Farhana Dewan

Diagnostic and therapeutic role of laparoscopy in the Current Fertility Practice

Background: Laparoscopy is perceived as a minimally invasive surgical technique that both provides a panoramic & magnified view of the pelvic organs and allows surgery at the time of diagnosis. Laparoscopy has became an integral part of gynaecologic surgery for the diagnosis and treatment of abdominal and pelvic disorders of the Female reproductive organs. Endoscopic reproductive surgery intended to improve fertility many includes surgery of the uterus, ovaries, pelvic peritoneum and the fallopian tubes. Aim: To determine the best treatment for infertility. Method: The prospective study was carried out among the infertile women during the period of July 2014 to December 2014, in Shaheed Suhrawardi Medical College Hospital. Fifty women identified with Infertility both primary and secondary with the criteria of menstrual cycles with duration of 25-45 days were selected. Semen analysis was considered to be normal. Result: Fifty women underwent diagnostic & therapeutic laparoscopy between the period of July 2014 to December 2014. Among them 20 suffered from primary subfertility & 30 from secondary subfertility. In primary subfertility 12 patients were diagnosed as poiycystic ovarian disease & 7 patients diagnosed as minimal to moderate endometriosis 1 patient diagnosed as pelvic inflammatory disease. In secondary subfertility 15 patients diagnosed as pelvic inflammatory disease, 12 patients with endometriosis & 03 patients as poiycystic ovarian disease. Therapeutic intervention were done in almost all cases of subfertility. Conclusion: The routine use of diagnostic laparoscopy for the evaluation of all case of female infertility is currently under debate. Current evidence indicates that the surgical treatment of minimal or mild endometriosis increase the spontaneous pregnancy rate in Infertility women J Shaheed Suhrawardy Med Coll, December 2015, Vol.7(2); 73-75

Aggressive angiomyxoma of the vulva - An Enigma in Clinical Practice

A 25 years old nulliparous regularly menstruating woman presented inShSMC Hospital with the complaints of swelling in the right side of vulva and Dysparunia for 4 months. The swelling was initially small and painless but later on it became painful. The swelling recurred after surgical treatment. Examination revealed a swelling in the right Labium majus which was about 4x3 cm, bulging into right side of vagina. It was diagnosed as a case of recurrent bartholin cyst but during surgical procedure it was apparent that the swelling was not bartholin cyst but some other fleshy structure. The removed mass was 7x4 cm. Histopathology revealed benign lesion containing hypocellular structure with large blood vessels and no malignancy. It was diagnosed as Aggressive angoimyxoma. Aggressive Angoimyxoma is a very rare mesenchymal tumor, uptil now only 200 case have been reported in the world. It is a slow growing benign tumor which is typically located in the pelvis and perineum. It often presents with asymptomatic perineal or vulval mass and may be confused with Bartholin’s cyst, lipoma or hernia. Local recurrence is upto 70%; metastasis is very rare. Treatment is surgical resection Histology reveals a mass of mixed mesenchymal origin with low mitotic activity.It is a hypocellular and highly vascular tumor with myxoid stroma. Bangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 46-48