[The role of echography and hysteroscopy in detection of the causes of uterine hemorrhage in the postmenopausal period]. / Ro'l ékhografii i gisteroskopii v vyiavlenii prichin matochnykh krovotechenii v postmenopauze.

Forty-six patients with bloody discharge in the postmenopausal period were examined by echography and hysteroscopy, and the data of these techniques were compared with the results of endometrial curettage. The results evidence that echography is a valuable diagnostic method that permits the detection of or ruling out the hyperplastic processes of the endometrium in the postmenopausal period. Diagnostic curettage of the uterine cavity, monitored by hysteroscopy, improves the accuracy of the diagnosis of causes of hemorrhages in the postmenopausal period, for it helps purposefully remove the involved sites of the endometrium.

[Surgical hysteroscopy in preventing the occurrence of Asherman's syndrome following the removal of intrauterine contraceptive devices]. / Operatsionnaia gisteroskopiia v profilaktike vozniknoveniia sindroma Ashermana pri udalenii vnutrimatochnykh kontratseptivov.

PIP: The most prevalent form of contraception today in the U.S.S.R. is the IUD (Lippes loop). One of the complications in connection with the removal of IUD consists of the rupture of the sutures in the cervix uteri and fragmentation of the IUD. Most frequently curettes or hooks are used to remove fragments and, in case blind manipulation is applied, the development of intrauterine synechiae (Asherman's syndrome) could result. It should therefore be done by using hysteroscopy. If there are no sutures or fragments, in all cases hysteroscopy is necessary. 42 women were under observation at the Leningrad Institute for Higher Medical Education. 23 had ruptured sutures, 10 previously had the IUD removed through the use of hooks, and 19 had carried a fragmented IUD in the uterine cavity for more than 3 years. In order to remove the IUD and its fragments liquid hysteroscopy using a 0.05% aqueous solution of chlorohexedine was applied in order to reduce the number of inflammatory complications. The duration of the operation did not exceed 7 mins. No complications were reported. 2 women were urgently treated for endometritis. In 4 patients, for whom the adhesive process was combined with partly endometrial atrophying, the adhesions were separated by curettage after radiographing the areas. For 2 women, a red-white cord between the uterine walls was determined. The article describes the operation procedures in the various instances. During the postoperative period, it was necessary to separate the uterine walls in order for the traumatized surface to heal (epithelization) and to prevent the development of a secondary adhesive process. In order to more effectively separate the walls, a protector was applied consisting of a soft polyethylene tube, whose ends were fastened to the cervix uteri and remained there for 3-4 weeks. For 2 women with fragmented IUD, the hysteroscopic operation was unsuccessful due to uterine amenorrheal forms and decreased dimensions of the uterine cavity making it difficult to locate the fragments. Both had to receive abdominal operations which included the opening of the uterine cavity.^ieng