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Background: Hysterectomy is the most common operation performed by gynecologist, next to caesarean section. Currently, there are three main types of hysterectomy operations in practice for benign diseases-Abdominal hysterectomy (AH), vaginal hysterectomy (VH) and Laparoscopic hysterectomy (LH). Vaginal route for non-descentuterus is an acceptable method of hysterectomy. The objective of present study was to compare the operating time, intraoperative and postoperative complications between VH and TAH in non-descent uterus. Methods: The study was conducted in the Department of Obstetrics Gynaecology for a period of 18months at Darbhanga Medical College & Hospital, Laheriasarai, Bihar. Results: Over the study period 100 patients were taken, 50 patients underwent non-descent vaginal hysterectomy andlabelled as group A and 50 patients were under went total abdominal hysterectomy and labelled as group B. It wasseen that intraoperative complications and postoperative complications were less in group A patients and operating time is also less with group A patients when compared with group B patients. Conclusions: From the present study, it was concluded that NDVH is associated with less blood loss during surgery, quicker recovery, and early mobilization, less operative and less postoperative morbidity when compared to TAH. NDVH is a less invasive technique with shorter hospital stay and faster convalescence.

Background This study was performed to evaluate the clinical feasibility of a U-net for fully automatic uterine segmentation on MRI by using images of major uterine disorders. Methods This study included 122 female patients (14 with uterine endometrial cancer, 15 with uterine cervical cancer, and 55 with uterine leiomyoma). U-net architecture optimized for our research was used for automatic segmentation. Three-fold cross-validation was performed for validation. The results of manual segmentation of the uterus by a radiologist on T2-weighted sagittal images were used as the gold standard. Dice similarity coefficient (DSC) and mean absolute distance (MAD) were used for quantitative evaluation of the automatic segmentation. Visual evaluation using a 4-point scale was performed by two radiologists. DSC, MAD, and the score of the visual evaluation were compared between uteruses with and without uterine disorders. Results The mean DSC of our model for all patients was 0.82. The mean DSCs for patients with and without uterine disorders were 0.84 and 0.78, respectively (p = 0.19). The mean MADs for patients with and without uterine disorders were 18.5 and 21.4 [pixels], respectively (p = 0.39). The scores of the visual evaluation were not significantly different between uteruses with and without uterine disorders. Conclusions Fully automatic uterine segmentation with our modified U-net was clinically feasible. The performance of the segmentation of our model was not influenced by the presence of uterine disorders.

BACKGROUNDAdenomyosis is a benign uterine disorder where endometrial glands and stroma are pathologically demonstrated within the uterine myometrium. The pathogenesis involves sex steroid hormone abnormalities, inflammation, fibrosis and neuroangiogenesis, even though the proposed mechanisms are not fully understood. For many years, adenomyosis has been considered a histopathological diagnosis made after hysterectomy, classically performed in perimenopausal women with abnormal uterine bleeding (AUB) or pelvic pain. Until recently, adenomyosis was a clinically neglected condition. Nowadays, adenomyosis may also be diagnosed by non-invasive techniques, because of imaging advancements. Thus, a new epidemiological scenario has developed with an increasing number of women of reproductive age with ultrasound (US) or magnetic resonance imaging (MRI) diagnosis of adenomyosis. This condition is associated with a wide variety of symptoms (pelvic pain, AUB and/or infertility), but it is also recognised that some women are asymptomatic. Furthermore, adenomyosis often coexists with other gynecological comorbidities, such as endometriosis and uterine fibroids, and the diagnostic criteria are still not universally agreed. Therefore, the diagnostic process for adenomyosis is challenging.OBJECTIVE AND RATIONALEWe present a comprehensive review on the diagnostic criteria of adenomyosis, including clinical signs and symptoms, ultrasound and MRI features and histopathological aspects of adenomyotic lesions. We also briefly summarise the relevant theories on adenomyosis pathogenesis, in order to provide the pathophysiological background to understand the different phenotypes and clinical presentation. The review highlights the controversies of multiple existing criteria, summarising all of the available evidences on adenomyosis diagnosis. The review aims also to underline the future perspective for diagnosis, stressing the importance of an integrated clinical and imaging approach, in order to identify this gynecological disease, so often underdiagnosed.SEARCH METHODSPubMed and Google Scholar were searched for all original and review articles related to diagnosis of adenomyosis published in English until October 2018.OUTCOMESThe challenge in diagnosing adenomyosis starts with the controversies in the available pathogenic theories. The difficulties in understanding the way the disease arises and progresses have an impact also on the specific diagnostic criteria to use for a correct identification. Currently, the diagnosis of adenomyosis may be performed by non-invasive methods and the clinical signs and symptoms, despite their heterogeneity and poor specificity, may guide the clinician for a suspicion of the disease. Imaging techniques, including 2D and 3D US as well as MRI, allow the proper identification of the different phenotypes of adenomyosis (diffuse and/or focal). From a histological point of view, if the diagnosis of diffuse adenomyosis is straightforward, in more limited disease, the diagnosis has poor inter-observer reproducibility, leading to extreme variations in the prevalence of disease. Therefore, an integrated non-invasive diagnostic approach, considering risk factors profile, clinical symptoms, clinical examination and imaging, is proposed to adequately identify and characterise adenomyosis.WIDER IMPLICATIONSThe development of the diagnostic tools allows the physicians to make an accurate diagnosis of adenomyosis by means of non-invasive techniques, representing a major breakthrough, in the light of the clinical consequences of this disease. Furthermore, this technological improvement will open a new epidemiological scenario, identifying different groups of women, with a dissimilar clinical and/or imaging phenotypes of adenomyosis, and this should be object of future research.

Studies about prevalence of uterine pathologies in bitches are scarce. Although correlation between age and uterine disorders was documented, the most suitable age for a preventive sonographic screening has not been proposed yet. Present study aimed to estimate the eligible age for an ultrasonographic screening of uterine abnormalities in dogs. Data regarding ultrasound examination and clinical records of non-pregnant intact females were retrospectively analysed. The age of each bitch was expressed as age ratio (actual/maximum age expected for the respective breed). The cut-off age ratio was determined by a ROC curve for overall uterine abnormalities. Frequencies of different abnormalities below and over the cut-off derived from the ROC curve were calculated and statistically analysed by chi-Square and OR. Prevalence of three categories of ultrasonographic findings was as follows: cystic endometrial hyperplasia (CEH) 18%; uterine collections (UC) 10.5%; masses (M) 1.3%. By the cut-off age ratio (0.325), derived by ROC curve (AUC = 0.91; SP 84.23%; SE 79.2%; PPV 83.4%; NPV 80%), 228 cases were divided into two subgroups: bitches over (exposed group: n.83) and below cut-off (control group: n.145). All abnormalities resulted more frequent in exposed group: OR was 24.96 (p

Adenomyosis is a benign uterine disorder in which endometrial glands and stroma are pathologically demonstrated in the uterine myometrium and it is considered a specific entity in the PALM-COEIN FIGO (polyp; adenomyosis; leiomyoma; malignancy and hyperplasia; coagulopathy; ovulatory dysfunction; endometrial; iatrogenic; and not yet classified – International Federation of Gynecology and Obstetrics) classification of causes of abnormal uterine bleeding (AUB). Although it has always been considered the classic condition of multiparous women over 40 years old who have pain and heavy menstrual bleeding, diagnosed at hysterectomy, the epidemiological scenario has completely changed. Adenomyosis is increasingly identified in young women with pain, AUB, infertility, or no symptoms by using imaging techniques such as transvaginal ultrasound and magnetic resonance. However, there is no agreement on the definition and classification of adenomyotic lesions from both the histopathology and the imaging point of view, and the diagnosis remains difficult and unclear. A uniform and shared reporting system needs to be implemented in order to improve our understanding on imaging features, their relationship with pathogenic theories, and their importance in terms of clinical symptoms and response to treatment. In fact, adenomyosis pathogenesis remains elusive and not a single theory can explain all of the different phenotypes of the disease. Furthermore, adenomyosis often coexists with other gynecological conditions, such as endometriosis and uterine fibroids, increasing the heterogeneity of available data. Treatment requires a lifelong management plan as the disease has a negative impact on quality of life in terms of menstrual symptoms, fertility, and pregnancy outcome and has a high risk of miscarriage and obstetric complications.

The present study evaluated whole-body radiographs of female rabbits regarding uterine disorders.Based on radiographs of 143 rabbits, visibility, size, shape and density of the uterus, nutritional status of the animal and possible metastasis in other organs were examined. A suspected diagnosis was deduced. The radiological findings were compared with the results of the histopathological examination.Especially the nutritional status was important regarding the visibility of the genital tract. In 99 of the 130 visible uteri (76.2 %), a pathological alteration was detected. Thereof, endometrial hyperplasia was most frequently seen (63.6 %), followed by neoplasia (altogether 42.4 %, 39.4 % of these with adenocarcinoma), endometritis (35.4 %) and other diseases (18.2 %). Forty-six rabbits showed only one disease, 42 rabbits had two, 10 rabbits three and one rabbit four different diseases. Among 13 of the 143 uteri that were not visible in the radiograph four were altered pathologically. In 31 of the 130 rabbits with a visible uterine region (21.7 %) the uterus was unaltered. Visualising the uterus proved impossible in two of four skinny rabbits (2.8 %), whereas in all 39 obese rabbits the uterus was visible. Only in one of the four skinny rabbits was the uterus without pathological findings and six of the 39 obese rabbits showed no pathological alteration, visibility notwithstanding. Calcification indicated a tumourous occurrence in 23 of 53 cases. Except for one rabbit, the mineralised neoplasia was an adenocarcinoma (n = 22). Five animals with calcification in the uterine region showed no abnormalities. Of these, the calcification of four animals was no longer existent in the radiograph after ovariohysterectomy. Neoplastic changes in the uterus did not always show calcification. In 20 of the 44 patients with uterine neoplasia no calcification was seen. Changes in uterine size occurred in 118 of the 143 rabbits (82.5 %) and alteration of the uterine shape in 109 of the 143 rabbits (67.1 %).Thus, the above presented parameters - especially size, shape and mineralisation - are very important regarding uterine diseases.Überprüfung von Übersichtsröntgenaufnahmen weiblicher Kaninchen hinsichtlich Uteruserkrankungen.Anhand der Röntgenbilder von 143 Kaninchen wurden Darstellbarkeit, Größe, Form und Dichte des Uterus, Ernährungszustand des Tieres sowie mögliche Metastasen in anderen Organen beurteilt. Daraus wurde eine Verdachtsdiagnose abgeleitet. Die röntgenologischen Befunde wurden anhand der Ergebnisse der histopathologischen Untersuchung überprüft.Bei 99 von 130 sichtbaren Uteri (76,2 %) war eine pathologische Veränderung feststellbar. Darunter lag die endometriale Hyperplasie am häufigsten vor (63,6 %), gefolgt von Neoplasien (gesamt 42,4 %, 39,4 % davon Adenokarzinome), Endometritis (35,4 %) und anderen Erkrankungen (18,2 %). 46 Kaninchen zeigten lediglich eine Erkrankung, 42 Kaninchen hatten zwei, 10 Tiere drei und ein Kaninchen vier Veränderungen der Gebärmutter. Von den 13 nicht im Röntgenbild visualisierbaren Uteri der insgesamt 143 Kaninchen waren vier pathologisch verändert. Bei 31 der 130 Kaninchen (23,8 %) mit röntgenologisch erkennbarem Uterusbereich wurde das Organ histopathologisch als unverändert befundet. Bei zwei der vier mageren Tiere (2,8 %) gelang eine Visualisierung des Uterus nicht, während der Bereich des Uterus bei allen 39 adipösen Tieren erkennbar war. Nur bei einem der vier mageren Tiere ergab die histopathologische Untersuchung einen unauffälligen Uterus und bei sechs adipösen Tieren wies das Organ trotz Erkennbarkeit keine pathologische Veränderung auf. Verkalkungen deuteten in 23 von 53 Fällen auf ein tumoröses Geschehen hin. Mit Ausnahme eines Falls handelte es sich dabei um ein Adenokarzinom (n = 22). Fünf Tiere mit verstärkter Mineralisation in der Uterusregion waren in der pathologischen Untersuchung unauffällig. Bei vier dieser Kaninchen war die Verkalkung in postoperativ angefertigten Röntgenaufnahmen nicht mehr sichtbar. Bei 20 der 44 Patienten mit Uterusneoplasie zeigten sich im Röntgenbild keine Kalzifizierungsherde im Organ. Größenveränderungen des Uterus traten bei 118 der 143 Kaninchen auf (82,5 %), Formabweichungen bei 109 der 143 Tiere (67,1 %).Anhand der Beurteilung der oben dargestellten Parameter des Uterus – insbesondere Größe, Form und Verkalkung – ist ein guter Hinweis bezüglich einer Uteruserkrankung zu gewinnen. Eine vollständige Darstellbarkeit des Uterus ist die Voraussetzung für eine komplette Beurteilung.

We present a case of rudimentary horn pregnancy in the 18th gestational week with fetal demise and treatment failure. After failure in pregnancy termination, the patient was admitted to a tertiary care hospital. Following laparatomy, a definitive diagnosis was confirmed. Laparotomy was performed to remove the rudimentary horn and ipsilateral fallopian tube. Overall, physicians should be cautious about the risk of uterine disorders in the event of several failures in terminating pregnancy.

Llamas and alpacas are important production animals in South America, with increasing interest in other parts of the world. Poor reproductive efficiency combined with several unique anatomical and physiological reproductive features offer challenges in the diagnosis and treatment of infertility in camelids. This review presents an approach to the clinical investigation and common causes of infertility and subfertility in the male and female. The selection of males for breeding should be made based on complete evaluation to eliminate congenital and possibly hereditary disorders. Common disorders of the male reproductive system include testicular hypoplasia, testicular and epididymal cysts and testicular degeneration. Semen evaluation presents some challenges owing to the viscous nature of the ejaculate in these species. Females should be screened for congenital genital defects before breeding. Causes of subfertility in the female are dominated by ovarian and uterine disorders. A systematic clinical approach and the use of endometrial biopsy and advanced techniques, such as laparoscopy, allow early identification of these disorders. Further research is needed for continued understanding of the reproductive pathological processes in these species.

Adenomyosis was the main topic in the 2016 Society of Endometriosis and Uterine Disorders (SEUD) Congress. Latest evidence in endometriosis and other uterine disorders, such as fibroids and abnormal uterine bleeding (AUB) were also covered. About 106 oral communications, practical sessions, and debates on etiology, pathogenesis, diagnosis and treatment of the different themes were presented. Posters on the same topics were on view. Live surgical sessions and video sessions were also held. Six “tips and tricks” sessions in endometriosis and uterine disorders were scheduled at the beginning of each day throughout the congress. Monographic own-language sessions comprising Canadian, Spanish, Asian, Russian and Latin American participants were held with presenters contributing their own vision of the congress topics. Finally, the congress ended with a patient session: dedicated to those who are affected by endometriosis: pain, quality of life, sex-life, and environment were issues covered by specialists and the testimonies of the patients also had their place in the congress.

Dysmenorrhoea is considered to be caused by excessive levels of prostaglandins, which stimulate abnormal uterine contractions. This study aimed to investigate the modulatory effects of quercetin that is a main flavonoid in onion on uterine contractility and its possible underlying mechanisms. In vitro and in vivo contractile activities of the uteri were determined using uterine horns isolated from adult rats. The results indicated that (1) for contractions induced by PGF2α-, oxytocin-, and carbachol, quercetin showed the most potent suppressing effect among the tested flavonoids; (2) Ca2+-dependent uterine contractions were inhibited by quercetin; (3) quercetin reduced the PGF2α-elicited Ca2+ responses in human uterine smooth muscle cells; (4) quercetin inhibited uterine contractions stimulated by Ca2+ channel activator and depolarisation in response to high K+; (5) quercetin was able to block Ca2+ influx through voltage-operated Ca2+ channels in plasma membrane; and (6) quercetin effectively reduced PGF2α-induced contractions through the administration of increasing doses of 10, 25, and 50 mg/kg in rats. The present findings suggest that onion's major active compound, quercetin, may be a potential adjuvant for treating uterine disorders.

Thin endometrium (TE) is a heterogeneous uterine disorder characterized by TE that results in infecundity. Patients with TE are usually associated with menstrual abnormalities and suffer from pelvic pain. A number of treatments have been employed to promote endometrial growth, but none has been validated effective. With the development of stem cell therapy, better means for TE treatment to improve endometrium, thus restoring its function become possible. Studies in TE mouse models have shown that stem cell implantation could improve pregnancy. However, the efficiency is relatively low and the safety for its clinical applications remains unclear. Here, we summarize recent progresses on the clinical application of stem cells for TE treatment, which would provide valuable references for stem cell therapy in TE patients.

Reproductive diseases, mainly endometritis, are important hurdles in cattle raising, In the current study we evaluated gross, bacteriological, cytological, and histological findings from selected sites of the genital from 23 slaughtered cows and tested whether there is an association between these findings and the probability of reaching a reliable diagnosis. The results from the examinations of macroscopic aspects of uterine secretions, the cytological, bacteriological, and histopathological findings were then correlated. There was no significant correlation (P>0.05) of the statistical data from different parts of the genital tract. Trueperella pyogenes and Escherichia coli were isolated from the vagina in 3/23 cases. In only 2/23 samples Enterococcus faecalis and a gram-negative, oxidase-positive bacteria were isolated from the cervix uteri. Only Staphylococcus epidermidis, in 1/23 case, was isolated from the uterus. Histopathological findings in uterus from samples of Groups II (moderate lesions) and III (severe lesions) did not translated in grossly visible changes. Samples from reproductive tracts with secretion in the vagina and cervix uteri had no detectable changes in the other parameters analyzed from this portion. Uterus with positive bacterial culture had evidence of ascendant inflammation judging by the high granulocyte count in the three analyzed portions. This study reinforces that vaginitis and cervicitis in the cow diagnosed only by clinical examination does not reflect the real status of the uterine health. For this reason, treatment of uterine disorders should be conducted based on reliable tests to determine the appropriate therapy for each situation. RESUMO: Doenças reprodutivas causam altas perdas econômicas nos rebanhos bovinos, sendo a endometrite uma das alterações mais relevantes. Os objetivos desta pesquisa foram avaliar a associação dos achados fisiopatológicos em exames macroscópicos, bacteriológicos, citológicos e histopatológicos nas porções do trato genital de 23 vacas abatidas, bem como avaliar a necessidade de associação destes exames para efetuar diagnóstico fidedigno. A avaliação macroscópica da secreção, os exames histopatológico, citológico e as bactérias identificadas foram correlacionados. Não houve associação (P>0,05) dos resultados nas diferentes porções do trato genital. Na vagina foram isoladas as bactérias Trueperella pyogenes e Escherichia coli. Na cérvix, em apenas 2/23 (8,6%) amostras isolou-se Enterococcus faecalis e gram negativo oxidase positiva. No útero houve isolamento apenas da bactéria Staphylococcus epidermidis. As amostras histopatológicas classificadas em grupo II e III não apresentaram alterações detectadas no exame macroscópico. As amostras com secreção não fisiológica na vagina e cérvix não apresentaram alterações nos outros exames na porção uterina. A amostra com cultura bacteriológica positiva no útero demonstrou uma infecção ascendente através da alta contagem de granulócitos nas três porções analisadas. O presente estudo reforça o conceito de que a vaginite e cervicite diagnosticadas pelo exame clinico na vaca não retratam o real status da saúde uterina e por esta razão, o tratamento do útero deve ser conduzido com critério, alicerçado nos exames complementares para definir a terapia adequada para cada situação.

Post-partum uterine disorders and reproductive tract infections cause ovarian dysfunction and infertility. Histone deacetylases (HDACs) prevent the relaxation of chromatin, and positively or negatively regulate transcription. Hence, HDACs play a pivotal role in altering the gene expression that impact different signalling pathways underling ovarian dysfunction. Thus, HDAC inhibitors (HDACi) may act as potential therapeutic targets in the treatment of an array of disorders impacting ovarian function.

Objectives: To evaluate the efficacy of three-dimensional transvaginal sonography (3D-TVS) in diagnosis of uterine cavity abnormalities among infertile women. Methods: This was a cross-sectional study at Royan Institute, Tehran, from April 2012 and March 2013. All infertile women who were booked for hysteroscopy during this period of time were recruited in the study. Patients underwent preoperative 3D-TVS by an expert radiologist and hysteroscopy was performed by an expert surgeon. Patients history, 3D-TVS findings and hysteroscopy results were assessed to collect data. Agreement between sonography findings and hysteroscopy results, sensitivity, specificity, positive and negative predictive values, and efficacy of 3D-TVS in diagnosis of congenital and acquired uterine disorders were calculated by SPSS18 software using Cross-tabs, Kappa test, and other statistic analysis. Results: Totally, 153 women were recruited in the investigation. Patients aged 30.78 4.79 years in average and the duration of infertility was 4.2 2.91 years among them. Uterine abnormalities were grouped as congenital and acquired. Overall efficacy of 3D TVS in diagnosis of uterine disorders was calculated 92.8% with Kappa value of 82.3, indicating a good agreement between ultrasound findings and hysteroscopy results. Efficacy of 3D TVS in diagnosis of congenital and acquired uterine lesions was calculated 92.1% and 87.6% respectively. Conclusions: Our study demonstrated that 3D TVS has a good efficacy and reliable agreement with hysteroscopy in diagnosis of uterine lesions among infertile women. Therefore, it can decrease the number of diagnostic hysteroscopies.

Operative hysteroscopy in a hospital setting has revolutionized surgical treatment of benign uterine disorders. It is minimally invasive, cost- and time-effective, and may spare patients major surgical interventions. Operative hysteroscopy in a day-case hospital setting is regarded as a safe and well-tolerated procedure with low complication rates. However, prevention of adverse events is crucial in daily practice to optimize patient care. Complications in operative hysteroscopy can be divided into early complications, including bleeding, uterine perforation, infection and fluid overload, or late complications and suboptimal outcomes, such as incomplete resection and intrauterine adhesions. Awareness and knowledge of management of adverse events as well as the use of possible preventative measures will increase the quality and safety of hysteroscopic surgery. The present commentary focuses on these issues as an up-to-date basis for everyday clinical practice.

Objectives Sonoelastography is an ultrasound-imaging technique that measures tissue strain. The aim of this study was to define, in a systematic manner, specific sonoelastographic characteristics of the myometrium, fibroids and adenomyosis, to evaluate the feasibility of sonoelastography in patients with suspected gynecological pathology and to compare the results with histology and/or magnetic resonance imaging (MRI)-based diagnoses. Methods We performed a prospective observational cohort study between 2009 and 2011. Two-hundred and eighteen women with suspected gynecological pathology underwent routine transvaginal ultrasound and additional real-time sonographic elastography. Sixty-nine of the 218 women underwent MRI and/or histological examination and were included in the final analysis. Acquisition of elastographic images was standardized. We analyzed the elastographic characteristics of myometrium, fibroids and adenomyosis. An independent observer, unaware of clinical, histological or MRI findings, evaluated the recorded elastographic images and cineloops. These elastographic-based diagnoses were compared with histology and/or MRI diagnoses. Results With elastography, the uterus was well delineated from the surrounding bowel. The myometrium was uniform in color in 49% of the cases, with a main color of purple or dark blue, indicating stiffer tissue. Fibroids and adenomyosis had different elastographic characteristics and different color patterns. In general, fibroids were darker and adenomyosis was brighter than adjacent myometrium. The agreement between elastography-based diagnosis of fibroids and adenomyosis with MRI-based diagnosis was excellent; with histology-based diagnosis, agreement was substantial for fibroids and adenomyosis. Conclusions Elastography is able to identify clear discriminating characteristics of the uterus, fibroids and adenomyosis, and elastography-based diagnoses are in excellent agreement with those of MRI. Agreement between elastography-based diagnosis of adenomyosis and histology is substantial but not optimal. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd.

New Findings What is the topic of this review? How do medicinal plants act on the myometrium? What are the underlying mechanisms whereby medicinal plants exert their effects? What advances does it highlight? We show that medicinal plants can affect uterine contraction at many loci. These studies give us a better understanding of how medicinal plants work on the uterus and can be applied in other areas of smooth muscle physiology, as well as pharmacy and medicine. This knowledge is also useful for developing new agents with potential to improve women's reproductive and gynaecological heath. This report summarizes work investigating the effects of some medicinal plants on uterine contraction. As there is a clinical need to find better drugs to help control uterine activity, and novel compounds are sought, the mechanisms whereby the medicinal plants exert their effects, as well as their major compounds, are discussed. By identifying the plants, major constituents and mechanisms, this review also illustrates the potential for development of new drugs, so that better ways to treat uterine disorders will be available to women worldwide.

Background: Uterine disorders are common postpartum diseases in dairy cows. In practice, uterine treatment is often based on systemic or locally applied antimicrobials with no previous identification of pathogens. Accurate on-farm diagnostics are not available, and routine testing is time-consuming and cost intensive. An accurate method that could simplify the identification of uterine pathogenic bacteria and improve pathogen-specific treatments could be an important advance to practitioners. The objective of the present study was to evaluate whether a database built with uterine bacteria from European dairy cows could be used to identify bacteria from Argentinean cows by Fourier transformed infrared (FTIR) spectroscopy. Uterine samples from 64 multiparous dairy cows with different types of vaginal discharge (VD) were collected between 5 and 60 days postpartum, analyzed by routine bacteriological testing methods and then re-evaluated by FTIR spectroscopy (n = 27). Results: FTIR spectroscopy identified Escherichia coli in 12 out of 14 samples and Trueperella pyogenes in 8 out of 10 samples. The agreement between the two methods was good with a Kappa coefficient of 0.73. In addition, the likelihood for bacterial growth of common uterine pathogens such as E. coli and T. pyogenes tended to increase with VD score. The odds for a positive result to E. coli or T. pyogenes was 1.88 times higher in cows with fetid VD than in herdmates with clear normal VD. Conclusions: We conclude that the presence of E. coli and T. pyogenes in uterine samples from Argentinean dairy cows can be detected with FTIR with the use of a database built with uterine bacteria from European dairy cows. Future studies are needed to determine if FTIR can be used as an alternative to routine bacteriological testing methods., Facultad de Ciencias Veterinarias

Aims: This study aims to determine the frequency of near-miss obstetric events and analyze its nature such as reasons for near-miss, organ dysfunction associated and critical management required among pregnant women managed over a 3-year period in a Tertiary Care Teaching Hospital in Nepal. Methods: This hospital based prospective, descriptive study was done from August 2011 to February 2015. Case eligibility was defined by WHO Near-Miss Guidelines. Medical records of the patients and the interview with the patient, accompanying family members and health workers from referral centres were used to generate the data which were filled in the pre-designed questionnaire. The data generated and analyzed included age and gestation weeks, parity, mode of intervention, associated organ dysfunctions, reasons for near-miss and critical intervention accompanied to manage the near-miss cases. Results were presented in mean ± SD and percentages, wherever applicable. Results: There were 4617 deliveries with 28 near-miss cases. The major factors contributing near-miss events were obstetric haemorrhage followed by hypertensive disorder. Three fourth (n=21) of cases required blood transfusion and almost all cases (n=26) required ICU management. Coagulation disorder was observed in majority of cases (n=23) followed by cardiovascular, respiratory and uterine atony. Conclusions: In this study, maternal near-miss event was mainly attributable to obstetric haemorrhage followed by hypertension and sepsis. Major organ-system disorders observed were coagulation disorder, cardiovascular, respiratory and uterine disorders. Almost all the cases were managed in ICU and majority of them required blood transfusion.

Postpartum uterine infections result from uterine contamination with bacteria during parturition. The uterine infection implies adherence of pathogenic organisms to the mucosa, colonization or penetration of the epithelium, and release of bacterial toxins that lead to establishment of uterine diseases. Treatment of endometritis with parenteral or intra-uterine infusion of the antibacterial agents and antibiotics have met with varying degree of success but inconsistence of recovery rate, high cost of treatment, milk disposal after antibiotic therapy, immergence of microbial resistance are obvious disadvantage of their use. They also markedly destroy the phagocytic activity of polymorphonuclear leucocytes, which are responsible for maintaining non-specific uterine defence. So, there is urgent need to find out an alternative therapy for treatment of uterine infections by activation of natural defence mechanism in the uterus. Prospects in use of certain non-specific immunomodulators in routine therapeutic protocol for endometritis and other uterine disorders is reviewed in present studies.

Peptides and neuropeptides influence the uterine disorders of healing or cicatrization, chronic pelvic pain and disorder of pregnancy, labor and puerperium. They also promote changes in the lower uterine segment (LUS) during pregnancy, labor and delivery. We investigated the tissue quantity of neurotensin (NT), neuropeptide tyrosin (NPY) and Protein Gene Product 9.5 (PGP 9.5) in women submitted to elective cesarean section (CS) and urgent CS. During surgery, authors biopsied tissue samples of vesico-uterine space (VUS) to detect nerve fibers, and compared them. VUS samples from 106 patients have been evaluated with light microscopy, immunochemistry and Immunohistochemistry, and finally by Quantimet Leica analyzer software. Significantly higher amount of nerve fibers, containing NT, NPY and PGP 9.5 have been found in VUS tissue samples obtained during the first elective CS and during the first urgent CS were respectively 5±0.7, 7±0.6 and 5±0.9 CU and 2.5±0.5, 3.6±0.4 and 3.5±0.9 CU (p

Phosphatase and tensin homolog (PTEN) deletion induces uterine pathology, whereas androgen actions via androgen receptor (AR) support uterine growth and therefore may modify uterine cancer risk. We hypothesized that the androgen actions mediated via uterine glandular epithelial AR could modify PTEN deletion-induced uterine pathology. To test our hypothesis, we developed uterine glandular epithelium-specific PTEN and/or AR knockout mouse models comparing the uterine pathology among wild-type (WT), glandular epithelium-specific AR inactivation (ugeARKO), PTEN deletion (ugePTENKO), and the combined PTEN and AR knockout (ugePTENARKO) female mice. The double knockout restricted to glandular epithelium showed that AR inactivation enhanced PTEN deletion-induced uterine pathology with development of intraepithelial neoplasia by 20 weeks of age. In ugePTENARKO, 6/10 (60%) developed intraepithelial neoplasia, whereas 3/10 (30%) developed only glandular hyperplasia in ugePTENKO uterus. No uterine pathology was observed in WT (n=8) and ugeARKO (n=7) uteri. Uterine weight was significantly (P=0.002) increased in ugePTENARKO (374±97 mg (mean±s.e.)) compared with WT (97±6 mg), ugeARKO (94±12 mg), and ugePTENKO (205±33 mg). Estrogen receptor alpha (ERα) and P-AKT expression was modified by uterine pathology but did not differ between ugePTENKO and ugePTENARKO, suggesting that its expressions are not directly affected by androgens. However, progesterone receptor (PR) expression was reduced in ugePTENARKO compared to ugePTENKO uterus, suggesting that PR expression could be regulated by glandular epithelial AR inactivation. In conclusion, glandular epithelial AR inactivation (with persistent stromal AR action) enhanced PTEN deletion-induced uterine pathology possibly by downregulating PR expression in the uterus.

Success in cattle breeding is one of the most important goals in livestock farming and it requires particular attention when it is about securing unobstructed reproduction. Final goal in cattle breeding is to produce one live calf per year, which will likewise enhance milk production through successful pregnancy. The aim of our research was to monitor uterine involution speed with aid of ultrasound device and make records when cows are ready to be inseminated again, which cows need more time to complete involution and how many cows will have uterine disorders and require therapy. The experiment was carried out from October 2009 until the end of January 2010. In our experiment 50 cows were included and 412 transrectal ultrasound examinations were performed. Cows were transrectally examined, starting from 6th day postpartum until 52 days postpartum. Speed of uterine involution has been monitored through decrease of uterine horn diameter and wall thickness. Cows with normal puerperium have completed involution in the period from 38 - 45 days postpartum, while those with abnormal puerperium needed more time to complete it or required therapy of disturbed uterine status. In total 48% of cows had normal uterine involution, 52% of cows had some abnormalities in involution and 10% of cows in experiment required therapy. With continuous monitoring of reproductive tract in cattle with ultrasound it is possible to timely detect right time for first insemination postpartum, decrease period of open days or to detect abnormalities in uterine health status and treat it.

New diagnostic approaches are required to recognize early canine hypofertility or infertility. We suggest that the identification of different cytologic types, cellular aspects, and nuclear features of the endometrial epithelial cells may be suitable for this purpose. This study was performed on the bitch (Canis familiaris) during the physiologic reproductive cycle and in uterine diseases. We also applied computerized cytomorphometry to evaluate nuclear area, perimeter, diameter, density, aspect, and roundness of endometrial epithelial cells in healthy dogs (N = 35) at different stages of the reproductive cycle (before puberty, during proestrus, estrus, diestrus, and anestrus) and in bitches affected by uterine disorders (N = 10). The stage of the estrous cycle was determined by vaginal cytology and progesterone evaluation and also confirmed by clinical and histologic observations. Samples for endometrial cytology were collected in vivo by uterine flushing with transcervical uterine cannulation. After uterine sampling, each dog underwent OHE or uterine stump revision. Cytologic analyses were compared with histologic examinations to verify the uterine condition. The uterine cellular population was represented by endometrial epithelial cells, erythrocytes, neutrophils, lymphocytes, eosinophils, macrophages, plasma cells, and cervical or incidental vaginal cells. Bacteria and amorphous material were observed. The proportion of different cells and nuclear features in the cytologic samples varied throughout the stages of the reproductive cycle and between normal and pathologic uterine conditions. The computer-assisted nuclear morphometry, performed in cytologic specimens by means of the six nuclear parameters chosen to evaluate the endometrial epithelial cell population, proved to be useful for determining the stage of the reproductive cycle. Furthermore, this system was demonstrated to be a valid support to diagnose and distinguish uterine disorders.

The medical records of 59 rabbits with uterine disorders were assessed retrospectively. Ten animals were presented because of vaginal discharge; the reasons for presentation of the remaining 49 rabbits included mammary masses, skin tumours, anorexia and poor general health. All the rabbits underwent a clinical examination, and 54 were examined by ultrasonography and/or radiography. Forty-five rabbits underwent ovariohysterectomy and the other 14 rabbits were euthanased, three because of pulmonary metastases and 11 because of very poor health unrelated to their uterine disease. The genital tracts of all the rabbits were submitted for histological examination. Endometrial hyperplasia (in 24 rabbits) and adenocarcinoma (in 18 rabbits) were the most common uterine disorders; in a further 11 cases both conditions were observed. The remaining six rabbits had other uterine disorders. Four rabbits that were presented with adenocarcinoma of the mammary gland were found to have concurrent uterine disorders. The mean age of the rabbits with endometrial hyperplasia was 4.5 years, and that of the rabbits with adenocarcinoma was 6.1 years. Four rabbits had ovarian tumours.

BACKGROUND: Endometriosis and uterine leiomyomas are leading hormone responsive, benign uterine disorders responsible for high morbidity in women of reproductive age group. A polymorphic (CAG)n repeat length located in exon 1 of the androgen receptor (AR) gene has been proposed as a risk marker for both endometriosis and leiomyomas in some ethnic groups. The present study was carried out to assess the frequency of AR (CAG)n repeat polymorphism as a risk marker for endometriosis and uterine leiomyomas in Asian indian women. METHODS: DNA was isolated from peripheral blood samples of 331 subjects, which include 90 endometriosis cases, 140 cases of leiomyomas and 101 healthy age- and sex-matched controls. PcR was carried out to amplify exon 1 of the AR gene. All the PCR amplicons were analysed initially on 2% agarose gel electrophoresis, followed by bidirectional sequencing to calculate the number CAG repeats in individuals. RESULTS: The CAG repeat ranges detected in endometriosis cases were 4–33 (mode-19) and in leiomyomas cases 5–34 (mode-20), whereas in controls it was 5–34 (mode-22). A distinct variation was observed in the three groups at 14, 18, 19, 20 and 22 (CAG)n repeats, which were statistically analyzed using chi-square and odds ratio tests. 19 CAG repeats were found to be higher in endometriosis cases (19.09%) when compared with controls (9.04%), while 20 CAG repeats were higher in leiomyomas cases (14.02%) compared to controls (6.14%). A statistically significant (P

The objectives of this study were to investigate the associations between peripheral blood neutrophil (PMN) function, energy status, and uterine health in periparturient dairy cows. Data were collected from 83 multiparous Holstein cows. Blood samples for PMN function determination were collected weekly from 1 week prior to calving (week -1) through 4 weeks after calving and again at 8 weeks after calving. Energy metabolites were measured and dry matter intake (DMI) was determined from weeks -2 to 5 to evaluate energy status of cows during the periparturient period. All cows were examined for uterine health disorders. Blood PMN killing ability was evaluated by determining myeloperoxidase activity and cytochrome c reduction activity in isolated blood PMN's. For cows that were diagnosed with puerperal metritis and subclinical (SC) endometritis and puerperal metritis, blood PMN functions were significantly (P

Although the incidence of uterine disorders in pet rabbits is high there are only a few retrospective studies and case reports on genital tract disease in female rabbits. Uterine disorders were assessed in 50 pet rabbits. In 31 pet rabbits with suspected clinical uterine disease, medical records were further reviewed regarding clinical signs, diagnostic workup, treatment as well as the outcome itself. Uterine adenocarcinoma (54%) was most frequently diagnosed, followed by endometrial hyperplasia (26%). Serosanguineous vaginal discharge was the predominant clinical sign observed by the rabbit owners. In approximately 50% of the rabbits with suspected uterine disorders, abdominal palpation revealed enlarged and/or irregular masses in the caudoventral abdomen indicating uterine lesions. Out of 23 rabbits undergoing ovariohysterectomy, four were either euthanized or died shortly after surgery because they were clinically unstable. Overall, 80% of the ovariohysterectomized animals were still alive 6 mo after surgery. In female pet rabbits that are not breeding, either ovariohysterectomy should be performed at an early age or routine checks including ultrasonography of the abdomen are recommended on a regular basis.

This study was conducted to define the characteristics of the uterus of reproductively failed pigs by transcutaneous ultrasonography (SONO) in order to investigate the appropriateness of SONO to diagnose presumptive uterine disorders. Zearalenone (ZEA) is known to affect uterine function and causes endometrial liquid accumulation and was also determined. In 33 sows and 14 gilts, of unknown reproductive stages and culled for failing to conceive, the uterus was scanned transcutaneously and the females slaughtered on the same day or the day after scanning. Parameters determined by SONO were uterine echotexture (UET; graded 1 for homogeneous to 4 for highly heterogeneous), uterine size (US; expressed as the mean sectional area of two to three cross-sections of the uterine horns given in cm2) and intrauterine content. Post mortem, the ovarian structures were assessed and females grouped accordingly into those in estrus (n=2), early diestrus (n=14), diestrus (n=15), late diestrus (n=1), anestrus (n=10) and having polycystic ovarian degeneration (n=5). The uterine weight (UW) was recorded and uterine specimens microscopically evaluated for an endometrial oedema (EO; grades 1 for none, to 4, if an oedema was clearly evident) and for immune cells to assess endometritis. Total ZEA was analysed in bile and females with >or=50 ng/ml judged as positive. The uterus could be examined in all animals. UET, US, UW and EO was found to be different between groups, and a positive correlation (P

Various uterine disorders in camelids, such as uterine infections, play an important role in reduced fertility in these species. Cytological techniques can be used to identify the presence of uterine infection. In this study 44 reproductive tracts of slaughtered female camels were examined. The reproductive phase of each tract was estimated by ovarian performance. The uterus and ovary dimensions were measured by caliper. Cytological smears were prepared from cervical mucosa and uterine fluid collected by aspiration methods. The smears were stained and examined for differential cellular counts. The results showed no significant difference (P≥0.05) for cellular densities between cervical and uterine smears. There was no significant difference (P≥0.05) for cellular densities between cervix and uterus in different phases of anestrus, estrus cycle (follicular and luteal phases), and pregnancy. Therefore, in dromedary camel, cervical smears may be used for evaluation of uterine condition. However, more work is required on live and synchronized camels before the importance of these findings can be assessed.

Color Doppler sonography (CDS) of uterine disorders has clinical applications for the evaluation of uterine fibroids, polyps, and vascular malformations. This review describes and illustrates these applications as well as the use of 3D CDS.

The present study was designed to investigate the possible modulator effect of melatonin on uterine estrogen and progesterone receptors in rats as well as the uterine response to oxytocin. Non-pregnant rats were pretreated with melatonin in a dose of 0.8 mg kg(-1) per day for 15 consecutive days. Control animals received the vehicle. The uterus was dissected out and uterine contraction in one horne was recorded in vitro for each animal as a response to oxytocin (0.5 x 10(-11) to 2 x 10(-11)M). The other uterine horne was subjected to estrogen and progesterone receptors detection by immunohistochemical and image analysis techniques. The results reveal a significant reduction (59%) in the number of uterine estrogen receptors with concomitant increase in the progesterone receptors (53%) in melatonin-pretreated rats as compared to the control ones. In addition, our data show an inhibitory effect of melatonin on the uterine contraction as a response to oxytocin (0.5 x 10(-11), 1 x 10(-11), and 2 x 10(-11)M) amounting to 48, 77, and 59.5% reduction, respectively, in the amplitude of contraction as well as 62, 19.9, and 47% reduction in the area under the curve (AUC) of uterine contractions, respectively. The data, so far obtained, may indicate a possible relationship of melatonin-induced modulation of the number of estrogen and progesterone receptors and its inhibitory effect on uterine contraction. These findings merit further investigations on the possible beneficial role of melatonin in a plethora of hormone-dependent uterine disorders.

Although ultrasound (US) is the primary imaging modality of choice in the radiologic evaluation of the female patient with acute pelvic pain, the role of computed tomography (CT) in the evaluation of abdominal and pelvic pain continues to expand. CT may be performed if a gynecologic disorder is not initially suspected, if US findings are equivocal, or if the abnormality extends beyond the field of view achievable with the endovaginal probe and further characterization of pelvic disease is required. Many gynecologic disorders that cause acute pelvic pain (eg, uterine disorders, ovarian disorders, endometriosis, pelvic inflammatory disease, postoperative or postpartum complications) demonstrate characteristic CT findings. Familiarity with these CT appearances is important: It will allow the radiologist to guide appropriate treatment of affected patients and may eliminate the need for further imaging evaluation.

Background: Hysterectomy is the most common operation performed by gynecologist, next to caesarean section. Currently, there are three main types of hysterectomy operations in practice for benign diseases-Abdominal hysterectomy (AH), vaginal hysterectomy (VH) and Laparoscopic hysterectomy (LH). Vaginal route for non-descent uterus is an acceptable method of hysterectomy. The objective of present study was to compare the operating time, intraoperative and postoperative complications between VH and TAH in non-descent uterus.Methods: The study was conducted in the Postgraduate department of Gynaecology and Obstetrics for a period of 18 months between April 2013 to October 2014 in the Government Lalla Ded Hospital - an associated hospital of Government Medical College, Srinagar; which is the sole tertiary care referral centre in the valley.Results: Over the study period 100 patients were taken, 50 patients underwent non-descent vaginal hysterectomy and labelled as group A and 50 patients were under went total abdominal hysterectomy and labelled as group B. It was seen that intraoperative complications and postoperative complications were less in group A patients and operating time is also less with group A patients when compared with group B patients.Conclusions: From the present study, it was concluded that NDVH is associated with less blood loss during surgery, quicker recovery, and early mobilization, less operative and less postoperative morbidity when compared to TAH. NDVH is a less invasive technique with shorter hospital stay and faster convalescence.

The uterus plays a primordial role in the transport of spermatozoids. In the evaluation of the infertile patient, the uterine pathology does not occupy a principal place. As a unique factor, the uterine disorders represent only 5 % of the causes of infertility; nevertheless it can be linked to other alterations and represent an important cause in patients with frequent abortions.

This is the first study carried out to describe the role of fetal microchimerism (FM) in the pathogenesis of uterine cancer. The prevalence and concentration of male fetal microchimeric cells (FMCs) were examined in endometrial tissues in relation to subtypes of uterine cancer, and the histological grade and stage of the tumor. FM occurrence was analyzed in relation to risk factors, including hypertension, obesity, type 2 diabetes, dyslipidemia, age at cancer diagnosis, and patient pregnancy history. The prevalence and concentration of FMCs were examined in endometrial tissues using real-time polymerase chain reaction, SRY and β-globin sequences as markers for male fetal FMCs and total DNA. The studied group involved 47 type 1 endometrial cancers, 28 type 2 endometrial cancers, and 41 benign uterine diseases. While the prevalence of FM was decreased only in type 1 endometrial cancer, compared with benign uterine disorders (38.3% vs.70.7%; odds ratio [OR]=0.257, 95% confidence interval [CI]: 0.105 to 0.628, p=0.003), FMC concentrations did not differ within examined groups. The lower FM prevalence was detected in low-grade (grade 1 and grade 2) endometrioid cancer (38.3% vs. 70.7%, OR=0.256, 95% CI: 0.105 to 0.627, p=0.003) and in FIGO 1 tumors (40.7% vs. 70.7%, OR=0.285, 95% CI: 0.120 to 0.675, p=0.004). No correlation between FM prevalence or FMC concentrations and risk factors was demonstrated. A lower prevalence of male FM seemed to be associated with better prognoses in uterine cancer based on tumor subtype, histological grade, and stage of the tumor.

Ovarian cysts are nonfunctional, fluid-filled cysts that develop spontaneously near the ovaries throughout the female guinea pig's reproductive cycle, reducing fertility in females older than 15 months and causing potentially serious uterine disorders. Permanent treatment requires ovariohysterectomy or ovariectomy. This article reviews the clinical signs, diagnosis, histopathology, treatment (including hormonal therapies), surgery, and postoperative care.

Uterine disorders like usual infertility factors (male factor, ovarian and tubal problems of women) may affect the outcome of infertility treatment in infertile patients. In our clinical trial, 110 couples diagnosed with infertility were candidate for intra uterine insemination (IUI). The patients were divided randomly into two equal groups (n = 55): In group one (control group), patients without hysteroscopy underwent ovulation induction by clomiphene citrate and hCG followed by intrauterine insemination. The second group (experiment group), patients were undergoing hysteroscopy before intra uterine insemination on the day 21 of the cycle and due to abnormal findings, going under surgical treatment if they needed. The rates of pregnancy complications in patients were evaluated. The age, BMI, kind of infertility, duration of infertility, number of previous trial, duration of stimulation, the type of procedures used and semen analysis (TMC, Motility and morphology of sperm) were similar for both groups and no statistically significant differences emerged at all between them. In experimental group, hysteroscopy revealed pathology in the uterine cavity in 26 out of 55 cases. The overall rates of clinical pregnancy were higher in experimental group compared to the control group. The findings from this study showed that the use of hysteroscopy as a diagnostic or therapeutic procedure before IUI, can increase the rate of pregnancy and finally decrease the failure rate of infertility treatment and perinatal complications in infertile couples.

Vaginal sildenafil citrate (Viagra, Pfizer, Inc., New York, NY) has been shown to be useful in increasing endometrial thickness and achieving pregnancy in women with varied uterine disorders. However, it failed to demonstrate favorable results in the setting of Asherman's syndrome, a condition characterized by the presence of uterine synechiae. We have successfully applied this treatment in two women noted to have inadequate endometrium after surgical resection of uterine synechiae. Both patients had a history of a postpartum uterine curettage with subsequent secondary infertility. Asherman's syndrome was surgically demonstrated and treated in both patients. Postoperatively, both patients were noted to have a thin endometrium and failed to conceive despite fertility treatment. Subsequently, these women achieved pregnancy in the first treatment cycle with vaginal sildenafil citrate. Using transvaginal ultrasound, endometrial thickness was noted to improve when sildenafil citrate was administered. It is suspected that this medication causes selective vasodilatation, resulting in improved endometrial development.

Objective This study is intended to clarify the significance of different types of intrafascial hysterectomies in comparison to classical hysterectomy techniques in cases of benign uterine disorders. Design A comparison of six types of hysterectomy, performed for benign indications, as transabdominal, vaginal or intrafascial hysterectomy which were carried out in our Department of Obstetrics and Gynecology between 1993 and 1994. Subject and intervention 368 women who underwent hysterectomies for benign disorders at the University of Kiel. Of these, 58.7% were performed either by pelviscopic or by laparotomic classic intrafascial supracervical hysterectomy (CISH). Of the remaining, 14.8% were performed by abdominal hysterectomy, 13.6% by intrafascial vaginal hysterectomy (IVH), 12.2% by vaginal hysterectomy (VH), and only 0.05% by laparoscopic-assisted vaginal hysterectomy (LAVH). Measures Comparative data of these six surgical techniques, concerning patient characteristics, indications for operation, histological features, blood loss, operating time, hospital stay, uterine weight and postoperative analgesia, are described. Results and conclusions Although no striking advantages of the three intrafascial supracervical hysterectomy techniques described became evident, the operating time of the new procedures was a little shorter than the conventional ones as was the postoperative convalescence time, and the techniques, although new, could compare well with to 50 years of experience with abdominal and vaginal hysterectomy.

Clinical endometritis (CE) is a common uterine disorder in high producing dairy cows that negatively impacts reproductive performance, thus diminishing profitability and sustainability. Reducing pathogenic bacteria load and uterine inflammation while enhancing immune defense are the general principle for endometritis therapy. An in vitro study has shown mannose to inhibit the adhesion of bacteria to the epithelial cells of the equine endometrium (King et al, AJVR 61:446, 2000). The use of PGF2alpha (PG) is generally recommended, but the lack of concrete experimental evidences makes it difficult to promote an effective therapy approach for CE. Therefore, the use of non-pharmaceutical antimicrobial therapy (50% dextrose in water) that targets the uterine environment rather than the bacterial pathogen itself may be a viable and cost-effective strategy for conventional and organic dairy cows. The objective of this study was to determine whether an intrauterine flushing with a hypertonic solution (50% dextrose in water) of lactating dairy cows diagnosed with CE result in comparable fertility to conventional therapy (parental ceftiofur) as opposed to non-treated CE animals (control group) and healthy cows (without CE)., American Association of Bovine Practitioners Proceedings of the Annual Conference, 2010

Much of our knowledge of human uterine physiology and pathology has been extrapolated from the study of diverse animal models, as there is no ideal system for studying human uterine biology in vitro. Although it remains debatable whether mouse models are the most suitable system for investigating human uterine function(s), gene-manipulated mice are considered by many the most useful tool for mechanistic analysis, and numerous studies have identified many similarities in female reproduction between the two species. This Review brings together information from studies using animal models, in particular mouse models, that shed light on normal and pathologic aspects of uterine biology and pregnancy complications.

The laparoscopic approach to uterine disorders requires greater skills and expertise but may be associated with longer operating times, and complications when compared to the abdominal approaches. Of the potential complications during laparoscopic hysterectomies, ureteric injures are of a major concern. We report on three ureteric injuries encountered during total laparoscopic hysterectomy and review the relevant literature.

Adenomyosis is a benign uterine disorder that causes menorrhagia and dysmenorrhea. Although it was once considered a contraindication to uterine artery embolization, several authors have examined whether adenomyosis can be treated with uterine artery embolization. This article reviews the pathophysiology of adenomyosis, its imaging characteristics, as well as recent studies evaluating the efficacy of uterine artery embolization for treatment of adenomyosis.

An epidemiological study was carried out on 2823 cows from 34 dairy herds from Goiania in the State of Goias-Brazil during 2001 to 2002. The pregnancy rate was 47.8%. In 1473 non-pregnant cows, causes of reproductive failure problems were sought. The most prevalent uterine infection was endometritis (17.0%). Uterine disorders such as partial hypoplasia of the genital system (0.04%), macerate fetus (0.01%), adhesion of ovaries (0.04%), stillbirth (0.04%), retained placenta (0.01%), cervix inflammation (0.6%) and abortion (0.88%) also were found. Uterine swabs were collected aseptically for microbiological culture. Gram positives cocci (41.3%) and Gram negatives rods (52.6%) were found, and Staphylococcus aureus and Escherichia coli were the most prevalent pathogens. Susceptibility patterns of microorganisms suggested the use of chloramphenicol, gentamicin and neomycin for antimicrobial therapy. No período de março 2001 a julho 2002 foram estudadas 2823 fêmeas bovinas, em idade de reprodução, mestiças das raças Holandesa e Gir, pertencentes a 34 propriedades da bacia leiteira de Goiânia. A taxa de prenhez foi 47,8%. Entre os animais não gestantes (n= 1473), 17% apresentaram alterações inflamatórias do útero. Outras anormalidades encontradas foram: aplasia parcial do sistema genital (0,04%), feto macerado (0,01%), ovário aderido (0,04%). Casos de natimortalidade (0,04%), retenção placentária (0,01%) e cervicite (0,6%) e taxas de abortos (0,88%) também foram registrados. Cocos Gram positivos (41,3%) e bastonetes Gram negativos (52,6%) foram os microrganismos mais isolados, sendo Staphylococcus aureus e Escherichia coli os principais patógenos encontrados nas infeccções uterinas. Testes in vitro mostraram que esses microrganismos apresentaram maior susceptibilidade frente ao cloranfenicol, à gentamicina e à neomicina.

Objective To compare the morbidity of vaginal hysterectomy in obese and non-obese women in a single institution. Design Obese and non-obese women with benign uterine disorders matched for age, parity and race underwent vaginal hysterectomy without laparoscopic assistance. Peri-operative outcome complications were compared. Thirty-eight women had a BMI over 30 kg/m2 (study group) and 178 women had a BMI below 30 kg/m2 (control group). Setting Gynaecologic department of a university hospital. Population Women who were referred to our department with an indication of vaginal hysterectomy for benign disorders. Methods Case control study. Main outcome measures Peri-operative complications, the fall in the haemoglobin concentration, the duration of the procedure, the length of the hospital stay and uterine weight were analysed. Results Mean BMI was 33.2 and 23.7 kg/m2 in the study and control groups, respectively. None of the obese women had severe co-morbidity contraindicating surgery. There were no significant differences in surgical or anaesthetic risk factors, including parity, hormonal status, pre-existing disease and estimated mean uterine weight. The overall complication rates were 14% and 16% in the obese and non-obese groups, respectively (P= 0.7). Obesity did not increase the duration of the procedure (48 [7] minutes vs 50 [10] minutes, P= 0.1) or the length of hospitalisation (5.8 [1.4] days vs 5.5 [1.2] days, P= 0.2). Conclusion Vaginal hysterectomy can be successfully performed, with acceptable morbidity, in obese women.