Bilateral hydrosalpinx in patients with Hirschsprung's disease.

PURPOSE: Hirschsprung's disease (HD) is uncommon in females. There are very few reports on the patients' obstetric and gynecological outcome. Hydrosalpinx causes pain and infertility. It is rare in nonsexually active teenagers. It may be because of an intrinsic disease of the fallopian tubes or secondary to surgery. AIM: to describe the relationship between hydrosalpinx and HD or its surgical approach; to report the impact of bilateral hydrosalpinx on fertility in HD. METHODS: The records of all females with HD since 1980 were reviewed. Only patients who reached menarche were included. Prevalence of hydrosalpinx and hydrosalpinx-free survival were compared after abdominoperineal (A) or transanal (T) surgery. Treatment for hydrosalpinx was reviewed. RESULTS: Seventeen out of 27 patients had reached menarche (Group A: 13 patients; Group T: 4 patients). Five patients in group A and none in group T presented bilateral hydrosalpinx (p=0.261). There were no statistical differences in hydrosalpinx-free survival between groups (p=0.344). Hydrosalpinx treatment: two bilateral and one unilateral salpingectomy, one pyosalpinx evacuation and one untreated. Three patients had conception desire: one has children; two are on IVF program. CONCLUSION: An association between hydrosalpinx and HD was observed. The development of hydrosalpinx was not associated with surgical approach in our study. Females with HD should have a gynecological follow-up for the development of hydrosalpinx, which can impair fertility. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Postoperative vesicoureteral reflux after high-pressure balloon dilation of the ureterovesical junction in primary obstructive megaureter. Incidence, management and predisposing factors.

OBJECTIVE: To describe the incidence, predisposing factors and management of postoperative vesicoureteral reflux (VUR) after high-pressure balloon dilation to treat primary obstructive megaureter (POM). MATERIALS AND METHODS: We have reviewed patients that underwent endoscopic treatment for POM from May 2008 to November 2013. All patients were evaluated with renal ultrasound, voiding cystourethrography and diuretic renogram. Endoscopic treatment was done with high-pressure balloon dilation of the ureterovesical junction under general anesthesia; a double-J stenting was done in all patients. Follow-up was performed with ultrasonography, voiding cystourethrography and a diuretic renogram in all patients. RESULTS: Fifteen boys and five girls with a mean age of 14.18 months (3-103) were reviewed. A total of 22 ureters underwent HPBD to treat POM. Ureterohydronephrosis improves in 19 ureters. After endoscopic treatment, six ureters developed VUR. Four ureters were managed surgically, and in the other two, VUR disappeared in a second cystogram. The presence of parameatal diverticulum in the preoperative cystography and those patients with bilateral POM are factors related to postoperative VUR (p < 0.05). Urinary tract infection after HPBD was observed in four patients, but only one of them was affected with VUR.

Enteroparasitosis en poblaciones indígenas y mestizas dela Sierra de Nayarit, México / Enteroparasitoses in indigenous and mestizo individuals from the Nayarit mountain range, Mexico

Comparamos las prevalencias de enteropa-rasitosis a partir de 420 individuos, 306 de ellos eran indígenas y 114 eran mestizos, sin dife-renciación de género, y de todos los rangos de edad, de la Sierra de Nayarit. Se hicieron seis viajes al campo a la región durante un año para recoger muestras de materia fecal, algunos individuos proporcionaron solamente una muestra y otros cinco muestras. Las muestras de materia fecal fueron diluidas en una solución de formalina al 10 por ciento en una relación 1:10, para su conservación durante su transporte a la Ciudad de México, donde se procesaron por análisis coproparasitoscópico directo teñido con solución de lugol. Nosotros encontramos 59,8 por ciento de entamoeba histolytica, 22,2 por ciento de Giardia lamblia, 22,2 por ciento de Enterobius vermicularis, 15,4 por ciento de Hymenolepis nana, 2 casos de taeniosis (0,7 por ciento), 21 casos de ascariosis (6,9 por ciento), 2 casos de estrongyloidosis (0,7 por ciento) y 7 casos de trichuriosis (2,3 por ciento) entre la población huichol. En la población mestiza, encontramos 43,9 por ciento de entamoebosis, 14,0 por ciento de giardiosis 9,6 por ciento de hymenolepiosis, 5 casos de ascariosis, 2 de taeniosis, 1 de strongyloidosis y 1 de enterobiosis. Los resultados se analizaron por la prueba del Chi-cuadrada y revelaron diferencias estadísticas significativas entre las dos poblaciones estudiadas