[Torsion of a nongravid leiomyomatous uterus].

The torsion of a nongravid uterus is not of frequent occurence. The leading reasons are a presence of an adnexial formation or leiomyomas. In this case report it has been presented a 65-year old patient with a hard abdominal pain. After the gynecologic and ultrasound examination it has been found an uterus myomatosus with three intramural-subseros leiomyomas. By the following laparotomy was confirmed the ultrasound results - the uterus with big intramural-subserous leiomyoma 8-9 cm in a diameter, and two more leiomyomas - 5 cm, a torsion of the body uterus at 180 degree above the vaginal part of the cervix. The adnexes were rotated around the supravaginal (isthmic) part of the uterus, the uterine tubes were hyperemic, swollen, with livid color, and the ovarian were atrophic. Total hysterectomy with bilateral adnexectomy was performed. We suggested that the main reason for this torsion of the uterus was the presence of leiomyomas and the genital descensus played a role as a predisposition.

[Amyloid-producing leiomyoma of the womb--a complete morphological study and possible etiology].

Case study of a 41 year old woman with tumor-related amyloidosis in a singular intramural leiomyoma of the uterine corpus. The tumor has been thoroughly revised with electron microscopy and underwent a histological, histochemical, and imunohistochemical studies. A hypothesis of its origin has been suggested. To our knowledge, this is the first documented case of amyloid-producing leiomyoma.

[A technique of continuous sutures for reconstruction of episiotomies]. / Tekhnika s prod'lzhitelen shev za v'zstanoviavane na epiziotomii.

The aim of the study is to establish the possibility for reconstructing episiotomies with a continuous uninterrupted suture. In a prospective study are included 54 women with a lateral episiotomy without further lacerations. As sewing material were used Cat-gut or Vicryl Rapide. Reconstruction of vagina, perineum and skin is done by a continuous suture with a single thread. The technical accomplishment does not provide problems to the surgeon. What is more, it reduces the durability of the intervention by achieving a good haemostasis and anatomic adaptation. All episiotomies heal per priman. An important advantage for women from a psychoemotinal point of view is the lack of the necessity to remove threads.

[Strategies in antibiotic prophylaxis in abdominal hysterectomy]. / Kum strategiite v antibiotichnata profilaktika pri abdominalna khisterektomiia.

The following study presents the high effectiveness of the short-term antibiotic prophylaxis versus long-term in elective abdominal hysterectomy. The authors compare two groups of 68 patients each for a period of 10 months. In the first group 67 patients have received one antibiotic and one--a combination of two antibiotic per 24 hours. In the second group 66 patients have received one antibiotic and two patients--a combination of two antibiotics for a period of 3 days. The two groups were compared using two clinical characteristics--axillary temperature and pulse, and also postoperative complications--vulnerary infections (parametrial, subfascial, and subcutaneous) The results demonstrate that in these cases the short-term antibiotic prophylaxis has higher effectiveness than the long-term one in the prevention of febrile complications and postoperative infections.

[Massive ovarian edema--a case report]. / Masiven otok na iaichnik--opisanie na sluchai.

A case with massive ovarian oedema, which is a rare pseudotumorous condition in young women, is described. The conceptions about the etiology and pathogenesis are considered as well as the morphological changes (with the corresponding clinical symptoms) which could be found in the affected ovary. Attention is drawn to the differential diagnostical difficulties and to the possibilities of semiconservative treatment of this rare clinicomorphological entity.

[Use of a urinary balloon catheter in abortions after the 20th week of gestation and in premature labor]. / Izpolzuvane na uretralen balon katetur pri aborti sled 20-ata gestatsionna sedmitsa i pri prezhdevreminni razhdaniia.

PIP: The authors report on their experience with application of urethral balloon-catheter with a volume of 75-100 ml for pregnancy interruption due to obstetric indications after the 20th week of gestation. The study was carried out on 22 women and failure was recorded in only 1 case. All the pregnant women had a low pelvic score--from 0-4--but 11 had live fetuses. Oxytocin infusion (during placement of the balloon or during the course of delivery) was used in 19 women. The dilatation, obtained by the balloon-catheter, was from 4-6 cm and took about 4 hours on the average; duration of delivery was 10 hours on the average. No complications were recorded. The authors feel that the application of a urethral balloon-catheter replaces successfully the original obstetric-balloon catheter of Slavcev-Minceva after the 20th week of gestation, and its use in obstetric practice is recommended. (author's modified)^ieng