Laparoscopic Burch Colposuspension with the Choi's Hook / 대한산부인과학회지

OBJECTIVE: Burch operation has been effective method for the treatment of stress incontinence. Burch operation is a well-accepted procedure for treating stress urinary incontinence secondary to urethral hypermobility without intrinsic sphincter deficiency and is the reference standard with which other procedures are compared. This study is to evaluate the effectiveness of the Choi's hook in laparoscopic Burch operation. METHODS: This study included 47 patients who had undergone laparoscopic Burch operation from October 2000 through March 2005. Of these 47 patients, 27 patients underwent traditional laparoscopic Burch operation (Group 1) and 20 patients underwent laparoscopic Burch operation with Choi's Hook on anchoring the endopelvic fascia to the Cooper's ligament (Group 2). RESULTS: The mean age of patients of Group 1 was 55.6+/-9.37 years of age and that of Group 2 was 56.0+/-5.93 years of age. There is no difference in the mean age of patients (P>0.05). The mean operating time was 90.5+/-15.32 minutes for Group 1 and 38.5+/-10.14 minute for Group 2. The mean operating time was shorter in Group 2 than Group 1 (P0.05). CONCLUSION: We performed laparoscopic Burch operation with the Choi's Hook on anchoring the endopelvic fascia to the Cooper's ligament. When we compared traditional laparoscopic Burch operation with laparoscopic Burch operation with Choi's Hook, we could shorten the operation time using the Choi's Hook.

A Case of Thrombotic Thrombocytopenic Purpura Detected after Delivery in Preeclamptic Woman / 대한주산의학회잡지

TTP is a thrombotic microangiopathy not unique to pregnancy and with the increasing incidence in reproductive aged women. The estimated incidence is around one case per million people, sixty percent of the cases occur in women, the median age of onset is 35 years. Pregnancy is a predisposing factor of TTP and may be an inciting state for relapse. TTP usually develops during the antepartum, the mean gestational age of onset of the symptoms is 23.5 weeks, and 58% of patients initially present at or before 24 weeks of gestation. This report was a case of 36 years old mother who was performed cesarean-section at 31 weeks gestational age because of severe preeclampsia. Febrile sensation, convulsion, comatous mentation abruptly developed after cesarean section and we diagnosed TTP. The patient recovered after she was treated with plasmapheresis for 7 days. We recently experienced a unique case of TTP, which was diagnosed after cesarean delivery, because it overlapped with symptoms and thus report this case.