Vol 63, No 1 (2014)

The paper presents data on comparison of microscopy, culture and molecular (PCR) methods for diagnosis of trichomoniasis, as well as on evaluation of the quality of culture media for isolation of trichomonads produced by Russian and international manufacturers. The highest sensitivity was shown for the molecular (real-time PCR) method. Microscopy of stained and wet smears demonstrated relatively high sensitivity. The culture media that are widely used in our country for Trichomonas vaginalis isolation need optimization.

Women with significant genitourinary prolapse may be continent in spite of a weak urethral sphincter because of kinking of the poorly supported urethra. After the surgery for prolapse 19-30 % of the patients identify “occult” urinary incontinence due to a weak urethral sphincter. The aim of this study is to evaluate the role of complex urodynamic testing to identify “occult” urinary incontinence, neuromuscular dysfunction of the bladder and urethra for adequate combined therapy. Methods: 257 female patients with no urinary incontinence at the age of 30-86 years old were examined, before the surgery the pelvic organ prolapse of II-IV stages was reduced by Simps vaginal speculum: 102 women were clinically tested, and 155 women were complexly (clinically and urodynamically) evaluated. In addition to clinical examination urodynamic testing was made. Complex examination was repeated to all of them after 1-3 and 12-36 months after the operation. Results: Decrease of values of abdominal pressure transmission (APT) of less than 100 % was found significantly more often (38 ± 3.9 %) compared to a positive cough test while clinical exami-nation(19.4 ± 3.2 %) P < 0.001. Preoperatively detrusor overactivity was diagnosed in 12.5 ± 3.5 % and 11.8 ± 4.2 % cases, urethral instability - in 3.1 ± 1.7 % and 5.1 ± 2.8 % cases, detrusor sphincter dyssynergy - in 3.1 ± 1.7 % and 1.7 ± 1.6 % cases, detrusor hypotonia in 9.4 ± 3.0 % and 13.5 ± 4.4 % cases of patients with APT of more than 100 % and less than 100 % respectively. Patients with detrusor overactivity, urethral instability, detrusor hypotonya got medical preoperation treatment during 3 months and longer. 6 patients with detrusor-sphincter dyssynergy, detrusor hypotension were contraindicated for sling operation. Patients who had clinically and urodynamically confirmed urinary incontinence underwent simultaneous sling operations (13 women in a clinical group and 51 - in a complex group). In 12-36 months after the surgery no patient with APT of more than 100 % showed urinary incontinence. Clinically examined patients revealed totally 7 out of 102 (7.14 ± 2.5 %) complications after 12-36 months after surgery (mixed urinary incontinence in 4 cases and difunctional urination due to hypotonia detuzor in 3 cases). There are no these complications in the group of complexly examined women. Conclusions: Urodynamic testing can identify those women at risk of developing postoperative urinary incontinence and difunctional urination so that prophylactic measures can be undertaken. In cases when neuromuscular dysfunction is corrected and values of APT are less than 100 % simultaneous sling operation is reasonable.

Vitrification of oocytes is one of the most promising and rapidly developing areas of embryology and ART. Oocyte vitrification technology allows for cryopreservation of female gametes for the long term with the possibility of further use in IVF/ICSI cycles. The use of vitrification to extend the capabilities of ART programs, and high survival rates of oocytes after vitrification and the percentage of normal fertilization will contribute to further increase efficiency and improve IVF programs in the future.

This lecture will begin by discussing the development of the fetal brain. We will look at the neuronal development with clinical correlates in all trimesters of pregnancy. Discussion of the advantages of looking at the developing fetal brain in the first trimester of pregnancy as a window into the detection of fetal anomalies will be discussed. Integration with MRI and CT imaging will be interspersed with sonographic discussion and interpretation. Common fetal CNS abnormalities will be outlined and their evolution during advancing gestation will be reviewed. Less common defects will be discussed with attention to the clues in imaging that make their diagnosis easier. The limitations of ultrasound imaging for certain CNS anomalies will be outlined in detail. This will include both fetal as well as maternal limitations. Tips and options for sonographic imaging will be interspersed within the lecture to allow the participant several options for imaging fetal anomalies with neurosonography and improving their diagnostic accuracy.