• Clinical and Experimental Reproductive Medicine
• /
• v.16 no.1
• /
• pp.57-68
• /
• 1989

Some infertile patients who need IVF-ET for conception have small ovarian cysts diagnosed in pelvic ultrasonography. It is well known that it is impossible or very difficult to perform controlled ovarian hyperstimulation(COH) for such patients because of the poor ovarian response or the possibility of ovarian hyperstimulation syndrome(OHSS). To remove or to decrease the size of ovarian cysts, estrogen and progesterone (E-P) therapy with oral contraceptives for 2 cycles and transvaginal aspiration of ovarian cysts using transvaginal ultrasonography were performed in 36 IVF-cancelled infertile patients with ovarian cysts from February to October, 1988 at Seoul National University Hospital. Thirty-nine ovarian cysts($32.8{\pm}9.6$mm in mean diameter) were treated with E-P therapy, and their size decreased to $28.2{\pm}11.0mm$ after 1 cycle and significantly to $24.8{\pm}14.7mm$ after 2 cycles. After E-P therapy for 2 cycles, 7(17.9%) ovarian cysts disappeared in ultrasonography, 9(23.1%) decreased in size significantly, 18(46.2%) had no change in size and 5(12.8%) increased in size. Thirty-two ovarian cysts($30.2{\pm}9.7mm$) in 30 patients were aspirated transvaginally, and there was no significant decrease in size after follow-up transvaginal ultrasonography($27.8{\pm}12.5mm$). After transvaginal aspiration, 3(9.4%) ovarian cysts disappeared and 28(87.5%) had no change in size. The mean amount of the transvaginally aspirated cystic fluids was $19.6{\pm}13.2ml$, and there was no malignant cells in aspiration cytology. Four endometrioid cysts, one dermoid cyst and one mucinous cyst could be diagnosed in consideration of the findings of transvaginal ultrasonography and the characteristics and cytology of aspirated fluids. Therefore E-P therapy and transvaginal aspiration of ovarian cysts had made it possible to restart IVF program earlier in the IVF-cancelled patients with ovarian cysts.

• Journal of Embryo Transfer
• /
• v.12 no.2
• /
• pp.203-209
• /
• 1997

This study was carried out to compare the actual size(length and height) of ovaries, follicles and corpora lutea of Korean native cow with those on sonograms. We used 3 different probes(3.5 MHz abdominal probe, 6.5 MHz transvaginal probe and 5.0 MHz transrectal probe) and a calipher for measurements of ovaries, follicles and corpora lutea on sonograms and actual size. Under water immersion, 157 ovaries were scanned with 3 probes and measured in actual size and compared each other. The average height and width of ovaries of Korean native cows were 17.40$\pm$3.99 and 34.23$\pm$6.02mm, respectively. In comparison of height, length of ovaries and preovulation follicles, we found that image with a transvaginal probe was nearly the same as the actual size(p<0.01), but with an abdominal probe the image was appeared larger than the actual size. In measurement(diameter) of preovulation follicles the transvaginal probe was proven to be more accurate to the actual size than other probes and in corpus luteum measurement all probes were accurate. In the comparison of number of follicles by different size ranges, there was no statistical difference in the count of follicles over 10 mm in diameter between the transvaginal probe and naked eyes.

• Journal of Yeungnam Medical Science
• /
• v.16 no.2
• /
• pp.376-379
• /
• 1999

We report our experience with a case of urethrolysis using a transvaginal suprameatal approach without lateral perforation of the urethropelvic ligament. A 43-year-old woman suffered from voiding difficulties such as hesitancy, frequency, urgency, decreased urinary flow, residual urine sensation after Marshall-Marchetti-Krantz operation concurrent with hysterectomy. The results of multidisciplinary work-ups of urethral obstruction such as history, vaginal examination, voiding cystourethrography, urodynamic study, showed that she had urethral obstruction due to a previous operation. Since clean intermittent catheterization and alpha-blocker therapy did not improve her symptoms, suprameatal transvaginal urethrolysis was performed to resolve the symptoms. Postoperative follow-up for 5 months showed that the patient remained free from voiding difficulty in their life. We believe that suprameatal transvaginal urethrolysis is worth attempting for urethral obstruction associated with anti-incontinence surgery.

• Journal of Veterinary Clinics
• /
• v.34 no.4
• /
• pp.304-306
• /
• 2017

A 3-year-old Thoroughbred mare was referred to J&C Equine Hospital with gestation day 30 twin pregnancy. On transrectal ultrasonographic examination, two similar sized (28 mm) embryonic vesicles, unilaterally fixed in the uterine horn, were detected. Transvaginal ultrasound-guided aspiration (TUGA) was performed for reduction of one embryonic vesicle. Yolk sac and allantoic cavity fluids from one embryonic vesicle were aspirated by a needle guided by using transvaginal ultrasound. The mare continued normal singleton pregnancy after twin reduction and delivered a foal successfully. This is the first case described the clinical use of TUGA in Korea. Clinical use of TUGA in twin reduction after embryonic fixation is recommended for equine clinicians.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.16
• /
• pp.6733-6736
• /
• 2014

Background: Despite the growing acceptance of laparoscopic colon surgery, an abdominal incision is needed to remove the specimen and perform an anastomosis. Recently, natural orifice specimen extraction (NOSE) and intracorporeal anastomosis have been proposed to minimize abdominal wall trauma and improve the quality of laparoscopic colon resections Objective: To evaluate the feasibility and safety of a new approach combining intracorporeal delta-shaped anastomosis and transvaginal specimen extraction for totally laparoscopic sigmoid colectomy. Materials and Methods: Mobilization of bowel and dissection of lymph nodes were performed laparoscopically. After both proximal and distal incisal edges about 10.0 cm distance from sigmoid neoplasm were transected with an Endoscopic Linear Cutter-Straight, a small incision about 1.0 cm was created on the each colon wall of the contralateral side of the mesentery. Then anvils of an Endoscopic Linear Cutter-Straight were inserted into each colon through the small incisions, and incision and anastomosis between the walls of each colon were performed with a linear stapler. A V-shaped anastomosis was made on the wall and the remnant openings was reclosed with the Endoscopic Linear Cutter-Straight. The culdotomy was enlarged with laparoscopic ultrasound dissector. Transvaginal extraction of specimens was accomplished through a wound protector. Results: Surgery was performed for 11 patients with sigmoid cancer. No intraoperative complications or conversions occurred. The mean operating time was 132 min. All the patients were treated laparoscopically without any postoperative complications. Conclusions: The procedures of intracorporeal delta-shaped anastomosis and transvaginal specimen extraction are safe and oncologically acceptable for selected colon cancer cases.

• Clinical and Experimental Reproductive Medicine
• /
• v.23 no.1
• /
• pp.11-24
• /
• 1996

The number of multifetal pregnancies has increased dramatically as a result of the widespread clinical use of ovulation induction and assisted reproductive technology(ART) in infertile patients. In multifetal pregnancies, the adverse outcome is directly proportional to the number of fetuses within the uterus, primarily because of an increased predisposition to premature delivery. It is extremely difficult to counsel patients about the expected outcome of pregnancies involving three or more fetuses. To increase the chances of delivering infants mature enough to survive without being irreversibly damaged by the sequelae of marked prematurity, selective fetal reduction(SFR) to the smaller number of fetuses should be considered in multifetal pregnancies. From January, 1991 to December, 1992, transabdominal SFR in multifetal pregnancies was performed in 22 patients including 13 triplet, 7 quadruplet, 1 quintuplet and 1 heptuplet pregnancies. Transabdominal SFR using intracardiac KCI injection and aspiration of amniotic fluid was carried out in 8-13 weeks of gestation. After procedure, 20 patients were remained as twin pregnancies, and 2 patients as triplet pregnancies. There have been 11 sets of twin delivery including 2 stillbirths, 2 sets of triplet delivery including 1 stillbirth, and 1 singleton delivery. Six cases were delivered after 37 weeks of gestation, 4 cases in 33 - 37 weeks, and 1 case in 30 weeks. Unfortunately, 3 stillbirths occurred in 20-24 weeks of gestation, and 4 cases were aborted. As 7 losses of pregnanancy including 1 case of septic abortion occurred, the delayed fetal loss rate was 38.9%(7/18) in transabdominal SFR. All babies born after 30 weeks of gestation were healthy, and no fetal anomaly directly related to the procedure was encountered. From July, 1993 to February, 1995, transvaginal SFR was performed in 20 patients including 15 triplet, 4 quadruplet and 1 quintuplet pregnancies. Transvaginal SFR using the same method as transabdominal SFR was carried out in 8-11 weeks of gestation. After procedure, 19 patients were remained as twin pregnancies, and 1 patient as singleton pregnancy. There have been 13 sets of twin delivery including 2 stillbirths, and 1 singleton delivery. Six cases were delivered after 37 weeks of gestation, 5 cases in 36-37 weeks, and 1 case in 30 weeks. Unfortunately, 2 still-births occurred in 20 weeks and 21 weeks of gestation, respectively, and 2 cases were aborted. As 4 losses of pregnancy including 1 case of septic abortion occurred, the delayed fetal loss rate was 25.0%(4/16) in transvaginal SFR. No fetal anomaly directly related to the procedure was encountered. It is suggested that transvaginal SFR could be performed more easily and earlier with the lower fetal loss rate as compared with transabdominal SFR. In conclusion, SFR is a rather safe and ethically justified procedure that may improve the outcome of multifetal pregnancies.

• 대한생식의학회:학술대회논문집
• /
• 2000.02a
• /
• pp.31-35
• /
• 2000

• Journal of Embryo Transfer
• /
• v.12 no.1
• /
• pp.111-116
• /
• 1997

The present study was carried out to produce in vitro fertilized embryos with immature follicular oocytes collected by transvaginal aspiration from Holstein cows. A simple aspiration apparatus consists of two stainless steel tubes, an inner tube (needle holder; 1.2cmdiameter, 55cm long) and an outer tube (1.5cm diameter, 4Scm long), and a hand-operated vacuum pump was used. Under epidural anesthesia, the needle guide was passed into the vagina of the cow to a point next to the cervix. An ovary was placed against the wall of the vagina over the end of the aspiration needle by rectal manipulation. As the needlepassed into the ovary, an assistant was asked to apply vacuum(l00mrnHg) and the ovary was manipulated back and forth in all directions over the needle. When all sites of the ovary was aspirated, the needle was withdrawn and the needle guide was moved to the other side of ovary and the procedure was repeated. When the oocyte aspiration procedure was finished, collected fluid was transported to laboratory. Oocytes surrounded with at least 1 layer of cumulus cells were matured, fertilized and cultured in vitro. The results were as follows; Ninety seven oocytes were collected by transvaginal aspiration from seventeen Holstein cows(5.7 /head). The number of oocytes surrounded with at least 1 layer of cumulus cells were 60(61.9%). Following in vitro maturation, fertilization and culture, the cleavage and development rate to morula+blastocyst were 83.3% and 30.0%, respectively. From this study, transferable in vitro fertilized embryos could be produced with imma- ture follicular oocytes collected by transvaginal aspiration from Holstein cows using a simple aspiration apparatus.

• Journal of Menopausal Medicine
• /
• v.24 no.3
• /
• pp.163-168
• /
• 2018

Objectives: To investigate the rate of postoperative urinary retention (POUR) and identify the risk factors for this complication in women who underwent transvaginal uterosacral suspension surgery. Methods: A retrospective chart review was conducted for 75 women who underwent transvaginal uterosacral suspension surgery with vaginal hysterectomy, repair of cystocele, and levator myorrhaphy with/without transobturator anti-incontinence surgery. POUR was defined as a need for continuous intermittent catheterization on the third day subsequent to removal of the urethral indwelling catheter. Results: Acute POUR was reported in 18 women (24.0%). Thirty-six of the 75 patients (48.0%) had undergone anti-incontinence surgery. Crude analysis revealed significant association between the following variables and the risk of POUR: hypertension, the lower average flow rate in the pressure-flow study (PFS), greater post-void residual (PVR) urine volume in PFS, and PVR >30% of the total bladder capacity (TBC) in PFS. In the logistic regression analysis, PVR >30% of the TBC in PFS was identified as the only significant predictor of POUR (odds ratio, 15.4; 95% confidence interval, 2.5-90.9; P = 0.003). Conclusions: The PVR >30% of the TBC in PFS was identified as the only predictive factor of acute POUR in women who underwent transvaginal uterosacral suspension surgery.

• Journal of the Korean Society of Radiology
• /
• v.84 no.6
• /
• pp.1233-1243
• /
• 2023

Percutaneous ultrasound-guided biopsy is useful for the pathologic confirmation of variable body lesions to establish diagnostic and therapeutic approaches. However, deep pelvic lesions are a challenge for pathologic diagnoses because of the presence of the bowel, bladder, major vessels, and pelvic bones which make a percutaneous approach difficult and dangerous. In female, the vagina is elastic and near the pelvic internal organs. Therefore, transvaginal ultrasound may serve as an effective and safe guide for the pathologic diagnosis of pelvis lesions. This review aimed to introduce the indications for, and the method of transvaginal ultrasoundguided biopsy, and to describe the reported diagnostic accuracy and safety.