[Laparoscopic hysterectomy with vaginal extraction]

In the paper authors present 30 laparoscopic hysterectomy made during 5 month (november 1992 till march 1993). Indications to laparoscopic hysterectomy were: myomata uteri, recurrent metrorrhagia and CIN III. The middle duration time of operation was 153 min. and the middle blood loss during operation was 122 ml. 28 patients during first control after operation felt well. In 1 patient intraoperative injury of urine bladder was noted and in next injury of left ureter.

[Laparoscopy in clinical practice. II. Usefulness in diagnosis of sterility]

The paper presents results of 1099 laparoscopies performed in sterility. Laparoscopy was made in the second phase of the menstrual cycle, 5 to 7 days after probable ovulation, as a last stage in diagnosis of sterility. Normal state of genital organs and minor pelvis was noted in 20.9% of investigated patients. In the remaining more than one etiologic factor was found, which may influence the sterility. The authors concluded, laparoscopy is valuable, accessory method in the diagnosis of sterility, which enables sometimes to find the etiologic factor in patients with "unexplained infertility".

[Laparoscopy in clinical practice. III. Complications]

In the paper authors made analysis of complications, which have appeared among 1527 laparoscopies. The authors noted complications in 14 cases (0.91%) among the whole laparoscopic interventions. The most frequent complication was subcutaneous oedema, which was noted in 7 cases (0.46%). Injury of internal organs was noted in 6 cases (0.39%) and cardiac arrest in 1 case (0.06%). In author's opinion laparoscopy carry a small risk of complications.

[Laparoscopy in clinical practice. I. Indications]

In the paper the authors analyzed indications to 1527 laparoscopies. The most frequent indications were: sterility (72.2%) and suspicions of adnexal tumours or extrauterine gravidity (14.1%). In 173 diagnostically difficult cases laparotomy was avoided. In these cases laparoscopy allowed to exclude the pelvic pathology or to quality to laparoscopic operation of ovarian cysts and intact tubal pregnancy. Diagnostic and operative laparoscopy give the possibility of quick diagnosis in diagnostically difficult cases and enables avoidance of laparotomy in many cases.

[Modern methods of treating ectopic pregnancy using surgical laparoscopic methods]

The authors present modern methods of radical treatment of tubal pregnancy by the endoscopic technique. The methods are presented of conservative and radical treatment of tubal pregnancy by laparoscopy.

[Use of diagnostic and operative hysteroscopy in clinical practice]

In the paper authors present indications and results of 141 hysteroscopies. The most frequent indications were: sterility, Asherman syndrome suspected, infertility and abnormal uterine bleeding. 55 diagnostic and 86 operative hysteroscopies were performed. In sterility and infertility group of patients were present 49.6% pathological findings of uterine cavity, between them the most frequent were: uterine septa and intrauterine adhesions. In the remaining cases the intrauterine pathology were present in 75.8% cases, between of them the most frequent were intrauterine adhesions and endometrial hyperplasia. Hysteroscopy should be the method of choice in some cases of gynecological pathology.

[Use of laparoscopy in gynecology]

Paper concerns 1822 performed laparoscopies. The most frequent indications to laparoscopy were: sterility, adnexal mass, tubal pregnancy and pelvic pain syndrome. In 80% cases of sterility we found pathologic findings, which could be the cause of sterility. adnexal mass, tubal pregnancy and pelvic pain syndrome. In 80% cases of sterility we found pathologic findings, which could be the cause of sterility. In 75% of cases we confirmed adnexal mass, which were operated by laparoscopy or by laparotomy. In 17 cases we confirmed unruptured tubal pregnancy, which were conservatively operated by laparoscopy or by laparotomy. Laparoscopy is useful method in gynecology, especially in diagnostically difficult cases of gynecologic disease.

[Laparoscopic surgery in gynecologic practice]

Paper concerns 293 laparoscopic operations. The most frequent types of laparoscopic operations in presented material were: adhesion lysis in minor pelvis (33.8% cases), cystectomy and cyst-ovariectomy (27.6%) and electrocoagulation of ovarian capsule. Operative laparoscopy because of small injury is useful method in the treatment some gynecological disease.

[Complications of endoscopy in gynecology]

The paper concerns the complications which appeared during 1822 laparoscopies and 141 hysteroscopies. The overall percentage of complications in presented material was 0.82% for laparoscopy and 2.8% for hysteroscopy. The most frequent complication during performance of laparoscopy was subcutaneous emphysema (8 cases). The most frequent complication during hysteroscopy was uterine wall perforation, which appeared in 3 cases during incision of dense and massive intrauterine adhesions. All patients with complications of gynecologic endoscopy recovered well.

[Treatment of tubal pregnancy laparoscopically]

Five cases of unruptured tubal pregnancy treated laparoscopically are described. Basing on the clinical evaluation of them we concluded, that selected cases of unruptured tubal pregnancy may be successfully treated using the laparoscopic technics. The use of this technics is less traumatic for patient, shorted the time of her stay in the hospital and lower the costs of therapy.

[Serum luteinizing hormone (LH) level during menstrual cycle in women treated for epilepsy]

In 22 women aged 18 to years treated for epilepsy with phenytoin (DPH) and phenobarbital (PB) the serum levels of LH were determined by radioimmunoassay on 8 days of various phases of the menstrual cycle. In 10 cases the attacks were related in time to the premenstrual phase of the cycle (group A), in 12 cases no such correlation was observed (group B). These results were compared with the results of similar investigations carried out in 8 women treated in hospital for ischalgia who received also DPH and PB or only PB (group C). A statistically significantly lower level of LH was found in group A in relation to groups B and C on the 13th and 22nd days of the cycle. Decreased LH level on the 22nd day may suggest that in women with attacks related to a phase of the menstrual cycle the corpus luteum may be failing with resulting deficiency of progesterone, which may be one of the factors increasing the readiness to attacks in the premenstrual phase. It may be supposed that DPH and PB given to patients with epilepsy may reduce the serum LH level.