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1.
Anticancer Res ; 40(3): 1513-1517, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32132051

RESUMO

BACKGROUND/AIM: Cervical cancer is the most common cancer among women in Ethiopia. The objective was to evaluate the participation rate of a free of charge vaginal self-sample (Aptima multitest swab, Hologic) for the detection of human papillomavirus (HPV) in an Ethiopian cohort. PATIENTS AND METHODS: Specimens were collected from women employed by Ethiopian Airlines in Addis Abeba (N=5950). Samples were analysed for the presence of high-risk (HR) HPV mRNA by the Aptima HPV assay (Hologic) and HPV positive women were referred for cytology. Identification of HPV types among HPV positive samples was performed by Modified general primer-PCR and Luminex assay. RESULTS: Participation rate was 3.1% and the prevalence of HPV mRNA was 20.6% (37/180). CONCLUSION: Primary HPV mRNA screening with vaginal self-sampling may be an acceptable approach in Ethiopia. One out of five women harbor HPV in their vaginal self-sample in agreement with other similar studies from the region.


Assuntos
Papillomaviridae/genética , RNA Mensageiro/análise , RNA Viral/análise , Vagina/virologia , Adolescente , Adulto , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/estatística & dados numéricos , Etiópia/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/virologia , Prevalência , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/virologia , Vagina/patologia , Esfregaço Vaginal , Adulto Jovem
2.
BJOG ; 127(2): 171-180, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31237400

RESUMO

BACKGROUND: Persistent infection with high-risk human papillomavirus can lead to cervical dysplasia and cancer. Recent studies have suggested associations between the composition of the vaginal microbiota, infection with human papillomavirus (HPV) and progression to cervical dysplasia and cancer. OBJECTIVE: To assess how specific cervico-vaginal microbiota compositions are associated with HPV infection, cervical dysplasia and cancer, we conducted a systematic review and network meta-analysis (registered in PROSPERO: CRD42018112862). SEARCH STRATEGY: PubMed, Web of science, Embase and Cochrane database. SELECTION CRITERIA: All original studies describing at least two community state types of bacteria (CST), based on molecular techniques enabling identification of bacteria, and reporting the association with HPV infection, cervical dysplasia and/or cervical cancer. DATA COLLECTION AND ANALYSIS: For the meta-analysis, a network map was constructed to provide an overview of the network relationships and to assess how many studies provided direct evidence for the different vaginal microbiota compositions and HPV, cervical dysplasia or cancer. Thereafter, the consistency of the model was assessed, and forest plots were constructed to pool and summarise the available evidence, presenting odds ratios and 95% confidence intervals. MAIN RESULTS: Vaginal microbiota dominated by non-Lactobacilli species or Lactobacillus iners were associated with three to five times higher odds of any prevalent HPV and two to three times higher for high-risk HPV and dysplasia/cervical cancer compared with Lactobacillus crispatus. CONCLUSIONS: These findings suggest an association between certain bacterial community types of the vaginal microbiota and HPV infection and HPV-related disease. This may be useful for guiding treatment options or serve as biomarkers for HPV-related disease. TWEETABLE ABSTRACT: This network meta-analysis suggests an association between different vaginal bacterial community types and the risk of HPV.


Assuntos
Neoplasia Intraepitelial Cervical/patologia , Lactobacillus/fisiologia , Microbiota/fisiologia , Papillomaviridae/fisiologia , Infecções por Papillomavirus/patologia , Neoplasias do Colo do Útero/patologia , Vagina/patologia , Neoplasia Intraepitelial Cervical/microbiologia , Feminino , Humanos , Meta-Análise em Rede , Infecções por Papillomavirus/microbiologia , RNA Ribossômico 16S , Neoplasias do Colo do Útero/microbiologia , Neoplasias do Colo do Útero/virologia , Vagina/microbiologia , Vagina/virologia
3.
Urologiia ; (5): 150-154, 2019 Dec.
Artigo em Russo | MEDLINE | ID: mdl-31808652

RESUMO

The symptoms of genitourinary syndrome of menopause are considered as typical for late menopausal period. However, these symptoms are increasingly diagnosed in perimenopausal and early menopausal period. Women seldom seek medical care, since autonomic menopausal symptoms are usually more bothersome. In many cases, doctors are not sure in necessity of any hormonal replacement. Moreover, a confusion still exists between systemic hormone replacement therapy (HRT) and local estrogen preparations. Besides moisturizers and local intravaginal estrogens, novel treatment modalities have emerged that extend therapeutic armamentarium.


Assuntos
Atrofia/terapia , Menopausa , Disfunções Sexuais Fisiológicas/terapia , Vagina/patologia , Doenças Vaginais/terapia , Vulva/patologia , Atrofia/diagnóstico , Atrofia/etiologia , Consenso , Feminino , Humanos , Lubrificantes/uso terapêutico , Reino Unido
5.
Ceska Gynekol ; 84(5): 331-336, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31826628

RESUMO

OBJECTIVE: The aim of this prospective, unicentric, cohort study was to evaluate the effect of dienogest use in the therapy of symptomatic endometriosis of rectovaginal septum in patients of fertile age. STUDY DESIGN: Prospective, unicentric, cohort study. SETTING: Department of Obstetrics and Gynaecology, Brno University Hospital and Masaryk University Medical School, Brno. MATERIAL AND METHODS: Prospective analysis of the group of 32 patients in reproductive age who have previously been diagnosed with endometriosis of rectovaginal septum. These patients were treated conservatively with dienogest 2 mg per day during a 24-week period. Through questionnaires and clinical assessment, we have studied the presence of symptoms like dyspareunia, diffuse pelvic pain, Biberoglu-Behrman(B-B) score assessment and subjective pain perception using Visual Analogue Scale (VAS) of pain. Data were collected at the beginning of therapy, after 4, 12 and 24 weeks of dienogest use. RESULTS: Continual use of dienogest during the 24-week period diminishes symptoms of dyspareunia by 62% (p.


Assuntos
Endometriose/tratamento farmacológico , Antagonistas de Hormônios/uso terapêutico , Nandrolona/análogos & derivados , Dor Pélvica/etiologia , Estudos de Coortes , Endometriose/patologia , Feminino , Humanos , Nandrolona/uso terapêutico , Medição da Dor , Estudos Prospectivos , Qualidade de Vida , Reto/patologia , Resultado do Tratamento , Vagina/patologia
6.
J Med Life ; 12(3): 271-275, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31666830

RESUMO

Pelvic organ prolapse is a common complaint among older women. Vaginal pessary insertion is an appropriate treatment as a non-surgical method with few complications. This paper is a prospective observational study of 68 patients with pelvic organ prolapse that was carried out at the Imam Khomeini Hospital's Pelvic Floor clinic. The degree of pelvic organ prolapse was graded according to the Pelvic Organ Prolapse Quantification (POP-Q) System. For all patients, the Pelvic Floor Distress Inventory-20 (PFDI-20) questionnaire was completed before vaginal pessary insertion, and after approximately 6 months of treatment. After 6-8 months, we found out that vaginal discharge was significantly increased and the feeling of fullness in the vagina was significantly decreased. However, sexual dissatisfaction, the feeling of incomplete evacuation, fecal and urinary incontinence, frequent urination, and pain or discomfort in the genital region were not significantly different after using a pessary. Approximately half a year later, 96.7% of the women with a successful pessary fitting trial were satisfied and reported a significant improvement in symptoms. Further studies with larger sample size, a different type of pessary, and a longer follow-up duration are recommended to evaluate all the symptoms associated with pelvic organ prolapse and its treatment.


Assuntos
Satisfação do Paciente , Prolapso de Órgão Pélvico/terapia , Pessários , Vagina/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários , Resultado do Tratamento
8.
Nat Med ; 25(10): 1500-1504, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31591599

RESUMO

We report the results of a first exploratory study testing the use of vaginal microbiome transplantation (VMT) from healthy donors as a therapeutic alternative for patients suffering from symptomatic, intractable and recurrent bacterial vaginosis (ClinicalTrials.gov NCT02236429 ). In our case series, five patients were treated, and in four of them VMT was associated with full long-term remission until the end of follow-up at 5-21 months after VMT, defined as marked improvement of symptoms, Amsel criteria, microscopic vaginal fluid appearance and reconstitution of a Lactobacillus-dominated vaginal microbiome. One patient presented with incomplete remission in clinical and laboratory features. No adverse effects were observed in any of the five women. Notably, remission in three patients necessitated repeated VMT, including a donor change in one patient, to elicit a long-standing clinical response. The therapeutic efficacy of VMT in women with intractable and recurrent bacterial vaginosis should be further determined in randomized, placebo-controlled clinical trials.


Assuntos
Lactobacillus/crescimento & desenvolvimento , Microbiota , Vagina/microbiologia , Vaginose Bacteriana/terapia , Adulto , Feminino , Humanos , Lactobacillus/genética , Microbiota/genética , Pessoa de Meia-Idade , Probióticos/uso terapêutico , Indução de Remissão , Doadores de Tecidos , Vagina/patologia , Vaginose Bacteriana/microbiologia , Vaginose Bacteriana/patologia
9.
Medicina (Kaunas) ; 55(10)2019 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-31547180

RESUMO

The aim of this review is to provide an overview of genitourinary health in peri- and postmenopause, particularly of vulvovaginal atrophy (VVA), which is part of genitourinary syndrome (GSM). This condition has a high prevalence among post-menopausal women and negatively affects a woman's quality of life. Epidemiology, signs, symptoms, diagnostic criteria of VVA and target treatments for restoring vaginal health are discussed in light of the most recent literature. Issues related to this condition in menopausal women are under-diagnosed, lack objective diagnostic criteria, and consequently under-treated. Over the years, many treatments have been developed but their long-term effectiveness and safety have yet to be clearly defined. Patients are often dissatisfied and stop treatment, suggesting the need for a more personalized and tailored approach to achieve better compliance and thereby effectiveness. The aim of this paper is to provide an overview of the most recent literature on VVA in order to help the gynecologist in the management of this condition.


Assuntos
Emolientes/administração & dosagem , Terapia de Reposição Hormonal , Lubrificantes/administração & dosagem , Perimenopausa/fisiologia , Pós-Menopausa/fisiologia , Vagina/patologia , Doenças Vaginais/terapia , Administração Intravaginal , Atrofia/epidemiologia , Atrofia/terapia , Feminino , Humanos , Terapia a Laser , Vagina/fisiopatologia , Doenças Vaginais/diagnóstico , Doenças Vaginais/epidemiologia
10.
Medicina (Kaunas) ; 55(9)2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31480774

RESUMO

Sexual function worsens with advancing menopause status. The most frequently reported symptoms include low sexual desire (40-55%), poor lubrication (25-30%) and dyspareunia (12-45%), one of the complications of genitourinary syndrome of menopause (GSM). Declining levels of sex steroids (estrogens and androgens) play a major role in the impairment of sexual response; however, psychological and relational changes related with aging and an increase in metabolic and cardiovascular comorbidities should also be taken into account. Although first-line therapeutic strategies for menopause-related sexual dysfunction aim at addressing modifiable factors, many hormonal and non-hormonal, local and systemic treatment options are currently available. Treatment should be individualized, taking into account the severity of symptoms, potential adverse effects and personal preferences.


Assuntos
Terapia de Reposição de Estrogênios , Menopausa/fisiologia , Menopausa/psicologia , Disfunções Sexuais Fisiológicas/terapia , Saúde Sexual , Atrofia/tratamento farmacológico , Fármacos do Sistema Nervoso Central/uso terapêutico , Estrogênios/deficiência , Feminino , Humanos , Disfunções Sexuais Fisiológicas/tratamento farmacológico , Vagina/patologia
11.
Surg Oncol ; 30: 90-91, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31500793

RESUMO

BACKGROUND: Transvaginal natural orifice transluminal endoscopic surgery (NOTES) is a surgical technique - "scarless" abdominal operations performed with a multi-channel endoscope passed through a natural orifice (mouth, urethra, anus, vagina etc.) and offers less invasive and more excellent cosmetic results [1]. It is regarded as safe and feasible in patients with benign disease [2,3]. The first case of pure NOTES for sigmoid colon cancer was reported in 2012 [4]. We describe here a case of curatively intended resection for early-stage sigmoid colon cancer using the hybrid transvaginal NOTES approach. METHODS: This video demonstrates the case of a 52-year-old woman with sigmoid colon cancer treated by hybrid transvaginal NOTES. Her body mass index was 20.4 kg/m2. A laparoscope was inserted above the umbilicus and tumor's position was located. Two 5 mm trocars inserted in the right lower abdominal quadrant were mainly used for the assistant's instruments to provide traction and exposure. A single-port was inserted into the abdominal cavity transvaginally through the colpotomy. Then all the procedures were performed transvaginally with conventional rigid laparoscopic instruments. The sigmoid colon was mobilized using a lateral to medial approach. Then the root of the inferior mesenteric artery and the inferior mesenteric vein were divided with absorbable clips. After complete isolation of the proximal rectum, the rectum was transected 5 cm distal to the lesion with a linear stapler inserted through the single port. The proximal resection margin of descending colon was identified and the transection of the colon was performed. The specimen was removed transvaginally. The colon was then exteriorized and the anvil was fixed in the colon. An end-to-end anastomosis was performed using a circular stapler, and a leak test was done. RESULTS: The operative time and estimated blood loss were 182 min and 50 mL. A 20 cm long segment of sigmoid colon was resected with negative tumor margins, and 16 lymph nodes were harvested. There was no intraoperative or postoperative morbidity. The patient was with out-of-bed activity on day 1, fluid diet on day 2, bowel movement on day3, and the drainage tube and catheter removing on day 4. On day 5, she was discharged. Pathological examination revealed a moderately-differentiated adenocarcinoma: 50 × 45 × 10 mm, with growing into subserosa, without vascular or nervous invasion, pT3N0M0 and pStage IIA. There were two scars less than 5 mm and one scar less than 10 mm visible on the abdominal wall at one month. The patient was alive without recurrence after one year's follow-up. CONCLUSION: Hybrid transvaginal NOTES of radical sigmoidectomy may be safe and feasible for selected patients with sigmoid colon cancer and give less pain, potentially low rates of complication, faster recovery, and better cosmesis. A future large study is warranted to better evaluate this procedure. Although there are many reasons for skepticism, there is undoubted interest in this field from both surgeon and patient.


Assuntos
Colo Sigmoide/cirurgia , Cirurgia Endoscópica por Orifício Natural/métodos , Neoplasias do Colo Sigmoide/cirurgia , Vagina/cirurgia , Gravação em Vídeo , Colo Sigmoide/patologia , Feminino , Humanos , Laparoscopia , Pessoa de Meia-Idade , Prognóstico , Neoplasias do Colo Sigmoide/patologia , Vagina/patologia
12.
Biomed Pharmacother ; 118: 109359, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31545243

RESUMO

As one of the highly contagious forms, herpes simplex virus type 2 (HSV-2) commonly caused severe genital diseases and closely referred to the HIV infection. The lack of effective vaccines and drug-resistance proclaimed the preoccupation for alternative antiviral agents against HSV-2. Molecules bearing indole nucleus presented diverse biological properties involving antiviral and anti-inflammatory activities. In this study, one of the indole molecules, arbidol derivative (ARD) was designed and synthesized prior to the evaluation of its anti-HSV-2 activity. Our data showed that the ARD effectively suppressed HSV-2-induced cytopathic effects and the generation of progeny virus, with 50% effective concentrations of 3.386 and 1.717 µg/mL, respectively. The results of the time-course assay suggested that the ARD operated in a dual antiviral way by interfering virus entry and impairing the earlier period of viral cycle during viral DNA synthesis. The ARD-mediated HSV-2 inhibition was partially attained by blocking NF-κB pathways and down-regulating the expressions of several inflammatory cytokines. Furthermore, in vivo studies showed that oral administration of ARD protected BALB/c mice from intravaginal HSV-2 challenge by alleviating serious vulval lesions and histopathological changes in the target organs. Besides, the treatment with ARD also made the levels of viral protein, NF-κB protein and inflammatory cytokines lower, in consistent with the in-vitro studies. Collectively, ARD unveiled therapeutic potential for the prevention and treatment of HSV-2 infections.


Assuntos
Colo do Útero/patologia , Colo do Útero/virologia , Células Epiteliais/virologia , Herpesvirus Humano 2/efeitos dos fármacos , Indóis/farmacologia , Animais , Antivirais/química , Antivirais/farmacologia , Citocinas/metabolismo , Células Epiteliais/efeitos dos fármacos , Células Epiteliais/patologia , Feminino , Humanos , Indóis/química , Indóis/toxicidade , Camundongos Endogâmicos BALB C , NF-kappa B/metabolismo , Receptores Toll-Like/metabolismo , Vagina/efeitos dos fármacos , Vagina/patologia , Vagina/virologia , Replicação Viral/efeitos dos fármacos
13.
Breast Cancer Res Treat ; 178(1): 135-140, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31377895

RESUMO

PURPOSE: Vulvovaginal atrophy (VVA) is a commonly reported issue among breast cancer patients, and its aetiology is multifactorial. Treatment is difficult in these women, particularly because the use of oestrogens has traditionally been discouraged. Vaginal laser treatment has been reported to improve symptoms. We aimed to assess the impact on symptoms and sexual function of vaginal laser in women with early breast cancer (EBC). METHODS: We performed a single-arm investigator initiated pilot study of female EBC patients with symptomatic VVA. A total of 3 vaginal laser treatments were administered 4 weeks apart. Questionnaires were completed at baseline, 4, 8 and 12 weeks. Our primary endpoint was symptomatic improvement of VVA at 12 weeks on 10 cm visual analogue scales. Our secondary endpoints were improvement in sexual function using the Female Sexual Function Index (FSFI) and patient-reported improvements in symptoms, sexual function and quality of life. Statistical analysis was performed with a Wilcoxon Signed Rank test. RESULTS: 26 patients were enrolled between February 2016 and August 2017. All patients were post-menopausal, 25 of whom had received anti-oestrogen therapy for their breast cancer. Questionnaire compliance was high (98%) and all patients received the three pre-planned treatments. There was significant improvement in each of the VVA symptoms: dryness (p < 0.001), itch (p < 0.001), burning (p = 0.003), dysuria (p < 0.001) and dyspareunia (p < 0.001). Patients also reported improvement in sexual function on the FSFI (p ≤ 0.001). CONCLUSIONS: Patients receiving vaginal laser had improvement in VVA symptoms and sexual function. Further randomised sham-controlled trials are needed to further assess this treatment.


Assuntos
Neoplasias da Mama/complicações , Lasers de Gás/uso terapêutico , Disfunções Sexuais Fisiológicas/cirurgia , Vagina/patologia , Vulva/patologia , Administração Intravaginal , Atrofia , Feminino , Humanos , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Projetos Piloto , Resultado do Tratamento , Vagina/cirurgia , Vulva/cirurgia
14.
Future Microbiol ; 14: 839-846, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31373210

RESUMO

Aim: The primary objective of this study was to evaluate the effects of polypeptide-enriched Gastrodia elata extracts (GE) on vulvovaginal candidiasis (VVC). Materials & methods: A VVC model induced by Candida albicans (C. albicans) infection was successfully developed in BALB/c mice. After treatment, the colony-forming unit (CFU) of vaginal lavage was measured by plating. The extent of the inflammatory response was assessed by hematoxylin-eosin (H&E) staining and enzyme-linked immunosorbent assay (ELISA). Results: GE had an inhibitory effect on the proliferation of C. albicans and inflammatory reaction. Meanwhile, it had a potentially beneficial effect on the growth of Lactobacillus. Conclusion: These results showed the potential application of GE as an antifungal agent in VVC treatment.


Assuntos
Candida albicans/efeitos dos fármacos , Candidíase Vulvovaginal/tratamento farmacológico , Gastrodia/química , Peptídeos/farmacologia , Peptídeos/uso terapêutico , Animais , Antifúngicos/química , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Candida albicans/crescimento & desenvolvimento , Candidíase Vulvovaginal/sangue , Candidíase Vulvovaginal/microbiologia , Candidíase Vulvovaginal/patologia , Modelos Animais de Doenças , Feminino , Inflamação/tratamento farmacológico , Inflamação/metabolismo , Inflamação/patologia , Interleucinas/sangue , Interleucinas/metabolismo , Camundongos Endogâmicos BALB C , Peptídeos/química , Resultado do Tratamento , Vagina/metabolismo , Vagina/microbiologia , Vagina/patologia
15.
Ulus Travma Acil Cerrahi Derg ; 25(4): 424-426, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31297779

RESUMO

Transvaginal small bowel evisceration is a rare, life-threatening condition, requiring urgent surgical intervention. In our case, ischemia developed in the intestinal segment with evisceration, with a laceration in the small intestine of the mesentery, and finally, a small bowel resection was required. An 89-year-old woman was brought to the hospital with a sudden onset of abdominal pain, which lasted for 4 hours. Upon the examination, it was found that approximately 50 cm of the small intestine was eviscerated from the vagina, with its mesentery. The intestines were edematous, and also there were signs of ischemia on the mesentery. The patient was urgently transferred to surgery. Functional end-to-end anastomosis was performed, following a 70 cm small bowel resection. The vaginal defect was repaired transvaginally. Transvaginal small bowel evisceration is rarely described in the literature. It is most commonly seen in postmenopausal, elderly women who underwent vaginal surgery before and who have enterocele. The treatment is an emergent surgical approach. Surgical treatment should be based on individual patient. Various surgical techniques have been described for the repair of transvaginal small bowel evisceration, such as vaginal, abdominal, laparoscopic, and combined approaches. Transvaginal small bowel evisceration should be considered in the differential diagnosis of patients with a sudden onset abdominal pain. Patients with an increased risk for transvaginal small bowel evisceration are postmenopausal women and patients who underwent vaginal surgery before. After the accurate diagnosis, patients should be operated as soon as possible, and necessary surgery should be done.


Assuntos
Intestino Delgado/patologia , Intestino Delgado/cirurgia , Vagina/patologia , Dor Abdominal , Idoso de 80 Anos ou mais , Anastomose Cirúrgica , Diagnóstico Diferencial , Edema , Emergências , Feminino , Humanos , Histerectomia , Isquemia , Laparoscopia/métodos , Mesentério/irrigação sanguínea , Mesentério/patologia , Fatores de Risco , Vagina/cirurgia
16.
J Obstet Gynaecol Res ; 45(9): 1918-1924, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31264339

RESUMO

AIM: To demonstrate the efficacy and safety of a modified technique of laparoscopic inguinal ligament suspension (LILS) with hysterectomy for the treatment of uterovaginal prolapse. METHODS: A total of 57 patients were treated by LILS combined with hysterectomy between Jan 2014 and Feb 2016. The perioperative parameters, such as operative time, estimated blood loss, length of stay and intra- and postoperative complications were recorded. The Pelvic Organ Prolapse questionnaire classification was applied to evaluate the Pelvic Organ Prolapse stage, and Patient Global Impression of Improvement scale was used to determine the patients' satisfaction. Pelvic Floor Distress Inventory-20 and Pelvic Floor Impact Questionnaire were used to evaluate the functional improvement. All data were collected preoperatively and then at 12 months postoperatively. RESULTS: The mean surgical time was 130.4 (82-190) min, the average blood loss was 50.4 (10-300) mL and the mean hospitalization was 5.3 (4-8) days. The rates of intra- and postoperative complications were low. After a minimal of 12 months follow-up, the anatomical success rate was 85.5%, and the subjective satisfaction rate was 92.7%. The functional measures also presented a significant improvement with no recurrence of prolapse. CONCLUSION: LILS combined with hysterectomy was a safe and effective technique and might be considered as an alternative treatment for patients with uterovaginal prolapse.


Assuntos
Histerectomia/métodos , Canal Inguinal/cirurgia , Laparoscopia/métodos , Ligamentos/cirurgia , Prolapso Uterino/cirurgia , Doenças Vaginais/cirurgia , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Duração da Cirurgia , Satisfação do Paciente , Diafragma da Pelve/cirurgia , Inquéritos e Questionários , Resultado do Tratamento , Vagina/patologia , Vagina/cirurgia
18.
Drugs Aging ; 36(8): 781-788, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31290076

RESUMO

Vulvovaginal atrophy (VVA) is a progressive condition commonly seen in postmenopausal women. The cessation of ovarian estrogen secretion and a fall in serum levels of dehydroepiandrosterone (DHEA), the remaining source of estrogens and androgens, are thought to promote the development of VVA in this population. Intravaginal prasterone (Intrarosa®) is a synthetic form of DHEA indicated for the treatment of VVA in postmenopausal women presenting with moderate to severe symptoms in the EU; prasterone is also approved in the USA for the treatment of dyspareunia due to menopause. Approval for the treatment of VVA was based on the results of the phase III ERC-231 and -238 trials in which intravaginal prasterone 6.5 mg/day significantly improved the signs and symptoms of VVA (as assessed by the percentage of parabasal and superficial cells, vaginal pH and the severity of dyspareunia) compared with placebo. The beneficial effects of prasterone were also evident during 52 weeks' treatment in the phase III ERC-230 safety trial. Prasterone was generally well tolerated, with the most common treatment-emergent adverse event being application site discharge. During 52 weeks of treatment with prasterone, changes in serum concentrations of estrogenic and androgenic metabolites of DHEA increased from baseline but remained within the normal postmenopausal ranges. Thus, intravaginal prasterone is an effective and generally well-tolerated option for the treatment of VVA in postmenopausal women.


Assuntos
Desidroepiandrosterona/uso terapêutico , Dispareunia/prevenção & controle , Menopausa , Vagina/efeitos dos fármacos , Vagina/patologia , Administração Intravaginal , Atrofia , Ensaios Clínicos Fase III como Assunto , Desidroepiandrosterona/administração & dosagem , Dispareunia/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
19.
Gene ; 711: 143937, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31228541

RESUMO

BACKGROUND & OBJECTIVES: Vaginal atrophy is characterized by thinning of vaginal epithelial layers and decreased local blood flow. We aimed to evaluate the regenerative effects of Adipose derived mesenchymal stem cells (ADMSC) and Bone marrow derived mesenchymal stem cells (BMDSC) on vaginal atrophy in rat menopause model. MATERIALS AND METHODS: Rats were randomly divided into 4 (four) groups: sham, control, ADMSC, BMDSC. Vaginal epithelial thickness, structure of the lamina propria, blood vessels in the lamina propria, collagen deposition, and muscle structure were evaluated. Anti ER α, VEGF, VEGFR 1, Bax and bcl-2 antibodies were analyzed. Beta actin gene was used as endogenous control. Genetical differences among the groups were compared by using Kruskal Wallis and Mann Whitney U test. p < 0.05 was regarded as statistically significant. RESULTS: Epithelial thickness of ADMSC group was higher than control group, but less than sham group Epithelial thickness of BMDSC group was less than sham group. Lamina propria and muscle tissue of ADMSC and BMDSC groups were found to be similar to sham group. VEGFR-1, VEGF, Bax and ER-α staining levels were higher in ADMSC and BMDSC groups than control group. ADMSC group stained stronger with VEGFR-1 and VEGF than BMDSC group. Bcl-2 staining level was increased in ADMSC applied group. No statistically significant difference was detected in Bax and Bcl-2 genes and Bax-/Bcl-2 ratio. CONCLUSIONS: Although genetic expression might have ended and could not be significantly demonstrated, histological and immunohistochemical results favor ADMSC application in vaginal atrophy rather than BMDSC.


Assuntos
Tecido Adiposo/citologia , Biomarcadores/metabolismo , Células da Medula Óssea/citologia , Menopausa/fisiologia , Transplante de Células-Tronco Mesenquimais/métodos , Vagina/patologia , Tecido Adiposo/metabolismo , Animais , Atrofia , Células da Medula Óssea/metabolismo , Células Cultivadas , Modelos Animais de Doenças , Receptor alfa de Estrogênio/metabolismo , Feminino , Humanos , Menopausa/metabolismo , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Ratos , Vagina/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/metabolismo , Proteína X Associada a bcl-2/metabolismo
20.
Microb Pathog ; 134: 103602, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31226289

RESUMO

Little attention has been paid to the influence of asymptomatic colonizers of genital tract on female infertility. Albeit, a variety of uropathogens have been known to negatively alter sperm parameters in vitro, but their impact on female fertility outcome under in vivo conditions is not clearly established. Therefore, the present study was intended to investigate the effect of Pseudomonas aeruginosa on sperm parameters and to identify its role in female infertility. The strain of P. aeruginosa was found to reduce sperm motility, viability and sperm Mg++ATPase activity. It could also lead to premature acrosomal loss and induce morphological defect in spermatozoa. For fertility studies, female mice administered intravaginally with 104, 106, 108 cfu of P. aeruginosa for 10 consecutive days, were allowed to mate with proven breeder male on day 12. The results showed that group of mice receiving P. aeruginosa were rendered infertile whereas group receiving PBS showed abdominal distension, string of pearls and finally delivered pups at the end of gestation period. Further, no other clinical manifestation could be observed apparently, histologically or immunologically. Thus, it can be concluded that infertility in mice might be attributed to asymptomatic colonization of genital tract with sperm immobilizing P. aeruginosa.


Assuntos
Infertilidade/etiologia , Infertilidade/microbiologia , Infecções por Pseudomonas/complicações , Pseudomonas aeruginosa/crescimento & desenvolvimento , Vagina/microbiologia , Acrossomo/metabolismo , Administração Oral , Animais , Antibacterianos/farmacologia , ATPase de Ca(2+) e Mg(2+)/metabolismo , Sobrevivência Celular , Citocinas/análise , Modelos Animais de Doenças , Feminino , Humanos , Imobilização , Infertilidade Masculina/etiologia , Inflamação , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Testes de Sensibilidade Microbiana , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/microbiologia , Infecções por Pseudomonas/patologia , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/patogenicidade , Reprodução , Aglutinação Espermática , Motilidade Espermática , Espermatozoides/citologia , Vagina/patologia
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