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Biomedical subjects

B G Molnár

Publications and source records attributed to B G Molnár.

9 recordsLinked to original sources

Long term follow up of hysteroscopic myomectomy assessed by survival analysis.

OBJECTIVE: To identify patient characteristics which affect outcome after hysteroscopic myomectomy for submucous fibroids. DESIGN: Prospective observational study. SETTING: A university teaching hospital. SAMPLE: One hundred and twenty-two consecutive patients treated by hysteroscopic myomectomy for submucous leiomyoma over a period of almost eight years. METHODS: Hysteroscopic electroresection of the leiomyoama using a continuous flow resectoscope. MAIN OUTCOME MEASURES: The avoidance of further surgery and patient satisfaction. RESULTS: The average age of the patients at the time of their surgery was 42.8 years. A total of 194 fibroids were removed. The mean follow up period was 2.3 years (range 1-7.6). Of those asked, 71.4% were satisfied with the results of surgery. Sixteen women required further surgery for fibroids, and six ultimately underwent hysterectomy. Survival analysis showed that the risk of further surgery was 21% at four years after the myomectomy, and 0% thereafter. Univariate regression analysis suggested that outcome was significantly better in older women, and in cases where the uterus was equivalent in size to < or = 6 weeks of gestation, the fibroid was < or = 3 cm in diameter and mainly intra-cavitary, and the procedure time was < or = 20 minutes. The influence of hormonal pre-treatment and the number of fibroids excised was not statistically significant. After multivariate regression analysis, only overall uterine size and the position of the fibroid being removed were found to significantly influence the success of surgery. CONCLUSIONS: Hysteroscopic myomectomy is an effective way to manage patients with symptomatic submucous leiomyomata, particularly when the uterus is not grossly enlarged and the fibroid(s) are mainly inside the uterine cavity.

Adult↗

Does endometrial resection help dysmenorrhea?

BACKGROUND: Menorrhagia is a common symptom and is often associated with dysmenorrhea. METHODS: The effect of transcervical resection of the endometrium (TCRE) on dysmenorrhea associated with menorrhagia was investigated in a prospective study. Ninety consecutive women were monitored before surgery and for a period of up to 12 months after resection. The amount of pelvic pain experienced was scored daily on a scale of 0-3, and was timed in relation to menstruation. RESULTS: There was a significant decrease in the level of pain experienced during menstruation and overall during the menstrual cycle (p < 0.001), but not in the premenstruum. The effect on pain was immediate and was maintained throughout the follow-up period of the study. The presence of adenomyosis or leiomyomata in the surgical specimen did not influence the beneficial effect on pain. CONCLUSIONS: Based on these findings, dysmenorrhea during menstruation should not be a contraindication to transcervical endometrial resection in women with menorrhagia.

Adult↗

Randomized studies in endoscopic surgery--where is the proof?

We have attempted to review the best available evidence for the commonest gynaecological endoscopic procedures. Controlled studies are the exception rather than the rule, and randomized studies are even rarer. Therefore, the results of large, uncontrolled series must be acknowledged. As a result, for most procedures, sufficient information is now available regarding indications, efficacy, and complications to determine their role in routine clinical practice.

Endoscopy↗

A series of 1000 consecutive out-patient diagnostic hysteroscopies.

OBJECTIVE: To review the success of out-patient diagnostic hysteroscopy. METHOD: Retrospective review of 1000 consecutive out-patient hysteroscopies. RESULTS: Hysteroscopy was successfully performed in 96%. Cervical dilatation was required in 15.0% and local anaesthesia was administered in 31.4%; 77.3% of those requiring cervical dilatation received local anaesthesia. Intrauterine pathology was noted in 49.3%. The procedure failed in 40 (4%) patients for the following reasons: pain or anxiety in 23, cervical stenosis in 11, equipment failure in 4, and extreme uterine retroversion and inadvertent false cavity formation in one case each. CONCLUSION: Out-patient diagnostic hysteroscopy is a safe, well tolerated and successful investigation procedure in the majority of patients and should be the procedure of choice for suspected intrauterine pathology.

Adult↗

[Magnesium substitution in pregnancy. A prospective, randomized double-blind study].

The results of a prospective, randomized double-blind study of magnesium substitution in pregnancy are reported. Of 997 gravidae, 985 were included in the study. Of these, 485 received magnesium aspartate (Mg 5-Longoral) and 500 a placebo. The results show that the course of pregnancy was better in the group which received the magnesium aspartate in a daily dose of 15 mmol (Mg 5-Longoral) than in the group given placebo. Among the women treated with magnesium were fewer premature births (less than 258 days' gestation). The proportion of newborns, small for date (less than 2500 g), was lower, as was the proportion of newborns with intrauterine retardation (greater than 10th percentile). There were significantly fewer cases of EPH gestosis in the magnesium group, and no serious side effects of treatment. In the authors' opinion, magnesium substitution should be included in routine antenatal care.

Aspartic Acid↗