- Email: [email protected]
5-Year follow-up of laparoscopic burch procedure
Abstracts
14. 5-Year Follow-up of Laparoscopic Burch Procedure
women with previous pelvic surgery and/or large adnexal mass. Measurements andMain Results. After placing a mark at the left ninth intercostal point on the left midclaviclar line, a 2-mm Veress needle was inserted directly downward. A 2-mm microlaparoscope was inserted through the same port, pneumoperitoneum was maintained easily, and the next cannula was inserted through an adhesion-free window under direct vision. This method was applied in five patients undergoing diagnostic or operative laparoscopy. Four women who had previous pelvic surgery (myomectomy) underwent diagnostic laparoscopy for infertility. Two women had vertical midline scars and another two had Pfannenstiel scars. Three had dense adhesions involving omenturn and intestine at the parietal peritoneum around the umbilicus. At entry of the Veress needle for pneumoperitoneum, conventional subumbilical approach may cause bowel injury in patients with such previous pelvic surgery. In one woman who had a large adnexal mass (dermoid cyst) reaching the level of the umbilicus, this method was applied to avoid leakage and the cyst was removed through the suprapubic 30-mm transverse incision. Conclusion. This approach appears to be a safe and easy method to help prevent bowel injury in patients with previous pelvic surgery, and to avoid spillage of a large benign adnexal mass.
KI Bajzak, WK Winer, TL Lyons. Center for Women's Care and Reproductive Surgery, Atlanta, Georgia.
Objective. To compare long-term success of laparoscopic Butch with that of open Burch procedure performed for urinary stress incontinence. Measurements and Main Results. In 109 women, success rates for procedures performed with absorbable suture in 1993 and 1994 were 50%. This improved to 75% for procedures performed in 1994 with permanent suture. Rates with permanent suture in 1995 and 1996 were 81% and 73%, respectively. Conclusion. Cure rates of laparoscopic Burch procedure were comparable with those for the open Burch procedure after 3- to 5-year follow-up. 15. Amenorrhea after Uterine Artery Embolization 1RP Berkowitz, 1FL Hutchins Jr, ~,2RWorthingtonKirsch. 7Roxborough Memorial Hospital, Philadelphia, Pennsylvania; 2Delaware Valley Imaging, Ltd., Bala Cynwyd, Pennsylvania.
Objective. To analyze retrospectively the occurrence of amenorrhea after uterine artery embolization (UAE) in 300 patients with myomas. Measurements and Main Results. Of 300 patients who underwent UAE, 14 (4.7%, mean age 47 yrs, range 40-52 yrs) became amenorrheic. Amenorrhea was permanent for 11 (3.7%, mean age 48 yrs, range 43-52 yrs) and transient for 3 (l.0%, mean age 43 yrs, range 40-47 yrs). The FSH levels were measured in five patients before the procedure. The level in one woman age 50 years was in the menopausal range. Of four women with normal premenopausal ranges, three became permanently menopausal. Conclusion. Permanent amenorrhea may result after UAE in women over age 40 years.
13. Microwave Endometrial Ablation Performed Under Local Anesthetic C Bain, KC Cooper, DE Parkin. Aberdeen Royal Infirmary, Foresterhill, Aberdeen, United Kingdom.
Objective. To assess the feasibility and acceptability of performing microwave endometrial ablation under local anesthesia. Measurements and Main Results. Eligible, consenting women were randomized to either local or general anesthetic in a trial with target recruitment of 190 women. The procedure performed under local anesthetic was acceptable and quick, with low pain scores and a conversion rate to general anesthesia under 10%. Conclusion. Microwave endometrial ablation under local anesthesia is an acceptable alternative to general anesthesia for motivated women. The results of a randomized comparison will be required before these results can be generalized to all women undergoing endometrial ablation.
16. H o w a 5F Bipolar Probe Should Change the
Approach to Submucous Uterine Myomas S Bettocchi, O Ceci. II Institute of Obstetrics and Gynecology, University of Bari, Bari, Italy.
Objective. To demonstrate the possibility of treating submucous and partially intramural myomas in an office setting using a normal 5-ram operative hysteroscope.
$4
14. 5-Year Follow-up of Laparoscopic Burch Procedure
women with previous pelvic surgery and/or large adnexal mass. Measurements andMain Results. After placing a mark at the left ninth intercostal point on the left midclaviclar line, a 2-mm Veress needle was inserted directly downward. A 2-mm microlaparoscope was inserted through the same port, pneumoperitoneum was maintained easily, and the next cannula was inserted through an adhesion-free window under direct vision. This method was applied in five patients undergoing diagnostic or operative laparoscopy. Four women who had previous pelvic surgery (myomectomy) underwent diagnostic laparoscopy for infertility. Two women had vertical midline scars and another two had Pfannenstiel scars. Three had dense adhesions involving omenturn and intestine at the parietal peritoneum around the umbilicus. At entry of the Veress needle for pneumoperitoneum, conventional subumbilical approach may cause bowel injury in patients with such previous pelvic surgery. In one woman who had a large adnexal mass (dermoid cyst) reaching the level of the umbilicus, this method was applied to avoid leakage and the cyst was removed through the suprapubic 30-mm transverse incision. Conclusion. This approach appears to be a safe and easy method to help prevent bowel injury in patients with previous pelvic surgery, and to avoid spillage of a large benign adnexal mass.
KI Bajzak, WK Winer, TL Lyons. Center for Women's Care and Reproductive Surgery, Atlanta, Georgia.
Objective. To compare long-term success of laparoscopic Butch with that of open Burch procedure performed for urinary stress incontinence. Measurements and Main Results. In 109 women, success rates for procedures performed with absorbable suture in 1993 and 1994 were 50%. This improved to 75% for procedures performed in 1994 with permanent suture. Rates with permanent suture in 1995 and 1996 were 81% and 73%, respectively. Conclusion. Cure rates of laparoscopic Burch procedure were comparable with those for the open Burch procedure after 3- to 5-year follow-up. 15. Amenorrhea after Uterine Artery Embolization 1RP Berkowitz, 1FL Hutchins Jr, ~,2RWorthingtonKirsch. 7Roxborough Memorial Hospital, Philadelphia, Pennsylvania; 2Delaware Valley Imaging, Ltd., Bala Cynwyd, Pennsylvania.
Objective. To analyze retrospectively the occurrence of amenorrhea after uterine artery embolization (UAE) in 300 patients with myomas. Measurements and Main Results. Of 300 patients who underwent UAE, 14 (4.7%, mean age 47 yrs, range 40-52 yrs) became amenorrheic. Amenorrhea was permanent for 11 (3.7%, mean age 48 yrs, range 43-52 yrs) and transient for 3 (l.0%, mean age 43 yrs, range 40-47 yrs). The FSH levels were measured in five patients before the procedure. The level in one woman age 50 years was in the menopausal range. Of four women with normal premenopausal ranges, three became permanently menopausal. Conclusion. Permanent amenorrhea may result after UAE in women over age 40 years.
13. Microwave Endometrial Ablation Performed Under Local Anesthetic C Bain, KC Cooper, DE Parkin. Aberdeen Royal Infirmary, Foresterhill, Aberdeen, United Kingdom.
Objective. To assess the feasibility and acceptability of performing microwave endometrial ablation under local anesthesia. Measurements and Main Results. Eligible, consenting women were randomized to either local or general anesthetic in a trial with target recruitment of 190 women. The procedure performed under local anesthetic was acceptable and quick, with low pain scores and a conversion rate to general anesthesia under 10%. Conclusion. Microwave endometrial ablation under local anesthesia is an acceptable alternative to general anesthesia for motivated women. The results of a randomized comparison will be required before these results can be generalized to all women undergoing endometrial ablation.
16. H o w a 5F Bipolar Probe Should Change the
Approach to Submucous Uterine Myomas S Bettocchi, O Ceci. II Institute of Obstetrics and Gynecology, University of Bari, Bari, Italy.
Objective. To demonstrate the possibility of treating submucous and partially intramural myomas in an office setting using a normal 5-ram operative hysteroscope.
$4