[The effectiveness of intravaginal estriol tablet administration in women with urge incontinence].

In postmenopausal patients, stress and urge incontinence often occur as a consequence of oestrogen deficiency. We performed a comparative study in a prospectively randomised and placebo controlled group of women with urge incontinence to investigate different dosages of intravaginally applied oestriol. Clinical and urodynamic parameters were also compared.

[Counseling in artificial fertilization].

Since 1 October 1990, German legislation requires compulsory counselling of an infertile couple before artificial insemination on the medical and psychosocial aspects, by a doctor not performing the treatment. A prerequisite of successful counselling, which enables the couple to take a decision and helps coping with the psychosocial stress of sterility and its consequences, is, in addition to the intrinsic motivation of the couple, also the empathy and the discussion with the doctor. Subject for counselling should be the burdens of therapy, effects of the sterility upon sexuality, partnership, and communication, motivations for wanting a child and the functions of the child for both partners individually and as a partnership.

[Improvement of Doppler ultrasonography findings following transcutaneous electrostimulation in women with placental insufficiency].

Previous perinatal trials using Doppler ultrasound have demonstrated a favorable correlation between abnormal blood flow spectra and feto-maternal problems. 33 patients with manifest placental unsufficiency were subject to daily transcutaneous nerve stimulation in a 2-week therapeutic course. 23 patients of the control group were treated by bed rest over 2 weeks.

[Morphologic and functional long-term results after Vecchietti operation for the formation of a neovagina].

For creation of a neovagina in patients with congenital vaginal agenesis, a variety of operative procedures are recommended. Basically, two different procedures are described: (1) Application of pressure or traction to the perineum and (2) plastic-surgical operations. Since 1981, the 2nd Department of Obstetrics and Gynecology, Vienna, utilises the method described by Vecchietti.

[Effects of primary radiotherapy on uterine circulation in advanced cervix cancer].

We examined 11 patients suffering from advanced cervical carcinomas, who were treated primarily with radiation. The blood flow through the uterus was established by measuring the Doppler pulse flow through the arteria uterina before and after radiotherapy. In a reference group of 25 women, free from cervical carcinomas, we established a median PI of the arteria uterina of 3.

[Comparison of perineal sonography and abdominal ultrasound examination in placenta praevia].

This study describes a comparison between two different ultrasound methods used to localize a low-lying placenta or a placenta previa. The methods implemented were the abdominal ultrasound and the so-called "perineal scan", an ultrasound examination of the female urogenital tract, which is performed by using the perineum as an acoustic window. Between 1985 and 1988, 84 patients, suspected of having a low-lying placenta, were examined by perineal scanning.

[Doppler ultrasonography--perinatal data in cases with end-diastolic block and reverse flow].

In 50 cases with an end-diastolic zero flow or reverse flow all antenatal and perinatal abnormalities have been recorded. The fetal outcome was registered. The percentage of highly dystrophic newborns (percentile less than 5) was 88%.

[Estrogen substitution therapy in climacteric: should progesterone be omitted in hysterectomized women?].

The replacement therapy in postmenopausal women is seen to be for transformation of the oestrogen-stimulated endometrium only, which does not apply to hysterectomised women. Because of the influence of estrane on lipids, one often advises against a replacement therapy with progestogens in hysterectomised women. With increasing knowledge of encountered extragenital functions of sexual steroids, the latter is questionable, if natural progesterone is given, which is (said to be) lipid-neutral, performing the function of the progestogens, which is quite more than reproduction only, more efficiently than estrane or gonane.

[New methods for treating surgically incomplete or inoperable recurrences of gynecologic malignancies].

Following radical or subradical surgery or an inoperable situation of recurrences of gynaecological tumours of the vaginal vault or the pelvic wall we suggest two different techniques of irradiation: 1. transtumoural afterloading-methods with a) flexible probes, and b) non-flexible probes 2. The application of iodine seeds.

Prostaglandin versus expectant management in early tubal pregnancy.

Since ectopic pregnancy may terminate in spontaneous recovery we compared treatment by means of prostaglandin (PG) application with expectant management in laparoscopically verified tubal gestations. Twelve patients received local and systemic PG, 4 patients were treated with sodium chloride and in 7 patients laparoscopy was discontinued without medical therapy. The comparison between the PG group and the placebo groups revealed a highly significant difference with regard to a subsequent necessary surgical intervention and hospitalisation.

[Discolored amniotic fluid--results of prenatal diagnosis and clinical significance].

7000 pregnancies were analysed after genetic amniocentesis in respect of the further course and results of prenatal diagnosis (observation period 1975-1988). In 3.1% (217 cases) samples of amniotic fluid were discoloured.

[Differences in blood flow in maternal blood vessels in normal pregnancies and gestosis].

Clinical studies showed a lower blood flow in renal und uterine vessels in gestotic pregnancies. A comparison was therefore made between three maternal vessels (uterine, renal und thyroideal vessels) in normal and gestotic pregnant and non-pregnant women to show if the higher vessel resistance in gestotic pregnancies is a local or systemic event. There was a significant difference between the collectives in the blood flow of renal and uterine vessels, but no difference between the resistance in thyroideal vessels.

[Eye manifestations as climacteric symptom].

The menopausal syndrome consists of a variety of psychic and physical signs of different intensity. At our outpatient department for problems in menopause and prevention of osteoporosis (1. Dept.

[Demonstration and biological significance of viral and cellular oncogenes in uterine carcinomas].

Premalignant and malignant lesions of the cervix uteri and endometrium were analyzed for the presence of human papillomavirus (HPV) DNA and c-myc or c-erbB2/neu oncogene expression. HPV DNA was detected by PCR in 100% of the cervical carcinomas and CIN lesions, but also in endometrial lesions (3/8 adenocarcinomas, two hyperplasias and one adenomyosis uteri). Myc-overexpression was found in 25-30% of the cervical carcinomas and severe dysplasias, but not in endometrial lesions.

[Hypergonadotropic amenorrhea (WHO III) as osteoporosis risk].

In 21 patients, suffering from amenorrhoeic hypergonadotropic ovarian insufficiency (age 27 +/- 3 years [FSH: 43 +/- 10, LH: 40 +/- 8]), the bone density was measured by single-photon densitometry (SPA), before starting a hormonal replacement therapy with oestrogen/progesterone. Every 5 months, the trend in bone density change was measured in all cases. The bone density before hormonal treatment was lower in the WHO III-group (1.

[Clinical aspects and morphology of extra-ovarian serous cancer of the pelvis].

An extraovarian peritoneal serous carcinoma is characterised macroscopically by ovaries without pathology, histologically, however, by a serous carcinomatous structure in the pelvis, in an advanced tumour stage of usually marked peritoneal carcinomatosis. Extraovarian pelvic serous carcinomas are rarely described in literature. In our study on five patients with such carcinomas, laparotomy findings revealed peritoneal carcinomatosis as in advanced ovarian carcinomas, but without ovarian involvement.

[Prognosis of triplet pregnancies].

31 triplet pregnancies (DG), treated during 1975-1989, were analysed retrospectively. 13 DG (D10) were registered up to the end of the 10th week of pregnancy, 16 (DG) (D16) were intact between the 11th and the 16th gestational week. 3 DG resulted from the reduction of high grade multiple pregnancies.

[Principles of physiologic and drug-induced cervix ripening--recent morphologic and biochemical findings].

Maturation of the cervix during pregnancy is an essential pre-requisite for an uncomplicated delivery at term. Physiological cervical ripening is characterised by a diffuse loosening of the collagenous connective tissue with widely scattered collagen fibrils and an increased amount of extracellular ground substance. These morphological changes are similar to those after prostaglandin (PG)-pre-treatment of the cervix.

[Extent of psammoma carcinomas of the ovary--a clinical, DNA flow cytophotometric and morphometric image analysis study].

There is no agreement in literature on the biological behavior of psammoma carcinomas of the ovary. The majority of authors consider psammoma bodies to be the result of tumour regression, associating the occurrence of psammoma bodies with longer survival. On the other hand, several studies reveal a poor prognosis for psammoma carcinomas, similar to that of other epithelial malignant tumours.

[Ante partum monitoring of fetal status by maternal recording of fetal movement].

Perceived fetal activity is the oldest and least expensive technique for monitoring fetal well-being. The mother's awareness of a loss or a significant decrease in propulsive fetal activity has been traditionally regarded as a warning sign, especially when uteroplacental insufficiency is present. Many investigators have reported the value of daily fetal movement charting as a means for signalling fetal jeopardy and possible demise.

[Measuring subcutaneous fatty tissue as a sonographic parameter for detection of fetal growth retardation and fetal hypertrophy in pregnancy].

This investigation contains a statistical evaluation of sonographic results concerning fetal subcutaneous adipose tissue aiming to examine and assess the relevance of this new sonographic parameter for the detection of fetal growth retardation, resp. fetal hypertrophy during pregnancy. The diagrammatic presentation of the growth of the subcutaneous adipose tissue of eutrophic fetuses shows low validity for the differentiation of hyper- and hypotrophic fetuses.

[A rapid test procedure for the detection of B streptococci in the perinatal period].

At the Hospital of the Department of Gynaecology of the University of Heidelberg, a latex agglutination test (Strep B Patho Dx Test) was applied after extraction of antigens from amniotic fluid and gastric aspirate, parallel to the routine screening programme (vaginal and anal swabs) for maternal colonization with B streptococci. The latex agglutination test was applied in 1336 cases. Maternal vaginal colonization was detected in 14%, anal colonization in 17% of the cases.

[Surgery of prolapse and incontinence in Austria--current status and prospects].

In early 1989, we sent a questionnaire to all 89 Departments of Gynaecology in Austria. Questions covered the number and type of gynaecological operations performed, perioperative management, and diagnosis and treatment of descent and urinary incontinence. 90% of questionnaires were returned.