Early pregnancy is elusive and robust.

We describe a live birth occurring following bilateral ovarian diathermy, hysteroscopy and dye test in women with clomiphene citrate resistant polycystic ovarian syndrome performed inadvertently during early pregnancy. A woman with polycystic ovarian syndrome resistant to Clomiphene citrate had bilateral laparoscopic ovarian diathermy performed inadvertently during early pregnancy. The patient was treated by Clomiphene citrate for 12 cycles then she had bilateral laparoscopic ovarian diathermy and hysteroscopy and dye test. Pelvic ultrasound examination, serum beta hCG, serum LH, FSH, Prolactin, T, SHBG, DHAS and serum E2 level. Successful outcome of pregnancy following bilateral laparoscopic ovarian diathermy and hysteroscopy and dye test inadvertently performed during early pregnancy. That all women scheduled for elective pelvic surgery should be advised to use effective contraception or avoid unprotected sexual intercourse in the preceding month as well as having an hCG test prior to surgery to exclude pregnancy.

Oestriol in the treatment of postmenopausal urgency: a multicentre study.

UNLABELLED: Oestrogen deficiency in postmenopausal women is thought to be important in the genesis of lower urinary tract symptoms, in particular the 'urge syndrome'. Evidence to support the use of oestrogen therapy in symptomatic postmenopausal women is, however, limited. Oestriol is a weak, naturally occurring oestrogen that may be beneficial to the urogenital tissues without stimulating the endometrium. We have investigated the use of oestriol in the treatment of postmenopausal sensory and motor urge incontinence. MATERIALS AND METHODS: A double-blind, placebo-controlled, randomised, multicentre study of 3 mg oral oestriol/day for 3 months in the treatment of women with urge incontinence was undertaken. RESULTS AND CONCLUSIONS: Sixty-four women were recruited into the study. Although oestriol produced both subjective and objective improvement in lower urinary tract function, it was not significantly better than placebo. Some of the difficulties of running a multicentre study were encountered.

Denervation and re-innervation of the urethral sphincter in the aetiology of genuine stress incontinence: an electromyographic study.

OBJECTIVE: To investigate the role of altered innervation of the urethral sphincter in the genesis of genuine stress incontinence. DESIGN: Prospective observational study. SETTING: Tertiary referral centre urodynamics unit. SUBJECTS: Sixty-eight women, 33 with urodynamically proven pure genuine stress incontinence and 35 controls without urinary symptoms. INTERVENTIONS: Concentric needle electromyography of the urethral striated sphincter. MAIN OUTCOME MEASURES: The means of motor unit potential duration, number of changes in polarity and the amplitude of individual motor unit potentials were compared between the two groups. RESULTS: There was no statistically significant difference in motor unit potential duration (P = 0.87) or in the number of changes in polarity (P = 0.85). There was a trend towards a higher amplitude of motor unit potentials in the control group (P = 0.07). CONCLUSIONS: Our findings suggest that denervation and re-innervation of the striated urethral sphincter following trauma to the pelvic floor, such as that occurring during childbirth, is not a major aetiological factor in the development of genuine stress incontinence.

A comparison of bioelectrical and mechanical activity of the female urethra.

OBJECTIVE: To determine the relationship between mechanical function and innervation of the urethra in order to clarify the effect of denervation and reinnervation on urethral function. DESIGN: Prospective observational study. SETTING: Tertiary referral urodynamics unit. SUBJECTS: Thirty-six women, 21 with urinary symptoms and urodynamically proven genuine stress incontinence and 15 without urinary symptoms. INTERVENTIONS: All women underwent concentric needle electromyography of the urethral sphincter and urethral pressure profilometry at rest and during cough induced stress. RESULTS: Significant correlations were found between variables indicating denervation and reinnervation and improved resting urethral function. No correlation was found between these variables and urethral function under stress. CONCLUSIONS: Our findings contradict current opinion that denervation of the urethral sphincter is associated with a reduction in the sphincteric function of the urethra, at rest or during stress, and suggest that denervation cannot therefore be a major aetiological factor in the development of genuine stress incontinence.

Analysis of cyclazocine in plasma.

The analysis of plasma cyclazocine by two methods is described. The radioimmunoassay employed a 125I-labeled radioligand, rabbit antiserum, and sepration of bound from free cyclazocine with a second antibody. The radioimmunoassay was specific for cyclazocine and had a detection limit of approximately 20 pg/ml. The GLC method employed a mass spectrometer as the detector and had a detection limit of approximately 109 pg/ml. Both techniques had acceptable accuracy and precision when used to quantitate cyclazocine in dog and human plasma. The methods were used successfully to quantitate cyclazocine from beagle hounds receiving 0.5 mg of 3H-cylazocine/kg iv. The decline in plasma cyclazocine fitted a two-compartment body model with a mean plasma clearance rate of 39.2 liters/hr.