Assessment of postoperative postvoid residual bladder volume using three-dimensional ultrasound volumetry.

The aim of our prospective study was to assess the concordance between postvoid residual volumes (PVR) of the urinary bladder obtained by two different three-dimensional (3-D) ultrasound (US) volumetric methods (VOCAL and XI VOCAL) and with measurement by the catheter in postoperative patients who have undergone radical hysterectomy. The 3-D sonographic volume-determination of PVR with both methods correlated significantly with the actual amount of PVR by the catheter. The accuracy of both 3-D US volumetric methods was significantly higher under 300 mL of PVR. Bland-Altman plots were generated to examine limits of agreement. Both noninvasive 3-D sonographic methods are appropriate for the correct volume-determination of PVR following radical hysterectomy. Thus, we may avoid routine, albeit often unnecessary, catheterization to measure postoperative residual bladder volumes and subsequently the incidence of lower urinary tract infection may be reduced and better postoperative comfort for patients may be permitted.

Assessment of three-dimensional sonographic features of polycystic ovaries after laparoscopic ovarian electrocautery.

BACKGROUND: Treatment of polycystic ovary syndrome-related infertility includes laparoscopic ovarian electrocautery. Three-dimensional (3-D) sonographic characterization of polycystic ovaries has been performed recently, including the study of the effect of laparoscopic ovarian drilling on ovarian volume. The impact of laparoscopic treatment on ovarian volume and vascular flow-patterns assessed by 3-D color power angiography (CPA), however, has not yet been elucidated. OBJECTIVE: To measure ovarian volume, to evaluate and quantify intraovarian blood flow with 3-D CPA histogram analysis before and after laparoscopic ovarian electrocautery, and to compare the hormonal effects of surgery with 3-D sonographic findings. SETTING: University hospital. PATIENT(S): Ten patients, aged 18-34 years, with polycystic ovary syndrome. INTERVENTION(S): Evaluation of serum and urinary hormone profiles as well as transvaginal 3-D ultrasonography were performed before and after laparoscopic ovarian surgery. RESULT(S): Ovarian volume decreased, and 3-D CPA showed increased intraovarian flow intensity after laparoscopic electrocautery. Serum LH and T levels, ratios of urinary steroids reflecting 5 alpha-reductase enzyme activity, and androgen to cortisol metabolites decreased; serum FSH levels increased 1 week after laparoscopy and correlated well with changes of 3-D sonographic features. Seven patients ovulated regularly after surgery, and five pregnancies were conceived within 1 year. CONCLUSION(S): Three-dimensional ultrasonography may be a useful adjunct and noninvasive method for correlating clinical parameters with the blood flow alterations in polycystic ovary syndrome patients.

[Hydrops fetalis--a retrospective study]. / Hydrops foetus universalis, visszatekinto tanulmány.

In a retrospective study, the authors examined the occurrence of hydrops in foetal and neonatal cases in a five-year period. During this time, the clinical and pathologic diagnosis of hydrops was established in 28 cases. In three cases, the hydrops was caused by Rh incompatibility, and in 25 cases non-immune hydrops was discovered by clinical and pathologic examination. The cause of hydrops was recognised in 25 cases and no underlying disease was discernible in three. In 12 cases, the pregnancy was spontaneously terminated. Artificial abortion was performed in four cases. In this series, four hydropic newborns died on the first week of their life. The average age in artificial abortion was 16-20 gestational week and 24 in spontaneous abortion or stillbirth. Pathologic examination revealed increased weight, oedema, ascites, and hydrothorax in all cases. In half of the cases, there was also hydropericardium. Hepatosplenomegaly, cardiomegaly, pulmonary hypoplasia, increased extramedullary hemopoiesis, and placenta oedema were seen in all the cases. Causes of the non-immune hydrops were cardiac malformation in 4 cases, chromosome anomaly in 3, cystic hygroma in 2, skeletal anomaly in 1, foeto-foetal transfusion in 3, infection in 7 and sacrococcygeal teratoma in 1 case. In two cases, the underlying disease was reported to be of maternal origin. Comparing the clinical and pathologic findings there were only three cases with absolute agreement. The underlying disease revealed by pathologic examination was regarded to be significant from respect of inheritance, therapeutic approach, and further management in 10 cases. The authors emphasise the importance of pathologic examinations in foetal hydrops and point out the significance of clinico-pathological collaboration in the decision about further management of hydropic foetuses.