Seguimiento de las lesiones escamosas intraepiteliales de alto grado (H-SIL) tras conización con asa diatérmica / Follow-up of high risk intraepithelial lesions after loop excision

Objetivo: Establecer el porcentaje de persistencias de las lesiones escamosas intraepiteliales de alto grado (H-SIL) tras realizar la conización con asa diatérmica, así como el momento del diagnóstico tras la intervención. Material y método: Revisión de los casos de conización por H-SIL en un período de 5 años en nuestra unidad de patología cervical. Analizamos el informe anatomopatológico de la pieza, las persistencias de H-SIL, la presencia de carcinomas y el número de curaciones, así como las pérdidas de seguimiento y la correlación de los márgenes afectados con la persistencia de H-SIL y con la presencia de carcinoma. Resultados: Nuestro porcentaje de curaciones es similar a las cifras publicadas. Hay diferencia significativa entre la existencia de carcinomas en las piezas de H-SIL cuando ambos márgenes están afectados y cuando los márgenes están libres. El momento de detección de la persistencia o recidiva de la lesión siempre fue en el primer control, excepto en un caso. Conclusiones: El seguimiento de las pacientes con conización por H-SIL es importante para detectar la persistencia de H-SIL

Objective: To evaluate whether the surveillance schedule for patients treated with loop excision for high-grade squamous intraepithelial lesions (H-SIL) could be improved. Material and method: We reviewed patients followed-up after loop excision of H-SIL in our unit over a 5-year period. We analyzed histologic confirmation of lesion, risk of recurrence of high-grade dysplasia, the presence of carcinomas, the number of patients with complete resolution, losses to follow-up, and the correlation between margin status and H-SIL recurrence and the presence of carcinoma. Results: The cure rate in this study was similar to rates reported in the literature. A significant difference was found between the presence of carcinoma in H-SIL surgical specimens when both margins were involved compared with disease-free margins. In all but one patient, recurrence was detected in the first follow-up examination. Conclusions: An optimal surveillance schedule for women treated for high-grade dysplasia with loop excision is important to detect and treat recurrent disease

[Study of urinary outflow in pregnancy]. / Análisis de los valores uroflujométricos durante la gestación.

Anatomical and physiological changes in the urinary tract develop during pregnancy. These changes may affect the urinary outflow. Urinary symptoms may develop during pregnancy in previously asymptomatic patients. Most of these symptoms will vanish after delivery. Some of them remain and others will become worse in consecutive pregnancies. A study was designed to compare if there was any difference in the urinary outflow between pregnant and non-pregnant women. Changes in the urinary outflow at different gestacional ages were studies too. In general, the urinary volume is higher in pregnant than in non-pregnant patients. Having said this, during the pregnancy this volume decrease in the third trimester. Peak urinary outflow is higher in pregnancy, being statically significant during the second and third trimester. Opposite to the non-pregnant patient, peak urinary outflow does not decrease with urinary volumes over 500 ml in pregnant patients. Significant differences were not found in the mean urinary outflow in both groups.