ABSTRACT
OBJECTIVE: This study was undertaken to evaluate a new needle electrode for conization of the cervix that was developed in my department. STUDY DESIGN: This was a prospective study of 58 unselected women with histologically verified cervical intraepithelial neoplasia who underwent conization with the diathermy needle. The operations were performed with local anesthesia as outpatient procedures. Follow-up time was 5 years. RESULTS: All cones were removed in one piece and were of high histologic quality. Mean (+/-SD) operating time, including anesthesia, was 7.9 +/- 2.7 minutes. Mean depth of thermal damage was 0.29 +/- 0.21 mm, and mean blood loss was 12.5 +/- 9.4 mL. No late complications have been noted, and 94.8% of patients have required no further treatment. CONCLUSION: Needle excision of the transformation zone is a simple and effective outpatient procedure that yields a one-piece cone specimen of high quality and carries a success rate of 94.8%.
Subject(s)
Conization/instrumentation , Gynecologic Surgical Procedures/instrumentation , Needles , Uterine Cervical Dysplasia/surgery , Uterine Cervical Neoplasms/surgery , Adult , Diathermy/instrumentation , Equipment Design , Female , Follow-Up Studies , Humans , Middle Aged , Neoplasm Recurrence, Local/surgery , Prospective Studies , Reoperation , Uterine Cervical Neoplasms/pathology , Uterine Cervical Dysplasia/pathologyABSTRACT
During a 3-year period, 525 women referred to our department with abdominal pain and/or vaginal bleeding in the first trimester of pregnancy were evaluated by transvaginal sonography. Ectopic pregnancy was suspected and laparoscopy done when sonography showed an empty uterus or pseudosac together with free pelvic fluid and/or a tubal mass. Fifty-seven patients fulfilled these criteriae. Among these patients, sonography showed an empty uterus in 48, pseudosac in five, a non-diagnostic intrauterine echo in four, a tubal mass in 45 and free pelvic fluid in 54. Laparoscopy confirmed ectopic pregnancy in 53 patients (93.0%). There were only five tubal ruptures. Pelvic blood was found in all of the 54 patients with free fluid on sonography; i.e. in 51 of 53 patients with ectopic pregnancy and in three with miscarriage. Forty-nine patients with ectopic pregnancy were managed by laparoscopy and four by laparotomy. All were hemodynamically stable. The diagnostic sensitivity and specificity of vaginal sonography for ectopic pregnancy was 96.2% and 99.4%, respectively, for the finding of free pelvic fluid, and 81.1% and 99.6% for a tubal mass. All patients with ectopic pregnancy were correctly selected for laparoscopic management. Transvaginal sonography is a valuable tool in the early diagnosis of ectopic pregnancy.
