Pub Date : 2025-08-14DOI: 10.1016/j.crwh.2025.e00743
Julia Grace Fitzgerald , Nidhi Chawla , Neil John Kocher
Advanced genitourinary syndrome of menopause (GSM) can lead to complete labial fusion (CLF) in postmenopausal women, which in turn may cause urinary retention, recurrent urinary tract infections, and diminished urinary flow. This report presents the case of a 72-year-old woman with CLF and a diminished urinary stream. She was treated through surgical labial separation, following the application of a fish skin biograft. This case is seemingly the first report of the application of such a biograft for labial fusion. The technique offers a minimally invasive approach for preventing re-adhesion, promoting tissue regeneration, and reducing complications in postmenopausal women with advanced labial adhesions.
{"title":"Surgical management of complete labial fusion in a postmenopausal woman with application of a fish skin graft: A case report","authors":"Julia Grace Fitzgerald , Nidhi Chawla , Neil John Kocher","doi":"10.1016/j.crwh.2025.e00743","DOIUrl":"10.1016/j.crwh.2025.e00743","url":null,"abstract":"<div><div>Advanced genitourinary syndrome of menopause (GSM) can lead to complete labial fusion (CLF) in postmenopausal women, which in turn may cause urinary retention, recurrent urinary tract infections, and diminished urinary flow. This report presents the case of a 72-year-old woman with CLF and a diminished urinary stream. She was treated through surgical labial separation, following the application of a fish skin biograft. This case is seemingly the first report of the application of such a biograft for labial fusion. The technique offers a minimally invasive approach for preventing re-adhesion, promoting tissue regeneration, and reducing complications in postmenopausal women with advanced labial adhesions.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00743"},"PeriodicalIF":0.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852161","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 : 2025-08-10DOI: 10.1016/j.crwh.2025.e00742
Roza Mahyoob , Keisuke Sugita , Akiko Yamamoto
Sertoli-Leydig cell tumors are a rare type of sex cord-stromal tumors that are mostly hormonally active (androgenic or estrogenic). Owing to the rarity of this disease, its impact on pregnancy is not fully understood. This report concerns a rare case of a Sertoli-Leydig cell tumor incidentally discovered during a cesarean section. In a resource-poor setting, a 21-year-old woman was referred to hospital for her first childbirth. She had clitoromegaly for a few years, had never had a gynecological consultation, and had not received antenatal care during this pregnancy. Three hours after admission, an emergency cesarean section was indicated because of fetal distress. During the procedure, a right ovarian tumor measuring approximately 10 × 10 cm was found. Considering the patient's age and obstetric history, and the inability to perform histological evaluation during surgery at the hospital she attended, the decision was made to proceed only with tumor resection. Considering the possibility of a sex-cord stromal tumor focusing on the clitoromegaly, histopathological evaluation was performed, and a diagnosis of a Sertoli-Leydig cell tumor was obtained. This case underscores the importance of clinical vigilance for rare hormonally active ovarian tumors during pregnancy, particularly in low-resource settings.
{"title":"Incidental detection of a virilizing Sertoli-Leydig cell tumor during cesarean section: A case report","authors":"Roza Mahyoob , Keisuke Sugita , Akiko Yamamoto","doi":"10.1016/j.crwh.2025.e00742","DOIUrl":"10.1016/j.crwh.2025.e00742","url":null,"abstract":"<div><div>Sertoli-Leydig cell tumors are a rare type of sex cord-stromal tumors that are mostly hormonally active (androgenic or estrogenic). Owing to the rarity of this disease, its impact on pregnancy is not fully understood. This report concerns a rare case of a Sertoli-Leydig cell tumor incidentally discovered during a cesarean section. In a resource-poor setting, a 21-year-old woman was referred to hospital for her first childbirth. She had clitoromegaly for a few years, had never had a gynecological consultation, and had not received antenatal care during this pregnancy. Three hours after admission, an emergency cesarean section was indicated because of fetal distress. During the procedure, a right ovarian tumor measuring approximately 10 × 10 cm was found. Considering the patient's age and obstetric history, and the inability to perform histological evaluation during surgery at the hospital she attended, the decision was made to proceed only with tumor resection. Considering the possibility of a sex-cord stromal tumor focusing on the clitoromegaly, histopathological evaluation was performed, and a diagnosis of a Sertoli-Leydig cell tumor was obtained. This case underscores the importance of clinical vigilance for rare hormonally active ovarian tumors during pregnancy, particularly in low-resource settings.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00742"},"PeriodicalIF":0.6,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828242","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 : 2025-08-05DOI: 10.1016/j.crwh.2025.e00739
Kathleen Mejia , Tara Ajith , Maria Memtsa , Emma Kirk
Expectant management of ectopic pregnancy employs regular monitoring of serum β-hCG levels until pregnancy testing is negative and the patient is asymptomatic. Although not routinely assessed in clinical practice, physical resolution of ectopic pregnancy can be determined via direct visualisation on transvaginal ultrasound. This report concerns the case of a woman in her late 20s who was managed expectantly for a right tubal ectopic pregnancy. Biochemical resolution was achieved 28 days from initial presentation. She was followed up with serial transvaginal ultrasound scans, as per unit protocol. During her follow-up, she conceived and transvaginal ultrasound scans showed a concurrent live normally sited pregnancy alongside the residual right tubal ectopic pregnancy. In view of this, she was followed up regularly until 13 + 0 weeks into her current pregnancy, when the residual ectopic pregnancy was no longer visualised.
{"title":"Live normally sited pregnancy with concurrent residual tubal ectopic pregnancy: A case report","authors":"Kathleen Mejia , Tara Ajith , Maria Memtsa , Emma Kirk","doi":"10.1016/j.crwh.2025.e00739","DOIUrl":"10.1016/j.crwh.2025.e00739","url":null,"abstract":"<div><div>Expectant management of ectopic pregnancy employs regular monitoring of serum β-hCG levels until pregnancy testing is negative and the patient is asymptomatic. Although not routinely assessed in clinical practice, physical resolution of ectopic pregnancy can be determined via direct visualisation on transvaginal ultrasound. This report concerns the case of a woman in her late 20s who was managed expectantly for a right tubal ectopic pregnancy. Biochemical resolution was achieved 28 days from initial presentation. She was followed up with serial transvaginal ultrasound scans, as per unit protocol. During her follow-up, she conceived and transvaginal ultrasound scans showed a concurrent live normally sited pregnancy alongside the residual right tubal ectopic pregnancy. In view of this, she was followed up regularly until 13 + 0 weeks into her current pregnancy, when the residual ectopic pregnancy was no longer visualised.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00739"},"PeriodicalIF":0.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772532","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 : 2025-08-05DOI: 10.1016/j.crwh.2025.e00738
Kohei Sakabe , Masumi Sunada , Mana Taki , Taito Miyamoto , Rin Mizuno , Koji Yamanoi , Ryusuke Murakami , Hiroaki Ito , Masaki Mandai
Cervical endometriosis is a rare benign condition characterized by ectopic endometrial glands and stroma within the cervix. Its clinical and imaging features resemble those of cervical adenocarcinoma, making preoperative diagnosis difficult.
This report concerns the case of a 41-year-old woman who presented with abnormal genital bleeding. Magnetic resonance imaging revealed a multicystic cervical mass with suspected solid components showing high T2 signal intensity and focal high signal on T1-weighted imaging, and positron emission tomography–computed tomography showed moderate uptake of fluorodeoxyglucose. Despite repeated evaluations, including cervical cytology, curettage, needle biopsy, and conization, no malignancy or endometriosis was detected. Owing to the persistent concern of gastric-type cervical adenocarcinoma, robot-assisted hysterectomy was performed. Intraoperatively, the lesion was adherent to the right ureter, prompting a conversion to laparotomy. Frozen sections revealed endometriosis. The final histopathological examination confirmed the presence of cervical endometriosis.
This case highlights the diagnostic challenges associated with cervical endometriosis and the risk of overtreatment. When imaging reveals a multicystic cervical lesion, this rare condition should be considered in the differential diagnosis to avoid unnecessary radical surgery.
{"title":"Cervical endometriosis mimicking cervical adenocarcinoma: A case report","authors":"Kohei Sakabe , Masumi Sunada , Mana Taki , Taito Miyamoto , Rin Mizuno , Koji Yamanoi , Ryusuke Murakami , Hiroaki Ito , Masaki Mandai","doi":"10.1016/j.crwh.2025.e00738","DOIUrl":"10.1016/j.crwh.2025.e00738","url":null,"abstract":"<div><div>Cervical endometriosis is a rare benign condition characterized by ectopic endometrial glands and stroma within the cervix. Its clinical and imaging features resemble those of cervical adenocarcinoma, making preoperative diagnosis difficult.</div><div>This report concerns the case of a 41-year-old woman who presented with abnormal genital bleeding. Magnetic resonance imaging revealed a multicystic cervical mass with suspected solid components showing high T2 signal intensity and focal high signal on T1-weighted imaging, and positron emission tomography–computed tomography showed moderate uptake of fluorodeoxyglucose. Despite repeated evaluations, including cervical cytology, curettage, needle biopsy, and conization, no malignancy or endometriosis was detected. Owing to the persistent concern of gastric-type cervical adenocarcinoma, robot-assisted hysterectomy was performed. Intraoperatively, the lesion was adherent to the right ureter, prompting a conversion to laparotomy. Frozen sections revealed endometriosis. The final histopathological examination confirmed the presence of cervical endometriosis.</div><div>This case highlights the diagnostic challenges associated with cervical endometriosis and the risk of overtreatment. When imaging reveals a multicystic cervical lesion, this rare condition should be considered in the differential diagnosis to avoid unnecessary radical surgery.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00738"},"PeriodicalIF":0.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860878","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 : 2025-07-26DOI: 10.1016/j.crwh.2025.e00737
Michael Herman , Alexandra Herman , Shruti Karanth , Jacquelyn Blackstone
Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune mediated peripheral neurologic disease characterized by symmetric, ascending progressive limb weakness and paresthesia. It is a rare and diagnostically challenging condition. Pregnancy-induced CIDP is especially rare, with few case series describing treatment courses, pregnancy outcomes and complications.
This report concerns a case of a 20-year-old primigravida with CIDP who was initially misdiagnosed with bilateral Bell's palsy. Symptoms progressively worsened to include ascending limb weakness, allodynia, urinary retention and fecal incontinence; she later met criteria for CIDP. Her pregnancy went on to be complicated by prolonged hospitalization and pre-eclampsia; after induction of intravenous immunoglobulin therapy, she developed acute pulmonary embolism and HELLP syndrome, and required emergent C-section delivery. The diagnosis, treatment and management of severe pregnancy complications associated with CIDP are described.
{"title":"Chronic inflammatory demyelinating polyneuropathy complicated by pre-eclampsia progressing to HELLP syndrome and pulmonary embolism: A case report","authors":"Michael Herman , Alexandra Herman , Shruti Karanth , Jacquelyn Blackstone","doi":"10.1016/j.crwh.2025.e00737","DOIUrl":"10.1016/j.crwh.2025.e00737","url":null,"abstract":"<div><div>Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune mediated peripheral neurologic disease characterized by symmetric, ascending progressive limb weakness and paresthesia. It is a rare and diagnostically challenging condition. Pregnancy-induced CIDP is especially rare, with few case series describing treatment courses, pregnancy outcomes and complications.</div><div>This report concerns a case of a 20-year-old primigravida with CIDP who was initially misdiagnosed with bilateral Bell's palsy. Symptoms progressively worsened to include ascending limb weakness, allodynia, urinary retention and fecal incontinence; she later met criteria for CIDP. Her pregnancy went on to be complicated by prolonged hospitalization and pre-eclampsia; after induction of intravenous immunoglobulin therapy, she developed acute pulmonary embolism and HELLP syndrome, and required emergent C-section delivery. The diagnosis, treatment and management of severe pregnancy complications associated with CIDP are described.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00737"},"PeriodicalIF":0.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144772479","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 : 2025-07-22DOI: 10.1016/j.crwh.2025.e00736
Richard Q. Vuong , Molly Hurd , Zeynep Tek , Nicole Brzozowski
While tubal ectopic pregnancies and molar pregnancies are relatively common, tubal molar pregnancies are exceptionally rare, with an estimated incidence of 1.5 per 1,000,000 pregnancies. Molar pregnancies are at risk for developing malignant gestational trophoblastic neoplasia (15–20 % for complete hydatidiform moles and 0.5–6 % for partial hydatidiform moles) and warrant robust diagnostic workup to determine appropriate management. Presented here is a case of an isthmic tubal ectopic pregnancy secondary to a partial hydatidiform mole; additionally, a literature review through PubMed discusses all tubal molar pregnancies reported within a 5-year period.
A 41-year-old woman (gravida 2, para 0, aborta 1) at 6 weeks and 5 days of gestation presented to the emergency department from the outpatient clinic because prenatal ultrasound did not show an intrauterine pregnancy and her a -hCG level was 17,913 mIU/mL. Due to concern for ectopic pregnancy, she underwent diagnostic laparoscopy, which revealed an unruptured right isthmic tubal ectopic gestation. The specimen was removed and sent for histological evaluation, which confirmed a partial hydatidiform mole that stained positive for p57; the finding was supported by molecular studies. The patient was discharged the same day and follow-up -hCG levels were monitored weekly until undetectable. The literature review found that 13 tubal molar pregnancies had been reported between 2019 and 2024.
Histopathologic examination of gestational trophoblastic disease should be supported by ancillary studies such as immunohistochemical, flow cytometry, and molecular analyses to ensure accurate diagnosis. Magnetic resonance imaging could offer a way to preoperatively diagnose molar ectopic pregnancy in select hemodynamically stable patients.
{"title":"Isthmic tubal ectopic pregnancy from a partial molar pregnancy: A case report and literature review","authors":"Richard Q. Vuong , Molly Hurd , Zeynep Tek , Nicole Brzozowski","doi":"10.1016/j.crwh.2025.e00736","DOIUrl":"10.1016/j.crwh.2025.e00736","url":null,"abstract":"<div><div>While tubal ectopic pregnancies and molar pregnancies are relatively common, tubal molar pregnancies are exceptionally rare, with an estimated incidence of 1.5 per 1,000,000 pregnancies. Molar pregnancies are at risk for developing malignant gestational trophoblastic neoplasia (15–20 % for complete hydatidiform moles and 0.5–6 % for partial hydatidiform moles) and warrant robust diagnostic workup to determine appropriate management. Presented here is a case of an isthmic tubal ectopic pregnancy secondary to a partial hydatidiform mole; additionally, a literature review through PubMed discusses all tubal molar pregnancies reported within a 5-year period.</div><div>A 41-year-old woman (gravida 2, para 0, aborta 1) at 6 weeks and 5 days of gestation presented to the emergency department from the outpatient clinic because prenatal ultrasound did not show an intrauterine pregnancy and her a <span><math><mi>β</mi></math></span>-hCG level was 17,913 mIU/mL. Due to concern for ectopic pregnancy, she underwent diagnostic laparoscopy, which revealed an unruptured right isthmic tubal ectopic gestation. The specimen was removed and sent for histological evaluation, which confirmed a partial hydatidiform mole that stained positive for p57; the finding was supported by molecular studies. The patient was discharged the same day and follow-up <span><math><mi>β</mi></math></span>-hCG levels were monitored weekly until undetectable. The literature review found that 13 tubal molar pregnancies had been reported between 2019 and 2024.</div><div>Histopathologic examination of gestational trophoblastic disease should be supported by ancillary studies such as immunohistochemical, flow cytometry, and molecular analyses to ensure accurate diagnosis. Magnetic resonance imaging could offer a way to preoperatively diagnose molar ectopic pregnancy in select hemodynamically stable patients.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00736"},"PeriodicalIF":0.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696838","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 : 2025-07-18DOI: 10.1016/j.crwh.2025.e00735
Lauren Yacobucci, Rebecca Wineland, Ramin Eskandari, Roger Newman, Annika Van Oosbree
Myelomeningocele (MMC) is the most common and complex birth defect of the central nervous system that is compatible with long-term survival. Historically, the preferred mode of delivery has been cesarean; however, more recent literature has questioned the benefit of cesarean delivery or avoidance of labor. A key aspect of this decision is determining the delivery mode which will best protect against rupture of the myelomeningocele, untoward traction on the neural placode, and functional spinal cord rostral to the defect site. Ruptured myelomeningocele is associated with significantly increased morbidity and necessitates urgent surgical repair within the first 72 h of life. There appear to have been no published case reports describing MMC drainage prior to delivery, with the goal of preventing rupture of the MMC. The present report concerns a case of an infant who underwent ultrasound-guided needle decompression of a large MMC prior to delivery. Because of the lack of severe rupture, there was a significant volume of healthy skin available for closure of the defect with no postnatal complications from the procedure. In conclusion, drainage of an MMC may result in a decreased risk of rupture of large MMCs at the time of delivery and may be considered in cases where concern for rupture is particularly high. It is also a procedure that may allow for a reduction in maternal morbidity by reducing the need for highly morbid vertical uterine incisions.
{"title":"Ultrasound-guided myelomeningocele drainage at time of cesarean section: A case report","authors":"Lauren Yacobucci, Rebecca Wineland, Ramin Eskandari, Roger Newman, Annika Van Oosbree","doi":"10.1016/j.crwh.2025.e00735","DOIUrl":"10.1016/j.crwh.2025.e00735","url":null,"abstract":"<div><div>Myelomeningocele (MMC) is the most common and complex birth defect of the central nervous system that is compatible with long-term survival. Historically, the preferred mode of delivery has been cesarean; however, more recent literature has questioned the benefit of cesarean delivery or avoidance of labor. A key aspect of this decision is determining the delivery mode which will best protect against rupture of the myelomeningocele, untoward traction on the neural placode, and functional spinal cord rostral to the defect site. Ruptured myelomeningocele is associated with significantly increased morbidity and necessitates urgent surgical repair within the first 72 h of life. There appear to have been no published case reports describing MMC drainage prior to delivery, with the goal of preventing rupture of the MMC. The present report concerns a case of an infant who underwent ultrasound-guided needle decompression of a large MMC prior to delivery. Because of the lack of severe rupture, there was a significant volume of healthy skin available for closure of the defect with no postnatal complications from the procedure. In conclusion, drainage of an MMC may result in a decreased risk of rupture of large MMCs at the time of delivery and may be considered in cases where concern for rupture is particularly high. It is also a procedure that may allow for a reduction in maternal morbidity by reducing the need for highly morbid vertical uterine incisions.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00735"},"PeriodicalIF":0.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670619","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 : 2025-07-18DOI: 10.1016/j.crwh.2025.e00734
Dineli Kalansuriya , Jay Roberts , Sumudu Britton , Rebecca Marie Kimble
Bladder exstrophy (BE) is a rare congenital anomaly of the anterior abdominal wall which results in externalisation of the distal urogenital tract and requires multiple surgeries for repair in early childhood. Pregnancy in patients with repaired BE can be high risk and may present with complications across the entire pregnancy. The literature reports decreased fertility rates and increased rates of miscarriage, preterm birth, placental abruption and postpartum complications in pregnancy for people with repaired bladder exstrophy. The present report concerns the case of a pregnant 27-year-old primigravida patient with repaired bladder exstrophy with an extreme bicornuate uterus. She experienced cervical shortening, recurrent urinary tract infection (UTI) with emerging antibiotic resistance, pelvic girdle pain and postpartum urinary incontinence. This pregnancy was managed by a large multidisciplinary team consisting of obstetrics, urology, infectious diseases, maternal foetal medicine, obstetric medicine and allied health. She achieved a term pregnancy that was delivered by elective individualised caesarean section.
{"title":"Pregnancy after repaired bladder exstrophy: a case report","authors":"Dineli Kalansuriya , Jay Roberts , Sumudu Britton , Rebecca Marie Kimble","doi":"10.1016/j.crwh.2025.e00734","DOIUrl":"10.1016/j.crwh.2025.e00734","url":null,"abstract":"<div><div>Bladder exstrophy (BE) is a rare congenital anomaly of the anterior abdominal wall which results in externalisation of the distal urogenital tract and requires multiple surgeries for repair in early childhood. Pregnancy in patients with repaired BE can be high risk and may present with complications across the entire pregnancy. The literature reports decreased fertility rates and increased rates of miscarriage, preterm birth, placental abruption and postpartum complications in pregnancy for people with repaired bladder exstrophy. The present report concerns the case of a pregnant 27-year-old primigravida patient with repaired bladder exstrophy with an extreme bicornuate uterus. She experienced cervical shortening, recurrent urinary tract infection (UTI) with emerging antibiotic resistance, pelvic girdle pain and postpartum urinary incontinence. This pregnancy was managed by a large multidisciplinary team consisting of obstetrics, urology, infectious diseases, maternal foetal medicine, obstetric medicine and allied health. She achieved a term pregnancy that was delivered by elective individualised caesarean section.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00734"},"PeriodicalIF":0.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679563","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}
There is limited data regarding management of vaginal strictures with a concurrent hysterectomy, in all realms, including pre-, intra- and postoperative care. A 44-year-old nulligravid woman with multiple vaginal strictures and clinically suspected endometriosis was evaluated preoperatively and underwent laparoscopic hysterectomy with simultaneous dilation of vaginal strictures without complication. Postoperative care included vaginal estrogens and vaginal dilators. Concurrent vaginal stricture dilation and laparoscopic hysterectomy can be successful and without complication with the use of intraoperative dilation and postoperative estrogens.
{"title":"Laparoscopic hysterectomy with intraoperative treatment of vaginal strictures: A case report","authors":"Maddison McLellan , Antoinette Abdelmalek , Nkiruka Chuba","doi":"10.1016/j.crwh.2025.e00733","DOIUrl":"10.1016/j.crwh.2025.e00733","url":null,"abstract":"<div><div>There is limited data regarding management of vaginal strictures with a concurrent hysterectomy, in all realms, including pre-, intra- and postoperative care. A 44-year-old nulligravid woman with multiple vaginal strictures and clinically suspected endometriosis was evaluated preoperatively and underwent laparoscopic hysterectomy with simultaneous dilation of vaginal strictures without complication. Postoperative care included vaginal estrogens and vaginal dilators. Concurrent vaginal stricture dilation and laparoscopic hysterectomy can be successful and without complication with the use of intraoperative dilation and postoperative estrogens.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00733"},"PeriodicalIF":0.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679564","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 : 2025-07-13DOI: 10.1016/j.crwh.2025.e00731
Igor Chiminacio , João Francisco Petry , Nataly Nunes Ladeira Ramalho Verissimo Campos , Carolina Obrzut
A case is reported of endometriosis present in several areas of the small intestine, successfully treated by excision using the conservative technique of shaving the intestinal wall. A 30-year-old woman with a 10-year history of pelvic pains, menstrual cramps since menarche, dyspareunia, and infertility for 3 years presented with symptoms of abdominal distension, diarrhea, nausea, and vomiting during menstruation, previously diagnosed as irritable bowel syndrome and dysbiosis. The diagnosis of deep endometriosis was made by clinical history, specialized physical examination, magnetic resonance imaging, and ultrasound mapping with intestinal preparation. The extensive pelvic endometriosis and a complex intestinal lesion in the rectosigmoid indicated the need for surgical intervention. During surgery, seven lesions of endometriosis were identified in the terminal ileum, as well as lesions in the uterine parametrium, ectocervical region, rectosigmoid, bilateral endometriomas, appendix, right iliac fossa and right diaphragmatic dome, which were not visualized in the preoperative examination. The excision included en bloc peritonectomy, segmental resection of the rectum, and removal of the intestinal lesions using a shaving technique and reinforcement sutures. There were no postoperative complications. Histopathological examination confirmed endometriosis. Endometriosis of the small intestine is a challenge to diagnose before surgery due to the lack of standardized imaging tests. Diagnostic suspicion should be based on symptoms of abdominal distension, nausea, or vomiting during menstruation. The shaving technique allowed for the safe removal of multiple lesions from the small intestine, proving a practical and reproducible approach.
{"title":"Multiple lesions of endometriosis in the small intestine treated by the shaving technique: A case report","authors":"Igor Chiminacio , João Francisco Petry , Nataly Nunes Ladeira Ramalho Verissimo Campos , Carolina Obrzut","doi":"10.1016/j.crwh.2025.e00731","DOIUrl":"10.1016/j.crwh.2025.e00731","url":null,"abstract":"<div><div>A case is reported of endometriosis present in several areas of the small intestine, successfully treated by excision using the conservative technique of shaving the intestinal wall. A 30-year-old woman with a 10-year history of pelvic pains, menstrual cramps since menarche, dyspareunia, and infertility for 3 years presented with symptoms of abdominal distension, diarrhea, nausea, and vomiting during menstruation, previously diagnosed as irritable bowel syndrome and dysbiosis. The diagnosis of deep endometriosis was made by clinical history, specialized physical examination, magnetic resonance imaging, and ultrasound mapping with intestinal preparation. The extensive pelvic endometriosis and a complex intestinal lesion in the rectosigmoid indicated the need for surgical intervention. During surgery, seven lesions of endometriosis were identified in the terminal ileum, as well as lesions in the uterine parametrium, ectocervical region, rectosigmoid, bilateral endometriomas, appendix, right iliac fossa and right diaphragmatic dome, which were not visualized in the preoperative examination. The excision included en bloc peritonectomy, segmental resection of the rectum, and removal of the intestinal lesions using a shaving technique and reinforcement sutures. There were no postoperative complications. Histopathological examination confirmed endometriosis. Endometriosis of the small intestine is a challenge to diagnose before surgery due to the lack of standardized imaging tests. Diagnostic suspicion should be based on symptoms of abdominal distension, nausea, or vomiting during menstruation. The shaving technique allowed for the safe removal of multiple lesions from the small intestine, proving a practical and reproducible approach.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"47 ","pages":"Article e00731"},"PeriodicalIF":0.7,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665648","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号