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Journal of Minimally Invasive Gynecology (2005) 12, S94-S116 Supplement
Posters 229 Barium Enema and Rectal Ultrasound on the Diagnosis 0f Rectal Endometriosis: Preliminary Report Abdalla HS, Ayroza Ribeiro P, Aoki T, Donadio N, Almeida Prado RA. Santa Casa Medical School, Sao Paulo, SP, Brazil Study Objective: To show multiple radiologic and echographic images associated to intestinal endometriosis Design: Prospective nonrandomized. Setting: Ob/Gyn Department - Santa Casa Medical School - University Hospital, Sao Paulo-Brazil. Patients: Forty patients with clinically suspected deep infiltrating endometriosis. Intervention: Radiologic investigation with double contrast barium enema and endoscopic rectal ultrasound. Measurements and Main Results: In this poster we present our preliminary data with special interest to the suggestive images of intestinal involvement. Conclusion: Double contrast barium enema although not as accurate as the rectal ultrasound, can be used as a less expensive and useful method on the diagnosis of intestinal endometriosis. 230 Suturing Versus Flowering Technique of Bruhart after Fimbrioplasty for Endometriosis-Related Infertility Abuzeid M, Thotakura A, Ashraf M, Abuzeid O, Mitwally MF. IVF Michigan & Michigan State University, Rochester Hills, Michigan; IVF Michigan & Michigan State University, Rochester Hills, Michigan; IVF Michigan & Michigan State University, Rochester Hills, Michigan; IVF Michigan Reproductive Endocrinology & Infertility, Rochester Hills, Michigan; Wayne State University, Bloomfield Hills, Michigan Study Objective: To compare the effectiveness of two surgical techniques (suturing versus flowering of Bruhart) after fimbrioplasty for treatment of endometriosis-related infertility. Design: Prospective historical cohort study with 24 months of follow up comparing pregnancy rates achieved spontaneously or after controlled ovarian hyperstimulation (COH) with intrauterine insemination (IUI) after fimbrioplasty in patients with endometriosis. Setting: Tertiary referral academic reproductive endocri© 2005 AAGL All rights reserved.
nology and infertility surgical center. Surgeries were done by the same surgeon under comparable operative settings in all patients. Patients were followed up until birth or pregnancy loss occurred in achieved pregnancies. Patients: A total of 151 patients with endometriosis-related infertility had fimbrioplasty, 43 flowering (group 1) and 108 suturing (group 2), followed by timed intercourse, and/or ovarian hyperstimulation with insemination (COH-IUI) with follow up until pregnancy or at least 24 months. Intervention: At time of laparoscopy, fimbrioplasty was performed if fimbrial phimosis or blunting was found. The edges of the fimbrial ostium were everted using either the flowering technique of Bruhart or 6-0 Vicryl sutures (intracorporeal knot technique) using microsurgical techniques. Measurements and Main Results: There was no significant difference in patients’ characteristics (age, infertility duration and endometriosis stage) between 2 groups. PID excluded by absent history and negative Chlamydia serology. The pregnancy rate per patient (37%) in group 1 was not significantly different from group 2 (40%). Conclusion: There appears to be no advantage of the technique of suturing over flowering after fimbrioplasty. The latter is easier to learn and requires less operative time to perform. 231 Minimally Invasive Approach to Treatment of Stress Urinary Incontinence Using TVT, TOT, and TVT-O Procedures Adamyan LV, Kulakov VI, Kozachenko IF, Sashin BE. Scientific Center for Ob/Gyn & Perinatology, Moscow, Russia Study Objective: To evaluate the efficacy of minimally invasive techniques in treatment of stress urinary incontinence (SUI). Design: Retrospective analysis of 136 cases of SUI. Setting: Dept. Operative Gynecology of the Research Centre for Obst., Gyn., & Perinatology. Patients: One hundred thirty-six women (aged 34 –75 years) with SUI and concomitant gynecologic conditions (endometrial hyperplasia, fibroids, adenomyosis). Intervention: TVT (50 cases), TOT operation (70), TVT-0 (15 cases), combined with total laparoscopic hysterectomy and pelvic floor reconstruction. Measurements and Main Results: The TVT operation
Posters 229 Barium Enema and Rectal Ultrasound on the Diagnosis 0f Rectal Endometriosis: Preliminary Report Abdalla HS, Ayroza Ribeiro P, Aoki T, Donadio N, Almeida Prado RA. Santa Casa Medical School, Sao Paulo, SP, Brazil Study Objective: To show multiple radiologic and echographic images associated to intestinal endometriosis Design: Prospective nonrandomized. Setting: Ob/Gyn Department - Santa Casa Medical School - University Hospital, Sao Paulo-Brazil. Patients: Forty patients with clinically suspected deep infiltrating endometriosis. Intervention: Radiologic investigation with double contrast barium enema and endoscopic rectal ultrasound. Measurements and Main Results: In this poster we present our preliminary data with special interest to the suggestive images of intestinal involvement. Conclusion: Double contrast barium enema although not as accurate as the rectal ultrasound, can be used as a less expensive and useful method on the diagnosis of intestinal endometriosis. 230 Suturing Versus Flowering Technique of Bruhart after Fimbrioplasty for Endometriosis-Related Infertility Abuzeid M, Thotakura A, Ashraf M, Abuzeid O, Mitwally MF. IVF Michigan & Michigan State University, Rochester Hills, Michigan; IVF Michigan & Michigan State University, Rochester Hills, Michigan; IVF Michigan & Michigan State University, Rochester Hills, Michigan; IVF Michigan Reproductive Endocrinology & Infertility, Rochester Hills, Michigan; Wayne State University, Bloomfield Hills, Michigan Study Objective: To compare the effectiveness of two surgical techniques (suturing versus flowering of Bruhart) after fimbrioplasty for treatment of endometriosis-related infertility. Design: Prospective historical cohort study with 24 months of follow up comparing pregnancy rates achieved spontaneously or after controlled ovarian hyperstimulation (COH) with intrauterine insemination (IUI) after fimbrioplasty in patients with endometriosis. Setting: Tertiary referral academic reproductive endocri© 2005 AAGL All rights reserved.
nology and infertility surgical center. Surgeries were done by the same surgeon under comparable operative settings in all patients. Patients were followed up until birth or pregnancy loss occurred in achieved pregnancies. Patients: A total of 151 patients with endometriosis-related infertility had fimbrioplasty, 43 flowering (group 1) and 108 suturing (group 2), followed by timed intercourse, and/or ovarian hyperstimulation with insemination (COH-IUI) with follow up until pregnancy or at least 24 months. Intervention: At time of laparoscopy, fimbrioplasty was performed if fimbrial phimosis or blunting was found. The edges of the fimbrial ostium were everted using either the flowering technique of Bruhart or 6-0 Vicryl sutures (intracorporeal knot technique) using microsurgical techniques. Measurements and Main Results: There was no significant difference in patients’ characteristics (age, infertility duration and endometriosis stage) between 2 groups. PID excluded by absent history and negative Chlamydia serology. The pregnancy rate per patient (37%) in group 1 was not significantly different from group 2 (40%). Conclusion: There appears to be no advantage of the technique of suturing over flowering after fimbrioplasty. The latter is easier to learn and requires less operative time to perform. 231 Minimally Invasive Approach to Treatment of Stress Urinary Incontinence Using TVT, TOT, and TVT-O Procedures Adamyan LV, Kulakov VI, Kozachenko IF, Sashin BE. Scientific Center for Ob/Gyn & Perinatology, Moscow, Russia Study Objective: To evaluate the efficacy of minimally invasive techniques in treatment of stress urinary incontinence (SUI). Design: Retrospective analysis of 136 cases of SUI. Setting: Dept. Operative Gynecology of the Research Centre for Obst., Gyn., & Perinatology. Patients: One hundred thirty-six women (aged 34 –75 years) with SUI and concomitant gynecologic conditions (endometrial hyperplasia, fibroids, adenomyosis). Intervention: TVT (50 cases), TOT operation (70), TVT-0 (15 cases), combined with total laparoscopic hysterectomy and pelvic floor reconstruction. Measurements and Main Results: The TVT operation