[Laparoscopic burch colposuspensio--our experience].

Stress incontinence is involuntary loss of urine that occurs during periods of increased intraabdominal pressure, such as sneezing, coughing or exercise. Retropubic Burch colposuspension has been considered by many to be the "gold standard" procedure for treatment of female stress urinary incontinence for almost 50 years. The firs reported retropubic surgery performed via the laparoscopic approach was described by Vancaillie and Schuessler in 1991. We present a clinical case of a female patient with stress incontinence who has been operated by laparoscopic approach by our team.

[3D laparoscopy system in gynecological practice].

Laparoscopic gynecologic procedures have become increasingly popular but their widespread use has been limited by training issues. Recent technological advancements have led to the introduction of new three-dimensional (3D) cameras in laparoscopic surgery. The use of 3-dimensional (3 D) vision may aid in training and performance of laparoscopic tasks. 3-D visualization improves the learning curve forlaparoscopic surgery. Surgeons must consider 3D systems when leaming complex laparoscopic surgeries.

[In vitro maturation--a potential approach of infertility treatment of patients with PCOS].

Polycystic ovary syndrome (PCOS) affects about 15-20% of women of reproductive age. This is a heterogeneous condition characterized by a combination of menstrual cycle disturbances, hyperandrogenism and polycystic ovaries. A significant percent of these women comes to the necessity of assisted reproduction procedure. During the conventional procedure of in vitro fertilization (IVF) the patients are being exposed to a controlled ovarian hyperstimulation (COH) with gonadothropine hormones with the purpose of ensuring collection of numerous mature oocytes for fertilization and respectively obtaining numerous embryos for selection and embryotransfer. The supraphysiological doses of exogenous gonadothropines used for COH often lead to an excessive ovarian response, characterized by the development of numerous follicles of different size and different quality, aspiration of immature oocytes and higher risk of severe ovarian hyperstimulation syndrome (OHSS) in women with PCOS. The retrieval of immature oocytes from unstimulated ovaries followed by in vitro maturation (IVM) procedure appears a potential therapy which eliminates aforenamed risks and respectively is highly beneficial for application to women with PCOS.

[Radical trachelectomy -- surgery for preserving woman's fertility in patients with invasive cervical cancer].

For the past 15 years gynecological oncologists have been seeking ways to preserve woman's fertility when treating invasive cervical cancer. Many cases of cervical cancer are diagnosed in young woman who wish to preserve their fertility. As more women are delaying childbearing, fertility preservation has become an important consideration. The standard surgical treatment for stage IA2-IB1 cervical cancer is a radical hysterectomy and bilateral pelvic lymphadenectomy. This surgery includes removal of the uterus and cervix, radical resection of the parametrial tissue and upper vagina, and complete pelvic lymphadenectomy. Obviously, the standard treatment does not allow future childbearing. For some women with small localized invasive cervical cancers, there is hope for pregnancy after treatment. Radical trachelectomy is a fertility-sparing surgical approach developed in France in 1994 by Dr. Daniel Dargent for the treatment of early invasive cervical cancer. The radical trachelectomy operation has been described and performed abdominally, assisted vaginally by laparoscopy and robotically.

[Laparoscopic hysterectomy -- indications, technic, complications].

In recent decades, interest in laparoscopic gynecological practice increase. This technic applied first as a diagnostic tool in women with infertility. Subsequently starts to be used to perform surgery in small region of the fallopian tubes and ovaries, being increasingly developed and today, it is considered that any gynecological operation can be performed laparoscopically.

[Studies on the level of proinflammatory cytokines IIL-1a, IL-1b, IL-6, TNF-a in pregnant women with acute pyelonephritis].

UNLABELLED: Proinflammatory cytokines (IL-1a, IL-1b, IL-6, TNF-a) are important mediators of acute inflammation. We studied the levels of those cytokines in pregnant women with acute pyelonephritis. MATERIAL AND METHODS. We studied 30 women with clinical and microbiological evidence of acute pyelonephritis and 30 healthy controls Urinary cytokine levels were measured using an ELISA test. RESULTS: The mean urinary cytokine levels of pregnant women with acute pyelonephritis were higher compared with controls. We found evidence for higher clinical microbiological activity in women with acute pyelonephritis compared to controls. CONCLUSIONS. The urinary levels of proinflamatory cytokines can be used as reliable biomarkers for acute pyelonephritis in pregnant women.

[Clinical efficacy of a new method for LEEP conization with pistol-shaped electroknife].

The aim of this study is to establish clinical efficacy of a new method for LEEP conization of uterine cervix. The study is open, retrospective, performed at Department of General and Oncogynecology - Military Medical Academy (Sofia, Bulgaria) for the duration from 2007 till Mar 2010. The study includes 37 women at age from 19-50 years with proved high grade CIN (included Ca coil uteri in situ) by abrasion or biopsy. Medical history was collected from all patients enrolled in the study as well as gynecological examination and colposcopy was performed to them. A LEEP with short intra venues anesthesia was performed to the patients. An innovation system for LEEP conization and generator for monopolar currency ERBE VIO 300D was used. The follow up visit was performed one month after the treatment procedure and included gynecological examination and colposcopy (positive/negative atypical colposcopy results). The clinical efficacy of the method was evaluated on the base of histological results. The patients whose histological results show negative endocervical margins were accepted for cured. From 37 patients in total with different stage of dysplasia and carcinoma in situ hospitalized at Clinic of surgical gynecology for surgical treatment, in 33 (89%) there are negative endocervical margins. These patients formed the cured group. In four patients (10.8%) were discovered histological evidences for positive endocervical margins. The LEEP was not the final operative procedure for them. They were included in the uncured group. The final results achieved from the study about the efficacy of the used method LEEP has statistical significance (d.f .= 1, X2 = 2.82, p < 0.05). The data shows that the LEEP eliminate completely the affected by malignant process areas of cervix uteri. The LEEP can be used as a common surgical method in the treatment of the women with high stage of pre-carcinoma and carcinoma in situ coli uteri.

[Laparoscopy with low abdominal pressure]. / Laparoskopiia s nisko intraabdominalno naliagane.

The authors present their experience from operative laparoscopies performed with lower than usually accepted intaabdominal pressure.

[Utrogestan--an alternative for synthetic gestagen treatment in spontaneous abortion]. / Utrogestan--alternativa na sintetichnite gestageni v lechenieto na spontanniia abort.

A clinical trial is conducted with 32 pregnant patients with a history of sterility and infertility, uterine malformations as well as progesterone deficiency. The mean week of gestation is 9-10. All patients were treated with Utrogestan in the usual doses 2 x 100 mg for vaginal application. No side effects were observed which is encouraging to its routine use.

[Effect of laser acupuncture and irradiation of the cervix uteri in cows on cardiac activity and morphological composition of the blood]. / Vliianie na lazerna akupunktura i obluchvane na tserviksa na matkata pri kravi vurkhu surdechna deinost i morfologichniia sustav na kruvta.

Tested is the action of helium-neon laser for acupuncture with capacity 7mV and diameter of the ray 2 mm in cows during the puerperal period. Laser acupuncture (LA) is applied on 6 cows by radiation of two main acupuncture points 49 and 50 for 2 min and additional--27, 28 and 29, radiated for 1 min each of them. Second group is locally radiated in area of the cervix of the uterus (LRCU) for 6 min. The radiation is done a day for 5 days. From the radiotelemetric research of the cardiac activity is established decreasing of the cardiac frequency and increasing of the interval R-R, the amplitude of peak--P and the duration of wave--T in both of the groups, and prolongation of the segments P-Q, S-T, T-P and the interval Q-P in cows with LRCU. There are not registered changes in the shape of the peaks of the EKG-telemetry, with the exception of the wave-T. Haematological research shows decreasing of the content of the haemoglobin in both of the groups and decreasing of the content of the erythrocytes in cows with LRCU, and increasing of C.U.E. after the second radiation. In the content of the blood sugar, the haematic values and the leukocyte formula are not observed mathematically reliable changes.

[Clinical, radiotelemetric and pathomorphological research on lambs experimentally infected with Cysticercus ovis]. / Klinichni, radiotelemetrichni i patomofologichni prouchvaniia pri agneta, eksperimentalno invaziiani s Cysticercus ovis.

Experiments were carried out with six 2-month-old lambs infected experimentally with 30,000 T. ovis ova each. It was found that with slightly infected lambs there were no deviations in the normal state of the animals and their ECG telemetry. Morphologically, there were sporadic cysticerci. With strong infections the disease was found to run its course with apparently manifested clinical signs: depressed general condition, lowered appetite, profuse salivation, lacrimation, pollakisuria, high temperature, and high pulse and heart rates. Electrocardiographically, essential changes were recorded in the elements characterizing myocardial infarction. Morphologically and histopathologically, beside cysticerci in the heart and skeletal muscles there were necrotic foci, hyalin-dystrophic and necrotic and lytic areas.

[Changes in the ECG telemetry of lambs infected with Cysticercus ovis]. / Niakoi promeni v EKG-telemetriia pri agneta, invazirani s cysticercus ovis.

Six lambs were experimentally infected with Cysticercus ovis. Some changes were followed up in the ECG by means of the radiotelemetric method. The infection process led to the following more important changes, such as sinus tachicardia and arhythmia, auricular fibrilation, sinoauricular block, atrial dissociation, the incidence of a pathologic Q deflection; lowering of the R deflection amplitude, and inversion of the T wave. It was found that the changes referred to persist for a longer period (in the case of infarction), and could be made use of in dispensary studies.