György Bacskó

Uterine surgery by operative hysteroscopy

Uterine anomalies are found in 10-15% of women with repeated pregnancy loss. Uterine malformations and benign tumors are common causes of abortions, premature labour and abnormal fetal presentation in some cases. One-third of patients with habitual abortion have a septated or subseptated uterus, and two-thirds of pregnancies in women with duplicated uterus progress to term. Müllerian fusion defects and submucous fibroid may cause poor implantation or ineffective maternal blood supply to the placental site of the developing pregnancy. When these abnormalities were evaluated in infertile patients or in habitual abortions, traditionally the abdominal correction (Jones, Strassman, Tompkins etc.) were used traditionally. These procedures require incision of abdominal and uterine walls in general anesthesia with relative long hospitalization and recovery. The new endoscopic procedure; hysteroscopy is used not only to evaluate the type and size of Müllerian fusion defects but also to treat this malformation. The uterine septum is transsectable, via this elegant method, without injury of abdominal wall and healthy uterine wall musculature. After a traditional abdominal metroplasty there is no other-choice other than the cesarean section to prevent rupture of the uterus, but after hysteroscopic septotomy the vaginal delivery is possible and the uterine rupture rarity.

Our experiences in Trans-Obturator Tape surgery after performing 150 cases

Europaban a felnőtt nők kozel 30 szazaleka szenved a vizelet-visszatartas zavaratol. A nehany eve megjelent Trans-Obturator Tape (TOT) műtet egy ujabb lehetőseget ad a stresszinkontinencia műteti gyogyitasara. Betegek es modszerek: A kivizsgalas reszletes anamnezisfelvetelből, stressz- es Q-tip-tesztet is magaban foglalo, altalanos es nőgyogyaszati fizikalis vizsgalatbol, illetve a QUID- (The Questionnaire for Urinary lncontinence Diagnosis) kerdőiv kitolteseből allt. Nem egyertelmű esetekben urodinamias vizsgalat tortent. A szerzők szazotven betegen vegeztek Trans-Obturator Tape beultetest. A műtet eredmenyessegenek ertekeleset szinten QUID-kerdőivek segitsegevel vegeztek. Eredmenyek: A betegek atlageletkora 50,8 ev volt (SD = 8,64). 69 paciensnek (46%) volt tisztan stresszinkontinenciaja, 33 betegnek (22%) keszteteses inkontinenciaja, mig 48 esetben (32%) stresszdominanciaval kevert inkontinenciat mutattak ki. Az atlagos kovetesi idő 16 honap (4–26 honap) volt. A stresszinkontinencia atlagos preoperativ...

Hasűri terhesség élő újszülöttel

Absztrakt: Az előrehaladott hasűri terhesseg nagyon ritkan fordul elő. A tunetek gyakran nem jellegzetesek, igy sok esetben a diagnozist sem sikerul időben felallitani. Az anyai mortalitas es morbiditas szinten nagyon magas, kulonosen azokban az esetekben, amikor a helyes diagnozis es megfelelő kezeles elmaradnak. A magzati malformaciok gyakori előfordulasaval szinten szamolnunk kell. A kozlemenyben egy 36. terhessegi heten felismert hasűri terhesseg esetet ismertetjuk. A 2090 g sulyu leany magzatot surgősseggel vegzett laparotomiaval hoztuk vilagra. A műtet utani harmadik napon relaparotomiat vegeztunk hasűri utoverzes miatt. Az anyat es ujszulottjet jo altalanos allapotban sikerult hazabocsatanunk. A kozlemeny a ritka, koros terhesseg ismertetese kapcsan irodalmi attekintest ad a hasűri terhesseg előfordulasarol, diagnosztikajarol es terapiajarol. Orv. Hetil., 2017, 158(13), 508–511.

Experiences in treatment of urinary incontinence with transobturator tape surgery

Abstract Condensation: As a result of the first Hungarian clinical experience, transobturator tape is an effective, quick, minimally invasive method requiring short hospital stay, with low morbidity. Objectives: Transobturator Tape implant provides a new surgical technique. Study design: Preoperative workup included history taking, stress-test and Q-tip test, general and gynaecological examination and completion of the QUID (Questionnaire for Urinary Incontinence Diagnosis). Sample size was 250 women suffering from urinary incontinence. Results: 115 patients (46%) had genuine stress incontinence, 55 patients (22%) had urge incontinence and 80 patients (32%) had mixed-type incontinence with dominant stress component. Mean length of follow-up was 16 months. Preoperative severity score of stress incontinence was 11.78 on average, while that of urge component was 6.63. Nine out of the 250 operations were complicated by adverse event. Mean length of hospital stay was 4.76 days. Evaluation of postoperative ques...

Evaluation of a cesarean section postoperative wound infection surveillance program at Kenézy Hospital, Debrecen, Hungary

A csaszarmetszes tipikus, reszben megelőzhető szovődmenye a sebfertőzes. Korhazunkban 2008 oktobereben kezdtuk a sebfertőzes-surveillance reszekent a csaszarmetszeses adatok gyűjteset. Celkitűzes: A műtetek korulmenyeinek, kimeneteleinek leirasa, a kozottuk levő osszefuggesek feltarasa. Modszer: A korhazban 2008. oktober 1. es 2009. szeptember 30. kozott vegzett 523 csaszarmetszes adatait dolgoztuk fel. A vizsgalt tenyezőket leiro statisztikai kimutatasokkal jellemeztuk. A sebfertőzes es a tobbi tenyező kozotti osszefuggeseket logisztikus regresszioval elemeztuk. Eredmenyek: Sebfertőzes 3,6%-ban lepett fel, gyakoribb volt fiatalabb korban, meconiumos/purulens magzatviz, anaemia es subcutan haematoma eseten; mintegy harmadara csokkent a masodik fel evben, az infekciokontroll-intezkedesek megszigoritasa utan. Kovetkeztetesek: Az eletkor helyettesitő valtozoja olyan tenyezőknek, amelyek osszefuggesben allnak a sebfertőzes kockazataval, igy klinikailag hasznosithato prediktiv szerepe van. A helyes infekciokon...UNLABELLED Wound infection is a typical, partly preventable complication of cesarean sections. We started extended recording of cesarean section data in October, 2008 as part of our general wound infection surveillance program. AIM To describe the circumstances and outcomes of the sections and analyze associations between them. METHODS We analyzed 523 cases over the period October 1, 2008 to September 30, 2009. Variables were assessed using descriptive statistics. Associations between explanatory factors and wound infection were evaluated using logistic regression. RESULTS Infections (overall rate: 3.6%) were more frequent in younger subjects, those with anemia, subcutaneous hematoma, in pregnancies with meconium stained or purulent amniotic fluid, and decreased to about a third after infection control was tightened. CONCLUSIONS by being a proxy variable of factors with which wound infection is associated, age is a clinically valuable predictive variable. Good infection control practice is effective in preventing wound infections. The results are consistent with appropriate prescription practices of prophylactic antibiotic use, and with prophylactic measures being effective.

OC10.07: Asymptomatic endometrial polyps can be detected by power Doppler ultrasound

Despite their importance to clinical gynecology, uterine leiomyomas, commonly known as fibroids, have rarely been the subject of clinical outcomes research. Additionally the high risk of recurrent fibroid formation following conservative therapy makes predictors of outcome useful in counseling women. There is even little information regarding treatment outcomes with standard demographic and anthropometrics predictors of treatment success of failure. The increasing use of minimally invasive therapies to target specific myomas makes prediction of high-risk women more important than when hysterectomy was the standard therapy. Understanding the biologic and genetic diversity underlying the clinical heterogeneity of this disease will markedly change future treatments. Several genes including fumurate hydratase (FH) and high mobility group A2 (HMGA2) have been identified as important in the formation and growth of uterine leiomyomas. Genotype/phenotype correlations are also beginning to be identified, including several instances where the risk of malignant disease is increased. The power of advanced imaging also may provide markers of specific phenotypes allowing non-invasive genotype/phenotype correlation. A genome-wide scan such as the Finding Genes for Fibroid Project (www.fibroids.net) will also be instrumental in finding additional genes, which influence disease outcome. This is especially important because genes identified to date appear to primarily affect Caucasian women and the increased relative risk and incidence rates in AfricanAmerican women has been well documented. Furthermore, research in genetic epidemiology will set the stage for prevention strategies for high-risk young women and potentially develop new therapeutic targets.