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Biomedical subjects

R Wenzl

Publications and source records attributed to R Wenzl.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Second look laparoscopy after fallopian tube perforation with the tubal endoscope].

In recent years, falloposcopic, visualization of the tubal lumen has become a topic of great interest. The development of a linear everting catheter system (Imagyn Medical Inc., Laguna Niguel, Calif., USA) allows cannulation of the fallopian tubes without exerting shear forces upon the tubal epithelium. We report the findings of a second-look laparoscopy after accidental tubal perforation at falloposcopy. Second-look laparoscopy was performed in a patient 6 months after tubal perforation with the falloposcope and no adhesions or signs of inflammation could be detected. On chromopertubation, no tubal fistula was found to be present. Two months after treatment, the patient got pregnant spontaneously. Pregnancy and delivery were without any complications. We conclude that technique of falloposcopy provides a safe access to the endotubal lumen. Even a perforation created by the microendoscope does not appear to be associated with any long-term complications.

Adult↗
PubMed1996

Laparoscopic surgery in cases of ovarian malignancies: an Austria-wide survey.

The purpose of the study was to determine the frequency of discovering a malignant ovarian mass when laparoscopy is used to manage an adnexal mass. A countrywide survey was undertaken in Austria, comprising questions about ovarian malignancy detected or accidentally treated by laparoscopy. The response rate of 66.7% represented a total of 54,198 laparoscopies, 16,601 laparoscopic surgeries on adnexal masses, and 108 cases of ovarian tumors subsequently found to be malignant (96 well-documented). Twenty patients were treated with laparoscopy alone. In 22 cases, laparoscopy was followed by immediate laparotomy. A delayed laparotomy (3-1415 days) was performed in 54 cases. Staging revealed FIGO classifications from stages Ia to IV. The follow-up time ranges from 2 to 220 months. Four recurrences have been reported. Thirteen patients died of tumor progression. Laparoscopic surgery on ovarian malignancies is a rare situation (0.65% of all endoscopic surgeries on adnexal masses). In cases of malignancy, a laparotomy has to be performed to ensure optimal staging and treatment.

Adolescent↗
PubMed1995

Ovarian function during low-dose oral contraceptive use.

Lowering the total steroid dose in modern oral contraceptives (OCs) has been connected with a higher incidence of ovarian follicle and cyst formation. To investigate the presence of ovarian follicles and cysts by means of vaginal ultrasonography and serum hormone determinations during use of two low-dose OCs, 65 volunteers were randomized to receive either 20 micrograms ethinylestradiol (EE) + 150 micrograms desogestrel (group A) or 35 micrograms EE + 250 micrograms norgestimate (group B) for a 2-month study period. At baseline, 39% of women in group A and 31% in group B exhibited at least one follicle < 35 mm in diameter. By the end of the second treatment cycle, the frequency of these follicles had decreased to 14% in each group. Only one subject in the higher estrogen group developed an ovarian cyst > 35 mm. One subject in each group demonstrated hormone levels characteristic of ovulation; no pregnancy occurred in either group. The 20 micrograms EE preparation was not found to lead more often to ovarian follicles or cysts when compared with a 35 micrograms EE preparation, possibly because of the type and dose of the progestogen used.

Contraceptives, Oral, Combined↗
PubMed1994

Three-dimensional video-endoscopy: clinical use in gynaecological laparoscopy.

We describe a system that displays the abdominal organs in three dimensions during laparoscopy. The system consists of a single-rod-lens endoscope and two integrated microchip cameras. The surgeon has to wear active-liquid-crystal shutter-glasses to obtain a three-dimensional impression during the operation. Improved orientation in the abdominal cavity allows exact handling of surgical instruments. The three-dimensional system permits surgery with more accuracy, speed, dexterity, and safety than conventional two-dimensional systems.

Female↗
PubMed1994

[Tuboscopy--new developments for accurate tubal diagnosis].

A specially developed linear everting catheter (LEC) in combination with a microendoscope, enables for the first time the visualisation of the complete tubal mucosa from a vaginal approach. Preliminary results in using this technique are described. Physiological and pathological results of tubal mucosa can be presented, which will influence the diagnostic and therapeutic part of subsequent sterility treatment.

Adult↗
PubMed1994

[Tuboscopy--an endoscopic approach to the intratubal lumen].

A linear everting catheter in combination with a 0.5-mm microendoscope enables the visualization of the tubal lumen. In 35 sterility patients, diagnostic tuboscopies were performed. Physiological and pathological results of tubal mucosa are described. Tuboscopy is a main tool in the diagnosis of the tubal factor. First steps are taken to use tuboscopy not only for diagnostic but also for therapeutic reasons. Yet, the role of this technique in cases of tubal pregnancies cannot be evaluated.

Endoscopes↗
PubMed1994

Pregnancy and spontaneous delivery 13 months after heart transplantation.

This case report is about a 23-year-old female patient who underwent heart transplantation because of dilatative cardiomyopathy. Four months after transplantation she conceived. Thirteen months postoperatively, the patient had spontaneous vaginal delivery and gave birth to a child in good physical condition.

Adult↗
PubMed1994

[Diagnosis of familial Holt-Oram syndrome].

Presented is one rare case in a family affected by a Holt- Oram-Syndrome. This syndrome is associated with an upper limb malformation and a congenital heart disease. In our case we found radiusaplasia on both sides, thenaraplasia on the left hand, a hypoplastic thumb on the right hand. The heart was malformed as a Fallot tetralogy, the left kidney was absent. Four additional affected members of the family are described. By routine ultrasound examination we could not find this malformation syndrome. In families with affected history ultrasound screening examination should be done on a center for prenatal diagnosis.

Abnormalities, Multiple↗
PubMed1993

Endovaginal Doppler flow measurements of the ovarian artery in patients with a normal menstrual cycle and with polycystic ovary syndrome during in vitro fertilization.

Women with a normal menstrual cycle (n = 21, controls), polycystic ovary syndrome (n = 10) and hypogonadotropic amenorrhea (n = 3) were stimulated with clomiphen-citrate (4th day to 8th day of the cycle) and with human menopausal gonadotropin (8th day to 11th day). The vascular impedance of the ovary carrying the dominant follicles was monitored by endovaginal pulsed Doppler flow measurement. Simultaneously, serum levels of LH, E2 and 17-OHP were assayed. Contrary to controls, women with polycystic ovary syndrome or hypogonadotropic amenorrhea showed decreased hormone levels and no lowering of the vascular impedance. In controls, the lower pulsatility index is caused by neovascularization around the dominant follicle and by E2-induced vasodilatation in the ovarian artery.

17-alpha-Hydroxyprogesterone↗
PubMed1993

Ovulation inhibition with a combined oral contraceptive containing 1 mg micronized 17 beta-estradiol.

OBJECTIVE: To evaluate ovarian function by ultrasonography and endocrine measurements. DESIGN: Prospective, open study. SETTING: Outpatient clinic of the First Department of Gynaecology and Obstetrics, University of Vienna, Austria. PARTICIPANTS: Twenty healthy women with regular cycles and established ovulation by ultrasonography. INTERVENTION: Treatment with a combination of 1 mg micronized E2 with 150 micrograms desogestrel daily for 21 days, followed by 7 pill-free days. MAIN OUTCOME MEASURES: Transvaginal ultrasonography and estimation of E2 and P at least twice a week for two consecutive cycles, followed by one after treatment cycle. RESULTS: Ovulation inhibition was apparent in all cases and no functional ovarian cysts were observed during treatment. On a few occasions a persistent follicle was noted, but in the majority of cases there was total absence of follicular activity. The bleeding pattern showed a tendency toward prolonged and more heavy bleeding when compared with the before treatment situation. Return of ovulation was prompt in all women but one. CONCLUSIONS: Ultrasonographic observations, accompanied by P and E2 measurements, allow us to conclude that the combination of 1 mg E2 with 150 micrograms desogestrel provides complete ovulation inhibition. However, the bleeding pattern does not show an acceptable profile.

Adult↗
PubMed1993

[Blood flow measurements of neovascularization in tubal pregnancy].

In a retrospective study the results of vagino- and colour flow Doppler sonography of 23 tubal pregnancies verified by surgery were documented. Due to the neovascularisation in the trophoblast tissue the vascular impedance was elevated in all cases. The mean value of all pulsatility indices was 0.85 +/- 0.2. The direct signs of tubal pregnancy were seen in only 20 cases with vaginosonography alone. The combination of vagino- and colour flow Doppler sonography offers the chance of an earlier detection (5th week of pregnancy) of a tubal pregnancy.

Adult↗
PubMed1993

[First use of a 3D video-endoscope in gynecology].

A new 3D-videoendoscope offers a three-dimensional visualisation of organs and anatomical structures during laparoscopy. This system consists of a stereoendoscope, two microchip cameras and an electronic control system. The use of liquid crystal (LC)-shutterglasses gives a three-dimensional impression to the examiner. The advantages of this 3D-videoendoscopic system are: exact preparation and more rapid application of endoscopic suturing techniques.

Equipment Design↗