Caracterización de pacientes con antecedente de colposuspensión de Burch que consultan en uroginecología / Characterization of patients with a background of Burch colposuspension consulting in urogynecology

INTRODUCCIÓN Y OBJETIVOS: La incontinencia de orina de esfuerzo (IOE) es una patología muy frecuente. El tratamiento estándar corresponde al uso de cintas medio uretrales. Dentro de las técnicas quirúrgicas clásicas se encuentra la colposuspensión de Burch (CSB), poco frecuente en la actualidad. El objetivo de este estudio es describir las características de las pacientes con antecedentes de una CSB que consultan en la unidad de Uroginecología. MÉTODOS: Revisión tipo transversal de los datos ingresados a la unidad de Uroginecología del Hospital Dr. Sótero Del Río desde 2007 al 2019. Análisis descriptivo de los antecedentes de las pacientes con antecedente de CSB. RESULTADOS: Durante el periodo analizado, 63 pacientes presentaban antecedentes de CSB. La edad promedio fue 68 años, 88% eran post menopáusicas, 60% fueron sometidas a histerectomía y 24% a cirugías por prolapso (POP). La paridad promedio fue 3 hijos, 15% tuvieron al menos un parto por fórceps. Un 51% consultó por IOE, 54% por vejiga hiperactiva (VH) y 56% por sensación de bulto o peso. El 38% consultó por incontinencia de orina mixta, 37% por IOE + POP y 41% por VH + POP. 22% fueron reoperadas, 16% por medio de TVT y 6% por TOT. CONCLUSIONES: El antecedente de CSB es infrecuente en nuestra población. Similar a lo descrito en la literatura, más de un 50% de las pacientes consultó por síntomas de recurrencia y por complicaciones como POP y VH. Próximos estudios deberían evaluar si el antecedente de CSB es un factor de riesgo de complicaciones quirúrgicas o recurrencia.

INTRODUCTION AND OBJECTIVES: Stress urinary incontinence (SUI) is a common pathology. The standard treatment corresponds to the mid urethral slings. Among the classic surgical techniques is Burch colposuspension (CSB), currently rare. The objective of this study is to describe the characteristics of the patients with a previous history of CSB who consult in the Urogynecology unit. METHODS: Cross sectional review of the data of all the patients admitted to the Urogynecology unit of the Dr. Sótero Del Río Hospital from 2007 to 2019. Descriptive analysis of the antecedents of the patients with a history of CSB. RESULTS: During the analyzed period, 63 patients had a history of CSB. The average age was 68 years. 88% were postmenopausal, 60% underwent hysterectomy, and 24% underwent prolapse (POP) surgery. The average parity was 3, 15% had at least one forceps delivery. 51% consulted for SUI, 54% for overactive bladder (OAB) and 56% for sensation of lump or weight. 38% consulted for mixed urine incontinence, 37% for SUI + POP and 41% for OAB + POP. 22% were reoperated, 16% through TVT and 6% through TOT. CONCLUSION: The history of CSB is infrequent in our population. Similar to that described in the literature, more than 50% of the patients consulted for recurrence symptoms and complications such as POP and OAB. Future studies should assess whether a history of CSB is a risk factor for surgical complications or recurrence.

Fístula vesico-uterina pós cesárea: relato de caso / Vesico-uterine fester post cesárea: case report

Introdução: a fístula vesico-uterina é a comunicação menos comum entre sistema geniturinário e reprodutor. É uma complicação rara e representa apenas 4% de todas as fístulas urogenitais. A maioria dos casos ocorre após procedimento obstétrico ou ginecológico, sendo que 83% relacionam-se com cesariana repetida. Se diagnosticada precocemente, a terapia conservadora é uma opção, visto que em até 6 meses a fístula pode ter fechamento espontâneo. Entretanto, o tratamento primário é o reparo cirúrgico, o qual apresenta bons resultados. Método: relato de caso baseado em dados retrospectivos do prontuário médico do paciente e revisão de literatura. Resultado: paciente do sexo feminino submetida a cesariana e evoluiu no pós-operatório com diagnóstico de fístula vesico-uterina. Conclusão: a fístula vesico-uterina, assim como as demais fístulas urogenitais, apresenta boa resposta ao tratamento cirúrgico, sendo que a primeira intervenção é a de maior sucesso, resultando na cura

Introduction: The vesico-uterine fistula is the least common communication between the genitourinary system and the reproductive system. It is a rare complication and accounts for only 4% of all urogenital fistulas. Most cases occur after obstetrical or gynecological procedures, 83% of which are related to repeated cesarean section. If diagnosed early, conservative therapy is an option, since within 6 months the fistula may have spontaneous closure. However, the primary treatment is surgical repair, which has good results. Method: Case report based on retrospective patient medical records and literature review. Results: A female patient submitted to cesarean section and evolved postoperative with a diagnosis of vesico-uterine fistula. Conclusion: Vesico-uterine fistula, as well as other urogenital fistulas, presents a good response to surgical treatment, with the first intervention being the most successful, resulting in cure

Ginecología: Aporte de 70 años de vida institucional de la Sociedad Peruana de Obstetricia y Ginecología / Gynecology: Contribution of the Peruvian Society of Obstetrics and Gynecology in 70 years of institutional life

La Sociedad Peruana de Obstetricia y Ginecología (SPOG) ha desempeñado un importante papel en el desarrollo de la ginecología en el Perú, y ha contribuido de manera significativa en la unificación de la obstetricia y ginecología en los diferentes hospitales públicos del país, ya que antes los hospitales y servicios públicos brindaban atención o bien solo obstétrica o solo ginecológica. La SPOG, a través de la revista, congresos, cursos, simposios y mesas redondas, siempre ha dedicado sus mejores esfuerzos por poner los últimos avances de la ginecología al alcance de los médicos peruanos.

The Peruvian Society of Obstetrics and Gynecology (SPOG) has had a relevant role in the development of Gynecology in Peru and has contributed in the unification of services of Obstetrics and Gynecology in our public hospitals that used to be separated. The SPOG has facilitated updating the science of Gynecology in our associates trhough its Journal, meetings, courses, symposia and round tables in the specialty in order to give our patients the best care, with efficacy and warmth.