Reptroperitoneal lymph node dissection (RPLND) is associated with a risk of morbidity and ejaculatory dysfunction. Nerve-sparing RPLND shows promise in preserving ejaculation alongside oncological efficacy. Laparoscopic and robot-assisted modalities are feasible with good outcomes, highlighting the need for ongoing scientific research and refinement of surgical skills.
Matched MeSH terms: Organ Sparing Treatments/methods
Intramyometrial ectopic pregnancy (IMEP) is a rare form of ectopic pregnancy. It is defined as a conceptus implanted within the myometrium and is completely surrounded by myometrium with clear separation from both the uterine cavity and tubes. IMEP possesses not only diagnostic but also therapeutic challenge. The majority of reported cases were managed by hysterectomy. Early management of unruptured IMEP using methotrexate may help to preserve fertility. We, for the first time, report a case of ruptured IMEP managed successfully using suction and curettage followed by Bakri balloon tamponade and avoiding hysterectomy. Post-procedure, the patient received two doses of intramuscular methotrexate 50 mg/m2 due to plateauing serial beta human chorionic gonadotropin (β-hCG) levels and subsequently achieved undetectable level 10 weeks post-methotrexate. She also had complete resolution of the ectopic intramyometrial mass.
Matched MeSH terms: Organ Sparing Treatments/methods*