Post-fertilization effects of chronic renal failure in male rats.

We evaluated the potential for growth and intrauterine development of embryos generated from the fertilization of oocytes with spermatozoa recovered from animals with chronic renal failure (CRF). Group A included sham-operated rats (n = 28), group B1 involved CRF rats that had undergone erythropoietin plus bromocryptine treatment (n = 28), and group B2 included CRF rats that had received normal saline. Embryos derived from the in vitro fertilization of oocytes with spermatozoa recovered from rats of group A or group B1 or group B2 were transferred to female recipients. We induced CRF in a group of rats (group B; n = 56; the total kidney volume was reduced to one-sixth with two operations). One week after the second operation, the rats of group B were randomly divided into group B1 (they subsequently received bromocryptine plus erythropoietin) and group B2 (they received injections of saline). Nine weeks after the second operation, the fertility of each male rat was assessed by mating tests and in vitro fertilization of oocytes. The mean litter size was significantly smaller in the subpopulation of fertile animals in group B2 than in the fertile rats of group B1 and in the fertile rats of group B1 than in the fertile rats of group A. Per cent of transferred blastocysts that developed into alive offspring were significantly lower in group B2 than in group B1 and in group B1 than in group A. Epididymal spermatozoa demonstrated a significantly larger DNA-oxidative damage in group B2 than in group B1 and in group B1 than in group A. These findings demonstrate that sperm-DNA damage because of CRF development is accompanied by a defect in the development of embryos generated in vitro. We may suggest that bromocryptine and erythropoietin protecting sperm DNA from oxidative damage improve reproductive potential in rats with CRF.

Safety issues of hysteroscopic surgery.

The term hysteroscopy is used to determine the procedure during which an endoscopic view of the endometrial cavity is achieved with the help of a type of endoscopic device called "the hysteroscope." Hysteroscopy is used to assist the diagnosis for a series of female pathology. Apart from its diagnostic value, hysteroscopy can also be used for operative procedures including ablation and resection. Both diagnostic and operative hysteroscopy have been used for a number of years and various studies have been published to describe their success and complication rates throughout this period. Diagnostic hysteroscopy is relatively safe, whereas complications occur more frequently when operative hysteroscopy is used. These complications include uterine perforation, hemorrhage, fluid overload, gas embolization, and hyponatremia. The rate in the appearance of these complications is dependent on the type of the hysteroscopic procedure, the distending medium, and the experience of the hysteroscopist. To avoid any problems concerning the application of hysteroscopic procedures, it is important to take the necessary precautions both preoperatively and intraoperatively. For example, the preoperative use of thinning agents of the endometrium and the reduction of the operating time, or the avoidance of cutting too deeply into the myometrium, are some of the parameters to be considered when hysteroscopy is in argument.

Greek experience in the use of Thermachoice for treating heavy menstrual bleeding: prospective study.

Heavy menstrual bleeding (HMB) occurs in a considerable percentage of the general population and is one of the main causes due to which a patient is referred to health services. Despite the efforts for pharmaceutical interventions, the symptom usually persists, therefore operative techniques are needed to control the bleeding. Today, apart from the choice of hysterectomy, other less aggressive techniques have been invented. The first results of the Greek Study Group on Gynecological Endoscopy regarding the use of the Thermachoice device are hereby presented. One hundred patients suffering HMB were treated with the Thermachoice device following a standard protocol designed by the Study Group. The follow-up meetings with the patients were held at 3, 6, 12, 24, and 36 months. It seems that the overall effectiveness rate (96%) is satisfactory and it is similar to the overall effectiveness rate reported in other relevant studies upon the Thermachoice device.

Multi-detector CT features of benign adnexal lesions.

RATIONALE AND OBJECTIVES: The purpose of our study was to evaluate the multidetector computed tomography (MDCT) features of benign adnexal lesions. METHODS AND MATERIALS: We report the MDCT features of 68 histologically proven benign adnexal lesions. Pathologic diagnoses were nonneoplastic adnexal cysts (n = 16), endometriomas (n = 12), serous or mucinous cystadenomas (n = 15), fibromas or fibrothecomas (n = 7), teratomas (n = 6), and a variety of benign adnexal lesions (n = 12). The CT protocol included scanning of the abdomen after the intravenous administration of iodinated contrast material (portal phase) using a detector collimation of 16 x 0.75 mm and a pitch of 1.2. RESULTS: Ovarian cysts had a characteristic CT appearance of a cystic lesion, with smooth, thin wall, and occasionally a few septa. Serous and mucinous cystadenomas were detected as multilocular cystic tumors containing serous fluid or liquids of higher than water CT density, respectively. Dilated fallopian tube was seen as an oblong, tubular, fluid-filled structure. MDCT was accurate to characterize mature cystic teratomas. Endometriomas had a variable CT appearance, including a unilocular or multilocular cystic mass, and a homogeneous hyperdense mass lesion. Fibrous tissue had a 50 HU CT density in patients with fibromas or fibrothecomas. CONCLUSION: MDCT may provide accurate diagnostic information about the benign nature of adnexal lesions.

Fibromatous uterus in a 16-year-old girl: a case report.

Although uterine leiomyomas are the most common neoplasms of the female genital tract, this is not the case when referring to women under the age of 20. Only a few cases of uterus leiomyomas have been reported in this age. Preoperative imaging evaluation is mandatory in adolescent women for the accurate detection, localization, and characterization of uterus leiomyomas. We report a case of a 16-year-old girl admitted to our hospital for pain and abdominal distention. The patient underwent multidetector CT examination of the abdomen and MR examination of the pelvis. Both imaging modalities revealed uterine enlargement and the presence of innumerable variably sized leiomyomas. Histopathologic examination following exploratory laparotomy confirmed the presence of uterus leiomyomas. The patient underwent laparoscopic myomectomy two years after the first operation, following MR examination of the pelvis.