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PubMed · 3949046

A new culdocentesis system.

M A Wiegerinck·W N de Laat·E Moret
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Abstract

A new culdocentesis system is presented, based on vacuum fixation of the posterior vaginal wall together with Douglas peritoneum in a small vacuum cup, enabling a controllable central perpendicular puncture with a special catheter-needle unit. The advantages of the new system are the creation of a relatively safe and painless access to the pouch of Douglas, less risk of contamination, the possibility of repetitive examinations, and satisfactory effectiveness in collecting peritoneal fluid. The results of 164 culdocenteses in ambulant infertility patients are reported. Application of the technique is proposed for the investigation of sperm migration in vivo, steroid analysis of peritoneal fluid, and intraperitoneal insemination.

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Douglas' PouchFemaleHumansNeedlesPuncturesSuctionJournal Article

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BibTeXRIS

M A Wiegerinck, W N de Laat, E Moret. 1986. A new culdocentesis system.. https://doi.org/10.1016/s0015-0282(16)49234-4

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PubMed2003

Prevention of genital prolapse following Burch colposuspension: comparison between two surgical procedures.

Our objective was to evaluate the efficacy of cul-de-sac obliteration in preventing pelvic floor anatomical defects formation following Burch colposuspension. We evaluated 441 patients who had undergone Burch colposuspension. The patients were divided into two groups: group A (132 patients) who underwent Burch colposuspension only, and group B (309 patients) who had had a concomitant cul-de-sac obliteration. Cul-de-sac obliteration was performed using two different techniques, the Moschocowitz procedure in 131 patients, and approximation of the sacrouterine ligaments in 178 patients. The follow-up period was 8.6 years (range 3-16). In total we found 43/441 (9.7%) postoperative anatomical defects. Obliteration of the cul de sac significantly (P<0.0001) reduced the formation of anatomical defects compared to Burch colposuspension. In a comparison of the two surgical procedures for cul-de-sac obliteration, the approximation of the sacrouterine ligaments was significantly more effective than either the Moschcowitz procedure (P<0.001) or the Burch colposuspension alone (P<0.001). The Moschcowitz procedure reduced the formation of anatomical defects to 15/131 (11.4%) compared to Burch colposuspension only (25/132; 18.9%), but statistically the difference was insignificant. The time of anatomical defect detection was significantly reduced after cul-de-sac obliteration: 2 years 6/25 (24%) in group A compared to 1/8 (5.5%) in group B (P<0.01). After 5 years the detection rate was 64% (16/25) and 22.2% (4/18) respectively (P<0.01). It was concluded that cul-de-sac obliteration using approximation of the sacrouterine ligaments significantly reduced the incidence of anatomical defect formation following Burch colposuspension. A long follow-up period is needed to evaluate the truce incidence.

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