[Laparoscopic dissection of uterine artery and coagulation utero-ovarian ligament for the treatment of symptomatic myomas]. / Laparoskopowe przeciecie tetnic macicznych oraz koagulacja wiezadel wlasciwych jajników w leczeniu objawowych miesniaków macicy.

OBJECTIVES: Our purpose was to evaluate the effects and safety of laparoscopic dissection of the uterine artery and coagulation of the utero-ovarian ligament in treating symptomatic myomas. MATERIAL AND METHODS: We studied 40 women, aged 31 to 50, with symptomatic uterine fibroids undergoing laparoscopic dissection of the uterine artery and coagulation of the utero-ovarian ligament Ultrasound examination of uterus and dominant fibroid were performed. Their volume reduction was measured. Clinical response was evaluated according to questionnaire assessing the level of menstrual bleeding, pain and urgency. RESULTS: There were no complications during operations. Within 6 months after the surgery the mean uterus volume was reduced by 22% and mean volume of dominant fibroid was reduced by 51%. Six months after the surgery menstrual bleeding was reduced in case of 34/38 patients (85%), completed pain relief has been observed in case of 19/25 patients (76%). In case of 11/15 (73%) patients, a regression of urgency has been observed. CONCLUSIONS: Laparoscopic dissection of the uterine artery and coagulation of the utero-ovarian ligament is a safe and effective method of treating symptomatic myomas. It is an alternative to hysterectomy, especially for women who wish to preserve their uterus.

[TVT tape usage in the treatment of stress urinary incontinence]. / Zastosowanie tasmy TVT w leczeniu wysilkowego nietrzymania moczu u kobiet.

Stress urinary incontinence is one of the most common gynecological complains. The frequency of its occurrence is from 12 to 25 and even 60%. It is most often observed in patients after menopause, but in a few percent is also found in twenty and thirty years old women. During several years of searching the effective methods of stress urinary incontinence treatment, many operative techniques have been worked out, but none of them became a perfect one. The operation with the use of TVT tape is one of the newest methods of the stress urinary incontinence treatment. The aim of our study was the attempt of the estimation the TVT operation effectiveness in the treatment of stress urinary incontinence in women treated in Surgical Gynecology Department of Polish Mother Health Centre Research Institute in years 2000-2002. Performed analysis of 60 patients at the age between 38 and 76 years revealed that stress urinary incontinence symptoms regressed after TVT operation, as evaluated 7 days after the procedure. In 51.7% of patients anterior colpoplasty or colpoperineoplasty was performed simultaneously to TVT operation. Control studies were performed a month and six months after the operation. Recurrence of the symptoms was observed in 11.7% of the patients. Revealed data let us show that the efficacy of this procedure is very high and reaches 88.3%.

[Application of skin glue in wound repair after laparoscopy]. / Zastosowanie kleju skórnego w zaopatrywaniu ran po zabiegach laparoskopowych.

The aim of the study was to evaluate the usefulness of skin glue--Dermabond in wound repair after laparoscopy intervention. It is a new adhesive with the physical properties that differ from other cyanoacrylate adhesives and give a significantly greater tensile strength. It was proved to have similar cosmetic results in the repair of lacerations and incisions when compared with those closed with monofilament sutures. Octylcyanoacrylate tissue adhesive has been approved for clinical use by the Health Protection Branch of Health Canada and has been approved for clinical trials by the U.S. Food and Drug Administration. The study was conducted on thirty women with use of skin glue in wound closure after laparoscopy. Thirty-five patients served as controls whose skin was closed with a monofilament suture by standard sterile techniques. We estimated local tissue reaction, way of healing and cosmetic results. There was no difference in healing found in this study between the two examined groups. The only significant correlation outcome measures was in a very good cosmetic effect in the group where skin glue (p = 0.0231) was applied. The authors suggest high usefulness of Dermabond glue in good wound closure and correct healing.