Evaluation of the outcome of transobturator vaginal tape in management of stress incontinence in women

To evaluate the therapeutic results of a minimally invasive anti-incontinence operative procedure-the tension free vaginal tape [TVT]-obturator. With this prospective, observational, and consecutive patient series, TVT-obturator surgery was performed, according to de Leval [2003], on 44 patients with urodynamically proven stress urinary incontinence. Follow-up lasted 3-24 month. The demographic and therapeutic aspects of the patient group data were evaluated. The TVT-obturator required neither bladder catheterization nor intraoperative diagnostic cystoscopy. 4 patients [9.09%] with postoperative voiding difficulties had urethral bladder catheterization for 1-4 d; there were 4 cases [9.09%] of early therapeutic failure rate for the TVT-catheterization for 1-4 d; there were 4 cases [9.09%] of early therapeutic failure rate for the TVT-obturator, no postoperative field infections were noted. Use of the TVT-obturator, a novel midurethral sling, seems to reduce the incidence of some of the operative complications novel midurethral sling, seems to reduce the incidence of some of the operative complications associated with the TVT, primarily bladder penetration and postoperative outlet obstruction. The early therapeutic results and the cost-effectiveness of the TVT-obturator appear similar to those reported for common TVT surgery

Foetal weight assessment using sonographic femoral length: Honarvar equation

To evaluate the accuracy of the femoral length, by Honarvar equation during ultrasonographic examination at [36] weeks of gestation as a predictor of actual birth weight. A prospective observational study. Department of OB/GYN, women's health Hospital, Assuit University, Assiut, Egypt. Outpatient obstetric care clinic. One hundred [100] pregnant women at 36 weeks of gestation, were recruited in this study. Real time ultrasound examination was done to measure the femoral length, then the estimated foetal, weight was calculated using the Honarvar 2 equation. The correlation between estimated foetal weight [EFW] and real weight was tested by Pearson correlation coefficient and the relationships with the age and body mass index [BMI] of the mother, the gender of the neonate and parity were tested by multiple regression. there was significant correlation between sonographic EFW by the Honarvar 2 equation and the actual birth weight of the offsprings. Therefore, this equation is a valid method for foetal weight estimation, It also doesn't depend [no significant correlation] upon the maternal age, BMI and parity or neonatal sex. The Honarvar formula produced the best estimate of the real birth weight and its use is recommended

Evaluation of maternal morbidity in association with multiple repeated lower segment cesarean sections [more than four]

To determine the safety of repeated multiple caesarean sections more than four by comparing the outcome to a control group with lower number of repeated caesarian sections. Study design: A retrospective case-control study. Department of OB/GYN, women's health Hospital, Assiut University, Assiut, Egypt. Fifty patients who had previous four caesarian sections or more were compared to another control group of 50 patients who had lower number of repeated caesarian sections, as regards potential intra and post operative complications; including duration of surgery, degree of adhesion and possible adjacent organ injury. Also; dehiscence or rupture scar; blood transfusion and intensive care unit [ICU] admission were reported. in the study group [>/= 4 previous caesarian sections] the operative and hospital stay time were significantly longer with a higher rate of infra-operative adhesions, ileus and bladder injury than control group. The incidence of abnormal placentation [placenta accrete], caesarian hysterectomy and the need for blood transfusion was higher than that of the control group. There was no significant difference in postoperative complications or ICU admission. The neonatal outcome was comparable in the two groups and there was no maternal or fetal mortality. multiple repeated lower segment caesarian sections >/= 4 appears to be associated with higher rate of serious complications, so such patients must be advised to have the surgery in a tertiary obstetric care center with satisfactory facilities including a blood bank and adult as well as neonatal intensive care units. Also counseling about sterilization should be offered

Intraperitoneal lidocaine for postoperative pain relief after laparoscopic ovarian drilling

To evaluate the efficacy and safety of intraperitoneal installation of lidocaine as regards postoperative analgesia after laparoscopic ovarian drilling for polycystic ovarian syndrome [PCOs]. A prospective, randomized placebo controlled study. Setting department of Obstetric and Gynecology, maternal health center, Assuit University, Assuit, Egypt. This study was done upon fifty women undergoing operative laparoscopic ovarian drilling for polycystic ovarian syndrome [PCOs] under general anaesthesia, all patients were subjected to skin infiltration of 2.5 ml of lidocaine 2% at the site of Verres needle and trocar insertion. Patients were allocated randomly to one of two groups; group A [lidocaine group] 25 patients received 150 mg intraperitoneal lidocaine hydrochloride in the Douglas pouch, 50mg before CO[2] inflation and 100mg left in the peritoneal cavity, and the group B [control group] 25 patients received only saline [0.9% NaCl] instead of lidocaine. Shoulder and pelvic pain were evaluated using visual analogue score, postoperative analgesic requirements [the need for intramuscular non steroidal anti-inflammatory drugs, ketorolac 30], and time to return to normal daily activities were evaluated in the ambulatoiy unit and after discharge during the first 48 postoperative hours, The collected data were analyzed using SPSS [statistical package for social science] program and Chi square test [the probability of error P]. Pain score, analgesic requirements and time to return to normal daily activities were significantly reduced in patients who received intraperitoneal lidocaine [P <0.05]. Intraperitoneal installation of 150 mg lidocaine is simple to use, resulting in effective long lasting analgesia and improves the postoperative course