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Biomedical subjects

I Bukovsky

Publications and source records attributed to I Bukovsky.

At least 145 records · Page 8Linked to original sources
PubMed1990

Cervical internal os cerclage: description of a new technique and comparison with Shirodkar operation.

Internal os cerclage for cervical incompetence was performed in 90 patients who had previous McDonald procedure failure (70 patients) or had unfavorable cervical anatomy (short or lacerated cervix) for primary McDonald type cerclage (20 patients). Two different techniques were used: the Shirodkar operation (n = 44) with Mersilene band, and a simpler new technique (n = 46). The new technique is characterized by anterior colpotomy for exposure of the internal os, and a 0.6 mm nylon suture encircling the cervix to be tied high in the posterior fornix. The pregnancy outcome for both groups was similar. Late abortions of 8.7 and 11% and premature deliveries of 13 and 18% occurred in the new technique and the Shirodkar groups, respectively. The removal of the suture was generally difficult in the Shirodkar group and in eight patients analgesia and sedation were required. In the new technique group, the removal was easier and in only one patient was sedation required (p less than 0.0001). Severe vaginal discharge was found in 52% of the Shirodkar patients and none in the other group. Apparently the monofilament nylon suture prevented this side effect. It seems that the new technique is simpler to perform, involves fewer side effects, the removal of the suture is easier, and it is as effective as the Shirodkar procedure.

Cervix Uteri↗
PubMed1990

Penicillin-tetracycline prophylaxis in cesarean delivery: prospective and randomized comparison of short and long term therapy.

A prospective and randomized study was undertaken to determine the safety and efficacy of low price and discouraging bacterial resistance agents, given for 12 hours versus 72 hours, as prophylaxis at cesarean section. Ninety six patients received penicillin (ten million units) intravenously and tetracycline (0.25 g) intramuscularly at cord clamping and 12 hours postoperatively (table I). Among them 14% of febrile morbidity was recorded (table II). Eighty seven patients received the same treatment followed by oral ampicillin (2 g) and tetracycline (1.5 g) per day, for a further 60 hours (table I). Maternal febrile morbidity was not further reduced by the oral additional treatment (table II). This regiment prophylactic effect is comparable to previous reported data concerning other protocols, and even better, while expenses are reduced and efficacy for important pathogens such as chlamydia and mycoplasma is obtained. No side effects of the drugs were recorded.

Adult↗
PubMed1990

Colposuspension for urinary stress incontinence in premenopausal and postmenopausal women.

Sixty-nine premenopausal and 53 postmenopausal women had a colposuspension operation for urinary stress incontinence. A significant postoperative reduction (p less than 0.001) of symptoms of frequency, nocturia, urgency and urge incontinence was obtained in both groups. Postoperatively, 88.4 per cent of the premenopausal women were found to be dry compared with 66 per cent in the postmenopausal group (p less than 0.01). No differences were found preoperatively and postoperatively in the cystometric values or in the urethral pressure profiles at rest in both groups and between the groups. The pressure transmission ratios were significantly improved postoperatively in both groups. The postoperative transmission ratios in the premenopausal women were found to be significantly higher than those in the postmenopausal group, at the middle two-quarters of the urethra. Although surgical treatment for urinary stress incontinence in postmenopausal women results in lower cure rates than in younger women, it should be considered.

Adult↗
PubMed1990

Polymicrobial infections of the female low genital tract.

A complete microbiologic analysis of nine infectious agents causing low genital tract infection (LGTI) was obtained in 240 young women, of whom 193 were symptomatic for LGTI and 47 were asymptomatic (control group). The polymicrobial nature of LGTI was demonstrated by both the increased frequency of different microorganisms (1.77 +/- 1.09 SD in symptomatic vs. 1.08 +/- 0.98 in asymptomatic patients) and the increased total number of agents (0 agents 8.3 and 36.2%, 1-2 agents 67.4 and 55.3%, greater than or equal to 3 agents 24.3 and 8.5%, in symptomatic and asymptomatic patients respectively). There was a mutual association between Ureaplasma urealyticum and Mycoplasma hominis, where the presence of one nearly doubled the frequency of the other. Of 74 symptomatic patients with a single infectious agent, Chlamydia trachomatis was isolated most frequently, suggesting an important role of this agent in infections of the female low genital tract.

Adolescent↗
PubMed1989

Tubal patency after local methotrexate injection for tubal pregnancy.

Tubal patency was investigated by hysterosalpingography in 21 of 37 patients with unruptured tubal pregnancy treated by local methotrexate injection at laparoscopy. 18 of the 21 patients had bilateral tubal patency, and the only tube of a patient with a single fallopian tube was also patent. 6 subsequent intrauterine pregnancies have so far been recorded. Local methotrexate injection into the tubal pregnancy may provide an efficient and safe alternative to surgery in early unruptured ectopic pregnancy.

Chorionic Gonadotropin↗
PubMed1989

The importance of ultrasonography in infertile women with "forgotten" intrauterine contraceptive devices.

Seven cases in which an unknown intrauterine contraceptive device in situ was the cause of infertility were referred to our infertility Clinic after each patient had been told by her physician that she no longer had an intrauterine contraceptive device. In some cases, there were lapses in the infertility workup that might explain how the cause of infertility of an intrauterine contraceptive device in situ was missed. In other cases, a thorough investigation was made and infertility treatment was started without the existence of an intrauterine contraceptive device in situ being diagnosed.

Adult↗
PubMed1989

Local methotrexate injection: a nonsurgical treatment of ectopic pregnancy.

Twenty seven patients with unruptured tubal pregnancy were selected for nonsurgical treatment with the use of one injection of 12.5 mg of methotrexate into the ectopic site at laparoscopy. No adverse reactions were observed. In three patients (11%), a laparotomy was performed because of rising beta-human chorionic gonadotropin titers. In the other patients, serum beta-human chorionic gonadotropin levels decreased to the nonpregnant range with no further intervention, and the patients recovered uneventfully. This method is suggested as an alternative to surgery in selected cases of early unruptured tubal pregnancy.

Adult↗
PubMed1989

The effect of chronic gonadotropin-releasing hormone analog (D-Trp-6) treatment on elevated and normal serum prolactin levels.

A long-acting GnRHa (D-Trp-6 microcapsules) proved capable of lowering serum PRL levels in a young hyperprolactinemic patient treated for a large myomatous uterus. No similar inhibitory effect was found in normoprolactinemia. Chronic GnRHa therapy may constitute an alternative to the existing forms of treatment for hyperprolactinemia and pituitary adenomas.

Adult↗
PubMed1989

Congenital anomalies of the müllerian system.

Congenital anomalies of the müllerian system, the most common of which are uterine malformations, are associated with fertility problems. Multifactorial polygenic and familial factors are involved in their formation. The result may be deficient development (agenesis, rudimentary horn, unicornuate uterus), nonfusion (didelphys or bicornuate uterus), or defective canalization of the müllerian ducts (septate uterus). The principal diagnostic procedures include HSG, laparoscopy, hysteroscopy, and US. The clinical presentation varies from symptoms of obstruction of the menstrual flow in adolescence to hypomenorrhea and fertility problems in adult life. Repeated fetal loss, after excluding other reasons, is usually the indication for surgical intervention. Uterine septa should be resected hysteroscopically. A prophylactic cerclage has been suggested by various authors, including those of this work, in cases of symmetric uterine anomalies, especially bicornuate uteri, as a simple and effective treatment to be tried before embarking on major surgery such as metroplasty.

Abnormalities, Multiple↗
PubMed1989

D-Trp-6-luteinizing hormone-releasing hormone microcapsules in the treatment of uterine leiomyomas.

Long acting D-Trp-6-luteinizing hormone-releasing hormone (LH-RH) microcapsules, 3.2 mg were given monthly, intramuscularly for a period of 6 months to 26 menstruating patients with symptomatic leiomyomas. The patients ages were 22 to 52 years. Five patients (20%) were infertile. Patient evaluation before initiation of treatment included endometrial biopsy, ultrasonic measurements of uterine and tumor volumes, and bone-mineral density. The patients were periodically followed hormonally and ultrasonographically. A statistically significant reduction in uterine and tumor volumes (maximal after 4 months of treatment) was observed in all the patients except one. Two patients discontinued the treatment after 2 months, preferring surgery. A nonsignificant decrease in the mean bone-mineral density was noted after completion of therapy. Minor side effects such as hot flushes, vaginal dryness, backache, vaginal spotting, and nervousness, were encountered frequently, disappearing within 6 weeks after the last injection. A significant increase in uterine and myoma volume was noted in all the patients at 3 months after treatment.

Adult↗
PubMed1989

Elective caesarean hysterectomy. Indications and outcome: a 17-year experience of 140 cases.

In an earlier report of 86 elective Caesarean hysterectomies (1970-1979) we showed that the operation was associated with few complications but a high blood transfusion rate. In this paper we report an extended series comprised of 140 cases (1970-1986), and compare results of the 1970's series with that of the 1980's. The operative and postoperative complications were minimal during the entire period. The blood transfusion rate which was 64% in 86 cases of the 1970-1979 period decreased to 17% in 54 cases of the 1980-1986. Our results show that Caesarean hysterectomy is a safe procedure with some long-term advantages; therefore this option should be discussed with women who ask for tubal sterilization at the time of Caesarean section.

Blood Transfusion↗
PubMed1989

The effect of total abdominal hysterectomy on bladder function in asymptomatic women.

The effect of total abdominal hysterectomy as treatment for benign conditions on the postoperative incidence of urinary symptoms and abnormal urodynamic findings was evaluated in 16 premenopausal women who lacked urinary symptoms preoperatively. The urodynamic evaluation was performed preoperatively, at 4 weeks, and again at 4 months after surgery. No clinical symptoms of frequency, nocturia, urgency, or urge or stress incontinence were found postoperatively. There were no significant differences from the preoperative values for cystometry, uroflometry, and urethral pressure profiles. Urinary dysfunction should not be a consequence of an uncomplicated total abdominal hysterectomy for benign conditions in women who were previously free of urinary symptoms.

Adult↗
PubMed1988

The value of simultaneous hysterectomy during Burch colposuspension for urinary stress incontinence.

The effect of concomitant hysterectomy during colposuspension on the cure rate of genuine stress incontinence was evaluated prospectively in 45 patients. Twenty-two women underwent a colposuspension only (no-hysterectomy group) and 23 had a concomitant abdominal hysterectomy and cul-de-sac obliteration (hysterectomy group). Twenty-five months postoperatively, no differences were found in the cure rate for urinary stress incontinence between the two groups (95.5 and 95.7% for the no-hysterectomy and the hysterectomy group, respectively). In the no-hysterectomy group, three patients (13.6%) had enterocele formation after surgery; this complication did not occur in any of the patients in the hysterectomy group.

Female↗
PubMed1988

Colposuspension in patients with combined stress incontinence and detrusor instability.

Thirty women with combined urinary stress incontinence and detrusor instability were treated by a colposuspension operation for urinary incontinence. Following surgery we found a significant reduction of symptoms regarding detrusor instability, from 22/30 patients preoperatively (73.3%) to 10/30 patients (33.3%). Urodynamically, 40% of the patients had detrusor instability following surgery. Only one surgical failure was encountered (3.3%). It is suggested that patients with combined detrusor instability and stress incontinence should be operated on. This group of patients was cured as far as stress incontinence is considered, and 60% of the patients presented normal cystometric findings and more than 50% of the patients (12/22) greatly improved clinically, regarding symptoms of detrusor instability, following surgery.

Adult↗
PubMed1988

Ovarian residual syndrome.

During the years 1979 to 1983, 329 patients underwent hysterectomy with preservation of one or both ovaries. Six patients were evaluated for postoperative chronic lower abdominal pain and dyspareunia. Findings at laparotomy confirmed the diagnosis of residual ovarian syndrome in all six. Relief of symptoms was observed after adnexectomy in four, oophorectomy in one patient and ovariopexy in one. The literature concerning this rare complication after hysterectomy is briefly reviewed.

Abdomen↗