[The laparoscopic sterilization of women]. / Laparoskopicheskaia sterilizatsiia zhenshchin.

PIP: The optimal time for sterilization is 24-36 hours after childbirth or during the 8th week in the postpartum period. The surgical methods of sterilization of the ovarian ducts are simple, harmless, effective, reversible, economical, and voluntary. These considerations also apply to endoscopic methods. For the occlusion of ovarian ducts, electrical current (monopolar and bipolar) and mechanical means (Yoon ring, Hulka and Filshie clips) are used. Unipolar coagulation of the ovarian ducts is another method of surgical sterilization done by laparoscopy. The area of coagulation occupies about 1.5 cm. The length of bipolar coagulation is 10 times larger than the unipolar coagulation site. Patients can be released 4 hours or the next day after the operation. The frequency of complications with bipolar coagulation is low: burning occurs in 0.04-0.1% of cases and bleeding from the mesosalpinx in 0.16-0.5%. The incidence of pregnancy after the operation amounts to 0.1-0.4%. Mechanical methods of sterilization are also reliable, although they are not suitable for all women. For young women who may still want children it is uniquely expedient to employ the Hulka or Filshie clips. In the rest of the cases the Yoon ring can be used, which was first used in the US in 1972 and became popular subsequently. The rate of complications is rare with its use (0.12-3.75%), and pregnancy occurs in 0.08-0.4% of cases. The incidence of complications with the use of clips amounts to 0-0.71%, the pregnancy rate is 0-0.59%, and the possibility of reversal is 80-100%. This method is ideal for young women who do not want to use other contraceptives and who want to have more children.^ieng

[The surgical treatment of ovarian formations by a laparoscopic approach]. / Khirurgicheskoe lechenie obrazovanii iaichnikov laparoskopicheskim dostupom.

This study was aimed at assessment of the efficacy of surgical treatment of bulky formations in the ovaries. Surgical laparoscopy for benign tumors and tumor-like processes in the ovaries was carried out in 548 patients. The operations were performed for benign tumors (17%), tumor-like formations (23%), endometrioid cysts (16%), polycystic ovaries (14%), gonadal dyskinesia (2%), and stable menstrual dysfunction (24%). The size of ovarian formations varied from 2 to 8 cm. Partial or clinoid resection of the ovaries, adnexectomy, oophorectomy, removal of the parovarian cyst, or extended biopsy of the ovaries were carried out. The results were good. No relapses were recorded. Blood loss was virtually null. The mean duration of an operation was 67.34 +/- 10.5 min. Follow-up of 6 months to 3 years revealed no adhesions in 34.2% cases and first-degree adhesions in 65.8%.

[Characteristics of surgical treatment of pathologic conditions of the cervical stump]. / Osobennosti khirurgicheskogo lecheniia pri patologii kul'ti sheiki matki.

The paper gives the results of surgical management in 65 patients with cervical stump diseases. According to the pattern of the disease, 4 groups of patients were identified: 1) those with inflammatory diseases, 2) those with endometriosis, 3) those with myoma, and 4) those with prolapse of the cervical stump. Low-quality and inadequate suture material was found to be a cause of inflammatory diseases of the cervical stump. It is concluded that it is not expedient to use capron, lavsan, and silk to suture the cervical stump during supravaginal amputation of the uterus. Catgut, vicryl, debone were shown to be an optimal suture material. The practice of surgical management of patients with inflammatory diseases, endometriosis, cervical stump myoma and prolapse indicates that it is advisable to extend indications for uterine extirpation.

[The function of the hepatobiliary system in patients who have had inflammatory diseases of the uterus and adnexa]. / Funktsionalno sustoianie na khepato-biliarnata sistema pri bolni, prekarali vuzpalitelni zaboliavaniia na matkata i adneksite.

The function of the hepatobiliary system was studied on 60 women, undergone inflammatory diseases in the uterus and adnexa. The women of the basic group (n = 60) were divided into two subgroups in accordance with the state of genital organs. The first subgroup (n = 39) included women with residual manifestation of chronic salpingo-oophoritis. The second subgroup (n = 21) included women with tumours and tumour-like processes of genital organs, occurred on the back ground of a continuous inflammatory process. The control group included 10 healthy women. Dynamic scintigraphy of the liver and gallbladder utilizing Tc99 radionuclide with short duration of life, was used to determine the functional state of the liver and gallbladder together with biochemical parameters of blood. The obtained results showed that there were significant changes in hepatobiliary system of women with residual manifestations of chronic salpingo-oophoritis. In women with tumours and tumour-like processes of genitals, occurred on the background of continuous inflammatory process, there were significant disturbances in the engulfing-depurating function of the liver and gallbladder of hypokinetic type.

[Various anatomic and functional characteristics of the urinary system in patients with a history of adnexitis]. / Nekotorye anatomo-funktsional'nye osobennosti mochevydelitel'noi sistemy u bol'nykh, perenesshikh vospalenie pridatkov matki.

Anatomical and functional urinary parameters were assessed, by means of radioisotopic dynamic renal scintigraphy, in 60 female patients with a history of chronic adnexitis. Most of the patients showed anatomical of functional urinary disorders, such as nephroptosis, an enlargement of one of the kidneys, ureteral dilatation, bladder reflux and reduced renal excretion. The disorders were more marked in those cases where chronic adnexitis had been accompanied by genital tumor growth.

[Enzyme activity in the blood serum and lymphocytes of patients with chronic salpingo-oophoritis combined with benign tumors of the genitalia]. / Fermentnata aktivnost v seruma na kruvta i v limfotsitite na bolni s khronichen salpingooforit v suchetanie s dobrokachestveni tumori na polovite organi.

The activity of some enzymes was examined in blood serum and lymphocytes of women with chronic salpingo-oophoritis in combination with tumourous processes of the genital organs. The objects of the study were 96 women, divided into three groups: first group (control)-20 healthy women, second group-37 women with chronic salpingo-oophoritis and third group-39 women, who suffered from chronic salpingo-oophoritis together with tumours and tumourous processes of genital organs-uterine myoma, endometriosis, cysts and cystomas of the ovaries. The studies showed that in women with continuous course of inflammatory processes there were phenomena in the lymphocytes characteristic of tension of adaptation-compensatory reactions, but inhibition and lowering of the activity of energy metabolism was observed in women with tumours and tumourous processes at the same time. Lymphocyte acid phosphatase, asparataminotransferase, hydroxy-butiratdehydrogenase and lactatdehydrogenase appears to be a prognostic sign for early discovery of features of tumourous process in the female organism on the background of chronic inflammatory process of genital organs.