Background: The Myosure resectoscope has been in use since 2009. Our unit is the first in Australia to describe the use of the Myosure device in the outpatient setting to resect endometrial polyps. Aim: To compare patient satisfaction and pain scores of pre-and postmenopausal women undergoing outpatient removal of endometrial polyps using the Myosure device. Material and Methods: Public hospital based prospective study. Patients (n=42) who opted to have resection of endometrial polyps under local anaethesia were recruited. Procedures were performed using a 6.25-mm hysteroscope with a MyoSure Lite device. Patient experiences were collected using a questionnaire immediately postprocedure. Pain level was assessed using 100-mm visual analogue score (VAS). Resection times and untoward events were recorded. Results: Mean endometrial polyp size was 13 mm and the mean resection time was 39.4s. Complete resection was achieved in 95.2% of cases. The median VAS was 2.7 (range 0.7-7.5). The pain scores did not differ significantly between nulliparous or parous women who only had a caesarean section delivery and those who have delivered vaginally. However, VAS was statistically less in postmenopausal women in comparison with premenopausal women (2.5 vs 3.2, respectively; (P = 0.047)). Overall, women were very satisfied; 97.6% would recommend the procedure to a friend and 95.2% happy to consider a repeat procedure in the future if required. The complication rate was 4.8%, and all were minor in nature. Conclusion: Operative hysteroscopic procedures can be performed successfully in the outpatient setting using the Myosure Lite device with a high level of patient satisfaction.
Methods We describe the clinical presentation, results of laboratory and radiological investigations, treatment and outcome to date.A review of current available literature on this topic was also undertaken. Results An 8 year old boy presented to the PED with severe nausea and vomiting with a cyclical pressure type right upper quadrant pain for 7 hours. On presentation the pain had reduced significantly. No symptoms of infection, no concerning vomit contents, diarrhoea or constipation.This was the 10th similar episode in the previous 2 months. Previous investigations including blood panel, urine were normal and symptoms had resolved on attendance.No abnormality was found on clinical exam. Abdominal ultrasound demonstrated a large right sided hydronephrosis secondary to PUJO confirmed by CT KUB. A renogram demonstrated a partial obstruction and surgical management was planned electively. Conclusion Our patient had experienced multiple episodes of Dietl's Crisis which had resolved independently. PUJO is not a common first time presentation in children of this age. We suggest that Paediatricians consider this diagnosis when the other more common differentials have been outruled while being mindful that clinical examinations, radiological and labaroratory investigations may be normal in between episodes of Dietl's crises.
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