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H Kölbl

Publications and source records attributed to H Kölbl.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Electro- versus laser surgery for conservative laparoscopic revision of tubal pregnancies].

The objective of this study was to determine possible benefits of carbon dioxide laser over electrosurgical usage in conservative laparoscopic treatment of ectopic pregnancies (EP). 41 ectopic pregnancies managed by laparoscopic surgery were analysed retrospectively in regard to operation time, intraoperative blood loss and postoperative complications. No significant differences between both groups were observed. According to our data no advantage of the CO2 laser over electrosurgery in the conservative laparoscopic management of EP's could be demonstrated.

Adolescent↗
PubMed1994

Microsurgical treatment of tubal sterility using the CO2 laser: a reasonable alternative to IVF in cases of tubal sterility.

A retrospective analysis of women treated microsurgically using the CO2 laser in sterility treatment was performed. The aim of the study was to determine women's personal feeling about the procedure, prognostic factors, success rates, and complications. Included were 192 patients with tubal occlusions or pelvic adhesions treated by means of CO2 laser microsurgery between February 1984 and July 1992. A standardized questionnaire was used to evaluate women's procedure-related stress, extrauterine and intrauterine pregnancy rates, pregnancy complications, and postoperative complaints. In 75 cases, records and questionnaires contained sufficient data and were included for further analysis. Adhesiolysis alone, unilateral neosalpingostomy, bilateral neosalpingostomy, or new implantation was done in 7%, 52%, 33%, and 8%, respectively. In the range of 1-10, a medium degree procedure-related stress (mean 4.3, range 1-10) was expressed by the treated women. No surgery-related complications were observed. The overall pregnancy rate was 37.3%, and 10.7% were tubal pregnancies. In 26.7%, fertility surgery resulted in intrauterine pregnancies, and 21.3% of the treated women delivered living children. Three women had two consecutive pregnancies after surgery. Women with intrauterine pregnancy, extrauterine pregnancy, and no pregnancy had a mean age of 29.5 +/- 3.8, 27.3 +/- 5.3, and 32.3 +/- 4.2 years, respectively (p = NS). Mean duration of infertility before start of surgical treatment was 42.4 +/- 34.6, 41.6 +/- 25.8, and 48.8 +/- 33.2 months, respectively (p = NS). Intraabdominal instillation of streptokinase to prevent reformation of adhesions had no significant impact on tubal patency results or pregnancy rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Fallopian Tube Diseases↗
PubMed1994

[Is the Gaudenz Incontinence Questionnaire still relevant in diagnosis of urodynamic function?].

The results of this study show that the Gaudenz incontinence questionnaire can still be used to help determine the history of the incontinent patient. However, the questionnaire cannot substitute--Gaudenz stressed this fact in his study--a complete urogynecologic workup. Especially delicate problems as urinary incontinence require reliable and objective diagnostics and therapy using the advantages of the available diagnostic potential.

Female↗
PubMed1994

The diagnostic value of magnetic resonance imaging for the detection of tumor recurrence in patients with carcinoma of the ovaries.

Disease status during follow-up evaluation of patients with carcinoma of the ovaries is the main criterion for the selection of appropriate management. A cohort analysis was performed to investigate if magnetic resonance imaging (MRI) could improve noninvasive assessment of disease status in patients with carcinoma of the ovaries during follow-up examination. Twenty-four women with carcinoma of the ovaries after primary surgical treatment with subsequent platinum containing chemotherapy were entered into the study. MRI was performed in addition to sonography and computed tomography (CT). Patients without evidence of disease underwent restaging laparotomy. Sensitivity of sonography, CT and MRI was 50, 63 and 75 percent, respectively. Combination of CT and MRI revealed a 75 percent sensitivity rate. Specificity for sonography, CT and MRI was 100, 94 and 94 percent, respectively, and for the combination of CT and MRI, 88 percent. Positive and negative predictive value and accuracy of these methods were 100, 80 and 83 percent for sonography; 83, 83 and 83 percent for CT; 86, 88 and 88 percent for MRI, and 75, 88 and 83 percent for the combination of CT and MRI. In one instance of false-negative sonographic and CT results, MRI detected recurrence located in postoperative scar tissue. In one instance, MRI did not add essential information to the other imaging methods. Therefore, MRI as a time- and cost-intensive procedure should be reserved for instances in which there are doubtful findings arising with other diagnostic tools, rather than as an indispensable routine procedure in the follow-up evaluation of patients with carcinoma of the ovaries.

Adult↗
PubMed1994

Development of ovarian pathology after hysterectomy without oophorectomy.

This study was done to determine the occurrence of disease in retained ovaries after hysterectomy. A retrospective analysis of patient charts was performed, comparing the patient reports of women who had secondary ovarian lesions with those whose ovaries showed no pathologic findings during the ten year period of observation (1980 to 1990). The study included 1,265 women with at least one ovary saved after hysterectomy for benign indications. Main outcome measures were ovarian pathologic findings after hysterectomy requiring repeat operation. The overall incidence of lesions in retained ovaries was 3.95 percent. There was a 3 percent risk of having secondary ovarian pathologic findings within three years after hysterectomy, with a decreased risk for the following seven years (mean follow-up time of 60 months, range of three to 120 months). Histologic findings at reoperation included common benign conditions of the ovary. No instance of carcinoma of the ovary was found. The risk of having pathology in the retained ovaries after hysterectomy was significantly higher in women who had only one ovary saved, compared with those who had both ovaries saved (7.63 versus 3.47 percent; p < 0.05). The mean age at hysterectomy was significantly lower in women who had ovarian disorders subsequent to hysterectomy than in those who did not (39.3 versus 43.9 years; p < 0.001). In the group of women with secondary ovarian lesions, mean parity was significantly lower than in those without reoperation (1.22 versus 1.94; p < 0.0001). Women with unilateral oophorectomy at the time of hysterectomy had twice the risk of secondary ovarian lesions, compared with those without oophorectomy at hysterectomy. Determinants, such as age, parity and gravidity must be considered when deciding whether or not to perform oophorectomy at hysterectomy.

Adolescent↗
PubMed1993

[Human papillomavirus infections and carcinoembryonic antigen expression in cervix intra-epithelial neoplasia of intermediate grade].

The objective was to investigate a possible correlation between expression of carcino-embryonic antigen (CEA) and human papilloma virus (HPV) infection in moderate cervical intraepithelial neoplasia (CIN II). We examined the correlation of the incidence in different cases and the topographical correspondence. CEA was detected by immunohistochemistry and HPV infection was diagnosed by in situ hybridization (including typing of 6/11, 16/18, 31/33) and well-established histologic criteria. Samples from 32 women were examined. In 29 cases (91%) CEA was expressed, mainly in the superficial layer of the epithelium. Twenty-three tissue samples (72%) showed HPV infection. There was topographical correspondence of the two markers (mainly in superficial cell layers) but no correlation concerning the incidence of HPV infection or particular HPV subtypes. The highest prevalence of HPV was found in dysplasias of the large-cell reserve cell type.

Adult↗
PubMed1992

[Drug dependence, smoking and fetal growth retardation].

Illicit drug abuse, as well as smoking, are known risk factors in the development of intrauterine growth retardation. In an attempt to clarify the influence of these two aetiological factors, a retrospective analysis was carried out. 35 drug- and nicotine-addicted pregnant women were compared to 104 smokers and 101 non-smoking controls with regard to foetal outcome. Relative risk estimates for intrauterine growth retardation of the drug and nicotine group were 3.14 (95% confidence limits 1.88-5.25; p = 0.0001) whereas the smoking group had 1.39 (95% confidence limits 0.96-2.02; p = 0.0482) compared to non-smoking controls. The foetal outcome was best in the latter group: children of drug-addicted mothers had a considerably higher morbidity and mortality rate. This study shows an almost threefold risk for intrauterine growth retardation in drug-addicts who smoke, compared to nicotine abuse alone.

Acid-Base Equilibrium↗
PubMed1992

[The value of the urethral depression quotient in diagnosis of female stress incontinence using the Brown-Wickham method].

Various parameters of the urethral pressure profile have been developed to improve diagnosis of genuine stress incontinence. By application of micro-tip transducers, a positive correlation between "depression ratio" and degree of incontinence as had been observed by Eberhard. The aim of this study was to examine Eberhard's observations by the use of Brown-Wickham's method. Significant differences in the parameters of the urethral pressure profile during stress, such as the urethral closure pressure, depression pressure, depression ratio, transmission ratio, and the area of continence, were found between continent and incontinent patients. Although pressure transmission and transmission ratio revealed significant differences, depression pressure and depression ratio were found to be similar in patients with mild and severe degree of incontinence. According to the results of this study, depression ratio does not reflect the degree of urinary loss, when open catheters are used.

Female↗
PubMed1992

[Surgical treatment of invasive malignancies of the vulva using CO2 laser].

In a retrospective study, we analysed 26 CO2-laser vulvectomies within the observation period between 1982 and 1990. Indications for vulvectomies were invasive malignancies of the vulva, FIGO stage I to III. 91.7% were squamous cell carcinomas. The mean age of patients was 69.3% (43 to 87) years. Five radical local excisions, one modified radical vulvectomy and in all other cases radical vulvectomy was performed. Laser surgery of the vulva was combined with bilateral lymphadenectomy or radiotherapy of inguinal lymph nodes. If necessary, a gluteal rotation flap was built to achieve closure of the wound without tension. No serious intra- or postoperative complications were observed, wound breakdown with per secundam healing as the most common complication occurred in 29.1%. Functional and cosmetic results were examined in a detailed follow-up at least 12 months postoperatively, showing promising results (56.3% good, 37.5% satisfactory, 6.3% unsatisfactory). The surgical procedure, perioperative management, recurrence rate (3 patients, 12.5%), as well as functional and cosmetic results, are presented and discussed in detail. The use of CO2-laser in surgical treatment of vulvar malignancies improves cosmetic and functional results. This is important, particularly with regard to the increasing number of young women with vulvar neoplasia.

Adult↗
PubMed1991

Immunohistochemical differentiation between ovarian granulosa cell tumors and ovarian carcinomas.

Differential diagnosis is a major problem in histopathology of ovarian tumors. Difficulties may arise if the tumor is a poorly differentiated carcinoma or a granulosa cell tumor of the sarcomatoid type. It was the aim of the present study to evaluate the usefulness of immunohistochemistry in differentiating between granulosa cell tumors of the ovary and ovarian carcinomas. We investigated 56 ovarian malignancies (13 granulosa cell tumors, 17 serous, 14 mucinous and 12 poorly differentiated carcinomas) and performed immunohistochemical detection of Vimentin, Keratin, CA125, CA19-9, CEA, S100 and Ber-EP4. Expression of Vimentin was highest and expression of Keratin was lowest in granulosa cell tumors in contrast to carcinomas. CA125 and CA19-9 were not expressed in granulosa cell tumors, whereas the detection rate in carcinomas (except for CA125 in mucinous carcinomas) was high. CEA, S100 and Ber-EP4 do not seem to be useful markers in differential diagnosis. A marker profile of Vimentin, Keratin, CA125 and CA19-9 allows a quite strict differentiation between poorly differentiated ovarian carcinomas and granulosa cell tumors of the ovary.

Adenocarcinoma, Mucinous↗