El endotelio sano y su disfunción en el riesgo cardiovascular / Healthy Endothelium and its Dysfunction in Cardiovascular Risk

Resumen El endotelio es una monocapa formada por células aplanadas llamadas w, que revisten la parte más interna del corazón, los vasos sanguíneos y los linfáticos. Es considerado un órgano que tiene una función de barrera, pero además se encarga de regular la permeabilidad y tono vascular, hemostasia, inflamación y angiogénesis. Esta revisión se centra sobre todo en las generalidades del endotelio vascular sano y su disfunción. Se analizan los conceptos de activación y disfunción, en donde la activación se considera como un proceso autolimitado, indispensable para la hemostasia y la inflamación. La disfunción endotelial, en cambio, es un proceso patológico, de mayor duración y que se presenta cuando el endotelio ya no puede autorregularse y cambia a un fenotipo proinflamatorio y protrombótico permanente. Esta disfunción es el primer cambio que lleva a la ateroesclerosis y al aumento del riesgo cardiovascular, por esta razón se revisan los principales biomarcadores de disfunción endotelial y riesgo cardiovascular. A medida que se avance en el conocimiento básico del endotelio y su disfunción, será posible diseñar nuevas medidas preventivas o terapéuticas que puedan disminuir dicho riesgo.

Abstract The endothelium is a monolayer of flatten cells named endothelial cells that form the inner layer of the heart, blood, and lymphatic vessels. Its function is not just as a barrier, but it is a regulator of vascular permeability and tone, hemostasis, inflammation, and angiogenesis. This review is about the general aspects of vascular endothelium and endothelial dysfunction that leads to increased vascular risk. Activation and dysfunction are discussed, considering the endothelial activation as a self-limiting process, necessary to promote inflammation and hemostasis. Endothelial dysfunction is a pathological process in which the endothelium loses its ability for self-regulation and acquires a prothrombotic and proinflammation phenotype. Endothelial dysfunction is the initial step for atherosclerosis and increased cardiovascular risk, so the main biomarkers of endothelial dysfunction are reviewed. As basic knowledge about endothelium increases, preventive or therapeutic measures can be designed as treatment or prevention the risk of its dysfunction.

A New Comestible Formulation of Parasiticide Fungi to Reduce the Risk of Soil-Transmitted Helminth Infections in a Canine Shelter.

Dogs cared for in a shelter are dewormed every three-four months, but they all become infected one-two months later by the soil-transmitted helminths (STHs) Toxocara canis, Toxascaris leonina, Trichuris vulpis, and Ancylostoma caninum. For the purpose of reducing their risk of infection by decreasing the survival of helminths' infective stages in soil, chlamydospores of two parasiticide fungi, Mucor circinelloides (ovicide) and Duddingtonia flagrans (larvicide) were formulated as handmade edible gelatins and given three days per week for 17 months to 18 dogs (DRF, dogs receiving fungi); a second group was maintained without fungi (CD, control dogs). All individuals were dewormed at months 0, 3, 7, 10 and 13, and it was observed that the levels of helminths egg-output were reduced by 96-98% fourteen days after each treatment. Fecal egg counts of STHs were similar in both groups until the 6th-8th months, and then remained significantly lower in DRF than in CD (42-100% ascarids; 30-100% trichurids and ancylostomatids). According to the results, and considering that gelatin treats have always been fully accepted, it is concluded that this new formulation offers an efficient solution to decrease the risk of infection among dogs maintained in shelters, and is therefore recommended.

Prenatal diagnosis of Greig Cephalopolysyndactyly Syndrome. When to suspect it.

Greig Cephalopolysyndactyly Syndrome (GCPS) is a very rare multiple congenital anomaly with an estimated incidence of 1-9:1,000,000 in newborns with principal findings of macrocephaly, ocular hypertelorism, and polysyndactyly (preaxial or mixed preaxial and postaxial). Very few cases of prenatal diagnoses have been reported. The postnatal diagnosis is based on clinical findings and family background. GLI3, the only gene associated with this anomaly, is altered in more than 75% of cases. Deletions over 1 Mb and involving other genes yield severe clinical cases, which are known collectively as Greig Cephalopolysyndactyly-contiguous gene Syndrome. We report a case in which, despite early polydactyly findings on week 16, the diagnosis was established during the third trimester of pregnancy due to the late presentation of other anomalies corresponding to this syndrome.

The Current Role of the Heavy/Light Chain Assay in the Diagnosis, Prognosis and Monitoring of Multiple Myeloma: An Evidence-Based Approach.

Despite tremendous progress being made in recent years, multiple myeloma (MM) remains a challenging disease. The laboratory plays a critical role in the overall management of patients. The diagnosis, prognosis, clinical monitoring and evaluation of the response are key moments in the clinical care process. Conventional laboratory methods have been and continue to be the basis of laboratory testing in monoclonal gammopathies, along with the serum free light chain test. However, more accurate methods are needed to achieve new and more stringent clinical goals. The heavy/light chain assay is a relatively new test which can overcome some of the limitations of the conventional methods for the evaluation of intact immunoglobulin MM patients. Here, we report an update of the evidence accumulated in recent years on this method regarding its use in MM.

Maternal Thinness and Obesity and Customized Fetal Weight Charts.

OBJECTIVE: The aim of the study was to determine if customized fetal growth charts developed excluding obese and underweight mothers (CC(18.5-25)) are better than customized curves (CC) at identifying pregnancies at risk of perinatal morbidity. MATERIAL AND METHODS: Data from 20,331 infants were used to construct CC and from 11,604 for CC(18.5-25), after excluding the cases with abnormal maternal BMI. The 2 models were applied to 27,507 newborns and the perinatal outcomes were compared between large for gestational age (LGA) or small for gestational age (SGA) according to each model. Logistic regression was used to calculate the OR of outcomes by the group, with gestational age (GA) as covariable. The confidence intervals of pH were calculated by analysis of covariance. RESULTS: The rate of cesarean and cephalopelvic disproportion (CPD) were higher in LGAonly by CC(18.5-25) than in LGAonly by CC. In SGAonly by CC(18.5-25), neonatal intensive care unit (NICU) and perinatal mortality rates were higher than in SGAonly by CC. Adverse outcomes rate was higher in LGAonly by CC(18.5-25) than in LGAonly by CC (21.6%; OR = 1.61, [1.34-193]) vs. (13.5%; OR = 0.84, [0.66-1.07]), and in SGA only by CC(18.5-25) than in SGAonly by CC (9.6%; OR = 1.62, [1.25-2.10] vs. 6.3%; OR = 1.18, [0.85-1.66]). CONCLUSION: The use of CC(18.5-25) allows a more accurate identification of LGA and SGA infants at risk of perinatal morbidity than conventional CC. This benefit increase and decrease, respectively, with GA.

Rotational forceps: a retrospective study evaluating anatomical and functional consequences for the pelvic floor.

INTRODUCTION AND HYPOTHESIS: The use of Kielland's rotational forceps is considered to involve greater technical difficulty and may be associated with a higher rate of pelvic floor trauma. Our main objective was to evaluate the association between avulsion of the levator muscle and rotational and non-rotational forceps. METHODS: This was an observational study carried out at a tertiary hospital that recruited singleton cephalic vaginally primiparous women with previous Kielland's forceps delivery between March 2012 and May 2017. Patients were retrieved from a local database, contacted consecutively and blinded to all clinical data. Power calculations determined a sample of n = 160 patients. All women underwent a urogynecological interview, clinical examination and 4D translabial ultrasound (TLUS). The 4D TLUS volumes were stored and analyzed offline by an experienced ultrasound examiner who was blinded to all clinical data. RESULTS: A total of 165 patients were available for analysis. Rotational forceps accounted for 27.3% (45 out of 165) of the study sample. Avulsion was present in 41.8% (69 out of 165) of all forceps deliveries. On multivariate analysis, rotational forceps was associated with avulsion, with an adjusted odds ratio (OR) of 2.57 (CI 95% 1.20-5.62, p = 0.016). Body mass index at the beginning of gestation was found to be a protective factor, with an adjusted OR of 0.918 (CI 95% 0.847-0.986, p = 0.025). CONCLUSION: Rotational forceps is associated with a higher avulsion rate than non-rotational forceps, with an adjusted OR of over 2.5. Obstetricians need to consider the potential long-term consequences of performing a rotational forceps for mothers.

Gestational Age-Specific Reference Ranges for the sFlt-1/PlGF Immunoassay Ratio in Twin Pregnancies.

OBJECTIVE: Establish reference ranges for the Elecsys® soluble fms-like tyrosine kinase-1 (sFlt-1)/placental growth factor (PlGF) immunoassay ratio in twin pregnancies. METHODS: Data analyzed were from 3 prospective studies: Prediction of Short-Term Outcome in Pregnant Women with Suspected Preeclampsia (PE) (PROGNOSIS), Study of Early-onset PE in Spain (STEPS), and a multicenter case-control study. Median, 5th, and 95th percentiles for sFlt-1, PlGF, and the sFlt-1/PlGF ratios were determined for normal twin pregnancies for 7 gestational windows and compared with the previous data for singleton pregnancies. RESULTS: The reference range analysis included 269 women with normal twin pregnancies. Before 29 weeks' gestation, median, 5th, and 95th percentiles for sFlt-1/PlGF ratios did not differ between twin and singleton pregnancies. From 29 weeks' gestation to delivery, median, 5th, and 95th percentiles for sFlt-1/PlGF ratios were substantially higher in twin versus singleton pregnancies. sFlt-1 values were higher in women with twin pregnancies across all gestational windows. PlGF values were similar or higher in twin versus singleton pregnancies; PlGF concentrations increased from 10 weeks + 0 days to 28 weeks + 6 days' gestation. CONCLUSIONS: Reference ranges for the sFlt-1/PlGF ratio are similar in women with twin and singleton pregnancies until 29 weeks' gestation but appear higher in twin pregnancies thereafter.

First-trimester cystic posterior fossa: reference ranges, associated findings, and pregnancy outcomes.

OBJECTIVE: To report reference ranges for fetal cerebral posterior fossa measurements and to describe the sonographic findings, karyotype results, and pregnancy outcomes in fetuses presenting with cystic posterior fossa (CPF) in the first trimester of pregnancy. METHODS: Two groups of patients undergoing first-trimester sonographic screening at 11-13 weeks' gestation were studied. The first (control group) consisted of 253 consecutive fetuses with normal posterior fossa, in which the brainstem (BS), fourth ventricle, cisterna magna, and BS-occipital bone (BS-OB) diameter were prospectively measured and the BS/BS-OB diameter ratio was calculated. The second (study group) consisted of 14 fetuses in which a CPF was detected. Information on sonographic findings, prenatal karyotype results, and pregnancy outcomes was obtained by reviewing ultrasound reports and medical records. The results from the two groups were then compared. RESULTS: In the control group, the size of all posterior fossa structures increased and the BS/BS-OB diameter ratio slightly decreased as the pregnancy progressed. In the study group, the BS diameter did not differ significantly from the measurements obtained in the control group. However, the BS-OB diameter and the fourth ventricle were significantly larger (p < .05 and p < .001, respectively) in the study group than in the control group. Additionally, the cisterna magna was not identified in 13 of the 14 fetuses (93%) in the study group, in comparison to zero out of the 253 fetuses in the control group (p < .001). Finally, the BS/BS-OB diameter ratio was significantly smaller in the study group when compared with the control group (p < .05). Regarding pregnancy outcomes, 12 of the 14 (86%) affected pregnancies underwent elective termination (n = 11) or ended in an early intrauterine demise (n = 1) due to the associated chromosomal abnormalities or structural defects. The two fetuses with isolated CPF had a normal second-trimester scan and resulted in the delivery of healthy newborn infants. CONCLUSIONS: The detection of a CPF in the first trimester is associated with a high rate of chromosomal and structural defects. By using normative data, early sonographic screening and detection of mildly and moderately abnormal cases is possible. Fetuses with isolated CPF require further study with a detailed second-trimester scan. This is essential in order to differentiate cases with poor and good perinatal outcomes. Finally, our data also demonstrate that the main sonographic tool when screening for CPF in the first trimester is the assessment of the fourth ventricle, which is significantly larger in abnormal cases as the result of the wide communication between the fourth ventricle and the cisterna magna.

Evaluation of the effectiveness of transcutaneous nerve stimulation during labor in breech presentation: a case series.

Objective: To analyze the effectiveness of pain relief with transcutaneous electrical nerve stimulation (TENS) dispositive during labor in breech vaginal delivery and also to describe its tolerance and satisfaction.Design: A randomized, double-blind, and placebo-controlled trial was conducted.Setting: Labor room of Complejo Hospitalario Universitario Insular-Materno Infantil (Spain).Participants: Ten women who met the inclusion criteria of the clinical trial and also had a fetus breech presentation were randomly assigned to three groups.Interventions: A portable TENS, Cefar Rehab 2pro®, unit was used to apply the experimental intervention, with different doses in the three groups in women during labor. The device intensity (amplitude) was individually adjusted to each participant's maximum sensory level. The pain was evaluated with visual analog scale (VAS). COMFORTS scale was used to measure women's satisfaction.Results: A significant association of VAS was detected depending on the type of TENS over time. Active TENS2 was the only group that obtained an improvement with clinically significant results. In connection with women satisfaction, active TENS2 group was also the group that presented higher values.Conclusions: We can recommend the use of TENS dispositive to relieve pain during labor, also in those women with breech presentation.

The Control of Zoonotic Soil-Transmitted Helminthoses Using Saprophytic Fungi.

Soil-transmitted helminths (STHs) are parasites transmitted through contact with soil contaminated with their infective eggs/larvae. People are infected by exposure to human-specific species or animal species (zoonotic agents). Fecal samples containing eggs of Ascaris suum or Lemurostrongylus sp. were sprayed with spores of the soil saprophytic filamentous fungi Clonostachys rosea (CR) and Trichoderma atrobrunneum (TA). The antagonistic effect was assessed by estimating the viability of eggs and their developmental rate. Compared to the controls (unexposed to fungi), the viability of the eggs of A. suum was halved in CR and decreased by two thirds in TA, while the viability of the eggs of Lemurostrongylus sp. was reduced by one quarter and one third in CR and TA treatments, respectively. The Soil Contamination Index (SCI), defined as the viable eggs that attained the infective stage, reached the highest percentages for A. suum in the controls after four weeks (66%), with 21% in CL and 11% in TA. For Lemurostrongylus sp., the values were 80%, 49%, and 41% for control, CR and TA treatments, respectively. We concluded that spreading spores of C. rosea or T. atrobrunneum directly onto the feces of animal species represents a sustainable approach under a One Health context to potentially reduce the risk of zoonotic STHs in humans.

Delivery in breech presentation: Perinatal outcome and neurodevelopmental evaluation at 18 months of life.

OBJECTIVES: To compare maternal and perinatal outcomes, including neurodevelopmental results at 18 months of life, between term breech and cephalic deliveries. STUDY DESIGN: In this longitudinal retrospective study of mothers seen at the Maternity and Paediatric University Hospital of the Canary Islands delivery unit from November 1, 2011, to October 31, 2012, we compared maternal and perinatal outcomes associated with breech or cephalic presentation of the foetus. A second analysis was performed to compare breech births, differentiating between whether a vaginal delivery attempt was made or if caesarean section (C-section) without labour had been directly scheduled. The psychomotor development of children 18 months after birth was assessed using the Haizea-Llevant scale. RESULTS: A total of 130 breech deliveries were matched with 130 cephalic deliveries. No perinatal mortality occurred in either group. The C-section percentage was greater in the breech presentation group compared with the cephalic delivery group (72.3 % vs. 14.6 %; p < 0.001). Children in the breech presentation had a threefold increased risk for Apgar scores <7 at 1 min (OR 3.2; 95 % CI: 1.2-8.4; p = 0.016) compared with cephalic presentation. These differences disappeared 5 min after birth. No differences were observed in moderate to severe neonatal morbidity between the breech and cephalic presentation groups. There were no differences between groups in neurodevelopmental outcomes. Of 130 pregnancies with breech presentation, 79 (60.8 %) made a vaginal delivery attempt, and 51 (39.2 %) were planned C-sections. Women who attempted vaginal breech delivery were younger and had a history of previous pregnancy. Apgar scores <7 at 1 min were more frequent in the vaginal delivery attempt group (27.9 % vs. 5.9 %; p = 0.002). A high percentage of type III resuscitation (36.5 % vs. 14.3 %; p = 0.007) and Neonatology admission (22.8 % vs. 5.9 %; p = 0.013) was observed in the vaginal delivery attempt group. Except for Apgar scores <7 at 1 min, none of these associations was significant after adjusting for nulliparity and maternal age. The mode of delivery was not associated with moderate to severe perinatal outcomes. CONCLUSION: The implementation of a specific protocol for selecting pregnant women with breech presentation as candidates for vaginal delivery achieved perinatal outcomes similar to births in cephalic presentation.

Prognosis Assessment of Early-Stage Chronic Lymphocytic Leukemia: Are We Ready to Predict Clinical Evolution Without a Crystal Ball?

BACKGROUND: The discovery of new biologic variables with high prognostic effect has been accompanied by the emergence of different prognostic indexes (PIs) to assess the time to first treatment in patients with early-stage (Binet A) chronic lymphocytic leukemia (CLL). The present study compared the prognostic value of 5 PIs: CLL international prognostic index (CLL-IPI), Barcelona-Brno, international prognostic score-A (IPS-A), CLL-01, and a tailored approach. PATIENTS AND METHODS: We applied the 5 PIs to a cohort of 428 unselected patients with Binet A CLL from a multicenter Spanish database with clinical and biologic information available. The predictive value of the scores was assessed using Harrell's concordance index (C index) and area under the receiver operating characteristic curve (AUC). RESULTS: We found a significant association between time to first treatment and risk subgroups for all 5 PIs used. The most accurate PI was the IPS-A (C-index, 0.72; AUC, 0.76), closely followed by CLL-01 (C-index, 0.69; AUC, 0.70), CLL-IPI (C-index, 0.69; AUC, 0.69), Barcelona-Brno (C-index, 0.67; AUC, 0.69), and the tailored approach (C-index, 0.61 and 0.58; AUC, 0.58 and 0.54). CONCLUSIONS: The concordance between the PIs was low (44%), suggesting that although all these PIs improve clinical staging and help physicians in routine clinical practice, it will be necessary to harmonize larger cohorts of patients to define the best PI for treatment decision-making in the real world.

Características ecocardiográficas de la mesocardia fetal: un corazón diferente / Echocardiographic features of fetal mesocardiac: a different heart

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Integrating the control of helminths in dairy cattle: Deworming, rotational grazing and nutritional pellets with parasiticide fungi.

Thirty-two Friesian cattle under a leaders/followers four-day rotation and passing eggs of trematodes and gastrointestinal nematodes (GIN) were studied in two trials for the integrated control of these helminths over two years. In the first trial, the effect of rotational pasturing was assessed on a group of leaders (milking cows, G-L1) and followers (dried-off cows and heifers, G-F1) supplemented daily with commercial nutritional pellets. In the second trial, leaders (G-L2) and followers (G-F2) were maintained under a rotational pasturing regime; the cows received daily commercial pelleted feed and heifers pellets manufactured with a blend of parasiticide fungi (3 × 105 chlamydospores of both Mucor circinelloides and Duddingtonia flagrans/kg pellet). Deworming via closantel and albendazole was performed in cows in each trial at the beginning of their drying periods, and fourteen days later, the fecal egg-count reductions (FECR) of Calicophoron daubneyi and GIN were from 94 to 100% (average 98 %), while the percentages of reduction of cattle shedding eggs (CPCR) were from 50 to 100% (average 77 % and 82 %, respectively). The heifers were dewormed one time only, at the beginning of each trial, and the values of FECR and CPCR were 100 % against C. daubneyi and 96 % and 83 %, respectively, against GIN. Over a period of 24 months, significantly higher numbers of helminth egg-output were observed in G-L1, with the lowest numbers in G-F2. C. daubneyi egg output was reduced by 5 % (G-L1) and 42 % (G-F1) at the end of trial 1 and by 83 % (G-L2) and 100 % (G-F2) at the end of trial 2; the numbers of GIN egg-output decreased by 13 % (G-L1) and 18 % (G-F1) at the end of trial 1, and by 72 % (G-L2) and 85 % (G-F2) at the end of trial 2. No adverse effects were detected in cattle taking pellets enriched with fungal spores (G-F2). It is concluded that long-term ingestion of spores of M. circinelloides and D. flagrans provides a valuable tool to improve the effect of rotational grazing and to lessen the risk of infection by C. daubneyi and GIN in dairy cattle, and accordingly, the performance of integrated control programs.

Nefropatía fetal por Valsartán / Fetal nephropathy due to Valsartan

La hipertensión arterial afecta aproximadamente al 7% de mujeres en edad reproductiva. Más de la mitad de estas mujeres quedarán gestantes mientras toman medicación antihipertensiva. Los inhibidores de la enzima convertidora de angiotensina y los antagonistas de los receptores de angiotensina II son fármacos antihipertensivos ampliamente utilizados en la población adulta, especialmente si tienen comorbilidades como diabetes o enfermedad renal, habiéndose descrito resultados perinatales adversos cuando se usan durante el embarazo. Presentamos el caso de una mujer en tratamiento con Valsartán que quedó gestante inadvertidamente, desarrollando el feto una nefropatía funcional no malformativa diagnosticada a las 22 semanas

Hypertension affects aproximately 7% of women in reproductive age. More than half will get pregnant while taking antihypertensive drugs. Renin angiotensine system blockers and angiotensin II receptor blockers are antihypertensive drugs broadly used in adult population, specially in patients with co-morbidities like diabetes or renal disease. Adverse perinatal outcomes have been reported in patients taking these drugs. We present a case report about a woman taking Valsartan whose pregancy was diagnosed at 22 weeks, with a fetal non malformative nephropathy

Tumor maligno de la vaina del nervio periférico primario de mama / Malignant peripheral nerve sheath tumor of the breast

Los tumores malignos de la vaina del nervio periférico representan del 5 al 10% del total de tumores malignos de tejidos blandos y frecuentemente se asocian con la neurofibromatosis tipoI. Su presentación en la glándula mamaria es poco frecuente, y el diagnóstico es muy difícil por su rareza y por la ausencia de características clínicas y/o radiológicas específicas, siendo preciso una adecuada interpretación del estudio inmunohistoquímico y su correlación con los hallazgos morfológicos. Presentamos un caso clínico y su revisión bibliográfica

Malignant peripheral nerve sheath tumours represent 5-10% of all malignant soft tissue tumours and are frequently associated with neurofibromatosis typeI. Their presentation in the mammary gland is rare. Because of this rarity, as well as the absence of specific clinical and/or radiological features, their diagnosis very difficult. It is therefore essential to correctly interpret immunohistochemical analysis and its correlation with morphological findings. We present a clinical case and literature review

Survival After Mitral Valve Replacement for Leaflet Escape in a Contemporary On-X Mechanical Valve.

Leaflet escape in contemporary mechanical valves is an extremely rare and potentially lethal condition. We report the case of a 77-year-old man who presented with embolization of a leaflet from an On-X mitral valve (CryoLife, Kennesaw, GA) with Conform-X Sewing Ring prosthesis (CryoLife) after exercise. The patient recovered completely 6 months after surgery, and he is currently asymptomatic.

Vaginal approach in the repair of vesicovaginal fistula / Abordaje vaginal en la reparación de fístula vesicovaginal

Objective: We present our experience in the vaginal approach to repair of vesicovaginal fistula (VVF) without interposition of flaps in a series of 8 patients. Material and methods: We performed a retrospective descriptive study of patients who underwent surgery between January 2015 and August 2018. Eight patients were diagnosed with VVF and underwent surgical repair. We analyzed age, associated comorbidity, type of surgery performed, time to diagnosis, diagnostic sequence, and classification of the type of fistula. All patients underwent the same procedure. We analyzed operative time, complications, additional procedures, and final outcome. The surgical technique was performed transvaginally by the same surgical team in all 8 cases. Results: We repaired 8 VVFs. Mean age was 49 years. All patients had a simple fistula, with a good prognosis a priori. The fistulas measured between 10 and 15 mm. Time to repair ranged between 2 and 9 months. The average operative time was 123 minutes. There were no major intraoperative complications. The average hospital stay was 1.9 days. The success rate was 94.6% (7/8). One patient had to undergo additional surgery that was not completely successful. No recurrences were observed during a 12-month follow-up. Conclusions: The vaginal approach, without interposition flaps, has proven highly successful for the repair of uncomplicated simple VVFs, with results comparable to other routes of approach. Good preparation of the vaginal mucosa, adherence to the key principles of surgical repair of VVFs, and the experience of the surgeon are important variables that affect the success rate of the procedure

Objetivo: presentar nuestra experiencia en la reparación de las fístulas vesicovaginales mediante abordaje vaginal sin interposición de colgajos, en una serie de ocho pacientes. Material y métodos: estudio descriptivo retrospectivo de los casos intervenidos en el período de tempo comprendido entre enero 2015 a agosto 2018. Se diagnosticaron en nuestro centro un total de ocho pacientes con fístula vesicovaginal (FVV) que se sometieron a reparación quirúrgica. Se analizó la edad, comorbilidad asociada, tipo de cirugía realizada, tiempo de evolución desde la presentación de la clínica hasta el diagnóstico, secuencia diagnóstica y clasificación del tipo de fístula. Se realizó la misma cirugía reparativa para todas las pacientes y se analiza el tiempo quirúrgico, complicaciones, reintervenciones y resultado final. La técnica quirúrgica fue estrictamente reproducida vía transvaginal por el mismo equipo quirúrgico en todos los casos. Resultados: se repararon ocho fístulas vesicovaginales, con una edad media de las pacientes de 49 años. Todas ellas fueron clasificadas como fístula única simple, a priori de buen pronóstico. El tamaño de la fístula se estimó entre 10 mm y 15 mm. El tiempo de fistulización hasta la reparación osciló entre 2 y 9 meses. El tiempo operatorio promedio fue de 123 minutos. No se produjeron complicaciones mayores intraoperatorias. El tiempo de hospitalización promedio fue de 1,9 días. La tasa de éxito fue del 94.6% (7/8), hubo una persistencia que se reintervino sin éxito completo y no se observaron recidivas en un seguimiento de 12 meses. Conclusiones: el abordaje vaginal, sin interposición de colgajo, es un procedimiento con alta tasa de éxito en la reparación de FVV simple no complicada, con resultados equiparables a otras vías de abordaje. La buena preparación de la mucosa vaginal, respetar los principios claves en la reparación quirúrgica de las FVV y la experiencia del cirujano son variables importantes que condicionarán la tasa de éxito