Selected Scientific Abstracts
Reproductive Outcome after Laparoscopic Adhesiolysis in 15 Patients With Severe Pelvic Adhesions and History of Infertility
urinary ascites, urinoma, and injury to the distal right ureter adjacent to the bladder. The injured segment was resected at laparoscopy. In the second patient, evaluation revealed fight ureteral injury 3 to 4 cm from the bladder. It was treated successfully with retrograde placement of a ureteral stent. The women recovered fully without compromise of the genitourinary tract. We believe the injuries in both women were caused by thermal effects of bipolar electrodes while coagulating uterine vessels. Thermal effects might have damaged the wall of the ureter, spread into the intima, and eventually resulted in focal necrosis and ureteral defect, causing delayed urine spillage into the pelvic cavity and delayed symptomatology.
S Asgarieh, M Abdolhosseinzadeh. Department of Obstetrics and Gynecology, Arad and Mirzacoochek-khan Hospitals, Tehran, Iran.
From May 1992 to July 1994, 15 women with history of primary and secondary infertility and hysterosalpingographic or laparoscopic evidence of severe pelvic adhesions underwent laparoscopic adhesiolysis. Two of the patients had had three to four previous laparotomies for other reasons. Six women had an intrauterine pregnancy within 2 to 18 months after laparoscopic adhesiolysis. One woman who conceived 2 months postoperatively miscarried at 8 weeks. Of interest, two of the patients with several previous laparotomies conceived after 3 to 4 months and delivered healthy babies at term by cesarean section. Laparoscopic adhesiolysis for severe pelvic adhesions in infertile women is effective, particularly in countries with few facilities for assisted reproductive technology.
Technical Considerations of Laparoscopic Treatment of Genuine Stress Incontinence Based on Long-Term Results F Alexandre, A Wattiez, M Canis, S Bhoughizane, C Pomel, JL Pouly, G Mage, MA Bruhat. Polyclinique de I'Hotel Dieu, Universite de Clermont-Ferrand I, Clermont-Ferrand, France.
Endoscopy has been performed to treat genuine stress incontinence for 4 years. The surgeon's learning curve influences the results. After evaluating the 4-year follow-up of more than 200 patients, we identified the technical features of endoscopy that are associated with the greatest success, and changed our operative technique accordingly. Our new approach can be applied effectively by other endoscopists.
Uterine Hemorrhage after Hysteroscopic Excision of the Septum With Miniscissors O Azmodeh, N Moghadami-Tabrizi, H Oabirashrafi, H Oaftari, V Ghafari. Endoscopy and Fertility Research Center, 1-ehran University of Medical Sciences, Tehran, Iran.
In our experience (1990-1995) with 63 patients with septate uterus operated on by hysteroscopic excision of the septum using miniscissors, 2 had uterine hemorrhage 7 and 12 days postoperatively, respectively. One woman was hospitalized twice for severe uterine hemorrhage and treated with progesterone. The other had three episodes of uterine hemorrhage and required blood transfusion in one instance. After these experiences we decided to change our surgical procedure. At the present time, while cutting the septum with miniscissors, we coagulate all pulsating severed vessels immediately.
False Positive Results of Hysterosalpingography and Laparoscopic Chromotubation Using the Cohen Cannula S Asgarieh, M Abdolhosseinzadeh. Department of Obstetrics and Gynecology, Arad Hospital, Tehran, Iran.
A false positive hysterosalpingography (HSG) in which the tubes appear blocked when they are actually open is not uncommon and may be due to tubal spasm. But false positive result of chromotubation at laparoscopy is very rare. Two cases of false positive HSG and also laparoscopic chromotubation with the Cohen cannula occurred. The two women underwent laparotomy for tubal reconstruction, and chromotubation with ftmdal injection of dye at the time revealed patent tubes in both patients. The false positive chromotubation may have been due to intrauterine pressure that was insufficient to overcome either spasm or occlusion of the tube by a mucus plug.
Four Casesof PostablationTubal Sterilization Syndrome IH Bae, AC Pagedas, HE Perkins. St. Francis Hospital, Medical College of Wisconsin, Milwaukee, Wl.
Postablation tubal sterilization syndrome has been reported as well as questioned in the literature. We found what we believe to be four patients with this syndrome. The women experienced cyclic pain over
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