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Reconstructive and Reproductive Surgery in Gynecology 2nd Edition Volume 2 PDF

Reconstructive and Reproductive Surgery in Gynecology 2nd Edition Volume 2 PDF Free Download: Gynecological Surgery

Reconstructive and Reproductive Surgery in Gynecology 2nd Edition Volume 2 PDF Free Download
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Key points
•• Surgical management of Müllerian anomalies has been revolutionized by imaging, and the development of hysteroscopic and laparoscopic surgical techniques that have rendered laparotomic management infrequent, and office hysteroscopic management of selected anomalies a reality.
•• The CONUTA system of classification provides increased granularity allowing for more accurate descriptions of Müllerian anomalies affecting the uterine corpus, particularly when they affect the cervix and the vagina.
•• For women with Mayer–Rokitansky–Kuster–Hauser syndrome (CONUTA U5-C4-V4) the success rate of the patient self-administered “Frank technique” is about 85%–90%.
•• For those with vaginal agenesis for whom the Frank technique isn’t feasible or successful, there exist other procedures, such as the Vecchietti and Davydov procedures that can be performed under laparoscopic guidance without the need for skin grafting.
•• Isolated cervical agenesis (CONUTA U0-C4-V0 or V4) has been treated with procedures linking the corpus to the existing or artificially created vagina, but study sample sizes are small, and there is inadequate reporting of pregnancy outcomes to allow for meaningful counseling of patients.
•• The unicornuate uterus and variants, CONUTA U4-C3 (rAFS Class IIb), are often associated with abnormalities of the urinary tract, such as unilateral renal agenesis, and can be treated with laparoscopically directed removal of the underdeveloped or obstructed uterine horn.
•• Uterus didelphus, which is CONUTA U3b-C2 (rAFS Class III) and rAFS Class VI (there is no corresponding CONUTA designation) generally require no surgical or medical intervention to deal with symptoms or to improve pregnancy outcomes.
•• The bicornuate uterus, CONUTA U3a-C0 (rAFS IV a/b), can be treated expectantly, or with Strassman metroplasty with hysterotomy and unification of the two endometrial cavities.
•• The septate uterus, CONUTA U2-C0/1 (rAFS Va/b), can generally be treated with hysteroscopically directed transection of the septum.
Reconstructive and Reproductive Surgery in Gynecology 2nd Edition Volume 2 Free Download, Reconstructive and Reproductive Surgery in Gynecology 2nd Edition Volume 2 PDF Ebook Free