RÉSUMÉ
Clinical features of severe urogenital prolapse, were studied. Fifteen patients were included in a retrospective study between January 1990 and June 1995. The diagnosis of severe uterine prolapse (where the cervix precedes the inverted vaginal tube) was the sole inclusion criteria. Age, parity, hormonal stage, occupation, simptomatology, body mass index, and the results of histopathological examinations were evaluated. The mean age was 60 years, parity most frequently observed was more than three, 80% were postmenopausal, the body mass index was 23.5, all patients were housewifes, the symptomatology that was present in 100% of the patients was the sensation of an intravaginal foreign material. The surgical treatment performed was vaginal hysterectomy. The results of histopathological examinations were in the most inflammation. The parity and postclimaterium were the principal factors associated with the pathogenesis of uterine prolapse.
Sujet(s)
Prolapsus utérin , Sujet âgé , Indice de masse corporelle , Femelle , Humains , Hystérectomie , Adulte d'âge moyen , Taille d'organe , Parité , Post-ménopause , Études rétrospectives , Prolapsus utérin/physiopathologie , Prolapsus utérin/chirurgie , Utérus/physiopathologieRÉSUMÉ
Postoperative acute urinary retention was evaluated in the patients who underwent Pereyra procedure. Comparison of suprapubic and urethral catheterization. Between January 1994 and July 1995, fifty two patients with urinary stress incontinence underwent Pereyra procedure, 31 female patient with suprapubic drainage (cistofix Ch 15) and 17 urethral catherization with a latex foley catheter. Sponatneous micturition and urinary retention was evaluated until the catheter was removed. Mean age was 43.8 years (32 a 66), the duration of suprapubic vesical drainage with suprapubic catheter were 3 days in 58.6% of the patients, and more than 3 days in 41.29%. Recatheterizacion in the patients with urethral drainage was more frequent. Urinary retention after 7 days was present in 23.99% with suprapubic vesical drainage and 28.5% with urethral catheter. Recatheterization is more frequent in patients with urethral catheter.
Sujet(s)
Drainage/méthodes , Complications postopératoires/prévention et contrôle , Incontinence urinaire/chirurgie , Rétention d'urine/prévention et contrôle , Adulte , Sujet âgé , Femelle , Humains , Adulte d'âge moyen , Études prospectivesRÉSUMÉ
We evaluated the accuracy of the Q-tip test to measure uretrhovesical junction mobility in patient's histories of urinary incontinence, and pelvic relaxation. A retrospective study of 183 files of patients with urinary incontinence and anterior vaginal wall relaxation in the Instituto Nacional de Perinatología (INPer) between march 1994 and may 1995. All patients underwent a systematic diagnosis evaluation with detailed history and physical examination including Q-test, neurology examination, urinary, urine culture, uretrhoscopy and urodinamic studies. We correlated Q-tip test pelvic relaxation to measure urethrovesical junction mobility. They were placed in three groups. Group I formed by stres incontinence, group II formed by mixed incontinence and group III formed by recurrent incontinence. Mean age 46.3 years (29-72), almost all the patients were multiparas, menopausal status in 72, with hormonal treatment 48. Q-tip test was not different between the groups. Group I had cystocele II with hipermobility statistically significant difference, the same in group II. No differences were found in the group III. We concluded that urethral position and mobility as measure by the Q-tip test are related to defects in interior vaginal support, but not to specific urologic diagnosis.
Sujet(s)
Urètre/anatomopathologie , Vessie urinaire/anatomopathologie , Incontinence urinaire/diagnostic , Adulte , Sujet âgé , Analyse de variance , Cystoscopie , Femelle , Humains , Adulte d'âge moyen , Parité , Études rétrospectives , Urètre/physiopathologie , Vessie urinaire/physiopathologie , Incontinence urinaire/anatomopathologie , Incontinence urinaire/physiopathologie , Urodynamique , Vagin/physiopathologieRÉSUMÉ
Patient's histories of urinary incontinence and results of several standard clinical tests, were correlated with final diagnosis obtained by multichannel urodynamic testing. One hundred and thirty one histories of women with urinary incontinence who were in the Urogynecology Clinics of the Instituto Nacional de Perinatología in the period from july to december 1992, were evaluated including dates of standardized questionnaire and structural clinical examination with the urodynamic testing to obtain a final diagnosis. Although the objective urinary loss and the cystocele II-III were significantly associated with genuine stress incontinence and mixed incontinence, in patients with detrusor instability did not. Women with complaints of urinary incontinence, especially those for whom surgery is contemplated, should undergo complete urodynamic evaluation.