effect of paracervical vasopressin analogus [Por-Eight] on the systemic absorption of irrigation fluid during hysteroscopic endometrial resection

The objective of this study was to examine the effect of paracervical injection of vasopressin analogue [por-8] on the amount of irrigation fluid absorption, visual clarity of hysteroscopic view, operating time and blood loss during transcervical endometrial resection. In this work, 30 women with a main complaint of excessive dysfunctional uterine bleeding were scheduled for hysteroscopic transcervical endometrial resection [TCER]. They were randomized into a study group [20 patients] and a control group [10 patients]. The results have shown a highly significant decrease in the mean operating time in the study group compared to the control group. Chi-square test revealed a significant increase in the visual clarity of hysteroscopic view among the study group when compared to the control group. In conclusion, paracervical injection of vasopressin analogue [por-8] before hysteroscopic endometrial resection may improve visual clarity, reduce the blood loss and duration of surgery and more importantly, it may reduce the systemic absorption of irrigation fluid during surgery. Therefore, using vasopressin analogue [por-8] may reduce the complications of fluid overload and dilutional hyponatremia that can lead to severe morbidity and mortality

Laparoscopic balloon neosalpingostomy and fimbrioplasty in cases of distal tubal occlusion

The objective of this study was to evaluate the technique of balloon catheterization of the fallopian tube after either laparoscopic neosalpingostomy or fimbrioplasty in cases of distal tubal occlusion and compare the results with those of laparoscopic neosalpingostomy or fimbrioplasty alone. In this work, 100 women with distal tubal occlusion were scheduled for either laparoscopic neosalpingostomy [52 cases] or fimbrioplasty [48 cases]. Balloon catheterization of the Fallopian tube using transluminal angioplasty catheter was done for 23 patients after laparoscopic neosalpingostomy and 27 patients after laparoscopic fimbrioplasty. Three out of 29 patients who underwent laparoscopic neosalpingostomy alone achieved intrauterine pregnancy and one patient proved to have tubal pregnancy. Among 23 patients who underwent laparoscopic neosalpingostomy with balloon catheterization of the Fallopian tube, six patients achieved intrauterine pregnancy. The difference was statistically significant and a positive tubal potency after laparoscopic neosalpingostomy with catheterization of the Fallopian tube was significantly more than that after laparoscopic neosalpingostomy, alone [86.9% versus 72.4%, respectively]. In conclusion, the technique of laparoscopic neosalpingostomy with balloon catheterization of the fallopian tube may lead to better results than that after laparoscopic neosalpingostomy alone as regards the pregnancy rate and postoperative tubal patency