OBJECTIVE To compare saline with and without added lignocaine and carbon dioxide distension for out patient hysteroscopy with regards to patient discomfort and hysteroscopic view. DESIGN Single blind prospective randomised controlled trial. SETTING Specialist out patient clinics in a large teaching hospital. POPULATION Women undergoing out patient hysteroscopy and endometrial biopsy for a...

BACKGROUND To evaluate the feasibility and validity of a large series of outpatient diagnostic hysteroscopies using a 4.9 mm flexible hysterofibroscope without anesthesia. METHODS In this observational clinical study, 2033 consecutive women referred with various indications underwent an outpatient hysteroscopy without analgesia or anesthesia. A 4.9 mm flexible hysterofibrescope (Olympus Corpo...

Fifty-seven patients who underwent hysteroscopic septum resection between January 1991 and December 1996 were studied; nine patients presented with recurrent abortions, 46 with infertility (26 primary and 20 secondary), one with dysmenorrhoea and one with an asymptomatic complete septum. Their reproductive history included 78 pregnancies: 69 (88.4%) abortions, two (2.6%) ectopics, two (2.6%) pr...

We reviewed the place of tubal surgery in the era of assisted reproductive technology. Reversal of tubal ligation is one of the main indications for tubal microsurgery. Adhesiolysis has the best results if the adhesion is the only factor responsible for infertility. There are no differences between adhesiolysis by laparoscopy or by laparotomy, and so laparoscopy must be preferred. Proximal tuba...

Adhesion formation has been found to be highly prevalent in patients with a history of operations or inflammatory peritoneal processes. These patients are at a high risk of serious intraoperative complications during a subsequent operation if adhesiolysis is performed. These complications include bowel perforation, ureteral or bladder injury, and vascular injury. In order to minimize the risk o...

There have been reports of abnormalities in the lumbosacral region involving a lower-than-normal termination of the dural sac, which is caused by disease or anatomical variation. Inadvertent dural puncture or other unexpected complications can occur during caudal epidural block or adhesiolysis in patients with these variations, but only a small number of case reports have described this issue. ...

A report on the hysteroscopic removal of a Gräfenberg ring after almost fifty years in utero. In addition to the differential diagnostic considerations, the medical history aspects of this case are particularly interesting.