Comparison of the TINTARA uterine manipulator with the Cohen cannula in gynecologic laparoscopy.

OBJECTIVE: To assess the efficacy of the TINTARA uterine manipulator and the Cohen cannula for gynecologic laparoscopy. MATERIAL AND METHOD: Sixty women scheduled for laparoscopy were randomized for use of TINTARA (n = 30) or Cohen (n = 30) as a uterine manipulator. The degree of anterior and lateral deviation of the uterus, operative time, surgical complications and ease of use were recorded and compared between the two groups. RESULTS: The mean ranges of anterior and lateral deviation of the uterus in TINTARA and Cohen groups were 61.17 +/- 19.37 vs. 49.33 +/- 22.58 degrees (p = 0.033) and 107.03 +/- 39.68 vs. 85.5 +/- 37.52 degrees (p = 0.035) respectively. The percentage of patients having dye leakage from the cervix in the Cohen group was greater than in the TINTARA group, but the difference was not statistically significant. Both instruments provided similar ease of use. Complications were not found in either group. CONCLUSION: TINTARA was found to have more advantages than the Cohen in moving the uterus in both anterior and lateral directions.

Spontaneous intra-abdominal bleeding during pregnancy.

Two cases of spontaneous hemoperitoneum caused by ruptured uterine vessels plexus during the second and third trimester of pregnancy were reported. All presented with acute abdominal pain. Emergency exploratory laparotomy and suture-ligation were performed One case had a recurrent intra-abdominal bleeding. The outcomes were good. One infant had complications from prematurity and both were discharged in good condition.

Effects of radiotherapy on sexual activity in women with cervical cancer.

OBJECTIVE: To assess changes in sexual activity in women treated for cervical cancer by radiotherapy over a period of 3 to 12 months. MATERIAL AND METHOD: Women treated for cervical cancer were selected at 3 to 12 months post-treatment. Main outcome measured were changes of sexual activity in sexual desire, arousal, orgasm, dyspareunia, frequency and satisfaction. Comparisons were made between after radiation and before radiation. RESULTS: The prevalence of sexual dysfunction increased in most patients treated with pelvic radiotherapy. There were significant reduction in sexual desire, arousal, orgasm, frequency of intercourse, and satisfaction after radiation. Increase in sexual pain was common after treatment, but was not significant in deep dyspareunia. Sexual frequency was significantly correlated with FIGO staging. CONCLUSION: Sexual activities were significantly reduced following radiotherapy. Educational and counseling programs on sexual activity after treatment should be provided to the patients.