGS AND financially burdening the avarage and below avarage class. IN SUCH SITUATIONS, 1) I believe that the comments are free facts are facts they are not secret but are sacred. 2) BOOKS MAY GIVES ONCE A ANYTHING OR EVERYTHING BUT A GOOD TEACHER gives what the student needs ,A CONSULTANT OR A SKILLED SURGEON certainly take a appropriate decision to that perticular situation after councilling ,modifying or altering ideal procedures in the interest of his client 3) I believe that One should not hesitate to take Openion of Others consultants whatever their speciality on the table on the mobile ie phone,what’s off or vedio call so on,many a time I did this and one should not have any ego in such situations. 4) Undergraduate degree is certain but the PG degree is uncertain after this degree one can modify or alter the protocols with his sound knowledge and the skills in the interest of the patient and the results of the consultants 5) Many a times it is very difficult to achieve the pregnancy in grade 4 ADENOMYOSIS even with IVF PROCEDURES INCLUDING WITH THE SURROGACY ,referring such cases to ART CENTERS will be a test skills of the consultants if achieved,my big salute to them.There is grading of Adenomyosis even with grade 1&2 it is very difficult to assure the couples of taking home baby with so many reasons. Sharing the management Sever ADENOMYOSIS WITH ? Chocolate cyst pt aged 27 years ML of 7yrs with A1 p1 L1 of 6 yrs suffering from severe dysmenorrhea ,dysperinorrhoe with succidal tendencies having consultations at Periyapatna, Hassan, Mysore ie OPERATIVE LAPAROSCOPY was done on 26/4/22 in the teaching institute GOT REMOVED Left tube and the ovary , it was frozen pelvis and had been evaluated being ?microadema. Symptoms were not relieved LAPROTOMY WAS DONE IN GOVERNMENT HOSPITAL OCT 23 it was a Frozen pelvis ,they can’t proceed and closed the abdomen. No were USG PEOPLE ATTER A WORD ABOUT THE ADENOMYOSIS, “I really thanks THE DISTRICT HOSPITAL PEOPLE REFFERING CASE TO ME KEEPING ASIDE THEIR EGOS, Operative laparoscopic findings. LAPROTOMY WAS DONE ON 5/ 1 / 24 ,findings it was a frozen with difficulty Hysterectomy was proceeded with precautions of injury to the URATERS,SIGMOID COLON AND THE RECTUM. HERE POSTERIOR WALL OF ADENOYOSIS FIRMLY ADHERENT TO ANTIRIOR WALL OF THE RECTUM . TAH WAS COMPLETED WITH RELEASING ADHESION OF RIGHT OVARY ? Chocolate cysts were aspirated,some were eneucleated , some spots were coagulated after exploration pelvis abdomen was closed. Difficult chocolate cyst one need not hesitate to sacrifice the ovary put on HRT, many a times HRT IS COASTLY AND UNRELIABLITY OF CONTINUING I WILL LEAVE BEHIND THE PART HEALTHY OVERIAN TISSUE WILL AVOIDED THE HRT AND SERVE A PART OF SURROGACY. Total hysterectomy specimen , sometimes in case of difficulty subtotal hysterectomy is sufficient. Two cornual adenocarcinomas may be the culprits for eliciting strong uterine contraction at the pace makers of the uterus Two cornual Adenomyosis See how hard to cut the tissue in Adenomyosis it is burrowing into the myometrium without any clevage where as in fibroid uterus it can be easily eneucleated because of its pseudo-capsule See how big was the posterior wall of Adenomyosis Absent left ovary and the tube Lateral wall adhesion of the right ovary was released ? Small chocolate cysts were aspirated, some were eneucleated and some of the endometriotic spots were coagulated. In both the scanning missed the strong feature Adenomyosis ( TVS) .Might have used colour Doplar or might have requested senior to scan might have helped the consultants to come to conclusion . Even today DIAGNOSTIC LAPAROSCOPY AND PROCEED MAY BE THE GOLD STANDERD but increased the chances conversion to laparotomy is about 90% and one who having good knowledge lower GIT AND UTI is equally important. Raised prolactin with negative for Microadenoma of the anterior pituitary with MRI scanning without the disturbance of other endocrinology ie thyroid,growth hormone and the adrenals carry’s no significance.It is well known endometriosis 3rd / 4th degree with infertility and luteal insufficiency will have prolactin level. Three days after the hysterectomy prolactine level markedly reduced and should be repeated during further follow up. |
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