Sonographic incidence of polycystic ovaries in a gynecological population

The prevalence of polycystic ovaries in a large population of 1078 women of reproductive age was determined by pelvic ultrasonography. The ovarian ultrasonic appearance of 183 (17%) women met the morphological criteria of polycystic ovaries. Of these women, 147 (80.3%) had irregular cycles (group A) and 36 (19.70%) had normal cycles (group B). The remaining women constituted the control group. Ovarian volume was calculated in all women in whom at least one ovary was visualized. Serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and testosterone were measured in 124 women from group A, 25 from group B and 50 controls. Mean ovarian volume was statistically higher in both group A (13.4 ml) and group B (11.8 ml) than in the control group (6.2 ml). Mean LH/FSH ratio and mean testosterone values were statistically higher in group A only (2.1 and 1.1 ng/ml, respectively) compared with the mean values in the control group (0.7 and 0.7 ng/ml, respectively). Obesity and hirsutism were more common in group A than in group B and the controls. Screening the ovaries in women of reproductive age and subsequent assessment of morphology in polycystic ovaries can aid in the diagnosis of this condition in patients who may have a varied clinical presentation. Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecology Copyright © 1995 International Society of Ultrasound in Obstetrics and Gynecolog

Genuine stress incontinence: Prospective randomized comparison of two operative methods

Eighty-one women with clinical and urodynamic findings of genuine stress incontinence and genital prolapse were randomly selected to be surgically treated with either anterior colporrhaphy or Burch colposuspension. Each patient had a complete clinical and urodynamic evaluation before surgery and at 2 months and 3 years after surgery. Differences in cure rates between the two procedures at the 2-month post-operative evaluation were insignificant: however, at the 3-year post-surgical evaluation, the cure rate of women who had undergone Burch colposuspension was significantly higher than that of women who had undergone anterior colporrhaphy (cure rates were 88% and 57%, respectively; P < 0.001). The Burch colposuspension was more effective than the anterior colporrhaphy in the stabilization of the bladder base, neck and proximal urethra as confirmed by transvaginal sonography. Post-operative spontaneous voiding was uneventful in both procedures. Results of this study demonstrate that the Burch colposuspension in our hands was more effective in treating genuine stress incontinence and pelvic relaxation than was anterior colporrhaphy

COMPARISON BETWEEN METAL CUP AND SILICONE-RUBBER CUP VACUUM EXTRACTOR

A total of 400 primiparous patients who were delivered by vacuum extractor were studied. The patients were divided in two groups: Group A included 200 patients who were delivered by metal cup vacuum extractor and Group B consisted of 200 patients who were delivered by rubber cup vacuum extractor. There were no statistically significant differences in the mean maternal age, mean gestational age, mean neonatal birth weight, indications for operative delivery, occipital positions and head stations between the two groups. No differences were found in the rates of birth canal trauma (11% vs. 12.5%), major neonatal scalp trauma (6.5% vs. 5.5%), neonatal jaundice (15.5% vs. 13.5%) and Apgar score. From this study we can conclude that both metal and silicone cups are equally satisfactory for vacuum extraction

Adenomyoma and leiomyoma: Differential diagnosis with transvaginal sonography

Purpose. The purpose of this study was to evaluate the capability of transvaginal sonography to differentiate adenomyomas from leiomyomas. Methods. Two hundred six patients scheduled for surgery for symptomatic uterine masses underwent preoperative transvaginal sonography. Sonographic findings were compared with pathologic findings. Pathologic findings showed that 111 patients had leiomyomas, 48 had diffuse adenomyosis, 31 had adenomyomas, and 4 had leiomyosarcomas. Results. For the diagnosis of adenomyoma, transvaginal sonography demonstrated a sensitivity of 82.0%, specificity of 88.3%, positive predictive value of 84.6%, and negative predictive value of 87.5% compared with a sensitivity of 95.1%, specificity of 82.0%, positive predictive value of 90.7%, and negative predictive value of 85.7% for the diagnosis of leiomyoma. Two sonographic characteristics, lesion margin (p = 0.0001) and lacunae (p = 0.0001), allowed the differentiation of adenomyoma from leiomyoma. Conclusions. Transvaginal sonography is an effective procedure for the preoperative differentiation of adenomyoma from leiomyoma. If the status of the lesion's margins and the presence or absence of hypoechoic lacunae were selected for analysis, leiomyomas could be correctly diagnosed with transvaginal sonography in 95% of cases

FALLOPIAN-TUBE SPERM PERFUSION HAS NO ADVANTAGE OVER INTRAUTERINE INSEMINATION WHEN USED IN COMBINATION WITH OVARIAN STIMULATION FOR THE TREATMENT OF UNEXPLAINED INFERTILITY

In this prospective randomized study we treated 60 couples with unexplained infertility with a combination of ovarian stimulation and either intrauterine insemination (IUI) or fallopian sperm perfusion (FSP). In the IUI we used a volume of 0.5 mi of inseminate and in the FSP a volume of 4 mi. The demographic characteristics of the patients, the stimulation parameters and the sperm data were not statistically different between the two groups. The pregnancy rate per cycle was 16.2% in the IUI group and 14.5% in the FSP group and the pregnancy rate per woman was 40 and 36.7%, respectively (not statistically different). We conclude that IUI and FSP are equally effective in the treatment of couples with unexplained infertility