Gynaecology
Roy Palmer, Diana Wetherill in Medicine for Lawyers, 2020
There are numerous methods of sterilization, some requiring open laparotomy, others performed through the laparoscope. They all have as their object the creation of a gap in the Fallopian tube (see Figure 9.2). It is not the application of stitches, clips or rings which effects the sterilization but rather the gap created by the absence of part of the tube. Even though that gap is effectively created, natural healing may achieve closure of the gap but there are always tell-tale pathological traces of the process. The Fallopian tube is composed mainly of muscle whose thickness varies throughout its length, and is lined on the inside (endosalpinx) and outside (serosa) by epithelium. While epithelium is capable of regeneration, muscle is not. When destroyed, muscle is replaced by scar tissue (collagen). The histopathologist can therefore always recognize the section of tube which has undergone recanalization. If the Fallopian tube, following whatever method of sterilization, is found to have an intact muscle layer throughout its length, it is a safe conclusion that that tube has not been subjected to a proper sterilization procedure.
The immune system of the genitourinary tract
Phillip D. Smith, Richard S. Blumberg, Thomas T. MacDonald in Principles of Mucosal Immunology, 2020
The female reproductive tract has upper and lower components. The lower female reproductive tract structures (ectocervix, vagina, and vulva) enable sperm to enter the body and protect the internal genital organs from potential pathogens. From the vulva to the vagina, the epidermis transitions from keratinized to stratified, nonkeratinized squamous epithelium. The vaginal mucosa consists of three distinct layers; (1) the outer surface layer, which is lubricated by mucus produced primarily by the cervix; (2) the intermediate layer, which acts as an active site of glycogen production; and (3) the basal layer, made up of actively dividing cells. Internal reproductive structures include the endocervix, uterus, and fallopian tubes (see Figure 20.1, left). The ovary produces both gametes (ova) and sex hormones (estradiol and progesterone). The fallopian tubes attached to the upper part of the uterus provide passage for the ovum from the ovary to the uterus. Following fertilization of an egg by a sperm in the fallopian tubes, the fertilized egg then moves to the uterus, where it implants into the lining of the uterine wall. Each site in the female reproductive tract functions to insure passage of sperm to the site of fertilization, permit release of menstrual flow, as well as provide a route of passage of the baby at birth.
Gynaecology
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie in Bailey & Love's Short Practice of Surgery, 2018
A hysterectomy can be carried out by three different routes: vaginally, abdominally or laparoscopically. The route of entry is dependent on a number of factors, including: uterine size; presence of other pathology; mobility and descent of the uterus; history of previous surgery; and skill of the operating surgeon. A total or subtotal (conservation of the cervix) hysterectomy can be performed. No difference in prolapse symptoms, sexual satisfaction or pelvic pain has been reported between the two techniques. Furthermore, it is now recommended that the Fallopian tubes are removed in conjunction with the uterine body, whether the ovaries are conserved or not. The Fallopian tubes have no continued functionality following a hysterectomy, but can be a potential source of malignancy if retained. Conservation or removal of the ovaries is dependent on the woman’s age, presence of coexisting pathology and/or risk factors for malignancy.
Study on diagnosis and management strategies on heterotopic pregnancy: a retrospective study
Published in Journal of Obstetrics and Gynaecology, 2023
Yan Zhang, Xiujuan Chen, Yuan Lin, Chengying Lian, Xiumei Xiong
The clinical characteristics of HP are listed in Table 1. The mean age of the 40 patients was 30.4 ± 4.9 (range 21–45) years, the mean body mass index (BMI) was 21.7 ± 2.7 (range 17.3–29.6) kg/m2. Concerning the surgical history, 12 (30.0%) patients underwent uni/bilateral tuboplasty to treat fallopian tube obstruction, and seven (17.5%) patients had bilateral salpingectomy/tubal ligation because of severe hydrosalpinx. Five (12.5%) patients had received unilateral salpingectomy due to tubal EP, and 16 patients had no history of tubal surgery. Fifteen (37.5%) patients had a history of primary infertility, and 25 patients reported a history of pregnancy. All patients had two embryos transferred. Of these women, 15 patients had pregnancies via fresh non-donor embryo transfer cycles, and 25 patients conceived after frozen-thawed embryo transfer.
Erzhi pills ameliorate cognitive dysfunction and alter proteomic hippocampus profiles induced by d -galactose and Aβ1–
40 injection in ovariectomized Alzheimer’s disease model rats
Published in Pharmaceutical Biology, 2021
Yongyan Xie, Bo Yan, Min Hou, Maofu Zhou, Chao Liu, Mengsheng Sun, Kun He, Cong Fang, Yaohui Chen, Liping Huang
Rats were anesthetized with intraperitoneal injections of 10% chloral hydrate (3.0 mL/kg). Bilateral ovariectomy (Huang et al. 2018) was performed using sterile surgical techniques. A small incision was made in the region between the hip and the last rib on each abdominal side. The fallopian tubes were clamped and ligated, and the ovaries and fat tissue around the ovaries were excised. The muscle and skin layers were then sutured. Sham surgery was performed in the same way but without ligation of the fallopian tubes and resection of the ovaries. After surgery, all rats were injected intramuscularly with penicillin sodium (50,000 U, for 3 days) to fight infection. All rats were fed a soy-free diet to exclude the effects of phytosterols in the diet. Two days after surgery, the exfoliated vaginal epithelial cell smear technique was used to evaluate the success of the ovariectomy. If keratinocytes were not detected in five consecutive day smears, which suggested successful ovariectomy, ovariectomized rats were randomly divided into four groups (n = 13 per group), labelled the ‘model’, ‘estradiol valerate’, ‘Erzhi pills high-dose’, and ‘Erzhi pills low-dose’ groups. In addition, sham-operated rats were selected for the sham-operated group (n = 13).
Effect of Surgical Adhesive on the Uterus of Rabbits Following Occlusion
Published in Journal of Investigative Surgery, 2019
Anran Xu, Tianyu Hao, Xiaoqing Wei, Chuanfen Li, Lihua Niu, Xiaohui Deng
In the present study, a novel type of surgical adhesive was used to treat New Zealand rabbits, in order to investigate occlusion of the uterus. Blocking of the rabbit uterus was selected as an animal model in the present study due to two reasons. First, the thin wall of the rabbit fallopian tube easily leads to perforation in the process of adhesive injection, thus making the surgical procedure challenging.6 By contrast, the relatively large and thick wall of the rabbit uterine cavity is less prone to perforation and adhesive extravasation, resulting in easier surgical intervention.7 Second, in clinical practice, the position of occlusion is at the interstitial and isthmus portion of the human fallopian tube. The appearance, lumen size, and histological structure of that part of the human fallopian tube are similar to those of the rabbit uterus. Thus, in the present study, rabbits were used to establish an experimental model to evaluate the possible effects of medical adhesives on the fallopian tube occlusion, as well as to examine their potential for clinical applications. Following the surgery, the occlusion effect was evaluated by hysterosalpingography and histological observations, which could provide an experimental basis and technical support for the clinical treatment of abnormal fallopian tubes.
Related Knowledge Centers
- Egg Cell
- Fertilization
- Mesosalpinx
- Mesovarium
- Ovary
- Mesentery
- Uterus
- Oviduct
- Female Reproductive System
- Broad Ligament of The Uterus
- Fertilization