Menelik MH Lee, MBBS, MRCOG, FHKCOG, FHKAM; Charles J Carter, MBChB, FRCS(urol); Tyrone T Carpenter, MBBS, BSc, MRCOG, MD, 20140601000000
Laparoscopic partial cystectomy is established as the optimal treatment of full thickness bladder endometriosis. Complete excision of the lesion is essential however over excision risks unnecessary reduction in bladder volume and may risk ureteric obstruction. The following case demonstrates a new technique of cystoscopic mapping and laparoscopic resection of bladder endometriosis, allowing complete removal of the endometriotic nodule while sparing maximum bladder capacity and minimising risk of injury to the ureteric orifices.
Krukenberg tumour is a metastatic signet ring cell adenocarcinoma of the ovary. This tumour is uncommon, accounting for 1–2% of all ovarian tumours. The stomach is the primary site in most Krukenberg tumour cases (70%), and the prognosis is generally poor. We report a case of a pregnant lady who was incidentally found to have a large ovarian mass during caesarean section which was later confirmed to be a Krukenberg tumour.
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Over the past few decades, there has been widespread concern about the increasing proportion of births born by caesarean delivery. The rising rate of primary caesarean section has led to the increased number of obstetric population with a history of prior caesarean delivery. Although this group of women may be offered planned vaginal birth after previous caesarean section (VBAC) or elective repeat caesarean section (ERCS), the VBAC rate is generally low particularly in well-developed countries. In the United States, the VBAC rate has decreased to 8.5% by 2006, while the total caesarean rate has increased to 31.1%.1
Tumor necrosis factor (TNF)-α inhibitors are commonly used in the treatment of inflammatory bowel disease (IBD), but the effects of these agents on pregnancy outcomes remain unclear. Now, a systematic review of the English literature has indicated that they pose little risk to the mother or her infant, even if use is continued through the third trimester.