Moty Pansky - Academia.edu (original) (raw)

Papers by Moty Pansky

Fertility and sterility, 2015

To assess the prevalence and risk factors for intrauterine adhesions (IUAs) after hysteroscopic t... more To assess the prevalence and risk factors for intrauterine adhesions (IUAs) after hysteroscopic treatment of retained products of conception (RPOC). Retrospective cohort study. Gynecologic endoscopy unit. A total of 167 women referred to our institution from 2009 to 2013. Operative hysteroscopy for treatment of RPOC and office hysteroscopic follow-up to assess for IUA. We investigated demographic characteristics, obstetrics parameters, and surgical variables to evaluate which factors could be associated with IUA formation. Of 167 women treated for RPOC, 84 (50.3%) had undergone a follow-up hysteroscopic evaluation after the operative hysteroscopy and were included in the study. Intrauterine adhesions were found in 16 cases (19.0%), of which only 3 (3.6%) were severe adhesions. Multivariate analysis showed that the presence of IUA was associated with RPOC after cesarean section (5 of 10 [50.5%] developed IUA, vs. 7 of 49 [14.3%] after vaginal delivery). Intrauterine adhesions were al...

Journal of Pediatric and Adolescent Gynecology, 2014

Vaginal bleeding in premenarchal girls is always abnormal and its source must be identified for a... more Vaginal bleeding in premenarchal girls is always abnormal and its source must be identified for appropriate management. Examination under anesthesia and vaginoscopy are commonly employed for evaluation of the vagina as a source of bleeding, and the examination may occasionally reveal vaginal pathology. A 16-month-old otherwise healthy girl presented with spotting. Exam under general anesthesia and vaginoscopy revealed a 1-cm polypoid-like lesion overlying the posterior vaginal wall which was excised using the hysteroscope. Pathology revealed a benign Müllerian cyst. Vaginal findings of causes of premenarchal bleeding such as Mullerian cysts may be diagnosed and treated with the vaginoscopic approach.

Journal of Minimally Invasive Gynecology, 2012

Use your Smartphone to scan this QR code and connect to the discussion forum for this article now... more Use your Smartphone to scan this QR code and connect to the discussion forum for this article now* * Download a free QR Code scanner by searching for ''QR scanner'' in your smartphone's app store or app marketplace.

Human Reproduction, 2004

BACKGROUND: Our aim was to supplement the mostly individual case reports on the rarely occurring ... more BACKGROUND: Our aim was to supplement the mostly individual case reports on the rarely occurring and lifethreatening condition of ectopic pregnancy developing in a Caesarean section scar. METHODS AND RESULTS: Eight of all the patients treated in our department between 1995 and 2002 had been diagnosed for ectopic pregnancy that developed in a Caesarean section scar. They comprised this case series group. Four of them underwent methotrexate treatment; one had expectant management, one transcervical aspiration of the gestational sac and two by open surgery. All the non-surgically treated women had an uneventful outcome. One underwent a term Caesarean hysterectomy and the other ®rst trimester hysterotomy and excision of the pregnancy located in the scarred uterus. Analysis of all these women's obstetric history revealed that ®ve of them (63%) had been previously operated because of breech presentation, one had a cervical pregnancy and one had placenta previa. Four of them (50%) had multiple (b2) Caesarean sections. CONCLUSIONS: The women at risk for pregnancy in a Caesarean section scar appear to be those with a history of placental pathology, ectopic pregnancy, multiple Caesarean sections and Caesarean breech delivery. Heightened awareness of this possibility and early diagnosis by means of transvaginal sonography can improve outcome and minimize the need for emergency extended surgery.

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2003

Objective: The aim of this study was to define the role of luteinizing hormone (LH) as a tumor ma... more Objective: The aim of this study was to define the role of luteinizing hormone (LH) as a tumor marker, specific for ovarian cancer. Methods: The study included 34 women with functional and benign ovarian cysts, 11 women with borderline ovarian tumors, 22 patients with advanced ovarian cancer and 15 patients with non-ovarian intraperitoneal malignancies. Serum, peritoneal fluid and ovarian cyst aspirates were obtained intraoperatively (laparoscopy or laparotomy) and were subjected to the LH analysis. Results: Peritoneal fluid LH levels were significantly increased in patients with ovarian cancer and those with borderline ovarian tumors as compared to patients with functional and benign ovarian cysts (P ¼ 0:005 and P ¼ 0:007, respectively). The patients with non-ovarian malignancies demonstrated the same peritoneal fluid LH levels as patients with benign ovarian tumors. There was no significant difference in the level of peritoneal fluid LH between ovarian cancer patients with and without ascites. The patients with functional and benign ovarian cysts demonstrated also significantly lower cyst fluid LH levels as compared to patients with malignant and borderline ovarian cysts (P ¼ 0:01 and P ¼ 0:03, respectively). Peritoneal and ovarian cyst fluid levels of LH were significantly increased in patients with fibrothecomas as compared to patients with other benign ovarian cysts. There were no significant differences in the serum LH levels comparing patients from all study groups. Conclusion: LH, detectable in peritoneal and ovarian cyst fluids, can be used as a tumor marker for identification of patients with borderline and malignant ovarian tumors.

European Journal of Obstetrics & Gynecology and Reproductive Biology, 2014

Journal of Minimally Invasive Gynecology, 2011

To evaluate the safety and effectiveness of Oxiplex/AP gel (Intercoat) in reducing intrauterine a... more To evaluate the safety and effectiveness of Oxiplex/AP gel (Intercoat) in reducing intrauterine adhesion formation after hysteroscopic treatment because of retained products of conception (RPOC). Design: Prospective double-blind, randomized, controlled pilot study (Canadian Task Force classification I). Setting: Tertiary medical center. Patients: All women who underwent hysteroscopic treatment because of RPOC at our institution between September 2009 and June 2012 were invited to participate. After operative hysteroscopy, participants were randomized to either have their uterine cavity filled with Oxiplex/AP gel (study group, n 5 26) or not (control group, n 5 26). Interventions: Diagnostic office hysteroscopy to assess for adhesion formation was performed after 6 to 8 weeks. Findings were graded according to the American Fertility Society classification. Rates of subsequent pregnancy in the 2 groups were assessed. Measurements and Main Results: Intraoperative complication rates were similar between the 2 groups. There were no postoperative complications after Oxiplex/AP gel application. Moderate to severe adhesions developed in 1 woman (4%) in the study group and 3 (14%) in the control group (p 5 .80). During follow-up of 20 months (range, 2-33 months), 7 women (27%) in the treatment group conceived, compared with 3 (14%) in the control group (p 5 .50). Conclusion: Intrauterine application of Oxiplex/AP gel after hysteroscopic removal of RPOC is safe. In this small sample, the difference in the rate of intrauterine adhesions was not statistically significant. A larger study would enable further establishment of the safety and efficacy of use of this gel.

JSLS : Journal of the Society of Laparoendoscopic Surgeons, 2009

Introduction: We suspected that paraovarian cysts of neoplastic origin may be underreported. This... more Introduction: We suspected that paraovarian cysts of neoplastic origin may be underreported. This study was designed to evaluate our data on the pathologic characteristics of cystic lesions located in the paraovarian area and compare them with previous studies that claimed the vast majority of these lesions were simple paraovarian cysts and only few (1.69% to 5%) were neoplastic ones. Methods: This is a retrospective analysis of the clinical, surgical, ultrasonographic, and pathologic features of 59 women operated on for cystic paraovarian lesions at our institution from January 2002 to April 2006. Results: Forty-four women (74.6%) had simple paraovarian cysts, and 15 (25.4%) had benign neoplastic paraovarian cysts (7 cystadenomas and 8 cystadenofibromas). There were no cases of malignant tumor. There was no difference in the clinical presentation of the women with either type of cyst. Preoperative ultrasound examinations (n=50) demonstrated more complex cysts with internal papillar...

Journal of Minimally Invasive Gynecology

Archives of Gynecology and Obstetrics

European journal of obstetrics, gynecology, and reproductive biology, 2018

To investigate whether women who were surgically treated for retained products of conception (RPO... more To investigate whether women who were surgically treated for retained products of conception (RPOC) by either suction curettage or hysteroscopy are at risk for recurrent RPOC on their subsequent pregnancies. Retrospective analysis of 442 women surgically treated for RPOC following delivery or abortion by suction curettage (N = 63, 14.3%) or hysteroscopy (N = 379, 85.7%). Information on subsequent pregnancies and their outcomes was available for 161 (36.4%) women. One or more live births were reported for 150 (93.2%) of the women for whom information on subsequent pregnancies was available. The overall rate of spontaneous abortions was 31/161 (19.3%). Recurrent RPOC were diagnosed in 25 (15.5%) cases, while third stage of labor placental problems (including retained placenta or cotyledons and placenta accreta) were found in 44 (27.3%) cases. Recurrent RPOC was associated with treatment by suction curettage compared with hysteroscopy for the initial RPOC on multivariate logistic regre...

Journal of Pediatric Surgery

The Israel Medical Association journal : IMAJ, 2016

Despite the large volume of evidence on the management of retained products of conception (RPOC),... more Despite the large volume of evidence on the management of retained products of conception (RPOC), there are virtually no data regarding the optimal time frame of surgical intervention in case of RPOC. To examine whether the time interval between spontaneous vaginal delivery or pregnancy termination and the uterine evacuation due to pathologically confirmed RPOC influences the reproductive outcome. We retrospectively reviewed all the records of women who were admitted to our department due to pathologically confirmed RPOC following either spontaneous vaginal delivery or pregnancy termination between January 2000 and December 2010. Based on the median time from delivery or pregnancy termination until the operative intervention in the study group, patients were stratified into two groups: early intervention (< 3 weeks) and late intervention (> 3 weeks). Reproductive outcomes were compared between the two study groups. Reproductive outcomes were analyzed in 172 patients with patho...

Fertility and Sterility, 2016

Objective: To compare adnexal torsion characteristics and torsion recurrence rates in a pre-and p... more Objective: To compare adnexal torsion characteristics and torsion recurrence rates in a pre-and postmenarchal pediatric and adolescent population. Design: Retrospective cohort study. Setting: University-affiliated medical center. Patient(s): Females <18 years old with surgically diagnosed adnexal torsion. Intervention(s): Adnexal detorsion, cystectomy, salpingectomy, or salpingo-oophorectomy by laparoscopy or laparotomy. Oophoropexy using the utero-ovarian ligament plication technique was performed in cases of recurrent torsion of normal adnexa. Main Outcome Measure(s): The clinical presentation, laboratory and ultrasound characteristics, surgical findings, surgical procedures, pathologic diagnosis, and torsion recurrence rates were analyzed and compared between pre-and postmenarchal patients. Result(s): Twenty premenarchal and 24 postmenarchal patients were identified. The clinical presentation, laboratory findings, and ultrasound characteristics were similar between the two groups, except for a higher prevalence of paraovarian cysts on preoperative ultrasound in the postmenarchal compared with in the premenarchal group (20.8% vs. 0%). For the whole cohort, torsion of normal adnexa constituted 25.0% (11/44) of cases, while torsion of ''pathologic'' adnexa constituted 75.0% (33/44) of torsion cases. Torsion recurrence was significantly more common among girls whose first torsion episode occurred in the premenarchal period compared with in postmenarche (35% vs. 4.2%). On multivariate logistic regression analysis, torsion recurrence was significantly associated with premenarchal status (odds ratio [OR] ¼ 12.7; 95% confidence interval [CI], 1.1-152.0) and with torsion involving normal adnexa (OR ¼ 19.1; 95% CI, 2.3-154.5). Conclusion(s): Recurrent torsion is common in patients whose first torsion episode occurred in the premenarchal period and involved otherwise normal adnexa. Ovarian fixation procedures may be considered in patients at risk for torsion recurrence.

Journal of Pediatric Surgery, Jan 8, 2009

The vaginal speculum can be safely and efficaciously replaced by the less traumatic small diamete... more The vaginal speculum can be safely and efficaciously replaced by the less traumatic small diameter continuous flow hysteroscopic vaginoscopy for diagnosis and treatment of genital tract lesion in children and adolescents.

Journal of Pediatric and Adolescent Gynecology, 2016

Accessory fallopian tube is a rare anatomical variation, which might rarely cause gynecological c... more Accessory fallopian tube is a rare anatomical variation, which might rarely cause gynecological complications such as infertility, ectopic pregnancy, cystic swelling, and pyosalpinx. It is usually diagnosed by surgeons during diagnostic laparoscopy for other purposes. We present a rare case of isolated accessory tube torsion in a young adolescent. A 16-year-old virgin teen presented with a 24-hour history of aggravating right lower-quadrant abdominal pain and nausea without vomiting or fever. On examination she had right lower quadrant abdominal tenderness with no peritoneal signs. On pelvic ultrasound a right corpus luteum cyst was suspected, but right adnexal torsion could not be ruled out. On laparoscopy, torsion of the right accessory tube was diagnosed. Because of its ischemic and bluish appearance it was removed. The postoperative course was uneventful. Pathology confirmed the diagnosis. Torsion of an accessory fallopian tube is rare. An English literature search showed that the current case is the third reported overall and the first in a young adolescent. Because of the rarity of this congenital variation, and the low suspicion index for its existence, the diagnosis of accessory tube is often missed. Preventive removal of such findings should be considered but weighed against its possible surgical complications.

Http Dx Doi Org 10 1089 Gyn 2006 22 57, Jul 13, 2006