Pub Date : 2019-09-22DOI: 10.3329/bjog.v33i1.43271
U. Ruman, T. Chowdhury, N. Mahmud, T. Chowdhury, S. Habib
Background: Infertility prevails in good number in our society, causing social disharmony and distress. Laparoscopy is now a very effective tool for diagnosis and evaluation of female infertility. Method: This cross sectional study was conducted in Infertility Unit of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, from July, 2012 to June 2014. The aim of the study is to identify common pelvic pathologies of female factor infertility by laparoscopy so that early detection and treatment modalities can be instituted. Total 230 sub fertile patients attending OPD were selected for this study. Patients with DM, HTN, known case of hypothyroidism and male factor infertility was excluded from study. Detailed clinical history of every patient was recorded on a pre-set questionnaire and physical examination was performed. Laparoscopy was scheduled in proliferative phase of menstrual cycle. Results: Among the study subjects, 130 (56.5%) had primary infertility while 100 (43.5%) secondary infertility. On laparoscopy, 64.4% patient had normal sized uterus, 31 % had bulky uterus. Two patients had bicornuate uterus in secondary infertility cases. Uterus was restricted in mobility in 41% of patients due to endometriosis, pelvic inflammatory disease (PID) or previous pelvic surgery. Fibroid uterus was detected in 30(13%) and 10(4.3%) cases of primary and secondary infertility cases respectively. Bilateral tubal blockage was present in 16(6.9%) and 17 (7.4%) cases of primary and secondary infertility respectively. Forty (17.4%) cases of primary infertility were detected as polycystic ovaries (PCO) which was 30(13%) in cases of secondary infertility. Endometriosis was found in total 9(3.9%) patient in both the groups. Pelvic adhesion was found in 22(9.5%) and 21 (9.1%) cases of primary and secondary infertility respectively. Conclusion: Laparoscopy could diagnose a substantial number of portion pelvic pathology. In a developing country like Bangladesh, earlier and justified intervention with laparoscopy can save time and expense of infertility treatment by diagnosing pelvic factor responsible for infertility. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 29-35
{"title":"Laparoscopic Evaluation of Female Factor in Bangladeshi Infertile Couple","authors":"U. Ruman, T. Chowdhury, N. Mahmud, T. Chowdhury, S. Habib","doi":"10.3329/bjog.v33i1.43271","DOIUrl":"https://doi.org/10.3329/bjog.v33i1.43271","url":null,"abstract":"Background: Infertility prevails in good number in our society, causing social disharmony and distress. Laparoscopy is now a very effective tool for diagnosis and evaluation of female infertility. \u0000Method: This cross sectional study was conducted in Infertility Unit of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, from July, 2012 to June 2014. The aim of the study is to identify common pelvic pathologies of female factor infertility by laparoscopy so that early detection and treatment modalities can be instituted. Total 230 sub fertile patients attending OPD were selected for this study. Patients with DM, HTN, known case of hypothyroidism and male factor infertility was excluded from study. Detailed clinical history of every patient was recorded on a pre-set questionnaire and physical examination was performed. Laparoscopy was scheduled in proliferative phase of menstrual cycle. \u0000Results: Among the study subjects, 130 (56.5%) had primary infertility while 100 (43.5%) secondary infertility. On laparoscopy, 64.4% patient had normal sized uterus, 31 % had bulky uterus. Two patients had bicornuate uterus in secondary infertility cases. Uterus was restricted in mobility in 41% of patients due to endometriosis, pelvic inflammatory disease (PID) or previous pelvic surgery. Fibroid uterus was detected in 30(13%) and 10(4.3%) cases of primary and secondary infertility cases respectively. Bilateral tubal blockage was present in 16(6.9%) and 17 (7.4%) cases of primary and secondary infertility respectively. Forty (17.4%) cases of primary infertility were detected as polycystic ovaries (PCO) which was 30(13%) in cases of secondary infertility. Endometriosis was found in total 9(3.9%) patient in both the groups. Pelvic adhesion was found in 22(9.5%) and 21 (9.1%) cases of primary and secondary infertility respectively. \u0000Conclusion: Laparoscopy could diagnose a substantial number of portion pelvic pathology. In a developing country like Bangladesh, earlier and justified intervention with laparoscopy can save time and expense of infertility treatment by diagnosing pelvic factor responsible for infertility. \u0000Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 29-35","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43861823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-22DOI: 10.3329/bjog.v33i1.43270
Afroza Khanam, Zannatul Ferdous Jesmin, F. Begum, N. Akhter, M. Akter, S. Nahar, Areendam Barua, A. Nessa
Back ground: Cervical cancer is the most common genital tract cancer and the important cause of cancer death among Bangladeshi women. Information about actual number of women living with preinvasive phase of cervical cancer and their diagnosis and treatment is limited. For strengthening the programme and policy for cervical cancer prevention , the baseline prevalence of cervical intraepithelial neoplasia ( CIN) need to be assessed. Methods: This population based study aimed to determine the prevalence of CIN among women of Khulna division of Bangladesh. Data has been collected from four upazila of four districts of Khulna division. VIA and colposcopy and histopathology was used for detection of cervical pre-cancers and early cancers among 1232 women of the mentioned population. Results: Crude prevalence of CIN was 5.84 %,CIN-II 1.1% and CIN- III .73% in colposcopically directed biopsy. Ninety two participants with CIN received treatment at the Colposcopy Clinic of Obstetrics and Gynaecology department of Khulna Medical College Hospital (KMCH). Conclusion: This population based prevalence study of CIN and socio demography would have conducive effect on future cervical cancer prevention programme. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 21-28
{"title":"Prevalence of Cervical Intraepithelial Neoplasia (CIN) at Khulna Division of Bangladesh","authors":"Afroza Khanam, Zannatul Ferdous Jesmin, F. Begum, N. Akhter, M. Akter, S. Nahar, Areendam Barua, A. Nessa","doi":"10.3329/bjog.v33i1.43270","DOIUrl":"https://doi.org/10.3329/bjog.v33i1.43270","url":null,"abstract":"Back ground: Cervical cancer is the most common genital tract cancer and the important cause of cancer death among Bangladeshi women. Information about actual number of women living with preinvasive phase of cervical cancer and their diagnosis and treatment is limited. For strengthening the programme and policy for cervical cancer prevention , the baseline prevalence of cervical intraepithelial neoplasia ( CIN) need to be assessed. \u0000Methods: This population based study aimed to determine the prevalence of CIN among women of Khulna division of Bangladesh. Data has been collected from four upazila of four districts of Khulna division. VIA and colposcopy and histopathology was used for detection of cervical pre-cancers and early cancers among 1232 women of the mentioned population. \u0000Results: Crude prevalence of CIN was 5.84 %,CIN-II 1.1% and CIN- III .73% in colposcopically directed biopsy. Ninety two participants with CIN received treatment at the Colposcopy Clinic of Obstetrics and Gynaecology department of Khulna Medical College Hospital (KMCH). \u0000Conclusion: This population based prevalence study of CIN and socio demography would have conducive effect on future cervical cancer prevention programme. \u0000Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 21-28","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48735031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-22DOI: 10.3329/bjog.v33i1.43268
Mst Moonmoon Begum, F. Sultana, H. Ferdousy
Background: Prevention of cervical cancer is the easiest with regular screening tests and follow up. CIN is a pre-malignant condition, detection of which is possible by VIA and colposcopy. Objective: To identify the performance of Cervical Cancer Screening Program in Rangpur Medical College Hospital through 11 Years. Methods and materials: Apparently healthy, married or sexually active women (>10 years) and women aged >30 years attending Gynae OPD were included in this study. After counseling and informed consent a speculum examination was performed for direct visualization of cervix to identify the squamo-columner junction. Freshly prepared 5% acetic acid was applied to the cervix for one minute. All the VIA positive women were further evaluated by colposcopy. Women with negative VIA were advised for 3 yearly VIA test. Suspected CIN cases were evaluated by colposcopy guided punch biopsy or LEEP biopsy and histopathology. Results: VIA screening was provided for 11,792 women from August 2005 to August 2016 and 932 (7.9%) were positive VIA. From November 2007 to August 2016, total women underwent colposcopy were 1548. Among them 632 (40.8%) were normal, out of abnormal cases 730 (80.3%) were CIN-1, 147 (16.1%) were CIN-2, 14 (1.5%) were CIN-3, 17 (1.8%) were invasive and 8 (0.5%) were unsatisfactory. From November 2007 to August 2016 punch biopsy was taken in 384 women and total 568 women were treated by LEEP. Conclusion: In a low resource setting like Bangladesh VIA and colposcopy can detect 80% pre-invasive cervical lesion and may be one of the most important tool to prevent cervical cancer and its mortality. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 11-16
{"title":"Cervical Cancer Screening Program in Rangpur Medical College Hospital: 11 Years Experience","authors":"Mst Moonmoon Begum, F. Sultana, H. Ferdousy","doi":"10.3329/bjog.v33i1.43268","DOIUrl":"https://doi.org/10.3329/bjog.v33i1.43268","url":null,"abstract":"Background: Prevention of cervical cancer is the easiest with regular screening tests and follow up. CIN is a pre-malignant condition, detection of which is possible by VIA and colposcopy. \u0000Objective: To identify the performance of Cervical Cancer Screening Program in Rangpur Medical College Hospital through 11 Years. \u0000Methods and materials: Apparently healthy, married or sexually active women (>10 years) and women aged >30 years attending Gynae OPD were included in this study. After counseling and informed consent a speculum examination was performed for direct visualization of cervix to identify the squamo-columner junction. Freshly prepared 5% acetic acid was applied to the cervix for one minute. All the VIA positive women were further evaluated by colposcopy. Women with negative VIA were advised for 3 yearly VIA test. Suspected CIN cases were evaluated by colposcopy guided punch biopsy or LEEP biopsy and histopathology. \u0000Results: VIA screening was provided for 11,792 women from August 2005 to August 2016 and 932 (7.9%) were positive VIA. From November 2007 to August 2016, total women underwent colposcopy were 1548. Among them 632 (40.8%) were normal, out of abnormal cases 730 (80.3%) were CIN-1, 147 (16.1%) were CIN-2, 14 (1.5%) were CIN-3, 17 (1.8%) were invasive and 8 (0.5%) were unsatisfactory. From November 2007 to August 2016 punch biopsy was taken in 384 women and total 568 women were treated by LEEP. \u0000Conclusion: In a low resource setting like Bangladesh VIA and colposcopy can detect 80% pre-invasive cervical lesion and may be one of the most important tool to prevent cervical cancer and its mortality. \u0000Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 11-16","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47215639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01DOI: 10.3329/bjog.v34i1.56670
T. Parveen, F. Begum, N. Akhter, Nigar Sultana, K. Nahar
Objectives: Immune thrombocytopenic purpura (ITP) in pregnancy necessitates management of two patients, the mother and the newborn. Complications like maternal bleeding, fetal and neonatal thrombocytopenia demands appropriate and timely therapy. This prospective observational study was designed to explore and summarize the current approach to the investigation, diagnosis, management and outcome of ITP in pregnancy. Materials and Methods: Women with ITP admitted in the Fetomaternal Medicine Department of Bangabandhu Sheikh Mujib Medical University (BSMMU) from 2009 -2017, were included in the study. Total number of high risk pregnancy during that period were 7704 among them 20 cases were pregnancy with Immune Thrombocytopenic Purpura (ITP). Patients were managed under joint supervision of the fetomaternal medicine specialist and the hematologist. Prednisolone was considered as a first line drug in management protocol. Platelet transfusion was considered if there were symptoms or count <20X109/L at any stage of pregnancy or <50 X109 / L in late pregnancy without symptoms. Platelet count of newborn was performed at birth and repeated on day four and count<150X109/L was considered as neonatal thrombocytopenia. Results: Frequency of ITP among high risk patients was found 2.5/1000 live birth, most were preexisting (75%). Almost all cases (95%) were treated with prednisolone. Commonest clinical presentations were gum bleeding (70 %) and purpuric rashes (60%). Though during pregnancy, severe thrombocytopenia (<50 X109/L) was found in 7 patients (35%) but none was at the time of delivery, as drugs and/or platelet transfusion was considered to make delivery process safe. Platelet transfusion needed in 77.7% cases in a range of 1-75 units. Primary PPH noted in 3 cases (17%), increased bleeding during surgery in 5 patients (33%) and one patient needed ICU support. Neonatal thrombocytopenia noted in 5 cases (28%). Though 2 of the neonates needed NICU admission but none needed platelet transfusion and all the babies were discharged healthy. Conclusion: This study documents that pregnancy with ITP need close monitoring, require agents to raise the platelet count and repeated platelet transfusion to maintain reasonable safe platelet count. There are chances of PPH, capillary oozing during surgery. However good outcome is possible for most women, fetus and neonates with appropriate and timely therapy. Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 15-21
{"title":"Immune Thrombocytopenic Purpura in Pregnancy- A Prospective Observational Study in a Tertiary Care Centre","authors":"T. Parveen, F. Begum, N. Akhter, Nigar Sultana, K. Nahar","doi":"10.3329/bjog.v34i1.56670","DOIUrl":"https://doi.org/10.3329/bjog.v34i1.56670","url":null,"abstract":"Objectives: Immune thrombocytopenic purpura (ITP) in pregnancy necessitates management of two patients, the mother and the newborn. Complications like maternal bleeding, fetal and neonatal thrombocytopenia demands appropriate and timely therapy. This prospective observational study was designed to explore and summarize the current approach to the investigation, diagnosis, management and outcome of ITP in pregnancy. Materials and Methods: Women with ITP admitted in the Fetomaternal Medicine Department of Bangabandhu Sheikh Mujib Medical University (BSMMU) from 2009 -2017, were included in the study. Total number of high risk pregnancy during that period were 7704 among them 20 cases were pregnancy with Immune Thrombocytopenic Purpura (ITP). Patients were managed under joint supervision of the fetomaternal medicine specialist and the hematologist. Prednisolone was considered as a first line drug in management protocol. Platelet transfusion was considered if there were symptoms or count <20X109/L at any stage of pregnancy or <50 X109 / L in late pregnancy without symptoms. Platelet count of newborn was performed at birth and repeated on day four and count<150X109/L was considered as neonatal thrombocytopenia. Results: Frequency of ITP among high risk patients was found 2.5/1000 live birth, most were preexisting (75%). Almost all cases (95%) were treated with prednisolone. Commonest clinical presentations were gum bleeding (70 %) and purpuric rashes (60%). Though during pregnancy, severe thrombocytopenia (<50 X109/L) was found in 7 patients (35%) but none was at the time of delivery, as drugs and/or platelet transfusion was considered to make delivery process safe. Platelet transfusion needed in 77.7% cases in a range of 1-75 units. Primary PPH noted in 3 cases (17%), increased bleeding during surgery in 5 patients (33%) and one patient needed ICU support. Neonatal thrombocytopenia noted in 5 cases (28%). Though 2 of the neonates needed NICU admission but none needed platelet transfusion and all the babies were discharged healthy. Conclusion: This study documents that pregnancy with ITP need close monitoring, require agents to raise the platelet count and repeated platelet transfusion to maintain reasonable safe platelet count. There are chances of PPH, capillary oozing during surgery. However good outcome is possible for most women, fetus and neonates with appropriate and timely therapy. Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 15-21","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42957320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01DOI: 10.3329/bjog.v34i1.56675
L. Chowdhury, Mahbubur Rahman, S. Chisty, Jesmin Jahan
Pyometra is a condition characterized by the accumulation of pus within the uterine cavity that usually develops in elderly women . Spontaneous rupture of pyometra causing diffuse peritonitis is very rare.Unless recognized in time it can be a life threatening condition. The aim of this article is to report a case of spontaneous rupture of pyometra who was admitted in our hospital as surgical emergency and was successfully treated by surgery. Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 48-51
{"title":"Spontaneous Ruptured Pyometra: A Gynaecological Emergency","authors":"L. Chowdhury, Mahbubur Rahman, S. Chisty, Jesmin Jahan","doi":"10.3329/bjog.v34i1.56675","DOIUrl":"https://doi.org/10.3329/bjog.v34i1.56675","url":null,"abstract":"Pyometra is a condition characterized by the accumulation of pus within the uterine cavity that usually develops in elderly women . Spontaneous rupture of pyometra causing diffuse peritonitis is very rare.Unless recognized in time it can be a life threatening condition. The aim of this article is to report a case of spontaneous rupture of pyometra who was admitted in our hospital as surgical emergency and was successfully treated by surgery. \u0000Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 48-51","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49271972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01DOI: 10.3329/bjog.v34i1.56674
S. Bachani, V. Dadhwal, D. Deka
Abstract not available Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 43-47
孟加拉妇产科杂志，2019;Vol. 34(1): 43-47
{"title":"Supernumerary Marker chromosome and Global Developmental Delay: Role of Microarray","authors":"S. Bachani, V. Dadhwal, D. Deka","doi":"10.3329/bjog.v34i1.56674","DOIUrl":"https://doi.org/10.3329/bjog.v34i1.56674","url":null,"abstract":"Abstract not available \u0000Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 43-47","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47999254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01DOI: 10.3329/bjog.v34i1.56667
M. R. Begum
Abstract not available Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 1-2
孟加拉妇产科杂志，2019;Vol. 34(1): 1-2
{"title":"Abnormal Uterine Bleeding","authors":"M. R. Begum","doi":"10.3329/bjog.v34i1.56667","DOIUrl":"https://doi.org/10.3329/bjog.v34i1.56667","url":null,"abstract":"Abstract not available \u0000Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 1-2","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41593412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01DOI: 10.3329/bjog.v34i1.56672
J. Sultana, Md. Manir Hossain Khan, Professor Fatema Ashraf, M. Sultana, M. A. Chowdhury
Objective: The aim of the study was to explore the surgical outcomes of total laparoscopic hysterectomy. Materials and methods: This was a prospective analysis of total Laparoscopic Hysterectomy (TLH) done between January, 2012 to December, 2018 in Shaheed Suhrawardy Medical College and Hospital. Demographic data, clinical criteria, intra operative and postoperative outcome data were recorded. Data were collected in a predesigned Data collection sheet. Follow up records done during discharge from the hospital, one week and four weeks postoperatively. Results: Total 298, laparoscopic hysterectomy were performed during the period. Among them 96 % (n=286) for benign and 4 %( n=12) for malignant condition were included in the study population. Mean age of the patients was 45.4 ± 5.6 years, mean parity was 1.9 ± 0.64 and the mean body mass index was 27.48 ± 0.57. The most common benign disease was leiomyoma, 51.7 %. Among the study cases 21.8% (n=65) had history of at least one previous abdomino-pelvic surgery. Maximum size of uterus removed was 28 weeks and maximum patients, 48% (n=143) had uterine size of 10-14 weeks. The operating time was variable between 50 min to 180 min and in the course of time, the mean operating time dropped from 130 min to 60 min. The mean length of hospital stay was 2 days and the return to normal activities was within 2 weeks. Major complications observed among 3.7 % of cases among them 2(0.67%) bladder injury, 2(0.67%) vesico-vaginal fistula (VVF), 3(1.0%) ureterovaginal fistula (UVF) and 4(1.3%) peroperative hemorrhage requiring blood transfusion. Among the 7 cases of urological complications, one patient with VVF and one patient with UVF needed relaparotomy. Ultimately all cases were managed without any residual problem. Conversion to laparotomy was 0.3 % (n=1) of case. Conclusion: TLH offers the benefit of minimally invasive surgery to the patient and is a safe and acceptable alternative to standard hysterectomy for various gynaecological indications. Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 28-35
{"title":"Clinical Outcomes of Total Laparoscopic Hysterectomy (TLH): Seven Years’ Experience in a Public Hospital","authors":"J. Sultana, Md. Manir Hossain Khan, Professor Fatema Ashraf, M. Sultana, M. A. Chowdhury","doi":"10.3329/bjog.v34i1.56672","DOIUrl":"https://doi.org/10.3329/bjog.v34i1.56672","url":null,"abstract":"Objective: The aim of the study was to explore the surgical outcomes of total laparoscopic hysterectomy. \u0000Materials and methods: This was a prospective analysis of total Laparoscopic Hysterectomy (TLH) done between January, 2012 to December, 2018 in Shaheed Suhrawardy Medical College and Hospital. Demographic data, clinical criteria, intra operative and postoperative outcome data were recorded. Data were collected in a predesigned Data collection sheet. Follow up records done during discharge from the hospital, one week and four weeks postoperatively. \u0000Results: Total 298, laparoscopic hysterectomy were performed during the period. Among them 96 % (n=286) for benign and 4 %( n=12) for malignant condition were included in the study population. Mean age of the patients was 45.4 ± 5.6 years, mean parity was 1.9 ± 0.64 and the mean body mass index was 27.48 ± 0.57. The most common benign disease was leiomyoma, 51.7 %. Among the study cases 21.8% (n=65) had history of at least one previous abdomino-pelvic surgery. Maximum size of uterus removed was 28 weeks and maximum patients, 48% (n=143) had uterine size of 10-14 weeks. The operating time was variable between 50 min to 180 min and in the course of time, the mean operating time dropped from 130 min to 60 min. The mean length of hospital stay was 2 days and the return to normal activities was within 2 weeks. Major complications observed among 3.7 % of cases among them 2(0.67%) bladder injury, 2(0.67%) vesico-vaginal fistula (VVF), 3(1.0%) ureterovaginal fistula (UVF) and 4(1.3%) peroperative hemorrhage requiring blood transfusion. Among the 7 cases of urological complications, one patient with VVF and one patient with UVF needed relaparotomy. Ultimately all cases were managed without any residual problem. Conversion to laparotomy was 0.3 % (n=1) of case. \u0000Conclusion: TLH offers the benefit of minimally invasive surgery to the patient and is a safe and acceptable alternative to standard hysterectomy for various gynaecological indications. \u0000Bangladesh J Obstet Gynaecol, 2019; Vol. 34(1): 28-35","PeriodicalId":39936,"journal":{"name":"Bangladesh Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49064085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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