Biomedical subjects

JS Haselkorn

Publications and source records attributed to JS Haselkorn.

4 recordsLinked to original sources

PubMed1996

Laparoscopic Bipolar Coagulation for the Conservative Treatment of Adenomyomas

We assessed the effectiveness of laparoscopic bipolar coagulation in 20 women with severe dysmenorrhea, chronic menorrhagia, and a magnetic resonance imaging diagnosis of adenomyomata. In addition, nine women underwent transcervical endomyometrial resection; three (33.3%) of these women underwent concomitant submucous leiomyoma resection. One woman (5.0%) had resection of submucous leiomyomas without endomyometrial resection. The mean (± SEM) total uterine volume before leuprolide acetate administration was 433 ± 29 cm3; this was reduced to 239 ± 11 cm3 after 3 months of drug therapy, a 44.8% reduction. This volume was further reduced to 156 ± 20 cm3 (p <0.0001) 7 to 12 months postoperatively, a 64.0% reduction from baseline. Twelve months postoperatively 16 women (80.0%) had satisfactory resolution of menorrhagia, and 14 (70%) had satisfactory resolution of dysmenorrhea. Three patients (15.0%) required hysterectomy, two (10.0%) required gonadotropin-releasing hormone agonist add-back therapy to resolve recurrent menorrhagia, and two (10.0%) required endometrial resection after bipolar coagulation of adenomyomata failed to resolve menorrhagia. Conservative treatment obviated the need for major surgery in most women (85.0%) with adenomyomata.

Journal Article↗

PubMed1996

Laparoscopic Leiomyoma Coagulation

From February 1992 through March 1995, 167 women (mean ± SEM age 44.7 ± 0.3 yrs, range 22-52 yrs) with symptomatic leiomyomata underwent laparoscopic leiomyoma bipolar coagulation. Women with chronic menorrhagia had concomitant transcervical endometrial resection (TEMR) and resection of any existing submucous leiomyomas (TSR). Follow-up was 30.2 ± 1.0 months (range 12-49 mo). Depot leuprolide acetate was administered for 3 months before surgery to 164 (98.2%) of the patients. The surgical procedure was evaluated in terms of numbers and types of concomitant procedures, whether or not symptoms were controlled, and changes in uterine and leiomyomata volumes. Mean total uterine volume decreased from 623 cm3 before leuprolide treatment to 139 cm3, a 77.7% reduction, 7 to 12 months postoperatively (p <0.0001). Six women (3.6%) had hysterectomy for recurrent menorrhagia, pain, and pressure; pathologic evaluation revealed adenomyosis or leiomyomata or both. Of 52 women with chronic menorrhagia, 33 (63.5%) developed amenorrhea, 17 (32.7%) had hypomenorrhea or eumenorrhea, and 2 (3.8%) required repeat TEMR. The two women who desired fertility had uncomplicated viable full-term pregnancies and delivered vaginally. Laparoscopic myolysis alone or in conjunction with TEMR and TSR obviated the need for major surgery in 161 patients (96.4%). Until further studies are concluded, only selected women contemplating pregnancy should undergo myolysis.

Journal Article↗

PubMed1996

The Effect of Dilute Vasopressin Solution on Blood Loss During Operative Hysteroscopy

A study was designed to assess the effect of intracervical injection of dilute vasopressin solution 0.05 U/ml on intraoperative blood loss during operative hysteroscopy. In a prospective, computer-randomized, double-blind study, vasopressin or placebo (normal saline) was injected into the cervical stroma of 108 women before dilatation of the cervix. Intraoperative bleeding was calculated by dividing the number of red blood cells/milliliter of outflow distention fluid by the number of red blood cells/milliliter of the patient's blood immediately before the procedure, and multiplying this quotient by the total amount of outflow fluid collected. Mean (± SEM) intraoperative blood loss of the placebo-treated group was 35 ± 6.5 ml (range 0-290 ml), and in the vasopressin-treated group was 18.2 ± 3.8 ml (range 0-135 ml), a 47.1% reduction (p <0.001). The visual clarity of the uterine cavity during surgery was not statistically different in the two groups. The concentration of vasopressin 50 U/ml may prove to be clinically significant to minimize the risk of cardiovascular morbidity, especially in women who are severely anemic and at risk for blood transfusion.

Journal Article↗

PubMed1996

The Effect of Dilute 0.25% Vasopressin Solution on the Linear Force Necessary for Cervical Dilatation

We assessed the force necessary for mechanical cervical dilatation on a nonpregnant uterus after intracervical administration of dilute vasopressin solution 0.05 U/ml. In a prospective, double-blind, randomized study, vasopressin or placebo was injected into the cervical stroma before dilating the cervix in preparation for resectoscopy. An electronic load cell was used to measure the peak linear force necessary to dilate the cervix from 3 to 11 mm using half-size metal dilators. Mean (± SEM) total peak linear force to dilate the placebo-treated cervix from 3 to 11 cm was 36.82 ± 1.88 lbs (range 6.11-52.2 lbs). In the vasopressin group it was 20.57 ± 5.54 lbs (range 5.54-40.82 lbs, p <0.001), a 44.1% reduction. One cervix (3.8%) in the placebo group and one (3.6%) in the vasopressin group required suturing of lacerations (p >0.05). This effect of dilute vasopressin solution may reduce trauma to the internal cervical os and lower uterine segment.

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