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Biomedical subjects

P Riss

Publications and source records attributed to P Riss.

At least 19 recordsLinked to original sources

Updated recommendations on ultrasonography in urogynecology.

Ultrasound is a supplementary, indispensable diagnostic procedure in urogynecology; perineal, introital, and endoanal ultrasound are the most recommended techniques. The position and mobility of the bladder neck can be demonstrated. In patients undergoing diagnostic work-up for urge symptoms, ultrasound occasionally demonstrates urethral diverticula, leiomyomas, and cysts in the vaginal wall. These findings will lead to further diagnostic assessment. The same applies to the demonstration of bladder diverticula, foreign bodies in the bladder, and bullous edema. With endoanal ultrasound, different parts of the sphincter ani muscle can be evaluated. Recommendations for the standardized use of urogenital ultrasound are given.

Female↗

Prevalence of female sexual dysfunction in gynecologic and urogynecologic patients according to the international consensus classification.

OBJECTIVES: To evaluate the prevalence of female sexual dysfunction (FSD) in an outpatient gynecologic and urogynecologic clinic using the current International Consensus Classification. METHODS: One hundred fifty-nine patients were asked to answer an anonymous survey about FSD. Patients in the gynecologic (group 1) and urogynecologic (group 2) clinics were compared. RESULTS: The mean age in group 1 was 37.8 years (range 20 to 76) and in group 2 was 55.7 years (range 18 to 82). The prevalence of FSD was 50% in group 1 and 48% in group 2; 86% of group 1 and 66% of group 2 patients had been sexually active within the past 2 years. The differences found in FSD according to the consensus panel classification achieved no significance. Of the 159 patients, 96% were not embarrassed by filling out this questionnaire about their sexual function. CONCLUSIONS: No statistically significant difference in FSD was found between the younger and older patients seeking help in a gynecologic or urogynecologic outpatient clinic. Because of the high incidence of FSD, we recommend integrating the inquiry about female sexual health concerns into routine gynecologic care. The simple survey based on the International Consensus Conference Classification of FSD gives reliable results, and this systematic framework facilitates methodologic examination.

Adult↗

The Austrian tension-free vaginal tape registry.

In Austria a central registry for all TVT operations has been established in which more than 800 cases have so far been registered. The registry contains information on pertinent data on the operated patients and intra- and postoperative outcomes of the TVT surgery. No serious complications and no mortality have been registered until now.

Austria↗

The relevance of angiogenesis in benign and malignant epithelial tumors of the ovary: a quantitative histologic study.

The ability of a tumor to grow and eventually to infiltrate adjacent tissues requires a sufficient blood supply. Many malignant neoplasms have been shown to induce neovascularization. We asked whether it is possible to characterize ovarian epithelial tumors on the basis of vascularization and whether vascularization can be used to differentiate between benign and malignant neoplasms. We examined 14 cases of benign cystadenomas and 18 carcinomas. The microvessels were identified by immunohistochemical staining of endothelial cells for factor VIII. They were counted within the most vascular area of a tumor (neovascular "hot spot") on a x 100 and a x 400 field. Mean vessel counts were 51.64 [standard error of the mean (SEM), 5.7] in the benign cystadenomas and 131.05 (SEM, 6.7) in the group of carcinomas at a x 100 magnification. The mean microvessel counts per x 400 field were 14.4 (SEM, 1.9) in the benign and 33.7 (SEM, 3.45) in the malignant tumors investigated. These differences were significant (t test for independent samples, P < 0.001). Since our study shows significantly fewer small blood vessels in the benign cystadenomas than in the malignant tumors, the histologically determinable vascular density may be the basis for imaging blood flow by means of color ultrasound.

Adult↗

Localization of blood vessels and qualitative assessment of blood flow in ovarian tumors.

OBJECTIVE: To study the localization of blood vessels within a tumor and the shape of the flow curve as a method of assessing ovarian neoplasms. METHODS: We studied 39 patients with malignant tumors and 63 patients with benign ovarian tumors by means of vaginal color Doppler ultrasound, noting the localization of blood vessels in the tumors, the shape of the flow curve, and peripheral resistance. RESULTS: Blood vessels could be visualized in 95% of the malignant tumors and in 70% of the benign tumors. Blood vessels tended to be localized centrally (65 versus 5%) in malignant tumors and peripherally in benign tumors (65 versus 0%). A diastolic notch was seen in 89% of the benign tumors, but in none of the malignant tumors. The mean resistance index (RI) +/- standard deviation was 0.48 +/- 0.19 in malignant and 0.69 +/- 0.09 in benign tumors (P < .05). The corresponding values for the pulsatility index (PI) were 0.56 +/- 0.13 and 1.06 +/- 0.07, respectively (P < .01). CONCLUSIONS: Low RI and PI values are general indicators of tumor growth. The localization of blood vessels within an ovarian tumor and the presence or absence of a diastolic notch are the most useful variables in the evaluation of ovarian tumors.

Adult↗

Nucleolar organizer regions as markers of endometrial proliferation: a study of normal, hyperplastic, and neoplastic tissue.

Nucleolar organizer regions (NORs) are loops of DNA that transcribe to ribosomal RNA. They can be visualized as intranuclear black dots by histochemical staining with a colloid silver solution. We applied this method to 78 sections of endometrial tissue obtained either from curettage or from hysterectomy specimens. The histological diagnoses were as follows: normal proliferative (N = 9) or secretory (N = 5) endometrium, simple hyperplasia (N = 10), complex hyperplasia (N = 18), atypical hyperplasia (N = 8), and adenocarcinoma (N = 28). Mean silver-stained NOR (AgNOR) counts per cell were 3.2 (standard error of the mean [SEM], 0.2) in normal proliferative and 2.7 (SEM, 0.2) in normal secretory epithelium, and increased to 4.1 (SEM, 0.3) in simple hyperplasia, to 5.4 (SEM, 0.4) in complex hyperplasia, to 8.1 (SEM, 0.7) in atypical hyperplasia, and finally to 10.0 (SEM, 0.5) in endometrial carcinoma. The differences were significant (one-factor analysis of variance [ANOVA], P < .001). A slight increase but no significant difference was seen between the mean AgNOR counts in endometrial carcinomas of different histological grades. Our study suggests that AgNOR counts are reliable markers of endometrial proliferation and allow a clear distinction between benign, premalignant, and malignant epithelial changes. Our AgNOR findings in endometrial hyperplasia support the concept of various degrees of hyperplasia that can be differentiated on morphological grounds.

Adenocarcinoma↗

[The birthing stool--an obstetrical risk?].

During 1992, 140 women out of a total of 1122 used the delivery chair at the department for obstetrics and gynaecology at the LKH Mödling. We compared them to a control group in the supine position. In order to evaluate the safety of deliveries on the delivery chair, we studied the duration of the stages of labour, rate and degree of soft tissue injuries, maternal blood loss, fetal outcome and complications in the puerperium. The use of the delivery chair showed no increased risk to either the mother or the fetus and therefore represents an appropriate alternative to the traditional supine position for delivery.

Adolescent↗

[Abdominal colposuspension--the gold standard in incontinence therapy?].

Abdominal colposuspension has become the operation of choice in moderate and severe urinary incontinence in the female. The operation involves an elevation of the bladder neck and approximation to the back of the symphysis pubis, resulting in an improved pressure transmission to the proximal urethra. These operative techniques have become standardised, while the various modifications differ in the exact location of the sutures in the vaginal fascia and connective tissue in the small pelvis. Most commonly, the sutures are placed lateral of the bladder neck and passed through the ileo-pectineal ligament (Cooper ligament). Even in unfavourable cases, success-rate lies between 70% and 90%.

Abdomen↗

[Histochemical characterization of endometrial proliferation using AgNOR (nucleolus organizer region)].

Nucleolar organizer regions (NORs) are loops of DNA that transcribe to ribosomal RNA. We used histochemical staining of NORs for 78 sections of endometrial tissue, obtained either from curettage or from hysterectomy specimens (normal endometrium 14, simple hyperplasia 10, complex hyperplasia 18, atypical hyperplasia 8 and adenocarcinoma 28). There was a significant positive correlation between mean AgNOR counts and the degree of hyperplasia. In adenocarcinoma, no significant difference was found between AgNOR counts in tissues of different histologic grades. Our study suggests that AgNOR counts are reliable markers of endometrial proliferation and allow a clear distinction between benign, premalignant and malignant epithelial changes.

Adenocarcinoma↗

In vitro fertilization with spermatozoa from alloplastic spermatocele.

This case report describes successful IVF of oocytes of a 22-year-old female with epididymal spermatozoa aspirated from alloplastic spermatocele of the husband presenting with bilateral congenital absence of the vas deferens. Motile spermatozoa were aspirated from the reservoir 3 months after implantation. Abortion occurred 22 days after embryo replacement.

Abortion, Spontaneous↗

[Surgery of prolapse and incontinence in Austria--current status and prospects].

In early 1989, we sent a questionnaire to all 89 Departments of Gynaecology in Austria. Questions covered the number and type of gynaecological operations performed, perioperative management, and diagnosis and treatment of descent and urinary incontinence. 90% of questionnaires were returned. We found that currently 2/3 of all hysterectomies and 9/10 operations for descent and incontinence are done vaginally, irrespective of the size of the department. There was no relationship between the frequency of vaginal hysterectomies and the percentage of vaginal operations for descent and incontinence. Suprapubic bladder drainage is used in over 50%, in 85% postoperative screening for urinary tract infection is done routinely, and 53% of departments use prophylactic antibiotics. We conclude, that vaginal hysterectomy is still the method of choice in Austria, and that there is extreme emphasis on vaginal operations for urinary incontinence.

Adult↗

[Surgical correction of uterus abnormalities: experiences with the Tompkins method].

In the last 10 years, 12 abdominal metroplasties (Tompkins) were performed at the 2nd Department of Obstetrics and Gynaecology, Vienna. All patients had a history of at least 2 spontaneous abortions, caused by a deformity of the uterus. The operation according to Tompkins, is technically simple and does not result in a defect in the uterus. There were no intraoperative or postoperative complications. Follow-up was possible in 10 patients, 8 of whom had a persisting wish for a child. 5 of these women became pregnant again, one had an abortion. All children were delivered by elective Caesarean section after the 36th week; the fetal outcome was satisfactory. In our experience, Tompkins' operation is the surgical therapy of choice in habitual abortion cause by Müllerian anomalies.

Abortion, Habitual↗