The Experts below are selected from a list of 66 Experts worldwide ranked by ideXlab platform
Th. Römer - One of the best experts on this subject based on the ideXlab platform.
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Hormone substitution following transcervical endometrial Ablation
Zentralblatt fur Gynakologie, 1997Co-Authors: Th. RömerAbstract:The transcervical Endometrium Ablation is more and more used for the treatment of therapy refractory bleeding disorders. Since in 70% of the patients, even with a postoperative amenorrhoea, a residual Endometrium can be found a hormone replacement therapy should in any case include a sequential or continuous application of progestagen. For the prevention of a hematometra by using a hormone replacement therapy the cervix should be spared during Endometrium Ablation. With recurrent therapy-refractory bleeding disorders during hormone replacement therapy an indication for Endometrium Ablation can also be given. In these patients a postoperative amenorrhoea can be reached by a continuous hormone replacement therapy.
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Hormonal premedication in Endometrium Ablation--results of a prospective comparative study
Zentralblatt fur Gynakologie, 1996Co-Authors: Th. Römer, J. Müller, Bernd Bojahr, G. Schwesinger, Lober RAbstract:In a prospective study in 40 patients the pretreatment for endometrial Ablation with a gestagen (Orgametril 10 mg/die), danazol (600 mg/die) and an injection of a GnRH-analogon (Decapeptyl-Depot) was compared with a control group without pretreatment. The subjective estimation of the surgeon (endometrial thickness and depth of coagulation) showed a sufficient pretreatment in 90 % of all cases following danazol- and GnRH-analogon-pretreatment. In 90 % of the danazol- and GnRH-analogon pretreated group the histological findings showed also an atrophic or little proliferative Endometrium. In a follow up of 6 months after endometrial Ablation the highest amenorrhoea-rates were reached following danazol- and GnRH-analogon pretreatment. These two regimes should be used for the pretreatment for endometrial Ablation.
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Hematometra after hysteroscopic Endometrium Ablation--a case report
Zentralblatt fur Gynakologie, 1995Co-Authors: Th. Römer, Campo R, Hucke JAbstract:13 months after a hysteroscopic endometrial Ablation a haematometra was diagnosed in a 44 year-old women as a source of recurrent pelvic pain. The cause of the haematometra was a complete obliteration of the ostium cervicae internum. This long-term complication of the endometrial Ablation shows that all patients should have a regular clinical and sonographical follow up after endometrial Ablation.
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Transcervical Endometrium Ablation with the roller ball method--an alternative to hysterectomy in therapy refractory, recurrent hypermenorrhea?--Initial experiences
Geburtshilfe und Frauenheilkunde, 1994Co-Authors: Th. RömerAbstract:In 40 patients, indicated for hysterectomy because of refractory recurrent hypermenorrhea, a "roller-ball" coagulation of the Endometrium was performed after exclusion of organic causes for hypermenorrhea by sonography, hysteroscopy and curettage. In 60% of the patients amenorrhoea occurred and in 37.5% hypomenorrhea was achieved. In one patient, the endometrial Ablation had to be repeated twice because of persistent hypermenorrhea. There were no intra- or postoperative complications. Endometrial Ablation using the Roller-Ball method can be an alternative method to hysterectomy in selected patients.
Munteanu-bogdan Liliana - One of the best experts on this subject based on the ideXlab platform.
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Long-term complications of Endometrium Ablation (review)
Arta Medica, 2018Co-Authors: Munteanu-bogdan LilianaAbstract:1 - CSF GALAXIAInițial, ablația totală a endometriului a părut extrem de sigură. Totuși, cu trecerea timpului, anumite complicații unice de lungă durată au devenit evidente. Acestea sunt datorate posibilității apariției cicatricilor și contracturilor intrauterine după procedura aceasta. Orice sângerare din endometriul persistent și regenerant după cicatrici poate duce la hematometra cornuară. At first, total Endometrium Ablation seemd extremaly safe in the short term. However, as time passed, certain unique long-term complications became evident. The problem is that after this procedure, intrauterine scarring and contracture can occur. Any bleeding from persisting or regenerating Endometrium behind the scar can leed to cornual haematometra.Inițial, ablația totală a endometriului a părut extrem de sigură. Totuși, cu trecerea timpului, anumite complicații unice de lungă durată au devenit evidente. Acestea sunt datorate posibilității apariției cicatricilor și contracturilor intrauterine după procedura aceasta. Orice sângerare din endometriul persistent și regenerant după cicatrici poate duce la hematometra cornuară. At first, total Endometrium Ablation seemd extremaly safe in the short term. However, as time passed, certain unique long-term complications became evident. The problem is that after this procedure, intrauterine scarring and contracture can occur. Any bleeding from persisting or regenerating Endometrium behind the scar can leed to cornual haematometra
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Long-term complications of Endometrium Ablation (review)
Arta Medica, 2018Co-Authors: Munteanu-bogdan LilianaAbstract:CSF GALAXIA, Conferința Științifică „Centrul Medical «Galaxia» la 20 de ani”Inițial, ablația totală a endometriului a părut extrem de sigură. Totuși, cu trecerea timpului, anumite complicații unice de lungă durată au devenit evidente. Acestea sunt datorate posibilității apariției cicatricilor și contracturilor intrauterine după procedura aceasta. Orice sângerare din endometriul persistent și regenerant după cicatrici poate duce la hematometra cornuară. At first, total Endometrium Ablation seemd extremaly safe in the short term. However, as time passed, certain unique long-term complications became evident. The problem is that after this procedure, intrauterine scarring and contracture can occur. Any bleeding from persisting or regenerating Endometrium behind the scar can leed to cornual haematometra
G. Bastert - One of the best experts on this subject based on the ideXlab platform.
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Addition of ethanol to the distension medium in surgical hysteroscopy as screening to prevent "fluid overload". A prospective randomized comparative study of ablative versus non-ablative surgical hysteroscopy and different ethanol concentration
Geburtshilfe und Frauenheilkunde, 1996Co-Authors: D. Wallwiener, S. Rimbach, R. Conradi, B. Aydeniz, A. Fischer, G. BastertAbstract:For answering the question at which hysteroscopical procedures an intraoperative screening method is necessary to avoid a fluid overload and whether a beginning fluid absorption can be diagnosed early by adding ethanol to the distension medium, a prospectively randomised comparative study of ablative versus non-ablative operative hysteroscopy with differing ethanol concentrations was performed (n = 120). Purisole (a mannit/sorbit solution) was used a distension medium. The measuring parameters (breath alcohol, amount of absorbed fluid, haematocrit and haemoglobin values, central venous pressure, heart frequency) were intraoperatively determined at 5-minute intervals. The results of the study show that with those hysteroscopical procedures during which the Endometrium is not or only minimally injured (e.g. syneciolysis, hysteroscopic proximal tubal catheterisation). Intraoperative screening is not necessary due to the low absorbing amounts. With hysteroscopical procedures such as resection of myoma, Endometrium Ablation and septum resection, however, an addition of ethanol of 2% to the distension medium has proved useful, because with this method absorption amounts of 400 ml and more can be detected by positive values of breath alcohol. As the result of a further absorption of fluid, delayed in time compared to the first positive value of breath alcohol, there is an increase in central venous pressure and hyponatraemia. Intraoperative ethanol monitoring is a non-invasive procedure which can be performed during ablative-operative hysteroscopies and has no negative influence on the course of the intervention and the general condition of the patients.
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Hysteroscopic Endometrium Ablation in "high-risk" situations and in hemorrhagic diathesis
Zentralblatt fur Gynakologie, 1995Co-Authors: D. Wallwiener, S. Rimbach, M. Kaufmann, Aydeniz B, C. Sohn, G. Bastert, R. Conradi, D. Von FournierAbstract:A hysteroscopic endometrial Ablation (HEA) under maximal anesthesiologic surveillance was performed on 34 high-risk patients (group I: chronic anticoagulant therapy n = 26; group II: endogenous coagulopathy n = 8) with therapy resistant meno-metrorrhagia to avoid a hysterectomy (HE). Total amenorrhea, or a least hypomenorrhea respectively cyclic spotting could be attained primarily in 22 patients (group I: 19; group II: 3), after a repeat procedure in further 6 patients (4 in group I, 2 in group II). Subjective evaluation of surgical results (overall 22 patients primarily satisfied, 6 secondarily) also differed between the two subgroups (group I: p < 0.01 primarily satisfied; p < 0.05 secondarily satisfied vs. p < 0.05 and p < 0.01 in group II). A HE had to be performed on two patients due to extensive adenomyosis uteri interna (group II). The significantly better results in the anticoagulation group were probably due to the basic illness. Larger groups will, however, be necessary before any conclusions from this difference can be drawn. No surgical or anesthesiological complications occurred. There also were no major postoperative complications (1 endomyometritis, 2 cervical stenoses). Endometrial Ablation was found to be a valuable treatment alternative for this specific group of patients with severe coagulopathy, thrombo-embolic or thrombotic disease.
D. Wallwiener - One of the best experts on this subject based on the ideXlab platform.
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Addition of ethanol to the distension medium in surgical hysteroscopy as screening to prevent "fluid overload". A prospective randomized comparative study of ablative versus non-ablative surgical hysteroscopy and different ethanol concentration
Geburtshilfe und Frauenheilkunde, 1996Co-Authors: D. Wallwiener, S. Rimbach, R. Conradi, B. Aydeniz, A. Fischer, G. BastertAbstract:For answering the question at which hysteroscopical procedures an intraoperative screening method is necessary to avoid a fluid overload and whether a beginning fluid absorption can be diagnosed early by adding ethanol to the distension medium, a prospectively randomised comparative study of ablative versus non-ablative operative hysteroscopy with differing ethanol concentrations was performed (n = 120). Purisole (a mannit/sorbit solution) was used a distension medium. The measuring parameters (breath alcohol, amount of absorbed fluid, haematocrit and haemoglobin values, central venous pressure, heart frequency) were intraoperatively determined at 5-minute intervals. The results of the study show that with those hysteroscopical procedures during which the Endometrium is not or only minimally injured (e.g. syneciolysis, hysteroscopic proximal tubal catheterisation). Intraoperative screening is not necessary due to the low absorbing amounts. With hysteroscopical procedures such as resection of myoma, Endometrium Ablation and septum resection, however, an addition of ethanol of 2% to the distension medium has proved useful, because with this method absorption amounts of 400 ml and more can be detected by positive values of breath alcohol. As the result of a further absorption of fluid, delayed in time compared to the first positive value of breath alcohol, there is an increase in central venous pressure and hyponatraemia. Intraoperative ethanol monitoring is a non-invasive procedure which can be performed during ablative-operative hysteroscopies and has no negative influence on the course of the intervention and the general condition of the patients.
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Hysteroscopic Endometrium Ablation in "high-risk" situations and in hemorrhagic diathesis
Zentralblatt fur Gynakologie, 1995Co-Authors: D. Wallwiener, S. Rimbach, M. Kaufmann, Aydeniz B, C. Sohn, G. Bastert, R. Conradi, D. Von FournierAbstract:A hysteroscopic endometrial Ablation (HEA) under maximal anesthesiologic surveillance was performed on 34 high-risk patients (group I: chronic anticoagulant therapy n = 26; group II: endogenous coagulopathy n = 8) with therapy resistant meno-metrorrhagia to avoid a hysterectomy (HE). Total amenorrhea, or a least hypomenorrhea respectively cyclic spotting could be attained primarily in 22 patients (group I: 19; group II: 3), after a repeat procedure in further 6 patients (4 in group I, 2 in group II). Subjective evaluation of surgical results (overall 22 patients primarily satisfied, 6 secondarily) also differed between the two subgroups (group I: p < 0.01 primarily satisfied; p < 0.05 secondarily satisfied vs. p < 0.05 and p < 0.01 in group II). A HE had to be performed on two patients due to extensive adenomyosis uteri interna (group II). The significantly better results in the anticoagulation group were probably due to the basic illness. Larger groups will, however, be necessary before any conclusions from this difference can be drawn. No surgical or anesthesiological complications occurred. There also were no major postoperative complications (1 endomyometritis, 2 cervical stenoses). Endometrial Ablation was found to be a valuable treatment alternative for this specific group of patients with severe coagulopathy, thrombo-embolic or thrombotic disease.
R. Conradi - One of the best experts on this subject based on the ideXlab platform.
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Addition of ethanol to the distension medium in surgical hysteroscopy as screening to prevent "fluid overload". A prospective randomized comparative study of ablative versus non-ablative surgical hysteroscopy and different ethanol concentration
Geburtshilfe und Frauenheilkunde, 1996Co-Authors: D. Wallwiener, S. Rimbach, R. Conradi, B. Aydeniz, A. Fischer, G. BastertAbstract:For answering the question at which hysteroscopical procedures an intraoperative screening method is necessary to avoid a fluid overload and whether a beginning fluid absorption can be diagnosed early by adding ethanol to the distension medium, a prospectively randomised comparative study of ablative versus non-ablative operative hysteroscopy with differing ethanol concentrations was performed (n = 120). Purisole (a mannit/sorbit solution) was used a distension medium. The measuring parameters (breath alcohol, amount of absorbed fluid, haematocrit and haemoglobin values, central venous pressure, heart frequency) were intraoperatively determined at 5-minute intervals. The results of the study show that with those hysteroscopical procedures during which the Endometrium is not or only minimally injured (e.g. syneciolysis, hysteroscopic proximal tubal catheterisation). Intraoperative screening is not necessary due to the low absorbing amounts. With hysteroscopical procedures such as resection of myoma, Endometrium Ablation and septum resection, however, an addition of ethanol of 2% to the distension medium has proved useful, because with this method absorption amounts of 400 ml and more can be detected by positive values of breath alcohol. As the result of a further absorption of fluid, delayed in time compared to the first positive value of breath alcohol, there is an increase in central venous pressure and hyponatraemia. Intraoperative ethanol monitoring is a non-invasive procedure which can be performed during ablative-operative hysteroscopies and has no negative influence on the course of the intervention and the general condition of the patients.
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Hysteroscopic Endometrium Ablation in "high-risk" situations and in hemorrhagic diathesis
Zentralblatt fur Gynakologie, 1995Co-Authors: D. Wallwiener, S. Rimbach, M. Kaufmann, Aydeniz B, C. Sohn, G. Bastert, R. Conradi, D. Von FournierAbstract:A hysteroscopic endometrial Ablation (HEA) under maximal anesthesiologic surveillance was performed on 34 high-risk patients (group I: chronic anticoagulant therapy n = 26; group II: endogenous coagulopathy n = 8) with therapy resistant meno-metrorrhagia to avoid a hysterectomy (HE). Total amenorrhea, or a least hypomenorrhea respectively cyclic spotting could be attained primarily in 22 patients (group I: 19; group II: 3), after a repeat procedure in further 6 patients (4 in group I, 2 in group II). Subjective evaluation of surgical results (overall 22 patients primarily satisfied, 6 secondarily) also differed between the two subgroups (group I: p < 0.01 primarily satisfied; p < 0.05 secondarily satisfied vs. p < 0.05 and p < 0.01 in group II). A HE had to be performed on two patients due to extensive adenomyosis uteri interna (group II). The significantly better results in the anticoagulation group were probably due to the basic illness. Larger groups will, however, be necessary before any conclusions from this difference can be drawn. No surgical or anesthesiological complications occurred. There also were no major postoperative complications (1 endomyometritis, 2 cervical stenoses). Endometrial Ablation was found to be a valuable treatment alternative for this specific group of patients with severe coagulopathy, thrombo-embolic or thrombotic disease.