Biomedical subjects
E Kemmann
Publications and source records attributed to E Kemmann.
Hysteroscopic removal of occult intrauterine contraceptive device.
Dilatation and curettage or hooking an occult intrauterine contraceptive device (IUD) may fail to recover the device on occasion. Theoretically, endoscopic observation should enable the controlled removal of this type of device. Of 200 patients who underwent hysteroscopic examination, 10 had an occult IUD. In 8 cases, the device was visible through the hysteroscope, and in 6 patients a successful removal was accomplished with this endoscopic technic. Failures and problems are discussed, and the importance of adequate preoperative study is stressed. Hysteroscopy is an effective procedure in the recovery of the occult intrauterine contraceptive device in selected nonpregnant patients.
Vaginal atrophy in the postmenopausal woman. The importance of sexual activity and hormones.
The effect of sexual activity on vaginal atrophy was investigated in a group of 52 postmenopausal women (mean age, 57 years). Subjects were divided into two groups: sexually active (intercourse frequency, three or more times monthly) and sexually inactive (intercourse frequency, less than ten times yearly). Two gynecologists examined all subjects and completed an index of vaginal atrophy that assessed six genital dimensions. Blood samples were also analyzed by radioimmunoassay for levels of circulating estrone, estradiol, androstenedione, testosterone, follicle-stimulating hormone, and luteinizing hormone (LH). As predicted, less vaginal atrophy was apparent in the sexually active women as opposed to the sexually inactive women. Further, women with less vaginal atrophy had significantly higher mean levels of androgens (androstenedione and testosterone) and gonadotropins (particularly LH). We discuss herein the implications of this study, particularly the importance of androgens in reducing atrophy and maintaining sexual interest.
Does ovulation stimulation improve fertility in women with minimal/mild endometriosis after laser laparoscopy?
Cycle fecundity was retrospectively analyzed in a group of infertile women after minimal/mild endometriosis had been treated by carbon dioxide laser laparoscopy. Patients were followed in spontaneous (observation) cycles as well as in treatment cycles using ovulation stimulation. Treatment protocols included clomiphene citrate (CC), sequential CC/human menopausal gonadotropins/human chorionic gonadotropin (CC/hMG/hCG), and hMG/hCG. Some patients who failed to conceive with ovulation stimulation protocols underwent in vitro fertilization (IVF). Eighty-nine patients were followed for a total of 605 cycles, during which 37 pregnancies occurred. Cycle fecundity was 0.028 in observation cycles, and was higher with the use of CC (0.066), and significantly higher (P < .05) with use of CC/hMG/hCG (0.114) and hMG/hCG (0.073). The highest cycle fecundity was attained in IVF cycles (0.222). This retrospective analysis suggests that active ovulation management in patients with minimal/mild endometriosis treated by carbon dioxide laser laparoscopy may significantly increase cycle fecundity.