Genital human papillomavirus infection in the male sexual partners of women with isolated vulvar lesions.

The purpose of this study was to detect human papillomavirus (HPV) positivity in the male sexual partners of women with isolated vulvar lesions. The male counterparts of the females were subjected to detailed physical and peniscopic evaluations. After the gross inspection, 5% acetic acid was applied and the whole genital organs were evaluated using a colposcope. Overall, 47 male sexual partners with isolated vulvar HPV lesions were included. None of the patients had condylomata acuminata. Twenty-six patients (55%) had papular or papillary lesions, and 21 (45%) had flat acetowhite lesions. Biopsies were taken from all these suspicious areas for histopathologic examination. Overall, 41 patients (87%) had the exact characteristics of HPV on biopsy specimens. Ninety-two percent of patients (24/26) having papular and/or papillary lesions on peniscopy had HPV on biopsy, while 81% of patients (17/21) who had acetowhite flat lesions had biopsy-confirmed HPV lesions. In conclusion, it is important to assess the male sexual partners of women with HPV-related lower genital tract disease. Peniscopy is valuable for detecting lesions, and histopathologic confirmation is mandatory.

Small diameter versus conventional laparoscopy: a prospective, self-controlled study.

The objective of this study was to determine visual quality, diagnostic accuracy, and surgical merits of small diameter laparoscopy (SDL). Thirty-seven patients were randomly selected. The indications for laparoscopy were infertility, desire for tubal sterilization or chronic pelvic pain. Patients underwent SDL, followed by conventional laparoscopy (CL) as a control under general anaesthesia. Findings at operation were compared. The mean time for diagnostic work-up was longer with SDL than CL, 11.7 +/- 5.6 versus 7.6 +/- 3.2 min respectively (P < 0.04). Visual quality was scored from 4 to 1 by the operator; mean visual quality, mean endometriosis score and mean adnexal adhesions score were slightly lower with SDL than CL. Sensitivity of SDL in diagnosing endometriosis, adhesions, ovarian, uterine and pouch of Douglas lesions were 71, 58, 81, 89 and 73% respectively; specificity was 100, 96, 100, 100, 100% in the same order. Suction irrigation, cyst aspiration, tissue biopsies, simple adhesiolysis, tubal ligation and cauterization were easily performed with SDL. We conclude that SDL seems a good alternative to CL in diagnosing macro-pelvic anatomy and coarse pelvic pathologies and may also be good in performing surgical procedures such as: tubal ligation, biopsies and differential diagnosis of pelvic fluids. But SDL must be used cautiously in micro-oriented, functional conditions such as infertility, pelvic pain, endometriosis and adhesion scoring or treatment. SDL may be regarded as a less invasive but less sensitive tool with limited surgical merits.

An extraperitoneal burch procedure: a case report.

A new laparoscopic Burch procedure with preperitoneal balloon dissection is introduced. A stress incontinence case without cystocele was operated by laparoscopic extraperitoneal colposuspension. The procedure was found to be effective a year after and no complications were seen. The extraperitoneal Burch procedure has the advantages of easy dissection, less bleeding, pain, and adhesion formation, a lower chance of injury to intraperitoneal organs, and short hospital stay and operation time; but the procedure has the disadvantages of a new anatomy orientation and the additional cost of a disposable balloon dissection set.