The use of bipolar technology in hysteroscopy.

Bipolar technology was introduced in the hysteroscopic clinical use in 1999, by the design of both loop electrodes addressed to resectoscopic surgery and miniaturized electrodes adaptable to small-size hysteroscopes. The need of an electrolytic solution as distension medium and the spatial relationships between the active and return bipolar electrode avoid, by definition, the risks of severe electrolyte imbalance syndromes and unpredictable electrical burns, sometimes complicating monopolar surgery. The true revolution in the hysteroscopy care has achieved through the availability of mini-hysteroscopes not requiring cervical dilatation, thus limiting uterine wall damages and allowing surgeons to manage several endometrial pathologies by mini-invasive procedures using an effective electrosurgical bipolar instrumentation. Many surgical interventions, traditionally accomplished by the resectoscope in a surgical room theatre, can be now carried out in an outpatient setting without any support from anesthesia. The patients' avoidance of surgical room access and the quick return to daily activities lead to an obvious - but not fully demonstrated - improvement in the medical and social costs associated to outpatient operative hysteroscopy. In the field of resectoscopy, bipolar electrodes are clinically as effective as monopolar devices. Randomized trials showed that bipolar resectoscopic technology prevents the electrolyte imbalance observed after monopolar surgery. However, in daily clinical practice the assumedly safer profile of bipolar with respect to monopolar resectoscopy has not been demonstrated yet.

Lactobacilli vaginal colonisation after oral consumption of Respecta(®) complex: a randomised controlled pilot study.

PURPOSE: The aim of the current pilot study was to determine if oral consumption of a combination of two probiotics; L. acidophilus La-14, L. rhamnosus HN001, and bovine lactoferrin (Respecta(®) complex), would lead to the detection with molecular techniques of the consumed probiotic strains in the vagina. METHODS: Healthy volunteers (40) consumed the study product twice daily for 2 weeks. Vaginal swabs were collected at 0, 1, 2 and 3 weeks and analysed for the consumed organisms by qPCR. RESULTS: Vaginal L. rhamnosus and L. acidophilus levels were significantly increased on days 14 and 21. On days 14 and 21 a significant number of women had increased levels of vaginal L. acidophilus and on days 7 and 21 a significant number of women had increased levels of vaginal L. rhamnosus. CONCLUSIONS: Consumption of L. acidophilus La-14, L. rhamnosus HN001 in combination with bovine lactoferrin leads to vaginal detection; even 1 week after consumption was stopped. This provides a basis for future studies on urogenital tract health.