Uteromap – a standardized method for measurement of the uterus as part of the preoperative work-up

Background Uterine morphology is not uniform and ultrasound reports of gynecologic patients are diverse. However, in clinical situations (consultation, preoperative planning, during surgery) detailed parameters, dimensions, pathology location are important to reconstruct the situation. Our aim was to develop a new systematic way of ultrasound description of the uterus that is using predefined and standard values (Uteromap). This standardized method is more useful in planning the proper surgical procedure. Methods Normal gynecological ultrasonographic examination were performed in 30 cases, as the part of the gynecological examination in gynecologic ultrasound unit of a tertiary referral academic centre. All examinations and uterine descriptions were performed by expert sonographers. Then an independent examiner made the measurements according to the Uteromap. Briefly, Uteromap includes 9 values for general cases and 24 values for special pathologies. 3D volume served as controls, which was analyzed later off-line. Duration of both examinations were recorded, as well. Equipment used was Philips Affiniti. Results Compared to the 3D volume analysis, Uteromap records gave more accurate description and position of the focal uterine pathology and served more data about the uterus. The Uteromap parameters were reproducible in the 3D volumes. Duration of Uteromap measurements was not significantly longer after the tenth examination. Conclusions Standardized measurements using the Uteromap system during the transvaginal ultrasound examinations give more accurate description the uterine pathology morphometry. Uteromap is a reproducible and quick method for the accurate localization of focal uterine pathologies and description of malformations and minimize the interrater interpretations. It helps the surgeon to choose the proper way of surgery, to maintain the normal uterine cavity and wall

Fallopian tubal obstruction is associated with increased pain experienced during office hysteroscopy: a retrospective study

This study aimed at evaluating the pain experienced during office hysteroscopy, with selective tubal cannulation and chromopertubation, by women with and without tubal obstruction in order to determine if such condition would be associated with increased pain during the examination. Women with a history of infertility underwent in-office hysteroscopy with selective chromopertubation using a continuous flow office hysteroscope with a 5 Fr operating channel fitted with a 4 Fr catheter for the injection of methylene blue dye. Experienced pain was recorded on a Visual Analog Scale (VAS) during diagnostic hysteroscopy after access to the uterine cavity. Of 90 women, 58 (66.4%) were found with at least one patent fallopian tube and inserted in the group “any”, meanwhile 32 (33.6%) were categorized into group “none” as both tubes were judged obstructed. There was no significant difference between groups in BMI and primary infertility rate, but the difference was significant concerning mean age (32.6 vs. 35.8; p < 0.001). The mean VAS score was 3.34 (± 1.07) in the group “any” and 4.25 (± 1.11) in “none”. Comparing the VAS score of the two groups, the difference was significant (p < 0.001). Tubal occlusion may have a potential role in the pain experienced by women undergoing in-office hysteroscopy. Women with bilateral tubal occlusion experienced a higher level of pain compared with patients with at least one patent fallopian tube. Operators may use milder intrauterine pressure of fluid distension medium when these patients are undergoing in-office hysteroscopy to reduce discomfort.L

Predictive value of bubble sign for tubal patency during office hysteroscopy

Objective: Our purpose was to investigate the predictive value of visible air bubble sign for real tubal patency during hysteroscopic procedures. Methods: In this cross-sectional study, clinical data of 61 infertile women who underwent diagnostic hysteroscopy and laparoscopy have been analysed. Results: Mean age of patients was 33.45 3.25 years. Bubble sign for the detection of patency demonstrated 73 % (95 % CI: 57–86 %) sensitivity, 70 % (95 % CI: 46–88 %) specificity, a positive predictive value of 83 % (95 % CI: 67–94 %), and a negative predictive value of 56 % (95 % CI: 35–76 %). Conclusions: A visible tubal “flow” of air bubbles during hysteroscopy was not accurate in the prediction of tubal patency

Monocyták és neutrophil granulocyták fagocitafunkciója ovariumcarcinomában

Bevezetés: A közelmúltban számos különböző daganatos megbetegedésben vizsgálták a tumorokat beszűrő immun- sejtek funkcióit. A perifériás immunsejtek tumorpatogenezisben betöltött szerepének vizsgálatára azonban kevesebb kutatás irányult.Célkitűzés: Célunk annak vizsgálata volt, hogy előrehaladott stádiumú ovariumcarcinomás betegek esetén a tumor jelenléte, illetve annak eltávolítása befolyásolja-e a perifériás monocyták és neutrophil granulocyták fagocitafunkcióját. Módszer: Előrehaladott stádiumú serosus epithelialis ovariumcarcinomás betegek (n = 12) perifériás vérmintáit vizs- gáltuk, amelyeket a tumorredukciós műtét előtt, valamint a 7. posztoperatív napon gyűjtöttük. A kontrollcsoportot 8 egészséges nő képezte. A monocyták és a neutrophil granulocyták vérmintákból való szeparálását követően a sejtek- kel opszonizált, fluoreszcein–izotiocianáttal jelölt zimozán-A-partikulumokat fagocitáltattunk. A monocytákat indi- rekt immunfluoreszcenciás módszerrel azonosítottuk. A sejtek által bekebelezett részecskéket fluoreszcens mikro- szkóp segítségével megszámoltuk, és kiszámítottuk a fagocitózisindexet. Statisztikai próbaként varianciaanalízist használtunk; a p<0,05 értéket tekintettük szignifikánsnak.Eredmények: A petefészekrákos betegek vérmintáiból izolált perifériás monocyták és granulocyták preoperatív fagoci- tózisindexei szignifikánsan alacsonyabbak voltak a kontrollcsoportból származó megfelelő sejtek értékeinél. A műtét utáni mintákból izolált monocyták és granulocyták fagocitafunkciója szignifikánsan emelkedett a preoperatív értékek- hez képest, és mindkét sejttípusnál elérte az egészséges kontrolloktól származó sejtek fagocitózisindex-értékét. Következtetés: Eredményeink alapján arra következtethetünk, hogy ovariumcarcinoma esetén a daganat és/vagy mik- rokörnyezete olyan faktorokat termel, melyek a neutrophil granulocyták és monocyták fagocitafunkcióját deprimál- ják. A citoreduktív műtétet követő fagocitózisindex-növekedés alapján feltételezhető, hogy a tumor eltávolítását kö- vetően e faktorok termelése csökken vagy megszűnik.L