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New findings indicate that the cutoff level for Hybrid capture 2 test for primary screening for high-grade cervical intraepithelial neoplasia can be increased to reduce the burden on women while still meeting international sensitivity recommendations.

Since World War II, evidence-based medicine has rapidly replaced custom and lore. Proliferation of imaging and laboratory studies has improved diagnostic accuracy.

Compared with anterior colporrhaphy, a trocar-guided transvaginal polypropylene mesh repair kit for prolapse of the anterior vaginal wall results in higher short-term success rates, but also higher rates of surgical complications and postoperative events, according to study findings.

Many options are currently available to treat the symptoms of endometriosis. Of these options, surgery is the only one that actually removes or destroys the endometriosis itself. There seems to be a fair amount of confusion surrounding the issue of which surgical technique (excision, laser vaporization, etc.) is the best method to surgically remove endometriosis.

At a resident's education conference, Dr. Richard M. Soderstrom, M.D. presented the following handout on today's evidence based evaluation of laparoscopic sterilization methods. Dr. Soderstrom is the author covering this subject in the USA'a first textbook on Laparoscopy, Ed. JM Phillips, Williams & Wilkins, 1977. Since then he has published widely on the subject and continues to act as a consultant to the FDA when new devices for sterilization are entertained.

The problems relating to searching the Internet for medical information are well known; too many sites are identified and there is no easy way to filter out the good from the bad. Consequently, if search engines are not the best place to start your exploration of the Web for information relating to gynaecology and reproductive medicine, where is? In my opinion the best place to start is at the OBGYN.net site .

Meigs´s syndrome is defined as the presence of ascites and hydrothorax in association with a benign ovarian tumor. It is a rare clinical entity, which is also considered to be an uncommon complication of benign leiomyomas of the female genital tract. The case of a 33 year-old female patient who presented rapid weight loss and a quickly increasing abdominal circumference is described. Clinical and ultrasonographic studies revealed a mobile, semi-solid right adnexal tumor in the lower abdominal quadrants of 15 x 14-cm and ascites as well as hydrothorax of the left lung, confirmed by chest radiography.

Unroofing the ureter in the cardinal ligament is the most important step during radical hysterectomy. At our institution we developed a modified laparoscopic technique to free the ureter from its roof through the cardinal ligament. The technique is based on the advantages of laparoscopic surgery which mainly are: more accurate haemostasis, magnification of the anatomical structures and positioning of the scope parallel to the ureteral course instead of perpendicular like in open surgery.

The forces that drive the development and refinement of surgical technique are multifocal. Physicians value effective procedures that combine safety, simplicity, and reproducibility. Third-party payers seek techniques that are cost effective, require shorter hospital stays, and result in less morbidity. Patients flock to physicians who are able to perform procedures that entail less discomfort, shorter recovery times, better cosmetic results, and also preserve or improve the equality of their lives. Such has been the case with the evolution of laparoscopic hysterectomy.

The mean uterine weight was 146 g (60-569 g). The mean operating time was 94 minutes (60-225 min.). Actual morcellation time was available in 19 cases by reviewing videotape with an average morcellation time of 11.8 minutes (4-23 min.). Average blood loss was 125 cc (20-600 cc) with one case of late postoperative bleeding requiring operative intervention. The average cost for the procedure was $7,998 ($6,989 - $11,581). Thirty-six patients were discharged within 23 hours from the time of admission and all patients were discharged within 48 hours of the time of admission.

In spite of readily available alternatives to hysterectomy such as endometrial ablation, hysterectomy rates have not fallen. Several comparative trials of hysterectomy have shown shorter hospital stay and convalescence after laparoscopic approach compared to an abdominal approach.

The diagnosis of uterine and/or tubal pathology as causes of female infertility represents a fundamental step in the evaluation of the infertile couple. Apart from the invasive diagnostic procedures, several others diagnostic techniques useful to the clinical evaluation of the uterine cavity and tubal anatomy are: transvaginal sonography (TVS), hysterosalpingography (HSG), hysteroscopy and hydrosonography (HDS) and laparoscopy.

Laparoscopic staging of apparent early ovarian cancer may be accomplished in patients where disease appears limited to the adnexa. For example a completely resected complex adnexal mass with intraoperative frozen-section revealing malignancy and no obvious limitation to complete laparoscopic staging.