Objective  To analyse all laparoscopic treatment of cystic adnexal tumours in the period 1998–2000. Design  Retrospective evaluation of surgical procedures (Canadian Task Force classification III). Setting  University department of obstetrics and gynaecology. Patients  427 patients with cystic adnexal masses. Interventions  141 patients underwent an adnectomy/ovariectomy and 286 an ovariectomy, ovarian cyst enucleation or biopsy by operative laparoscopy. Results  Laparoscopic treatment was possible in 97% of patients with adnexal masses. In 10 patients (2.3%) a conversion to laparotomy was necessary. Conclusions  After careful evaluation, most cases of adnexal mass can be managed laparoscopically. The risk of missing a malignancy is very low. Proper attention to techniques and training reduces complications and the risk of spillage.

Objectives To evaluate the degree of adhesion formation at laparoscopic surgery in different patient groups. Design A retrospective study using the American Fertility Society's Adhesion Scoring Method and the MCASM (More Comprehensive Adhesion Scoring Method). Subjects The 465 patients with adhesions among 2124 patients who underwent laparoscopy. Results Details of the 465 cases of adhesiolysis are given. In subgroup 1 (n = 34) there were no pre‐existing adhesions. All 34 patients were assessed for adhesion occurrence at a second‐look laparoscopy after 6–8 weeks; 29.4% were found to have no adhesions and 70.6% of patients had significant or mild adhesions. A more comprehensive adhesion scoring method (MCASM) was found to be more objective in the assessment of adhesions; however, it was difficult to record in an easily readable manner. In subgroup 2, 21 patients who had undergone previous surgery for adhesiolysis were operated upon again, and 24% revealed an increased adhesion score, 57% the same adhesion score and 19% a reduced adhesion score at second‐look laparoscopy. Conclusions The new data confirmed our previous knowledge: to avoid adhesions one must avoid surgery. If surgery has to be performed, laparoscopic surgery causes fewer adhesions than laparotomy.

ObjectiveThe Burch procedure remains an effective and durable procedure; however, it can be associated with many complications, the most important of which is voiding difficulties. To avoid overcorrection or undercorrection, placement of the sutures can be guided by a cystoscope to ensure equal placement and tension on both sides of the bladder neck. Patients and methodsIn all, 130 female patients with genuine urinary stress incontinence proved by urodynamic studies were enrolled in the study. They were operated upon by a Burch colposuspension guided by cystoscopic vision to the bladder neck during placement and tension of the sutures on both sides of the bladder neck. Results All patients were followed up for 6 months postoperatively: 122 of them for 12 months and the remaining eight for 24 months. All cases showed a negative stress test, and none of them suffered from urinary retention. Thirty-five cases (26.9%) who suffered urinary tract infection were treated medically; 11 cases (8.4%) reported urgency and were treated medically. ConclusionCystoscopy during Burch colposuspension could be helpful to guide the placement and adjustment of sutures. This additive simple procedure definitely improved the results of the procedure and decreased complications, especially urine retention and voiding difficulties.