Carcinosarcoma de ovario: revisión de la literatura médica a propósito de un caso / Carcinosarcoma of the ovary: A review of the literature apropos of a case

El carcinosarcoma de ovario es una forma infrecuente de neoplasia maligna del ovario con presencia de elementos carcinomatosos y sarcomatosos. Es un tipo histológico agresivo que a menudo se presenta en estadios ya avanzados y con mal pronóstico. La cirugía citorreductora óptima y la quimioterapia combinada con base de platino parecen tener los mejores resultados. En el siguiente artículo presentamos el caso de una mujer asintomática de 58 años con diagnóstico de carcinosarcoma de ovario estadio IIIC de la FIGO tratada con cirugía citorreductora óptima y quimioterapia con cisplatino/ifosfamida con respuesta completa y excelente evolución a los 6 meses de la intervención (AU)

Ovarian carcinosarcoma is a very rare form of ovarian cancer, with both carcinomatous and sarcomatous components. This aggressive histological type often presents in advanced FIGO stages and has poor prognosis. Optimal cytoreductive surgery plus platinum-based combination chemotherapy are associated with better outcomes. We present the case of an asymptomatic 58-year-old woman diagnosed with stage IV ovarian carcinosarcoma treated with optimal cytoreductive surgery and chemotherapy with cisplatin/ifosfamide. The patient showed complete response with excellent outcome at 6 months of the intervention (AU)

Incidence of overactive bladder after vaginal hysterectomy and associated repairs for pelvic organ prolapse.

OBJECTIVE: The aim of this study was to determine the incidence of overactive bladder (OAB) after vaginal hysterectomy for pelvic organ prolapse (POP) and analyze the associated risk factors. STUDY DESIGN: This was a retrospective cohort study of 217 patients who underwent primary POP vaginal surgery between the years 2000 and 2004 in Donostia Hospital and who did not report OAB before surgery. A personal interview was undertaken after surgery for the diagnosis of OAB, taking into account the ICS 2002 definition. Descriptive statistical analyses and multivariate logistic regression were performed to determine the factors associated with the development of OAB after POP surgery. RESULTS: De novo OAB was diagnosed in 43 (19.8%) patients. The median time at onset of OAB symptoms after surgery was 3 months. Urge urinary incontinence was present in 28 patients (12.9%). Those women operated on also for stress urinary incontinence were at an increased risk for de novo OAB. CONCLUSION: Nearly 20% of women operated on for POP develop OAB soon after surgery. Those operated on for POP and stress urinary incontinence are more at risk.

Risk factors for the recurrence of pelvic organ prolapse after vaginal surgery: a review at 5 years after surgery.

The objective of this study was to determine the factors associated with the anatomic and functional recurrence of prolapse. An examination was performed in 134 of the 228 patients who underwent primary vaginal surgery for prolapse of the pelvic organs (POP) between 2000 and 2001. Anatomical recurrence of the prolapse was established by pelvic examination using the pelvic organ prolapse quantification (POPQ) staging system. Functional results were obtained by interview with the patients. Descriptive statistical analyses and multivariate logistic regression were performed to determine the factors associated with recurrence. Five years after surgery, 42 women (31.3%) presented anatomical recurrence of the prolapse (grade > or = II), and only 10 of the 134 (7.4%) had prolapse-related symptoms. Those with high body weight (>65 kg) and younger women (<60 years) were associated with an increase in the risk for both anatomical and functional recurrence. Advanced preoperative prolapse (grade III-IV) of any compartment was associated with anatomical failure but not with symptomatic recurrence. There was a poor correlation between anatomical and symptomatic recurrence. Younger women and those with a higher body weight are more likely to experience recurrent prolapse after vaginal repair.