Outcomes of laparoscopic management of multicompartmental pelvic organ prolapse.

BACKGROUND: Pelvic organ prolapse (POP) is an increasing medical problem with complex diagnostics and controversial surgical management. It causes a series of dysfunctions in the gynecological, urinary, and anorectal organs. Numerous procedures have been proposed to treat these conditions, but in recent years, ventral mesh rectocolposacropexy (VMRCS) has emerged as the procedure of choice for the surgical treatment of POP, especially by a laparoscopic approach. This surgical technique limits the risk of autonomic nerve damage, and the colpopexy allows the correction of concomitant prolapse of the middle compartment. However, symptoms derived from anterior compartment prolapse remain a major morbidity and sometimes require an additional procedure. The aim of this study is to evaluate the results of laparoscopic prosthetic rectocolposacropexy (LRCS) and colposacropexy (LCS) procedures performed to manage combined multicompartmental POP. METHODS: Between November 2008 and December 2017, 38 patients with symptomatic POP underwent rectocolposacropexy (RCS) or colposacropexy (CS) by a laparoscopic approach. Demographics, mortality, morbidity, hospital stay, and functional outcomes were retrospectively analyzed. RESULTS: The median operating time was 200 min (IQR 160-220). Additional simultaneous surgery for POP was performed in nine cases: five suburethral slings and four hysterectomies were performed. No mortality was recorded. The conversion rate was 7.89%. There were two intraoperative complications (5.26%): one enterotomy and one urinary bladder tear. Late complications occurred in 5.26% of cases. After a mean follow-up of 20 months, constipation was completely resolved or improved in 83.33% of patients, urinary stress incontinence was resolved or improved in 52.94%, and gynecological symptomatology was resolved or improved in 93.75%. The recurrence rate was 5.26%. CONCLUSIONS: Laparoscopic mesh rectocolposacropexy and colposacropexy are safe and effective techniques associated with very low morbidity. In the medium term, they provide good results for POP and associated symptoms, but urinary symptomology has a worse outcome.

Metástasis hipofisiaria de un adenocarcinoma de endometrio: a propósito de un caso / Pituitary metastases from an endometrial adenocarcinoma: A propos of a case viernes, 03 sep 2010

Los tumores metastásicos de la glándula hipofisiaria procedentes de adenocarcinoma de endometrio son excepcionales. Se presenta el caso de una mujer de 59 años que dos años después de ser diagnosticada y tratada de un adenocarcinoma de endometrio comienza con una hemianopsia bitemporal, a raíz de la cual se le diagnostica una metástasis hipofisiaria. Se realiza una revisión de la clínica, el diagnóstico y el tratamiento de los pacientes con metástasis hipofisiarias (AU)

Metastatic tumors of the pituitary gland from an endometrial adenocarcinoma are extremely rare. We report the case of a 59-year-old woman who, 2 years after diagnosis and treatment of an endometrial adenocarcinoma, developed bitemporal hemianopsia. Pituitary metastasis was found. The clinical presentation, diagnosis and therapeutic management of patients with pituitary metastases are reviewed (AU)

Neumotórax catamenial. A propósito de un caso / Catamenial pneumothorax. A propose of a case

El neumotórax (NTX) catamenial se define como un NTX espontáneo ocurrido en las 72 h previas o posteriores al inicio de la menstruación. Se ha relacionado con la endometriosis torácica y puede tener diferentes cursos clínicos. Se han postulado diversas teorías etiopatogénicas que han suscitado discusión respecto a su etiología y tratamiento. Se presenta el caso de una mujer de 29 años que experimentó varios episodios de NTX espontáneos. Tras realizar el diagnóstico de NTX catamenial, se realizó con éxito tratamiento quirúrgico y tratamiento con análogos de gonadoliberina. Este caso confirma que el diagnóstico de NTX catamenial debe sospecharse en cualquier mujer en edad fértil que presente episodios recurrentes de NTX espontáneo (AU)

Catamenial pneumothorax (PTX) is defined as a spontaneous PTX occurring within 72 hours before or after the onset of menstruation. This entity has been related to thoracic endometriosis and the clinical course can vary. Several etiopathogenic theories have been suggested, leading to debate on the etiology and treatment of this entity. We report the case of a 29-year-old woman with several spontaneous PTX episodes. Once the catamenial PTX was diagnosed, surgery was successfully performed and gonadotropin-releasing hormone (GnRH) analogues were administered. This case confirms that the diagnosis of catamenial pneumothorax should be considered in all women of fertile age with recurrent episodes of spontaneous pneumothorax (AU)