About 15-20% of the time uterine surgery via laparotomy is replaced in our department by operative pelviscopy. Of these, in reference to myoma surgery, about 70% were tackled with operative pelviscopy and a laparotomy was avoided. This allows the preservation of the uterus, especially for those women who desire to bear children in the future. Organ-preserving, minimally invasive surgery is the current accepted operative ideal. Postoperative sequelae like adhesion formation, subacute intestinal obstruction, and chronic abdominal pain are thus decreased. The importance of correct and safely functioning equipment and instruments cannot be overstressed for optimal results. A closed drain, i.e., the Robinson drainage system, can be kept in place for at least 12-24 h to check the postoperative ooze. In two cases of extensive ooze, repeat pelviscopy was performed within 12 h and hemostasis was achieved by the use of endosutures and endocoagulation.

Adult↗

PubMedDate not supplied

[GnRH agonist and add back therapy--indications, results and problems in the treatment of genital endometriosis].

It was the aim of this paper to assess whether GnRH agonist and add-back therapy is an important post operative and long-term therapeutical supplement in the treatment of genital endometriosis, especially in cases of chronic pain. Although its effectiveness with regard to the relief of pain is not better than other therapeutical options, the spectrum of side effects is acceptable. Un-desired side effects of GnRH agonists are reversible and can be minimised under the synchronised application of an add-back therapy. In patients with symptomatic endometriosis the effectiveness of GnRH agonist therapy can remain and simultaneously the hypoestrogenic side-effects can be covered by the appropriate add-back therapy. In our investigations a useful combination treatment of leuprolide acetate depot (3.75 mg per month) and tibolone (2.5 mg per day) over a period of 3-6 months was found. The analyses of Hornstein et al. 1998 and Surrey et al. 2002 clearly demonstrate that a significant reduction in pain with few side effects results when from the first day of treatment with leuprolide acetate depot an add-back scheme of 5 mg norethindrone acetate per day is applied.

Drug Therapy, Combination↗

PubMedDate not supplied

Immunization with spermatozoal peptide antigens resulting in immuno-suppression of fertility rates in female rats.

Low molecular weight peptides have been isolated from the rat epididyml sperm surface using gel chromatography and preparative thin-layer chromatography. After coupling the partially purified peptides to rat albumin these were injected into female Wistar rats. Immunization with these spermatozoal peptides resulted in significantly reduced fertility rates as determined by the frequency of pregnancies and the number of fetuses per rat. The purification steps revealed that these rat spermatozoal peptides were comparable with peptides isolated form human ejaculated spermatozoa. It is therefore assumed that immunization with these antigens might induce sterility in humans.

Animals↗

PubMedDate not supplied

Characterization of porcine zona pellucida antigens by immunoaffinity chromatography and by high-pressure liquid chromatography.

In the present work, 500 and 50,000 porcine zonae pellucidae were solubilized using Lithium-3,5-diiodosalicylate. The zona antigens were purified by immunoaffinity chromatography (IAC) on immobilized antizona immunoglobulin G (IgG). The antizona-IgG was raised by immunization of female rabbits with 500 heat-solubilized porcine zonae. Four antigens could be detected following IAC: ZP I/1 (Mr = 42,000), ZP II/1 (Mr = 67,000), ZP II/2 (Mr = 32,000), ZP III/1 (Mr = 17,000). In a parallel experiment, 50,000 zonae were solubilized in a similar manner and the mixture was analyzed by high-pressure liquid chromatography (HPLC) using a protein column. Altogether, 9 protein peaks that contained the antigens ZP I/1, ZP II/1, ZP II/2, and ZP III/1 could be detected following HPLC. The carbohydrate composition is characteristic for O-glycosidic-glycoproteins. ZP II/1 and ZP II/2 are probably in close association within the zona. Based on the reaction of the antigens with antibodies induced by intact and heat-solubilized zonae, it is postulated that only ZP I/1 and ZP II/1 are expressed on the surface in intact zonae.

Animals↗