Histologic studies of the effects of circulating hot saline on the uterus before hysterectomy.

STUDY OBJECTIVE: To evaluate a new device for endometrial ablation. DESIGN: (Canadian Task Force classification II-1). SETTING: University-affiliated hospital. PATIENTS: Thirty-two women scheduled for hysterectomy. INTERVENTIONS: Endometrial ablation and hysterectomy. MEASUREMENTS AND MAIN RESULTS: The new device for endometrial ablation was evaluated by studying depth of necrosis after staining for the oxidative enzyme NADH. Uniform endomyometrial necrosis was achieved at a depth of 2 to 4 mm with 90 degrees C saline circulated for 10 minutes. CONCLUSION: The procedure was successful in all patients, and there were no adverse clinical sequelae. (J Am Assoc Gynecol Laparosc 6(3):269-273, 1999)

Evaluation of Hydro ThermAblator for endometrial destruction in patients with menorrhagia.

OBJECTIVE: To describe endometrial destruction with the Hydro ThermAblator. DESIGN: (Canadian Task Force classification II-1). SETTING: University-affiliated hospital. PATIENTS: Twenty-six women with uncontrolled menorrhagia. INTERVENTION: Endometrial ablation with saline heated to 90 degrees C and circulated in the uterine cavity for 10 minutes under hysteroscopic control. MEASUREMENTS AND MAIN RESULTS: All patients tolerated the procedure well, all but one was satisfied with the results, and there were no significant side effects or complications. Seventy-seven percent of women were either amenorrheic or hypomenorrheic after 6 months, and 88% were amenorrheic or hypomenorrheic after 1 year, including one patient who was treated a second time; 87.5% were amenorrheic or hypomenorrheic at 18 months. One woman had persistent menorrhagia and was treated by hysterectomy. CONCLUSION: In this study, endometrial ablation was performed successfully with the Hydro ThermAblator in 25 of 26 women. (J Am Assoc Gynecol Laparosc 6(3):275-278, 1999)

[Treatment of human papillomavirus infection of the uterine cervix with gel interferon]. / Tratamento da infecção do colo uterino por papilomavírus humano com interferon gel.

Treatment of uterine cervix infection caused by human papillomavirus still is an enigma. Some drugs have been tested with cure rates between 60 to 70%. Most of such agents are substances which produce a strong epithelial desquamation and have shown strictly toxic side effects. The use of interferon in this infection has been studied, but different authors disagree in their therapeutic findings. A randomized, double blind trial was conducted to compare interferon to placebo. Preliminary results are presented in this article. 47 patients were followed so far. 18 of them were evaluated and the results are shown in this article.

[Diagnosis of cervicovaginal infection by human papillomavirus. Value of colposcopy, cytology and histopathology as methods of diagnosis]. / Diagnóstico da infecção cervicovaginal por papilomavírus humanos. Valor da colposcopia, citologia e da histopathologia como métodos diagnósticos.

The authors evaluated 476 patients to determine the accuracy of colposcopy, cytology, and histopathology as diagnostic methods for cervical and vaginal HPV infections. Results were treated by statistical analysis which showed significant disagreement among the methods tested. Colposcopy was positive in 87.8% of the cases. Abnormal transformation zone was the most frequent finding in the cervix, acetowhite epithelium being its main representative. Condylomatous vaginitis was the most frequent feature in the vaginal surface. Cytology was positive in 76.9% of the cases. To increase sensitivity of this method, the authors suggest that not only koilocytosis is important, but other major aspects are also important, such as minimal koilocytosis, dyskeratosis, karyopyknosis, binucleation, and multinucleation. Histopathology was positive in 81.9% of the cases. In conclusion, the three diagnostic methods studied presented statistical disagreement, however, they are supplementary and efficient.