Technique of Serial Endometrial Biopsy in the Monkey Through a Utero-Cutaneous Fistula

Abstract

A method for the creation of an abdominal utero-cutaneous fistula in the monkey is described. This surgical technique provides a means for serial endometrical biospy and observation of histological response.Serial evaluation of the human endometrium by transcervical suction biopsy has recently found widespread use. Biopsy by this technique permits accurate evaluation of the effects of sex steroids, determination of pathological endometria and timing of ovulation. In the rhesus monkey, however, the tortuous endocervical canal resulting from a prominent cervical colliculus (Wislocki, 1933) prevents successful endometrial biopsy. Previous investigations have, for the most part, relied on hysterectomy in order to obtain endometrial samples for study. Recently both Martin & Eckstein (1966) and Mastroianni & Rosseau (1965) have published studies demonstrating techniques of transcervical cannulation of the monkey uterus, but neither method lends itself to dependable biopsy. Van Wagenen & Morse (1940) first described a technique for the formation of a partially exteriorized uterus in the monkey. In two of these preparations they were able to observe cyclic anatomical variations in the uterus and to obtain endometrial curettings.In our laboratory we have recently developed a technique for preparing a chronic utero-cutaneous abdominal fistula which permits repeated suction biopsy of the endometrium in the unanaesthetized monkey. This communica¬ tion gives an outline of the technique and of its successful application.The anaesthetized female monkey is placed on the operating table in a supine position. The lower abdomen is surgically opened midway between the umbilicus and symphysis through a 7 to 8 cm vertical incision. The uterine fundus is then grasped in a Babcock clamp and the serosal surface of the fundus elevated to the level of the skin incision at its lowest border. The anterior peritoneum is then closed circumferentially about the mid-segment of the corpus so that sutures unite peritoneum and serosa at the lower border of the peritoneal incision. The remainder of the peritoneal incision is closed in the 573

Cervicectomy With Uterovaginal Anastomosis in the Rhesus Monkey: A New Surgical Model for Reproductive Studies

“…All were observed for menstrual cyclicity and their menstrual blood loss (MBL) was quantified for several months 336 E. Azar and S. T. Shaw, Jr before and after surgery by the method described by Poon, Moyer, Forino & Shaw (1973). Because of prolonged periods of amenorrhoea before surgery, cycles were induced artificially in five monkeys by daily injections of oestradiol with or without progesterone as previously detailed (Shaw et al, 1972 Good & Moyer, 1966) has been extensively employed in this laboratory for studies of uterine physiology and uterine response to foreign bodies (Shaw, Cihak & Moyer, 1970;Shaw et al, 1972;Poon et al, 1973;Shaw, Jimenez, Moyer & Cihak, 1973;. This model continues to be useful for such studies, but is associated with inherent problems.…”

“…As a means of conveniently entering the uterine cavity of the rhesus monkey, by-passing the very tortuous and narrow endocervical canal of this species, uterocutaneous abdominal fistulae have been employed (Van Wagenen & Morse, 1940;Good & Moyer, 1966; Moyer, Poon & Nogueira, 1972). Such fistulae were surgically constructed between the anterior abdominal surface and the fundus of the uterine cavity.…”

Studies on Menstrual Blood Loss in Intact and Experimental Rhesus Monkeys

“…Prior to study, these animals were not utilized for any experiments. The fistula group consisted of ten animals (nine of which were formerly in the intact group) in which a fistula was surgically created between the fundal endometrium of the uterine cavity and the anterior abdominal skin as previously described [3, 12]. The ovariectomized‐fistula group consisted of 18 monkeys in which castration was performed at the time of uterocutaneous fistulation.…”

Technique for Obtaining Pure Endometrial Fluid From Rhesus Monkeys

“…The purity of this fluid was inferred from its gross appearance and viscous nature, both of which were similar to that found in the cavity of uteri removed at surgery or autopsy. The abdominal uterocutaneous fistula model of rhesus monkeys as previously described (Good & Moyer, 1966;Shaw, Moyer, Poon & Nogueira, 1972) was employed in this study. Both castrated, hormonally supplemented and non-castrated, naturally menstruating animals were used.…”