Evaluation of pain during hysterosalpingography with the use of balloon catheter vs metal cannula.

Our aim was to investigate the use of a balloon catheter device in comparison with metal cannula for hysterosalpingography (HSG) in terms of patient comfort. A total of 168 patients were randomised for HSG either with a balloon catheter (n = 83) or metal cannula (n = 85). Scores of pelvic pain during insertion of the devices, injection of the contrast medium and 1 h after the procedure were evaluated using the Wong Baker Faces Pain Rating Scale; complications and reinsertion rates were also noted. The pain scores were significantly lower in the balloon catheter group (p < 0.001). The reinsertion rate of metal cannula was higher (8.2% vs 2.4%) as well as the incidence of nausea being the most common short-term adverse effect (14.1% vs 1.2%) in the metal cannula group (p = 0.002). Performing HSG with a balloon catheter is advantageous for decreasing the pain and side-effects related to the procedure, when compared with the use of a metal cannula.

Surgical management of extrauterine mislocated intrauterine contraceptive devices and related risks.

Our aim was to evaluate the value of surgery, mainly laparoscopy in the diagnosis of the location of extrauterine lost intrauterine devices (IUCDs) and their removal. The diagnosis and management of 18 patients with extrauterine lost IUCDs between 2007 and 2011, were recruited in this study. Women whose lost IUCDs were removed by conventional methods (D&C, etc.) and hysteroscopy, were excluded from the study. Laparoscopy was performed initially for the management of these cases. The location of the IUCDs and complications related with surgery were recorded. The results showed that the most common extrauterine localisation of the lost IUCDs was the omentum (n = 10, 55.6%). Overall, 17 laparoscopies and one cystoscopy were performed for IUCD removal. Out of two cases whose IUCD were located adjacent to the bowel, one case required a laparotomy for repair of the perforation site. It was concluded that lost IUCDs outside the uterine cavity can be managed by laparoscopy as a first choice. Since the most common extrauterine localisation of the lost IUCDs is the omentum, a thorough exploration of this area should be carried out initially.

Blockade of endothelin receptors with bosentan limits ischaemia/reperfusion-induced injury in rat ovaries.

OBJECTIVE: To investigate the role of endothelin receptors in ovarian ischaemia/reperfusion (I/R) injury in rats using the endothelin receptor antagonist bosentan. STUDY DESIGN: Group 1: sham operation; Group 2: sham operation and bosentan 60 mg/kg; Group 3: bilateral ovarian ischaemia; Group 4: 3-h period of ischaemia followed by 3h of reperfusion; Groups 5 and 6: bosentan 30 and 60 mg/kg, respectively, with bilateral ovarian ischaemia applied 30 min later; the bilateral ovaries were removed after 3h of ischaemia; Groups 7 and 8: 3h of bilateral ovarian ischaemia was applied, with bosentan 30 and 60 mg/kg, respectively, administered 2.5h after the induction of ischaemia; following the 3-h period of ischaemia, 3h of reperfusion was applied, after which the ovaries were removed. RESULTS: Ischaemia and I/R decreased superoxide dismutase (SOD) activity and the level of glutathione (GSH) in ovarian tissue, but increased the level of malondialdehyde (MDA) significantly compared with the sham operation group. Bosentan 30 and 60 mg/kg before ischaemia and I/R decreased the MDA level and increased SOD activity and the GSH level in the experimental groups. The serum levels of the inflammatory cytokines interleukin (IL)-1ß, IL-6 and tumour necrosis factor-α were also measured in the I/R injury model in rat ovaries. The levels of these cytokines were significantly higher in the ischaemia and I/R groups compared with the sham operation and sham operation plus bosentan groups. The histopathological findings also demonstrated the protective role of bosentan against I/R-induced injury in rat ovaries. CONCLUSION: Administration of bosentan protects the ovaries against oxidative damage and I/R-induced injury.