Thermal balloon endometrial ablation as a safe alternative to hysterectomy

To evaluate the safety and efficacy of thermal balloon ablation therapy as an alternative to hysterectomy in the treatment of menorrhagia. A prospective observational study. Urogynaecology unit - Department of Gynaecology and Obstetrics. Ahmad Maher Teaching Hospital. 89 Patients were enrolled in the study. 89 procedures of thermal balloon endometrial ablation were performed from March 2003 till 31 August 2006 using the same protocol. Exclusion criteria includes structural uterine abnormalities, uterine cavity more than 12 cm and premalignant conditions. General anaesthesia was used for all patients. The procedure involves controlled heating of fluid in an intrauterine specifically designed balloon for thermal ablation of the uterine cavity. No intra-operative complications occurred, and post-operative complications were minimal. Success rate of the procedure was 93% which means reduction to eumenorrhea or less. Thermal balloon endometrial ablation is a safe as well as effective treatment for menorrhagia and could replace hysterectomy in properly selected women

Endothelin-1 and Interleukin-18 with polycystic ovary syndrome

The aim of this study is to evaluate the serum level of the endothilin-1 and the interleukin-18 In patients with polycystic ovary syndrome. A Case Control Study. Ain Shams University Maternity Hospital and Ahmed Maher Teaching Hospital. 45 women will participate in the study divided to two groups. Group A [30 with Polycystic Ovarian Syndrome]. Group B [15 controls]. Patients with PCOS will be recruited from the infertility and gynecological clinics. Control subjects are healthy volunteers with a normal menstrual cycle and with no clinical or biochemical features of hyperandrogenism, thereby excluding the diagnosis of PCOS in this group. Blood Samples will be collected and examined by in-vivo enzyme immunoassay for detection of total human lnterleukin-18 and Endothelin-1 in complex biological body fluids. Results shows that the PCO cases had a higher serum Endotheline-1 level than that of the controls with statistically significant difference; [p <0.001.] and results show that the serum level of Interleukin-18 is greater in PCO patients than that of the controls with statistically significant difference; p = 0.038. PCOS induce an increase in serum IL-18 levels and the endotheline-1 concentration

Safety of performing elective caesarian section without introducing a urethral catheter

To determine the appropriateness of performing an elective caesarian section without urethral catheterization safely, a prospective comparative study. Department of Gynacology and Obstetrics. Ahmad Maher Teaching Hospital. Cases were divided into 2 groups. GROUP A includes 80 women undergoing elective caeserian Section following the routine protocol of the department, using an indwelling urinary catheter before surgery. GROUP B comprises 120 women undergoing elective caesarian sections without urinary catheterization, voiding immediately before surgery. The mean volume of-urine measured at the end of caesarian section in group A was 50 ml [range 25-120 ml]. There was no significant increase in the rate of bladder injury was noticed. Similarly, there was no significant difference in the mean operating time in both groups. Caesarian section without urethral catheterization does not affect the safety or ease of surgery. It reduces the risk of urinary infection

comparison between TVT and TVTO as regards Safety

The aim of the study is to compare between the efficacy and Safety of the retropubic tension-free vaginal tape [TVT] and the transobturator suburethral Sling [TVT-O] in the surgical treatment of stress urinary incontinence infemales. a prospective randomized study. Urogynaecology unit - Department of Gynaecology and Obstetrics. Ahmad Maher Teaching Hospital. 120 cases were assigned to the study. Between the first of March 2003 and end of November 2006, 60 patients underwent TVT by the retropubic approach and 60 patients underwent TVT-O through the transobturator approach for surgical treatment of stress urinary incontinence. Patients with Primary urodynamic stress incontinence and urethral hypermobility were subjected to surgical treatment by either TVT or TVT-O. The pre-operative and post-operative protocol included the following: a detailed urogynsecological history, a thorough physical examination, urine analysis, a stress test with a filled bladder [300 ml], urodynamic evaluation, cystometry and urethral pressure profile. The outcome measures were the rate of success and the occurrence of complications. Intra-operative data were collected as those of post-operative course. The outcome of surgical treatment was estimated using the same tools before surgery. There was no difference between the two groups as regards pre-operative, demographic characteristics, clinical and uro-dynamic parameters. The rate of success was similar in both group 91.6% in the TVT and 90% in the TVT-O group. There was an incidence of 4% bladder perforation in TVT group compared with none in the TVT-O group. The mean operative time 35 min versus 20 min was significantly higher in TVT group .However more patients had wound aching/pain in the TVT-O group 10 versus 2 in TVT group. It was concluded that both procedures are equally effective for the treatment of female urinary incontinence, while TVT-O is a simpler procedure with a less rate of complications

Comparative study of misoprostol versus dinoprostone in cervical ripening and labour induction

The aim of this study was to compare the safety and efficacy of intravaginal administered misoprostol [cytotec] versus dinoprostone pessary [prostin E2] for cervical ripening and labor induction. Sixty patients requiring induction of labor for different medical or obstetrical indications were included in this study. The misoprostol group had a significant reduction in median induction delivery time compared to dinoprostone group. There was a reduced need for the oxytocin augmentation and there was no significant difference in the mode of delivery. There were no adverse neonatal outcomes associated with the use of misoprostol. It was concluded that 100 mug vaginal misoprostol was a more effective induction agent than 3 mg dinoprostone vaginal pessary

Hemostatic suturing technique for uterine bleeding in post-partum hemorrhage

The objective of this study was to assess the efficacy of multiple square suturing technique as a conservative surgical intervention in the management of postpartum hemorrhage. This technique was used in 20 patients with postpartum hemorrhage who did not respond to the conservative management. In 18 cases, bleeding decreased markedly and hysterectomy was avoided. Hemostatic multiple square suturing was an easy, safe conservative surgical technique alternative to hysterectomy for treating uncontrollable postpartum hemorrhage