Biomedical subjects

H T Lefler

Publications and source records attributed to H T Lefler.

6 recordsLinked to original sources

PubMed1992

Endometrial ablation. Improvement in PMS related to the decrease in bleeding.

Of 108 patients evaluated before and after ablation of the endometrium since July 1986, for menorrhagia and symptoms associated with the menstrual period, 57 met criteria for premenstrual syndrome (PMS). An additional 35 patients had symptoms associated with their menstrual period but did not qualify for a diagnosis of PMS. Following endometrial ablation most patients in both groups reported either amenorrhea or spotting and decreased severity of symptoms. The degree of improvement in both PMS and perimenstrual symptoms seemed to be related to the degree to which bleeding was reduced.

Adult↗

PubMed1992

Ablation of the endometrium. Three-year follow-up for perimenstrual symptoms.

Sixty-four patients who had undergone ablation of the endometrium since July 1986 were evaluated preoperatively and again postoperatively for menorrhagia, days of disability related to menstrual periods and perimenstrual symptoms. After ablation of the endometrium, most of the patients reported experiencing either amenorrhea or spotting, a decrease in the number of days of disability related to their periods and/or in their perimenstrual symptoms, and decreased severity of their symptoms. The improvements in menstrual bleeding and perimenstrual symptoms appeared to be sustained for at least three years.

Endometrium↗

PubMed1991

Modified endometrial ablation: electrocoagulation with vasopressin and suction curettage preparation.

Patient preparation and a modified operative technique are described for electrocoagulation ablation of the endometrium using a roller-bar electrode. No preoperative or postoperative endometrial suppression was used. Rather, the endometrial cavity was denuded by suction curettage just before ablation, which was performed in the early proliferative phase of the menstrual cycle. Lidocaine paracervical block containing vasopressin was injected at the start of the procedure to control pain and to minimize bleeding and irrigation fluid absorption. Pulsed irrigation of the uterus was used to improve visibility through uterine debris and the bubbles generated by the electrical current. The first 20 patients who had electrocoagulation ablation of the endometrium with these modifications were compared with the first 18 patients who had laser coagulation ablation using standard technique and preoperative endometrial suppression. Compared with the laser method, the modified coagulation method resulted in a comparable rate of satisfactory bleeding decrease at 6 months (90 versus 94%), but involved a clinically significant reduction in total anesthesia time (66.8 versus 117.3 minutes) and volume of irrigation fluid used (5.7 versus 15.9 L).

Adult↗

PubMed1989

Premenstrual syndrome improvement after laser ablation of the endometrium for menorrhagia.

Laser ablation of the endometrium was performed on 18 patients for menorrhagia. The patients were evaluated for the premenstrual syndrome (PMS) preoperatively and again at three and six months postoperatively. An improvement in both the severity and duration of PMS symptoms was noted postoperatively, and the reduction in menstrual bleeding was correlated with the reduction in PMS symptoms.

Endometrium↗

PubMed1976

Spring clip sterilization: one-year follow-up of 1,079 cases.

This is a report of 1,079 patients who underwent laparoscopic clip sterlization as of March, 1974. A one-year follow-up was obtained on 977 patients, or 90.5 per cent. Complications due to the clip technique appear limited to postoperative cramps for 24 to 48 hours in 26 per cent of patients. No ectopic pregnancies were detected. Pregnancies, when corrected for unsuspected existing pregnancies and surgical and manufacturing errors, occurred in 2 to 6 cases, for a method failure rate of 2 to 6/1,000. This report documents that experienced laparoscopists can perform this practice with local anesthesia, in combination with first-trimester abortion, and in hospital facilities other than an operating room.

Anxiety↗

PubMed1975

Sterilization by spring clip: a report of 1000 cases with a 6-month follow-up.

In September 1972, clinical trials of a spring-loaded clip for laparoscopic sterilization were begun and extended to a number of centers in the United States and overseas. As of March 1974, more than 1000 patients had undergone the procedure, usually performed under local anesthesia in an outpatient setting, with no fixed contraindications. Complications and pregnancy rates based on a preliminary 6-month follow-up are presented. Complications due to application of the clip appeared to be limited to postoperative cramps lasting 24 to 48 hours (26% of the patients). No ectopic pregnancies were reported. Pregnancies, when corrected for unsuspected pregnancies and misapplication of the clip, occurred in 2 of these first 1000 patients. The difficulties and relative contraindications learned from this unselected series and the advantages over electrocagulation techniques are discussed.

Abortion, Spontaneous↗