[Simultaneous pressure measurement of the bladder and urethra in the diagnosis of urinary incontinence in women].
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Biomedical subjects
Publications and source records attributed to K Kolmorgen.
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The presence of gonorrhoea was verified by culturing in 30.3 per cent of 119 patients in whom acute adnexitis had been confirmed by laparoscopy, gonorrhoeal findings being independent of types of inflammation.--Cervical, urethral, and abdominal cultures were prepared from various materials at one and the same time. Positive responses were recorded from them in one third of the cases of gonorrhoea. Three patients exhibited positive reactions only from abdominal cultures.--Additional aerobic and anaerobic pathogens were recorded from abdominal samples in 16 of 29 cases. Their occurrence should be taken into consideration in the treatment of female gonorrhoea with concomitant adnexitis.--A recommendation is made to the effect that abdominal gonorrhoeal cultures should be prepared in all cases of laparoscopy or laparotomy for acute adnexitis. Highest rates of detection can be expected, in that context, from tubal tissue cultures.--An approach is described by which to prepare gonorrhoeal cultures with no transport medium for conditions under which hospital and gonorrhoea laboratory are not located on one and the same premises.
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Reported in this paper is the authors' experience from 81 dura-sling operations in which human dura had been used. The procedures for dura collection and preservation are described in some detail. Treatment was rendered to 61 patients with primary incontinence and 20 patients with recurrent incontinence. The recurrence rate was 6.2 per cent, between one and five years from surgery.--Cases of severe stress incontinence were treated by dura-sling operation, preceded by careful presurgical diagnosis on the basis of both urethrocystotonometry and lateral urethrocystography. The method was found to be adequate.
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154 aspirations of ovary cysts by laparoscopy are reported. 16% of cysts have relapsed after 1 till 7 years. Cytologic investigation and investigation of tissue of cysts are recommended. The advantages of aspiration by laparoscopy over the vaginal blind aspiration are discussed.
11,8% (354 patients) of 3000 laparoscopies were performed because of suspected ectopic pregnancy (E.P.). In 23,4% of the diagnostic laparoscopy the diagnosis was confirmed. The rate of E.P. without bleeding was 11,8%. Laparoscopy is considered to be the method of choice to diagnose as well as to exclude E.P.
In cases of acute adnexitis laparoscopy is an excellent diagnostic method. By this way we found in 182 patients with clinical symptoms only 50,5% acute inflammatory diseases of adnexa. On the other hand there was a normal genital status in 18,1%, acute appendicitis in 9,9%, ectopic pregnancy in 7,7% etc. Clinical examinations and second-look-laparoscopy 6--8 weeks after ending the treatment cases of salpingitis alone showed the best results. Patients with more extensive inflammatory reactions had more adhesions too. An early diagnosis and treatment under hospital conditions is recommended. We have good experiences with immediately operation in cases of suppurative inflammation of the adnexa, which are only diagnosticate by laparoscopy.
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The authors performed 2000 laparoscopies in females with chronic and acute pelvic pain. In 399 cases an appendectomy had been done before. Among 478 patients with acute pelvic pain an acute appendicitis was found in 26 women by laparoscopy.
During the past nine years 2700 laparoscopies with 0,4% complications were performed. By reason of the increasing interest for laparoscopy it is refered to cause and avoidance of those complications. Exact technique, an optimum of equipment of apparatus and increasing experience are very important for the laparoscopic examination with the lowest risk.
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2000 laparoscopies were performed between 1968 and 1975. 253 from 493 patients with unexplained pelvic pain were followed up a half till 5 years after laparoscopy concerning the pains. The discrepancy of clinical diagnosis and laparoscopie statement is compared and discussed. The most clinical diagnosis were: chronic pelvic pain (149 cases) and unexplained pelvic pain (32 cases). Postlaparoscopic findings were: inconspicuous statements (27,3%), pelvic adhesions (27,3%), chronic disease of the fallopian tubes (21,1%), chronic appendix diseases (10,3%), ovary cysts (9,8%), endometriosis (4,3%).52,9% of the patients were cured by specific treatment a half till 5 years after laparoscopy. The laparoscopy is considered to be a diagnostic and therapeutic acurate method. 14,2% of the patients with little or inconspicuous statements were cured after instruction. The laparoscopy may be the base for acurate diagnostic and team-work of several branches of knowledge.
On 155 patients with vaginal descensus and urinary stress incontinence an vaginal-anterior and posterior colporrhaphy (Kelly)- or abdomino-vaginal operation--vaginal hysterectomie combined with colporrhaphy (Kelly) and Marshall-Marchetti-Krantz-had been performed regarding the lateral Cystorethrogram. The combined operation increased from 12,9% to 55,9%. The results with 13,9% recurrent stress incontinence are encouraging considering the results of severe vaginal operation with 20,4% recurrent stress incontinence. A good plastic result was obtained in 96,2% of the patients.
This report deals with 432 single breech presentation deliveries. Caesarean section frequency was 12,3%. As to the vaginal route of delivery, the simple Bracht manoeuvre had been prefered; in recent times, however, the assisted spontaneous delivery with oxytocin-infusion has been introduced. The corrected perinatal mortality was 4,9%. The rate of prematurely born infants amounted to 14,6%. The corrected perinatal mortality of infants up to 2500 g was 3,3%; of full term infants it was 1,4%. The importance of breech presentation delivery as a high risk delivery is being emphasized. Fetal monitoring and blood gas analysis were required. Indications of caesarean section and suggestions for the management of breech presentations were established. Generally caesarean section of primiparae is not recommended. The diminished rate of prematurely born infants is considered to be of great importance for the decrease of perinatal mortality of breech presentation infants. Intensive pregnancy care, widely used uterotocolysis, and cervix-cerclage in cases of breech presentation are recommended.