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1.
Int. microbiol ; 27(1): 179-202, Feb. 2024. graf, ilus
Artigo em Inglês | IBECS | ID: ibc-230253

RESUMO

Beneficial and pathogenic microbes coexist in the vaginal canal, where a diminishing population of lactic acid bacteria may cause recurring urogenital infections. Probiotic bacteria Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus vaginalis, and pathogenic microbes Enterococcus faecalis, Enterobacter cloacae, Shigella sp., Staphylococcus epidermidis, and Escherichia fergusonii were isolated from vaginal swabs. Lactobacillus sp. and their probiotic culture free supernatant (PCFS) inhibited the growth of the above-mentioned urogenital pathogens. L. crispatus produced both lactic acid and hydrogen peroxide, exhibiting the best antimicrobial potential against the studied pathogens. Lyophilized L. crispatus had a shelf life of 12 months and the lyophilized PCFS also retained its antibacterial property with a minimum inhibition concentration of 1 μg/μL. Carboxy-methyl cellulose-alginate, a green alternative to super-absorbent polymers, was encapsulated with L. crispatus cells. The probiotic in its encapsulated state retained its viability for 21 days, and the bead showed 30% solvent absorptive capacity. PCFS-laced non-woven fabric displayed antibacterial property with no change in its physicochemical properties. These probiotic and postbiotic formulations have excellent prophylactic potential for urogenital infections. Such formulations can be exploited as additives in sanitary suppositories to enhance vaginal health.(AU)


Assuntos
Humanos , Feminino , Ácido Láctico , Vagina/microbiologia , Infecções Urinárias , Lactobacillales , Antibacterianos , Probióticos , Microbiologia , Técnicas Microbiológicas , Bactérias , Supositórios
2.
Rev. int. med. cienc. act. fis. deporte ; 23(92): 249-263, aug.-sept. 2023. tab, graf
Artigo em Inglês | IBECS | ID: ibc-229402

RESUMO

Lactobacillus strains isolated from female athletes were tested. MRS broth was supplemented with a range of Metronidazole concentrations from 128 to 2000 μg/ml. The growth of these strains was monitored by measuring optical density at 3-hour intervals over 24 hours. Results: It was observed that at Metronidazole concentrations up to 128 μg/ml, there was no significant impact on the growth of the Lactobacillus strains. However, at concentrations above 512 μg/ml, Metronidazole significantly inhibited their growth. The response to Metronidazole varied among different Lactobacillus strains. For instance, at a concentration of 256 μg/ml, Lactobacillus delbrueckii, Lactobacillus jensenii, and Lactobacillus vaginalis showed notable inhibition, whereas Lactobacillus crispatus, Lactobacillus gasseri, and Lactobacillus fermentum were not significantly affected. Discussion: High concentrations of Metronidazole were found to inhibit the growth of the six Lactobacillus strains isolated from female athletes. Lower concentrations had negligible effects. The differential response of Lactobacillus strains to varying concentrations of Metronidazole (between 128 μg/ml and 512 μg/ml) highlights the need for careful consideration of Metronidazole use in managing vaginal microbiota health in female athletes (AU)


Assuntos
Humanos , Feminino , Atletas , Metronidazol/farmacologia , Antiprotozoários/farmacologia , Vagina/microbiologia , Lactobacillus/efeitos dos fármacos
3.
Cir. plást. ibero-latinoam ; 49(3): 293-300, Juli-Sep. 2023. ilus
Artigo em Espanhol | IBECS | ID: ibc-227163

RESUMO

Las malformaciones congénitas que incluyen agenesia vaginal requieren tratamiento quirúrgico en la infancia, pero las secuelas deformantes se presentan en edad adulta y son un motivo de consulta al que se debe dar solución.Con este caso pretendemos resaltar la importancia de la integración de técnicas quirúrgicas y complementarias en el tratamiento seguro de las secuelas quirúrgicas invalidantes en pacientes sometidas a reconstrucción vaginal, mostrando los resultados del tratamiento combinado con toxina botulínica y células madre adiposas en una paciente con síndrome de Mayer Rokitansky y estenosis vaginal postquirúrgica.Este tratamiento disminuyó el dolor y la contractura del introito vaginal que permitió la exploración física y la reintegración de la paciente a la vida sexual. Nivel de evidencia científica 4d Terapéutico.(AU)


Congenital malformations that include vaginal agenesis require surgical treatment in childhood, but deforming sequelae present in adulthood constitute a reason for consultation that must be solved.This case is intended to highlight the importance of integrating surgical and complementary techniques in the safe treatment of disabling surgical sequelae in vaginal reconstruction showing the results of the combined treatment with botulinum toxin and adipose stem cells in a patient with Mayer Rokitansky syndrome and post-surgical vaginal stenosis.This treatment decreased the pain and contracture of the vaginal introitus that allowed physical examination and that patient was reintegrated into sexual life.Level of evidence 4d Terapeutic.(AU)


Assuntos
Humanos , Feminino , Vagina/cirurgia , Anormalidades Congênitas , Constrição Patológica , Toxinas Botulínicas Tipo A , Manejo da Dor , Exame Físico , Vagina/anormalidades , Cirurgia Plástica
4.
Clin. transl. oncol. (Print) ; 25(6): 1748-1755, jun. 2023. tab
Artigo em Inglês | IBECS | ID: ibc-221206

RESUMO

Purpose Analyse the impact of different prognostic factors on G2-late vaginal complications after vaginal brachytherapy (VBT) ± external beam radiotherapy (EBRT) in postoperative endometrial cancer (PEC). Methods One hundred and twenty-six PEC patients treated with VBT ± EBRT were retrospectively analysed considering age, body mass index, applicator diameter, clinical target volume (CTV), use of dilators, chemotherapy and EQD2(α/β=3) at the most exposed 2 cm3 of the CTV as prognostic factors for vaginal complications. Late vaginal complications were evaluated using objective LENT-SOMA criteria. Statistics: descriptive analysis, Chi-square, Fisher and Student tests were applied. Univariate and multivariate analyses were performed with the Baptista–Pike exact method and multiple logistic regression. Results Mean age was 65 years (SD ± 10), and median follow-up was 66 months (8–104). 19/126 patients (15%) showed G2-late vaginal complications, and 107/126 (85%) G0–G1. Univariate analysis showed: CTV ≤ 9 cm3 (p = 0.036), use of dilators < 9 months (p = 0.015), and total ≥ 68 Gy EQD2 received by 2 cm3 of CTV (p = 0.039) were associated with G2-late vaginal toxicity. Multivariate analysis showed the use of dilators < 9 months as an independent prognostic factor for G2-late vaginal toxicity (p = 0.043, OR 8.59, CI 1.59–159.9). Conclusion The use of dilators < 9 months in VBT ± EBRT for PEC was an independent prognostic factor for G2-late vaginal toxicity. The use of vaginal dilators ≥ 9 months requires further analysis in studies evaluating late vaginal toxicity (AU)


Assuntos
Humanos , Feminino , Neoplasias do Endométrio/radioterapia , Braquiterapia/métodos , Dilatação/métodos , Vagina , Estadiamento de Neoplasias , Estudos Retrospectivos , Braquiterapia/efeitos adversos
6.
Rev. esp. salud pública ; 96: e202209064-e202209064, Sept. 2022. tab
Artigo em Espanhol | IBECS | ID: ibc-211319

RESUMO

FUNDAMENTOS: La infección por Estreptococo del Grupo B (EGB) sigue siendo a día de hoy, sin profilaxis periparto, la causa más frecuente de infección bacteriana perinatal de transmisión vertical en el mundo occidental. Se estima que la prevalencia de emba-razadas portadoras asintomáticas de EGB en nuestro país oscila entre el 10% y el 20,5%, pero son escasos los estudios realizados al respecto. Con la presente investigación tratamos de establecer la tasa de embarazadas colonizadas por EGB a nivel recto-vaginal en el momento del parto y evaluar la validez de nuestra estrategia para la identificación de embarazadas portadoras de EGB. MÉTODOS: Se seleccionó aleatoriamente una muestra de 290 gestantes, representativa de la población embarazada de la provincia de Jaén. En ella se analizó la presencia o ausencia de EGB en la microbiota recto-vaginal materna el día del parto. Posteriormente se hizo un análisis retrospectivo, caso a caso, con la finalidad de establecer si las técnicas de cribado aplicadas durante la gestación habían sido capaces de identificar correctamente el estado de colonización por EGB en el momento del parto. Se aplicaron técnicas estadísticas para realizar un análisis descriptivo muestral, que se complementó con un análisis de concordancia caso por caso para las dos determinaciones de EGB realizadas en el tiempo a cada sujeto (observaciones repetidas en el tiempo a los individuos de una misma cohorte). RESULTADOS: La tasa de embarazadas portadoras de EGB a nivel recto-vaginal en el momento del parto fue del 23,10%. CONCLUSIONES: En nuestro medio la tasa de embarazadas portadoras de EGB en el momento del parto es superior a lo previamente comunicado en la bibliografía. Además, nuestra estrategia de cribado durante la gestación podría catalogar erróneamente a una de cada ocho mujeres, haciendo que una de cada dieciséis portadoras de EGB no sea adecuadamente identificada.(AU)


BACKGROUND: Group B Streptococcus (GBS) infection remains to datey, without peripartum prophylaxis, the most common cause of vertically transmitted perinatal bacterial infection in the Western world. It is estimated that the prevalence of asymptomatic pregnant women with GBS in our country ranges between 10 and 20.5%, but there are few studies in this regard. With this research, we tried to establish the rate of pregnant women colonized by GBS at the recto-vaginal level at the time of delivery and to evaluate the validity of our strategy for the identification of pregnant women with GBS. METHODS: A 290 women sample representative of pregnant population from the province of Jaén was randomly selected and the presence or absence of GBS in the recto-vaginal microbiota was determined on the day of delivery. Subsequently, a retrospective analysis was made, case by case, in order to establish whether the screening techniques applied during pregnancy had been able to correctly identify the state of GBS colonization at the time of delivery. Statistical techniques were applied to perform a descriptive sample analysis, which was complemented with a case-by-case concordance analysis for the two GBS determinations made over time for each subject (repeated observations over time on individuals from the same cohort). RESULTS: The rate of pregnant women carrying GBS at the recto-vaginal level at the time of delivery was 23.10%. CONCLUSIONS: In our province, the rate of pregnant women with GBS at the time of delivery is higher than previously reported in the literature. Furthermore, our screening strategy during pregnancy could misclassify one of each eight women, causing one in sixteen GBS carriers to not be adequately identified.(AU)


Assuntos
Humanos , Feminino , Infecções Estreptocócicas , Ginecologia , Reto , Vagina , Gravidez , Parto , Transmissão Vertical de Doenças Infecciosas , Gestantes , Espanha , Saúde Pública , Estudos Longitudinais , Estudos Retrospectivos
7.
Clin. transl. oncol. (Print) ; 24(5): 875-881, mayo 2022.
Artigo em Inglês | IBECS | ID: ibc-203789

RESUMO

PurposeTo evaluate the preliminary results of the use of 68 Gy EQD2(α/β=3 Gy) as a dose limit to the lowest dose in the most exposed 2 cm3 of the vagina in order to reduce G2 late vaginal problems in postoperative endometrial carcinoma (EC).MethodsFrom November 2016 to October 2019, 69 postoperative EC patients receiving vaginal brachytherapy (VBT) ± external beam radiotherapy (EBRT) were prospectively analyzed. The median EBRT dose was 45 Gy (range: 44–50.4 Gy), 1.8−2 Gy/day, 5 fractions(Fr)/week. VBT was administered with the following schedule: 1Fr of 7 Gy after EBRT and 2 daily Fr × 7.5 Gy in exclusive VBT. The dose was prescribed at 0.5 cm from the applicator surface with an active length of 2.5 cm; 56 patients were treated with vaginal cylinders (49–3.5 cm, 6–3 cm, and 1–2.5 cm) and 13 with the colpostat technique. The overall VBT dose was adjusted to meet the vaginal restriction of < 68 Gy EQD2(α/β=3 Gy) at 2 cm3. Late toxicity was prospectively assessed using RTOG scores for bladder and rectum, and the objective LENT-SOMA criteria for vagina.ResultsWith a median follow-up of 31.0 months, no vaginal-cuff recurrences were found. Late toxicity: only 1G1(1.4%) rectal toxicity; 21G1(30.4%) and 3G2(4.3%) vaginal complications. Only one (1.4%) of 3 G2 manifested as vaginal shortening.ConclusionsIn postoperative EC patients treated with VBT, only one developed G2 vaginal stenosis with the use of 68 Gy EQD2(α/β=3 Gy) as a dose constraint. These preliminary results seem to indicate the value of this dose limit for reducing G2 vaginal stenosis. Nonetheless, these findings should be confirmed in a larger number of patients with longer follow-up.


Assuntos
Humanos , Braquiterapia/efeitos adversos , Braquiterapia/métodos , Constrição Patológica/etiologia , Constrição Patológica/patologia , Neoplasias do Endométrio/radioterapia , Neoplasias do Endométrio/cirurgia , Reto , Vagina/patologia
8.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 48(2): 117-121, Abr-Jun 2021.
Artigo em Espanhol | IBECS | ID: ibc-219484

RESUMO

Antecedentes: Las pacientes con neoplasias cervicales intraepiteliales (CIN) tienen mayor riesgo de desarrollar lesiones causadas por el virus del papiloma humano (VPH) en otras localizaciones del tracto genital inferior (entre ellas, la vulva). La vulvoscopia no está incluida en el seguimiento de las mujeres con CIN. Se propone estudiar la eficiencia de incluir la vulvoscopia en dicho seguimiento. Se analiza también la incidencia de la displasia vulvar de alto grado y la influencia de los factores protectores y de riesgo. Material y métodos: Se incluyeron 95 pacientes con diagnóstico de CIN (en pieza de conización). Se recogió toda la información relativa a sus características sociodemográficas y clínicas; se realizó vulvoscopia y, eventualmente, biopsia. Resultados y conclusiones: La media de edad de las pacientes fue de 40 años. El 62,1% de ellas eran o habían sido fumadoras (más de la mitad habían abandonado el hábito tabáquico en el momento del estudio). Solo el 21,1% declararon no utilizar método de barrera. Aunque el 78,9% de las estudiadas eran o habían sido usuarias de anticoncepción hormonal, solo ocho de ellas seguían utilizándola. Ochenta y ocho de las 95 mujeres (92,6%) estaban vacunadas contra el VPH (la mayoría postconización). No se diagnosticó ninguna displasia vulvar de alto grado. La modificación en el estilo de vida tras el diagnóstico de la patología cervical, la transitoriedad de la infección por el VPH y la mayor susceptibilidad del epitelio cervical a esta, se nos muestran como las causas más probables de la discordancia entre la prevalencia de la patología vulvar esperada y la encontrada en la población estudiada.(AU)


Background: Patients with cervical intraepithelial neoplasia (CIN) are more likely to develop lesions caused by the human papilloma virus (HPV) in other locations of the lower genital tract (including the vulva). Vulvoscopy is not included in the follow-up of women with CIN. It is proposed to study the efficiency of including vulvoscopy in follow-up. An analysis is also performed on incidence of high-grade vulvar dysplasia, as well as the influence of protective and risk factors analysed. Material and methods: The study included 95 patients with a diagnosis of CIN in the cone biopsy piece. All the information relative to their socio-demographic and clinical characteristics was collected and included, performing of the vulvoscopy as well as the biopsy. Results and conclusions: The mean age of the patients was 40 years. Just under two-thirds (62.1%) of them were or had been smokers (more than half of those had quit smoking at the time of the study). Only 21.1% said they were not using a barrier method. Although 78.9% of those studied were or had been users of hormonal contraception, only 8 out of the 95 continued using it. Most (88 out of the 95 women) were vaccinated against HPV. No high-grade vulvar dysplasia was diagnosed. The modification in the lifestyle after the diagnosis of the cervical disease, the transience of the HPV infection, and the greater susceptibility of the cervical epithelium to this, are indicated as the most probable causes of the discordance between the expected prevalence of vulvar disease and the effective rate found within the studied population.(AU)


Assuntos
Humanos , Feminino , Adulto , Carcinoma in Situ , Fatores de Risco , Colo do Útero/diagnóstico por imagem , Vulva , Vagina/diagnóstico por imagem , Ginecologia
10.
Clin. transl. oncol. (Print) ; 23(6): 1193-1200, jun. 2021.
Artigo em Inglês | IBECS | ID: ibc-221340

RESUMO

Purpose/objective(s) On October 5, 2018, a meeting of the Spanish Society of Radiation Oncology (SEOR) Brachytherapy Group was held, in collaboration with the Spanish Society of Medical Physics (SEFM), with the aim of preparing a consensus document on postoperative vaginal-cuff brachytherapy (VCBT). Materials/methods A survey including 42 questions was sent to Spanish Radiation Oncology Centres before the meeting. The survey items included: experience in VCBT, technique indications, previous patient preparation, applicator type, implant procedure, computerized tomography (CT) simulation, definition of target volumes and organs at risk (OAR), dose prescription, fractionation, treatment planning, dosimetric parameters and constraints to OAR. Thirty-three centres answered the survey. Statistical analysis of the survey considered that there was consensus when there was ≥ 85% of agreement related to a survey item, otherwise an item with < 85% of agreement would be discussed during the meeting to reach consensus. Results The results of the survey are reported here. The mean number of patients treated per centre in 2017 was 52 ± 41 (range 7–175), and the mean number of procedures per centre was 175 ± 150 (range 24–701).There was consensus on: the indications, applicator type, the OAR to be considered, the prescription point, standardisation and dosimetric quality parameters. There was no consensus on: patient preparation for the implant, the need for performing CT simulation and the frequency, the length of the vagina to be treated, if CTV should be delimited, the definition of the clinical target volume, fractionation, overall EQD2, active source length, separation between dwelling stepping source positions, if considering the uniformity/maximum values for dwelling stepping sources, the optimization mode, and the limiting doses to the OAR (AU)


Assuntos
Humanos , Feminino , Braquiterapia/instrumentação , Braquiterapia/normas , Neoplasias do Colo do Útero/radioterapia , Vagina , Tomografia Computadorizada por Raios X
12.
Actas urol. esp ; 45(3): 239-244, abril 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-216927

RESUMO

La cirugía de reasignación de sexo masculino a femenino o vaginoplastia incluye aquellos procedimientos quirúrgicos cuyo objetivo es recrear un perineo femenino funcional y estéticamente aceptable con una formación mínima de cicatrices. La técnica de elección en nuestro centro es la vaginoplastia con inversión peneana con o sin injertos escrotales. Presentamos 4 casos diagnosticados con fístulas rectoneovaginales tratados en nuestro centro con evolución favorable. La primera paciente fue diagnosticada en el postoperatorio tardío durante las dilataciones. Se sometió a 2 intentos de reparación vaginal sin éxito. Finalmente, se realizó una colostomía temporal y un colgajo rectal. La segunda paciente fue diagnosticada 2 semanas después de la cirugía inicial debido a una dilatación agresiva, siendo tratada con una colostomía temporal y cierre por segunda intención. La tercera paciente se diagnostica en el quinto día postoperatorio, después de la extracción del taponamiento vaginal. Se indicó restricción dietética y se realizó un colgajo rectal. Una cuarta paciente fue diagnosticada durante el postoperatorio tardío, realizando una exploración quirúrgica y un colgajo de pared rectal. Las fístulas rectoneovaginales después de la cirugía de reasignación de sexo tienen una incidencia de alrededor del 2-17%, siendo el tipo más común de fístulas después de este procedimiento. La causa más común es secundaria a lesiones rectales durante la cirugía inicial. Para el manejo de estas fístulas se plantean opciones que van desde el cierre primario a las colostomías de descarga, pasando por un manejo conservador o la confección de colgajos. Se recomienda el abordaje por un equipo multidisciplinario para el diagnóstico y tratamiento de esta complicación. (AU)


Male-to-female reassignment surgery or vaginoplasty includes those surgical procedures that aim to recreate a functional and cosmetically acceptable female perineum with minimal scarring. The technique of choice at our center is penile inversion vaginoplasty with or without scrotal skin grafts. We present 4 cases diagnosed with rectoneovaginal fistulas treated at our center with favorable evolution. The first patient was diagnosed in the late postoperative period during dilation. She underwent 2 failed vaginal repair attempts. Finally, a temporary colostomy and a rectal flap were performed. The second patient was diagnosed 2 weeks after the initial surgery due to aggressive dilation and was treated with a temporary colostomy and secondary wound closure. The third patient was diagnosed on the fifth post-operative day after removal of the vaginal packing. Dietary restriction was indicated, and a rectal flap was performed. A fourth patient was diagnosed within the late postoperative period; she was submitted to surgical exploration and a rectal wall flap was created. Rectoneovaginal fistulas after sex reassignment surgery has an incidence of about 2-17% and they are the most common type of fistula after this procedure. In most cases, it is secondary to rectal injury during the initial surgery. The management of these fistulas ranges from primary closure, diverting colostomies, conservative management, or the performance of flaps. A multidisciplinary team approach is recommended for the diagnosis and treatment of this complication. (AU)


Assuntos
Humanos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapia , Fístula Retal/diagnóstico , Fístula Retal/terapia , Cirurgia de Readequação Sexual , Fístula Vaginal/diagnóstico , Fístula Vaginal/terapia , Vagina/cirurgia
15.
Actas urol. esp ; 45(1): 57-63, ene.-feb. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-200669

RESUMO

OBJETIVOS: El presente trabajo evalúa el impacto de la cirugía vaginal del prolapso de órganos pélvicos (POP) en los síntomas de disfunción de vaciado (DV) y en el residuo posmiccional (RPM) un año después de la intervención. MATERIAL Y MÉTODOS: Estudio epidemiológico, longitudinal y prospectivo. Un total de 39 unidades de ginecología incluyeron mujeres con POP sintomático de grado 2 o superior según la clasificación Pelvic Organ Prolapse Quantification (POP-Q) que iban a ser sometidas a cirugía del prolapso por vía vaginal (estudio CIRPOP-IUE). Se recogieron variables sociodemográficas y clínicas antes y después de la intervención. En ambas visitas, las pacientes cumplimentaron los cuestionarios Epidemiology of Prolapse and Incontinence Questionnaire (EPIQ) y Pelvic Floor Distress Inventory (PFDI-20). El RPM se midió por sondaje vesical inmediatamente después de una micción espontánea. RESULTADOS: El 50% de las mujeres refirieron síntomas de DV antes de la intervención. El RPM se midió en 277 mujeres de las cuales en 116 (41,87%) fue > 50 ml y en 42/277 (15,2%) fue > 100 ml. Un año tras la intervención, se observó una reducción objetiva y subjetiva de los síntomas de DV. El RPM medio se redujo de forma estadísticamente significativa, pasando de una media (DE) de 66,4 (68,9) ml a 48,3 (51,3) ml. También disminuyó el número de pacientes que reportaron dificultad de vaciado y sensación de vaciado incompleto en los cuestionarios EPIQ y PFDI-20. CONCLUSIONES: En general, se observó una mejora de la función miccional tanto a través de la disminución de los síntomas específicos de DV como de la reducción del volumen medio del RPM


OBJECTIVES: The present study evaluates the impact of vaginal surgery for pelvic organ prolapse (POP) on voiding dysfunction (VD) symptoms and post-void residual (PVR) one year after the intervention. MATERIAL AND METHODS: Epidemiological, longitudinal, prospective study. Thirty-nine gynecology units included women with symptomatic POP grade 2 or higher according to the Pelvic Organ Prolapse Quantification (POP-Q) system, who would undergo surgery for vaginal prolapse (CIRPOP-IUE study). Sociodemographic and clinical variables were collected before and after the intervention. At both visits, patients completed the 'Epidemiology of Prolapse and Incontinence Questionnaire' (EPIQ) and 'Pelvic Floor Distress Inventory' (PFDI-20) questionnaire. PVR volume was measured by bladder catheterization immediately after spontaneous urination. RESULTS: VD symptoms were present in 50% cases before the intervention. PVR was measured in 277 women of which 116 (41.87%) were > 50 ml and 42/277 (15.2%) were > 100 ml. Objective and subjective reduction in VD symptoms was observed one year after the intervention. Mean PVR volume was reduced with statistical significance, from a mean (SD) of 66.4 (68.9) ml to 48.3 (51.3) ml. The number of patients who reported difficulty in emptying and sensation of incomplete emptying on the EPIQ and PFDI-20 questionnaires also decreased. CONCLUSIONS: In general, improved voiding functions were observed in the CIRPOP-IUE study through a decrease in specific VD symptoms and a reduction in mean PVR volume


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Prolapso Uterino/cirurgia , Retenção Urinária/etiologia , Incontinência Urinária/etiologia , Complicações Pós-Operatórias/etiologia , Estudos Longitudinais , Estudos Retrospectivos , Prolapso Uterino/complicações , Inquéritos e Questionários , Vagina/cirurgia
16.
Actas urol. esp ; 45(1): 64-72, ene.-feb. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-200670

RESUMO

INTRODUCCIÓN Y OBJETIVOS: La vejiga hiperactiva (VH) es un trastorno frecuente que aumenta con la edad y afecta a la calidad de vida de los pacientes. Las guías recomiendan los programas de modificación de la conducta como tratamiento de primera línea, aunque la fisioterapia también se ha utilizado con éxito, seguridad y bajo coste. La fisioterapia clínica está utilizando la electroestimulación transcutánea del nervio tibial (ETNT) y la electroestimulación vaginal (EV). Este estudio tuvo como objetivo evaluar si la combinación de EV con ETNT es más exitosa que la monoterapia con ETNT para el tratamiento de las mujeres con VH. PACIENTES Y MÉTODOS: En total, 106 mujeres mayores de 18 años diagnosticadas con VH o incontinencia urinaria mixta con síntomas típicos de VH se dividieron aleatoriamente en 2 grupos: grupo 1: ETNT (n = 52); grupo 2: ETNT + EV (n = 54). El diario miccional de 3 días, la fuerza muscular del suelo pélvico (escala de Ortiz), el cuestionario de salud de King y el cuestionario de VH se evaluaron antes y después del tratamiento. La variable principal fue la frecuencia urinaria y una reducción de ≥ 3 micciones/día se consideró como clínicamente relevante. Se usaron modelos lineales mixtos para la comparación de los 2 grupos. RESULTADOS: Inicialmente, los grupos fueron similares en edad, índice de masa corporal, número de embarazos, tiempo de aparición de VH y prevalencia de síntomas de VH. Después del tratamiento se observó una reducción en la frecuencia urinaria de 1,5 micciones en el grupo 2; a pesar de ser estadísticamente significativa, esta no fue clínicamente relevante. CONCLUSIONES: La combinación de EV con ETNT no hizo que el tratamiento para la VH fuese más efectivo que la monoterapia con ETNT


INTRODUCTION AND OBJECTIVES: Overactive bladder (OAB) is a prevalent disorder that increases with age and impairs patients' quality of life. Guidelines recommend behavior modifications as the first-line treatment; however, physiotherapy has also been used with success, safety, and low cost. Transcutaneous tibial nerve electrical stimulation (TTNS) and vaginal electrical stimulation (VS) are being used in clinical physiotherapy practice. This study aimed to verify whether the addition of VS to TTNS is more beneficial than TTNS alone for women with OAB. PATIENTS AND METHODS: In all, 106 women aged >18 years diagnosed with OAB or mixed urinary incontinence with prevalent OAB symptoms were randomly divided into 2 groups: Group 1: TTNS (n = 52); Group 2: TTNS + VS (n = 54). The 3 day voiding diary, pelvic floor muscle strength (Ortiz Scale), King's Health Questionnaire, and Overactive Bladder Questionnaire were assessed before and after treatment. Urinary frequency was considered the primary outcome, and a reduction of ≥ 3 micturitions/day was considered clinically relevant. Mixed linear models were used to compare the 2 groups. RESULTS: Initially, the groups were similar in age, body mass index, number of pregnancies, time of OAB onset, and prevalence of OAB symptoms. After treatment, a reduction in urinary frequency of 1.5 micturitions was observed in Group 2, which was not clinically relevant despite being statistically significant. CONCLUSIONS: The addition of VS to TTNS for the treatment of OAB was not more effective than TTNS as a single therapy


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Bexiga Urinária Hiperativa/terapia , Terapia por Estimulação Elétrica/métodos , Estimulação Elétrica Nervosa Transcutânea/métodos , Vagina , Nervo Tibial , Resultado do Tratamento , Inquéritos e Questionários , Qualidade de Vida , Bexiga Urinária Hiperativa/fisiopatologia
18.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(2): 65-68, abr.-jun. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-191317

RESUMO

La atresia vaginal distal es una anomalía infrecuente que deriva de la falta de desarrollo de los 2/3 distales de la vagina a partir del seno urogenital. Presentamos una paciente de 14 años con amenorrea primaria, abdominalgia, masa palpable en hipogastrio y ausencia de orificio vaginal. La ecografía abdominal y la RMN evidenciaron hematometrocolpos secundario a agenesia vaginal distal, con una distancia al periné de 5cm, sin otras malformaciones. Se realiza un drenaje vaginal transuretral y descenso vía perineal asistido por laparoscopia. Evolución favorable con calibre vaginal adecuado y normalización de la menstruación a los 6 meses


Distal vaginal atresia is an uncommon disorder that results from the lack of development of the distal 2/3 of the vagina from the urogenital sinus. The case is presented on a 14 year-old patient with primary amenorrhoea, abdominal pain, a palpable mass in the hypogastrium, and an absent vaginal opening. The abdominal ultrasound and magnetic resonance imaging showed haematometrocolpos secondary to distal vaginal agenesis, with a distance of 5cm to the perineum, with no other malformations. A transurethral vaginal drainage and laparoscopic assisted pull-through were performed. Her follow-up was favourable with an adequate vaginal calibre and normal menstruation after 6 months


Assuntos
Humanos , Feminino , Adolescente , Colo do Útero/anormalidades , Colo do Útero/cirurgia , Vagina/anormalidades , Laparoscopia , Hematometra/diagnóstico por imagem , Amenorreia/complicações , Dor Abdominal/etiologia , Hematocolpia/diagnóstico por imagem , Hematocolpia/cirurgia , Sonda de Prospecção , Períneo/anormalidades , Diagnóstico Diferencial
19.
Prog. obstet. ginecol. (Ed. impr.) ; 63(1): 32-35, ene.-feb. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-197731

RESUMO

ANTECEDENTES: el síndrome de OHVIRA es una malformación uterina caracterizada por un útero didelfo, una hemivagina ciega total o parcial y agenesia renal ipsilateral. Se describen 3 casos diagnosticados y tratados entre 2015 y 2017. CASOS CLÍNICOS: Caso 1: paciente de 11 años con agenesia renal izquierda, que consultó por dismenorrea intensa. En la ecografía se objetivó un útero didelfo, hematosálpinx y hematómetra que se drenaron en quirófano mediante incisión en el tabique vaginal evolucionando favorablemente. Caso 2: paciente de 16 años con síndrome de Rett y agenesia renal izquierda que consultó por amenorrea tras menarquia de 4 meses. En la ecografía se descubre un útero didelfo y hematocolpos. Se realizó drenaje y apertura del tabique vaginal con éxito. Caso 3: paciente de 16 años que acudió por dismenorrea e intenso dolor anal. Se diagnostica por ecografía útero didelfo, hematosálpinx y vagina izquierda ciega con hematocolpos. No se puede drenar la colección por la alta densidad del material por lo que se decide, junto con cirugía pediátrica, realizar hemihisterectomía, colposalpinguectomía y exéresis de hemivagina ciega izquierda por laparoscopia. CONCLUSIONES: ante el hallazgo en una paciente de una malformación o agenesia renal se deberían investigar posibles malformaciones genitales asociadas como el síndrome de OHVIRA, ya que el diagnóstico y tratamiento tempranos de estas últimas reducen el sufrimiento y previenen complicaciones


BACKGROUND: OHVIRA syndrome is a uterine malformation characterized by uterus didelphys, total or partial blind hemivagina, and ipsilateral renal agenesis. Three cases diagnosed and treated between 2015 and 2017 are described. CLINICAL CASE: Case 1: 11-year-old patient who consulted for intense dysmenorrhea; ultrasound showed a uterus didelphy, hematosalpinx and hematometra that were drained in the operating room by incision in the vaginal septum, making good progress. Case 2: A 16-year-old patient with Rett syndrome and renal agenesis who consulted for amenorrhea after menarche of 4 months. On ultrasound was found a uterus didelphy and hematocolpos. Drainage and opening of the vaginal septum were performed successfully. Case 3: A 16-year-old pacient who came for dysmenorrhea and intense anal pain; by ultrasound she was diagnosed of uterus didelphy, hematosalpinx and left blind vagina with hematocolpos. The collection could not be drained because of the high density of the material so it was decided, together with pediatric surgery dept, to perform a hemihysterectomy, colposalpinguectomy and exeresis of left blind hemivagina by laparoscopy. CONCLUSION: Given the finding of renal agenesia or renal malformations, possible associated genital malformations as OHVIRA syndrome should be investigated since early diagnosis and treatment could reduce suffering and prevent complications


Assuntos
Humanos , Feminino , Criança , Adolescente , Anormalidades Múltiplas/diagnóstico por imagem , Rim/anormalidades , Vagina/anormalidades , Útero/anormalidades , Rim/diagnóstico por imagem , Anormalidades Urogenitais/diagnóstico por imagem , Vagina/diagnóstico por imagem , Síndrome , Ultrassonografia
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