AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program
AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program
AGES XXIII Annual Scientific Meeting 2013 Abstracts & Program
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The Pelvis in Pain<br />
Digital Communications<br />
Endometriosis and Beyond<br />
Free COMMUNICATIONS / DIGITAL<br />
COMMUNICATIONS SESSION<br />
Submucous fibroids – a series of hysteroscopic<br />
morcellation<br />
Nesbitt-Hawes EM, Sgroi J, Abbott JA<br />
OBJECTIVE: To report surgical outcomes for women having<br />
submucous myomas treated with the Myosure hysteroscopic<br />
morcellator.<br />
METHODS: A prospective, observational study was<br />
performed. Nineteen women who were scheduled for<br />
hysteroscopic resection of submucous myomas were<br />
identified as candidates to be treated with the Myosure<br />
device. Demographic and pre-operative data were obtained<br />
including ultrasound characteristics of the myomas. The<br />
morcellator was used according to the manufacturer’s<br />
instructions, including continuous, electronic fluid<br />
monitoring. Intraoperative data were collected and analysed.<br />
RESULTS: Between July and December 2012, there were<br />
22 cases of myoma morcellation at the Royal Hospital for<br />
Women and Prince of Wales Private Hospital. There was<br />
agreement between the ultrasound and hysteroscopic<br />
assessment of the myoma in 9/22 (41%) cases. 10/22 (45%)<br />
were type 0, 10/22 (45%) were type 1 and 2/22 (9%) were<br />
type 2 myomas, with a mean diameter of 26mm (SD 12-<br />
39mm). The mean cutting time was 5 minutes and 3 seconds<br />
and the saline deficit 1222mL. The pathology was removed<br />
completely in 16/22 (73%) of the cases, with 2/22 (9%)<br />
requiring further treatment at the time of the first surgery<br />
and 3/22 (14%) requiring a second surgery. There were no<br />
intra-operative or post-operative complications.<br />
CONCLUSIONS: The Myosure hysteroscopic morcellator is<br />
effective in the treatment of submucous myomas including<br />
up to 50mm diameter. Difficulties with the morcellator<br />
seemed to be associated with calcified myomas and may<br />
relate to the calibre of the device.<br />
AUTHOR AFFILIATION: E. M. Nesbitt-Hawes, J. Sgroi, J. A.<br />
Abbott; Royal Hospital for Women, Randwick, New South<br />
Wales, Australia.<br />
Free COMMUNICATIONS / DIGITAL<br />
COMMUNICATIONS SESSION<br />
Thinking outside the box. Women’s experience of<br />
living with endometriosis: a qualitative study<br />
Moradi M, Parker M, Lopez V, Sneddon A, Phillips<br />
C, Ellwood D<br />
OBJECTIVES: Endometriosis is a chronic disease defined<br />
as the presence of endometrial tissue outside the uterus and<br />
is characterised by period and pelvic pain for many women.<br />
However QoL research has suggested that the impact and<br />
experience of living with endometriosis extends beyond the<br />
pelvis. 1 The aim of this study was to explore women’s long<br />
term experiences of living with endometriosis, the impact of<br />
disease on all aspects of their lives and whether impact varies<br />
across age groups.<br />
METHOD: A qualitative descriptive design with a<br />
phenomenological framework was used. Ten Semistructured,<br />
in-depth, face to face focus groups were run for<br />
three age groups (16-24, 25-34, 35 plus years). A sample<br />
of 35 Australian women with a laparoscopic diagnosis of<br />
endometriosis was purposefully recruited, including 23<br />
women from the Endometriosis Centre at The Canberra<br />
Hospital and 12 women who had not attended the Centre.<br />
Thematic analysis was used to analyze the data transcribed<br />
using NVivo 9 software.<br />
RESULTS: 10 focus group discussions of 2-2.5 hours were<br />
conducted. The age of participants ranged from 17-53 years.<br />
Average delayed diagnosis was 8.1 years and women had<br />
experienced symptoms for a range of 2 to 40 years.<br />
Common symptoms experienced were: period pain,<br />
dyspareunia, heavy bleeding, irregular bleeding, and infertility.<br />
20 final themes emerged from data analysis; six themes<br />
with regard to experiences of living with endometriosis and<br />
fourteen themes with regard to the impact of endometriosis<br />
on women’s lives. Most participants had experienced<br />
prolonged and severe pain, delayed diagnosis, various<br />
treatments, several surgeries and recurrence of disease.<br />
The majority of women reported that endometriosis had<br />
a high impact on their life with the four most commonly<br />
highlighted areas for all age groups being marital/sexual<br />
relationship, social life, physical and psychological although<br />
order of priority varied. However some differences in<br />
the next most highlighted areas were noted, education in<br />
the young women (16-24 years), life opportunities and<br />
employment for the 25-34 year olds; and financial impact for<br />
the 35 plus age group.<br />
CONCLUSION: Greater awareness of the negative<br />
impact of endometriosis highlights the importance health<br />
professionals play in best practice disease management that<br />
extends beyond the pelvis to reduce the negative impact<br />
of disease across the menstrual lifespan. For example,<br />
achieving a fulfilling sex life despite endometriosis may<br />
improve relationships and ensuring that young women with<br />
endometriosis are supported to complete their education may<br />
help maximize future employment and life opportunities.<br />
REFERENCE:<br />
1. Gao X. et al. Health-related quality of life burden of<br />
women with endometriosis: a literature review. Current<br />
Medical Research and Opinion 2006; 22(9): 1787- 1797<br />
KEYWORDS: Endometriosis, qualitative research, quality of<br />
life, impact<br />
AUTHOR AFFILIATIONS: M. Moradi 1 , M. Parker 2 , V.<br />
Lopez 3 , A. Sneddon 4 , C. Phillips 3 , D. Ellwood 3 ; 1. Australian