Dubravko Barišić

Laparoscopic approach to interstitial pregnancy

Case reportA successful laparoscopic management of an interstitial pregnancy of 42-year-old woman, treated by cornual resection was presented. The patient had an unremarkable postoperative course.DiscussionThe laparoscopic approach toward cornual pregnancy was presented as well as its advantages over classic laparotomy. Other techniques of conservative treatments have been reviewed.

Bilateral tubal torsion treated by laparoscopy: a case report

The history is described of a patient with bilateral torsion of the fallopian tubes successfully managed by laparoscopy.

Successful Laparoscopic Bipolar Coagulation of a Large Arteriovenous Malformation Due to Invasive Trophoblastic Disease: a Case Report

We report the case of an acquired large arteriovenous malformation due to invasive gestational trophoblastic tumor that was treated successfully with laparoscopic surgery. After 4 cycles of methotrexate chemotherapy, a vascular tangle (volume, 28 cm(3)) was noted that emerged from the right uterine horn, invading the broad ligament adjacent to the uterine artery. Doppler ultrasonography along with magnetic resonance arteriography confirmed the diagnosis. The location, size and relation of this arteriovenous malformation to the uterine vasculature demanded urgent intervention. Laparoscopy was performed, and bipolar coagulation of the ovarian and uterine artery feeding branches was achieved after surgical resection of the tumor. The defect in the uterine wall with an intact uterine cavity was reconstructed using sutures. There were no intraoperative or postoperative complications. The patient underwent chemotherapy, and at 2-month follow-up was cured and has since had regular menstrual cycles.

Pregnancy following the laparoscopic bipolar electrocoagulation of polycystic ovaries resistant to medicamentous ovulation induction – a case report

The case of a primarily infertile patient with polycystic ovaries (PCOS) resistant to medicamentous ovulation induction is presented. The preoperative condition, laparoscopic ovarian drilling using an original technique of bipolar electrocoagulation and consecutive spontaneous pregnancy and delivery are described. This case suggests that bipolar forceps with jaws 1 mm wide could be a useful instrument for laparoscopic ovarian drilling.

Fluconazole versus 3‐day clotrimazole in the treatment of sporadic and recurrent vulvovaginal candidiasis

It has been estimated that 72% of all adult women will have one episode of vulvovaginal candidiasis (VVC) and approximately 40% to 50% will have a second episode [1]. Treatment of candida vulvovaginitis includes topical 3 days to 1 week or shortterm oral antifungal treatment which tends to result in better patient compliance, followed by better overall response to therapy [2]. The objective of this randomized clinical study was to evaluate fluconazole efficacy in the treatment of recurrent VVC versus conventional clotrimazole therapy especially in recurrent disease. The study was performed between September 2004 and

Milk versus TEST-yolk — preincubated sperm; in vitro fertilization outcome

OBJECTIVE Preincubation of sperm in TEST-yolk medium enhances in vitro fertilization (IVF) outcome. However preincubation of sperm in milk at 5 degrees C enhances the results of sperm penetration assay and hemizona assay. This study was therefore performed to determine the influence of milk on in vitro fertilization rate of human oocytes, as compared with TEST-yolk medium. STUDY DESIGN Forty-one consecutive couples undergoing an IVF procedure were randomized. Of these 20 couples were admitted for the milk study (group 1) and 21 couples for the TEST-yolk study (group 2). Each ejaculate was Percoll-processed and the sperm pellet was resuspended in 0.5 ml of culture medium. An equal volume of heat-inactivated homogenized cows milk (95 degrees C, 10 min) was added to sperm suspension from group 1 and an equal volume of TEST-yolk medium was added to sperm suspension from group 2. After 2 h of incubation at 5 degrees C and washing with culture medium at 37 degrees C, oocytes were inseminated. Oocytes from group 1 couples were inseminated with milk-treated spermatozoa and those from group 2 couples with yolk-treated spermatozoa. Oocytes were evaluated for fertilization after 18 h. RESULTS Sperm preincubated in milk fertilized 75 out of 100 mature oocytes (75%). TEST-yolk-treated sperm fertilized 45 out of 64 mature oocytes (70%). The difference was not statistically significant. CONCLUSIONS Preincubation of spermatozoa in milk, as compared with preincubation in TEST-yolk medium yields a similar IVF outcome, so milk may be a suitable alternative medium for preincubation of spermatozoa to enhance its fertilizing potential.

A Single, Continuous Spiraling Suture for Uterine Wall Reconstruction after Laparoscopic Enucleation of Intramural Myomas

After laparoscopic enucleation of intramural myomas in eight women, the uterine wall defect was reconstructed with a single continuous spiraling suture. The procedure contained cost and reduced operating time. No patients had postoperative intramural hematoma. Although this is a reproducible method of laparoscopic uterine wall reconstruction, long-term results must be obtained to determine safety in pregnancy and extent of postoperative adhesions.