[Scheduled hysterectomy vs. urgent hysterectomy in patients with placenta accreta in a high specialty medical unit]. / Histerectomía programada vs. histerectomía de urgencia en pacientes con placenta acreta, en una unidad médica de alta especialidad.

BACKGROUND: Patients with placenta accreta have a high frequency of complications and death risk. OBJECTIVE: The aim of this study was to compare the results of scheduled hysterectomy vs. urgent hysterectomy in patients with placenta accreta in a high specialty medical unit. MATERIAL AND METHODS: An observational, comparative, cross-sectional study was conducted by reviewing patient records with confirmed diagnostic of placenta accreta, who attended in a one year period. They were divided into 2 groups based on the type of surgery, scheduled or urgent. Descriptive statistics were applied, with comparisons using Student t-test and chi squared tests. A value of P<.05 was considered significant. RESULTS: There were 4,592 births in the period of study, and 125 obstetric hysterectomies were performed, with 40 confirmed cases of accreta (8.7 per thousand births) with 20 in scheduled and 20 in urgent surgeries, with the most frequent type being placenta accreta. The mean maternal age was 32 years, with a mean of 5 hours operating time, total bleeding 3135 ml, and 3.5 units of packed cells transfused. There was no statistical difference when comparing these variables with re-interventions, hypovolaemic shock, and intensive care unit admission. Caesarean-hysterectomy with hypogastric artery ligation was the most frequent surgery performed. CONCLUSIONS: In this hospital, scheduled and urgent surgical treatment of patients with placenta accreta show similar results, probably because the constant availability of resources and the experience obtained by the multidisciplinary team in all shifts. Nevertheless, make absolutely sure to perform elective surgery while having all the necessary resources.

[Complications associated with the use of polypropylene mesh in women under colposacropexy]. / Complicaciones asociadas con el uso de mallas de polipropileno en mujeres a quienes se efectúa colposacropexia.

BACKGROUND: There have been numerous surgical procedures and modi fied in the hope of obtaining a lasting cure for pelvic organ prolapse These surgeries were performed using the traditionally native tissues of the patient. In an effort to reduce morbidity, improve surgical outcomes and reduce the complexity of these operations, we used a growing number of synthetic mesh repairs and biomaterials used tissue from cadaver or animal. OBJECTIVE: To evaluate the frequency of complications associated with the use of polypropylene mesh in women undergoing colposacropexy. MATERIAL AND METHODS: Retrospective, observational and descriptive study conducted at the Hospitalde Ginecología y Obstetricia 3 IMSS (Mexico) between 1 January 2006 and 15 February 2013. The main risk factors associated with pelvic organ prolapse were considered, comorbidity and complications directly linked to the procedure. RESULTS: With respect to the related complications colposacropexy procedure using polypropylene mesh were documented in 20 of 67 patients which corresponded to 30%. CONCLUSION: A number of complications have been associated with the use of meshes between these include: extrusion, erosion, pelvic pain, dyspareunia, bladder or bowel condition, but one aspect is poorly evaluated sexual dysfunction without to definitely plays an important role in the field bio-psychosocial.

[Treatment results for different categories of vaginal intraepithelial neoplasia with electrocoagulation, 5-fluorouracil and combined treatment]. / Resultados del tratamiento con esferolisis, 5 fluorouracilo y mixto de pacientes con diferentes categorías de neoplasia intraepitelial vaginal.

BACKGROUND: Vaginal intraepithelial neoplasia (VAIN) represents a variety of changes that initiate as an intraepithelial squamous lesion with the possibility of resulting in cancer. OBJECTIVE: To compare the results of the treatment for the different categories of VAIN with electrocoagulation, 5-fluorouracil and combined treatment. MATERIALS AND METHODS: Observational an analytical study. We stablished groups according to the category of VAIN evaluating and comparing remission, persistence, recurrence, or progression of the disease ac- cording to the received treatment, with a 1-year follow up. The results were compared by chi2 and Kruskal Wallis. The statistics analysis was done with the SPSS program version 20. RESULTS: One hundred thirty seven patients between 20 and 81 years of age (mean age: 52.49 years) were included. Seventy-four percent of the patients had a history of premalignant or malignant cervical lesions. Seventy-four patients had VAIN I, 34 patients had VAIN II, 22 patients had VAIN III and there were seven cases of vaginal carcinoma in situ. Fifty-eight patients were treated with electrocoagulation, 55 patients were treated with 5-FU, 16 patients had combined treatment, and eight patients received expectant management. Sixty three percent of patients had total remission of the lesion, 34% had persistence and 3% showed progression, and there were no cases of recurrence. Results were better in patients with VAIN I treated with 5-FU (bigger percentage of remission P .026), for the remaining categories of VAIN, no treatment showed superior results. CONCLUSIONS: The superior response occurs in patients with VAIN I treated with 5-FU. None of the treatments achieves a 100% remission. The VAIN frequency is high, patients with a history of malignant or premalignant cervical pathology should undergo a closer surveillance through cytocolposcopic control with respect to the remaining population.

[Case report. Aggressive angiomyxoma of vagina. A rare tumor diagnosed]. / Angiomixoma agresivo de vagina: un tumor poco diagnosticado.

The case of a female patient of 35 years of age, with a pedunculated tumor dependent of the vagina, of approximately 25 x 12 x 8 cm, who had a wide resection. The report was consistent with myxoid aggressive angiomyxoma. This is a myxoid mesenchymal neoplasm of slow growth, which mainly appears in deep soft tissues of the pelvic, genital or perineal areas of adult women. It is usually diagnosed after surgical resection by histopathologic examination. Routine evaluation includes: complete physical examination, imaging and pathology report of diagnostic confirmation.

[Prevalence of condyloma acuminata in women who went to opportune detection of cervicouterine cancer]. / Prevalencia de condiloma acuminado en mujeres que acuden a detección oportuna de cáncer cérvico uterino en un primer nivel de atención.

BACKGROUND: It has been considered the incidence and the prevalence of the disease of sexual transmission with base in the different data banks. Unfortunately, each of these sources has limitations. OBJECTIVE: To evaluate annual prevalence of genital condiloma acuminate in the women who go to opportune detection of cervicouterine cancer. MATERIAL AND METHOD: Study realized in a first level of attention, the Zaragoza clinic of the System of Collective Transport Metro of Mexico City; of January of the year 2000 to June of year 2009. All the patients included themselves in the study that went to opportune detection of cervicouterine cancer. RESULTS: 3,232 cervicovaginal cytologist were realized of which 106 cases presented condylomata acuminata genital confirmed by clinic and biopsy, settling down an annual prevalence of 3.2%; the prevalence by ages the greater number of cases appear between the 30 and 34 years with rate of 21.6%. DISCUSSION: The prevalence of the infection by human virus papailoma varies in the different regions from the world; usually they reach from 20 to 30% in the women of 20 to 24 years of age and falls later to 3 to 10% in the women majors of 30 years. CONCLUSION: It is important to establish measures of prevention directed to prevent the contagion, exhorting to the adolescent population men and women to have a responsible sexuality.

[Hydrometrocolpos: prenatal diagnosis. A case report]. / Hidrometrocolpos: diagnóstico prenatal. Informe de un caso.

Hydrometrocolpos is cHaracterized by a vaginal obstruction with cystic dilatation of uterus and vagina caused by accumulation of cervical and endometrial mucus. It could be in association with other malformations, such as postaxial polydactyly, anal atresia, esophageal atresia, renal agenesis, genital anomalies, cardiopathy or autosomal recessive disorder. The appropriate prenatal detection with the help of prenatal ultrasonography differential diagnosis and early treatment and prevention of complications.