Prevention of recurrent bacterial urinary tract infections by intravesical instillation of hyaluronic acid.

OBJECTIVE: To evaluate the efficacy of vesical instillation of hyaluronic acid against recurrent urinary tract infections. METHODS: Twenty women with a history of recurrent urinary tract infections each received 9 intravesical instillations of hyaluronic acid over 6 months. Their status was assessed prospectively over 47.6 weeks and compared with a retrospective review of patient charts covering 36.2+/-6.2 weeks. RESULTS: The total numbers of urinary tract infections were 67 before and 10 after treatment (p<0.001). Thirteen patients (65%) were free of recurrences until the end of the study. One had a recurrence during treatment, and 6 (30%) during follow-up. The number of infections per year per patient was reduced from 4.99+/-0.92 to 0.56+/-0.82 (p<0.001). In women with recurrences, time to recurrence was 178.3+/-25.5 days, compared with 76.7+/-24.6 days before treatment (p<0.001). CONCLUSION: Intravesical instillation of hyaluronic acid is effective in preventing recurrent urinary tract infections.

Propolis solution for the treatment of chronic vaginitis.

OBJECTIVE: To evaluate the efficacy of 5% propolis solution in recurrent vaginitis. METHOD: Fifty-four patients with recurrent vaginal infections having undergone at least one cycle of antibiotic treatment were instructed to apply a 5% aqueous propolis solution as a vaginal douche for seven days. Vaginal smears and specific symptoms were evaluated at baseline and 14 days after treatment. Long-term well-being was assessed by telephone interview six months after follow-up. RESULT: At the follow-up, the vaginal smears of 41 patients (75.9%) had improved. Forty-seven patients (87%) reported reliefs concerning at least one complaint. Associated improvement of smear and well-being was observed in 36 women (66.7%). After 6 months, 33 patients (61.1%) were satisfied with their condition without having undergone further treatment. CONCLUSION: Propolis may have a role as an alternative treatment for chronic vaginal infection.

[Special aspects of abdominal adhesions in gynecology]. / Besondere Aspekte abdomineller Verwachsungen in der Gynäkologie.

Even minor adhesions in the oviduct or in the ovarial region may lead to infertility. In a controlled trial the adhesion status was documented in 103 patients who underwent microsurgical operations for infertility. Solutions of (a) streptokinase/streptodornase, (b) hydrocortisone acetate or (c) Ringer's solution only were administered intraperitoneally as adhesion prophylaxis. During a control laparoscopy 1 week after the primary operation, newly formed adhesions of mainly intermediate extent were observed in about 10% of the patients. There was no significant difference in efficacy between the prophylactic treatment.

Surgical alteration of the mesosalpinx and its influence upon ovarian ovulatory function in the rabbit.

Ovarian ovulatory function as correlated with the production of corpora lutea was studied in 58 rabbits that were subjected to unilateral surgical procedures. Initially, a resection of 50% of the isthmus and 50% (n = 8) or all (n = 8) of the corresponding mesosalpinx was performed. Next, 50% of the ampulla and 50% (n = 7) or all (n = 8) of the corresponding mesosalpinx was resected. Finally, a variable length, either one third, two thirds, or all, of the ampulla (n = 27) was dissected from the adjacent mesosalpinx. After natural copulation of the animals, without administration of gonadotropin, the numbers of corpora lutea on the operated and control sides were counted. A slight but nonsignificant overall reduction in corpora lutea on the operated side was observed. This showed no correlation either to the amount of mesosalpinx resected or the proximity of the surgical procedure to the ovary. Also, no correlation was observed with the length of dissected ampullary part.

Surgical treatment for distal tubal occlusion. A review of 167 cases.

Surgery was performed on 167 patients for distal tubal occlusion. In 143 cases a terminal microsurgical salpingostomy was performed and in 24, a cuff neostomy. The overall intrauterine pregnancy rate was 20.4%, and 16.8% of the patients had live births. The ectopic gestation rate was 1.8%. None of the patients with a cuff neostomy became pregnant.

[Microsurgical reversal of sterilization: experiences and results in 119 cases]. / Sterilisation--Refertilisierung. Erfahrungen und Ergebnisse bei 119 mikrochirurgisch refertilisierten Frauen.

From January 1976 to March 1982 119 microsurgical reversals were performed. Most of these women were not older than 30 years at the time of sterilization. A new partnership was the main reason for a request of reversal. Up to now 69 patients (58,0%) achieved an intrauterine pregnancy. Ectopic pregnancies occurred in 3 women (2,5%). The prognosis of a reversal depends mainly on the remaining length of the fallopian tube and the site of the anastomosis. For isthmo-isthmic anastomoses the intrauterine pregnancy rate was 80%. Due to today's high divorce rates tubal sterilization in women younger than 30 years should be based on a well founded indication. In younger patients only such sterilization techniques should be performed, which offer the highest chances for reversal.

PIP: Between January 1976-March 1982, 119 microsurgical reversals were performed. Most of these women were not older than 30 years at the time of sterilization. A new partnership was the main reason for the request of reversal. Currently, 69 patients (58%) have achieved an intrauterine pregnancy. Ectopic pregnancies have occurred in 3 women (2.5%). The prognosis of a reversal depends mainly on the remaining length of the fallopian tube and the site of the anastomosis. For isthmo-isthmic anastomoses, the intrauterine pregnancy rate was 80%. Due to a high divorce rate prevalent today, tubal sterilization in women younger than 30 years should be based on serious indications. In younger patients, only such sterilization techniques should be used which offer the highest chances for reversal. (author's modified)

Ovulatory function after tubal microsurgical procedures in the rabbit.

Ovulatory function as correlated with the production of corpora lutea was studied in 72 rabbits that were subjected to unilateral tubal microsurgical procedures. Isthmo-isthmic reanastomosis was performed in 11 rabbits, ampullo-isthmic reanastomosis in 10, and ampullo-ampullary reanastomosis in 11. In a second group of 40 animals, 20% to 100% of the isthmic portion (n=20) and 20% to 60% of the ampullary portion (n=20) were resected with reanastomosis. After natural copulation of the animals, without administration of gonadotropin, the numbers of corpora lutea on the operated and control side were counted. A slight but nonsignificant overall reduction in corpora lutea on the anastomosed side was observed. This showed no correlation to amount of tubal resection or proximity of the anastomosis to the ovary.