Diagnostic conization for cervical neoplasia during pregnancy using the CO2 laser

Cervical conization during pregnancy has been reported as a procedure with a high morbidity, The authors report their experience in triaging pregnant women with abnormal cytopathology by laser CO2 cervical conization, in a retrospective review. Out of a total of 192 pregnant women, cervical conization was performed in 24 cases for diagnostic reasons. Indications for the procedure were suspected invasive disease, unsatisfactory follow-up in patients with high-grade squamous intraepithelial lesions (SIL), a major discrepancy between cytologic and colposcopic results, or suspected glandular disease. The procedure was performed with the patient under local anesthesia, using CO2 laser. Five cases of microinvasive carcinoma and 19 cases of intraepithelial disease were found. There were negligible complications from the procedure. Intraepithelial relapse was diagnosed in 3 women during a follow-up ranging from 24 to 69 months. Although colposcopy has eliminated the need for routine diagnostic conization during pregnancy, certain patients may need to undergo the procedure. The CO2 laser in experienced hands provides an excellent means of performing it safely and effectively

Septic lithiasis of the pelvis - An unusual late complication of laparoscopic cholecystectomy

Laparoscopic cholecystectomy has become a standard technique for the treatment of symptomatic cholelithiasis. Despite a significant reduction in the complication rate with increasing experience, bile duct injury and gallstone spillage still occur more frequently with this approach than with the open procedure. Unretrieved gallstones, in particular, have been associated with late infection and the formation of abscesses in virtually every area of the abdominal cavity. We present a rare case of an isolated pelvic abscess that developed in a postmenopausal woman 5 months after laparoscopic cholecystectomy for recurrent cholecystitis. The preoperative differential diagnosis of this case is also discussed

Intramural leiomyoma of the bladder

Mesodermal tumors of the urinary bladder are rare and the majority of them are malignant. We report a case of an intramural leiomyoma of the bladder presenting with symptoms of a mild lower urinary tract infection. The patient was managed with partial cystectomy and the outcome was excellent

Treatment of vaginal intraepithelial neoplasia with laser ablation and upper vaginectomy

To assess the effectiveness of laser ablation and upper vaginectomy in the treatment of vaginal intraepithelial neoplasia (VAIN), we have reviewed the charts of 52 patients managed with laser ablation (28 patients) and upper colpectomy (24 patients). On the basis of our results, patient selection and operator skill have a significant influence on the outcome. In posthysterectomy patients with VAIN(3) at the vaginal apex, in the region of vaginal cuff sear, upper vaginectomy is the treatment of choice, while multifocal VAIN(2-3) or colposcopically well defined lesions, involving large areas of vaginal mucosa, could be successfully managed by CO2 laser ablation. Copyright (C) 2002 S. Karger AG, Basel

Vulvar angiokeratoma following radical hysterectomy and radiotherapy

Angiokeratomas of the vulva are rare, benign tumors that present mostly on the labia majora. This is the first case report presenting a patient with this type of neoplasia, after radical hysterectomy and radiotherapy. Possible mechanisms for its pathogenesis could be increased venous pressure resulting from a hysterectomy or the loss of elastic tissue around the vessels from radiation, resulting in the formation of telangiectasias. Angiokeratomas should be included in the differential diagnosis of vulvar tumors in all women who have been treated for a lower genital tract malignancy