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1.
Ceska Gynekol ; 84(5): 345-350, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31826631

RESUMO

OBJECTIVE: A review of contemporary knowledge about uterine rupture during pregnancy, followed by a case-report of a patient with uterine rupture during pregnancy without an uterine scar. DESIGN: Review and case report. SETTING: Clinic of Obstetrics and Gynecology, University Hospital, Hradec Králové; Department of Gynecology and Obstetrics, Hospital Náchod. CASE REPORT: We present a case of an uterine rupture of a uterus without a scar from previous surgery. A patient in 33. week of pregnancy with stillborn fetus was administred to our hospital. While inducing the labor, the patient showed signes of shock, fetus was no longer present in uterus. An C-section was performed, but the stillborn baby was placed in abdominal cavity, with an abrupted placenta. Large uterine rupture was spotted, therefore a hysterectomy was performed. CONCLUSION: Uterine rupture during pregnancy is an urgent state. The incidency of uterine rupture is rising accordingly with the growing number of C-sections. However, it is important to include uterine rupture into differential diagnostics also in cases with other risk factors. The key to successful diagnosis is ultrasound examination and correct evaluation of clinical state, other imaging methods are less suitable because of time delay. Together with the change of major cause of uterine rupture, the approach to treatment has changed as well. If possible, a uterus-saving procedure is preferred. The aim of this case-report is presentation of a rare case of uterine rupture in an scar-free uterus. It also shows how troublesome diagnostics of uterine ruptures can be.


Assuntos
Histerectomia/métodos , Trabalho de Parto , Ruptura Uterina/cirurgia , Descolamento Prematuro da Placenta , Cesárea , Cicatriz , Feminino , Humanos , Gravidez , Natimorto , Resultado do Tratamento , Ruptura Uterina/etiologia
2.
Ceska Gynekol ; 82(2): 152-157, 2017.
Artigo em Tcheco | MEDLINE | ID: mdl-28585849

RESUMO

OBJECTIVE: Review of literature dealing with the specificity of the vagina from the standpoint of microbial colonization. DESIGN: Literature review. SETTING: Department of Obstetrics and Gynecology, Department of Clinical Microbiology, University Hospital and Medical Faculty in Hradec Kralove, Charles University Prague. METHODS: Analysis of the literature review and personal experience dealing with vaginal microbiota.


Assuntos
Microbiota , Vagina/microbiologia , Feminino , Humanos
3.
Ceska Gynekol ; 81(6): 411-413, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27918157

RESUMO

OBJECTIVE: Sling procedures are the preferred surgical treatment of stress urinary incontinence (SUI) due to their high success rate and low risk of complications. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, Medical Faculty of Charles University and Faculty Hospital Hradec Kralove. CASE REPORT: Necrotic fasciitis is a rare infectious complication, the mortality of which varies by age and can reach 73% if untreated. We present a case of a rare yet serious complication, necrotic fasciitis (NF), of a lateral muscle group of the thigh following antiincontinence implantation. Polypropylene transobturatory midurethral outside-in tape (TOT) was inserted, and NF occurred shortly after surgery. CONCLUSION: Effective treatment was based on a timely diagnosis, administration of wide-spectrum antibiotics, intensive care unit support, surgical treatment, and multidisciplinary cooperation. Timely initiation and adequate treatment are critical in preventing mortality.


Assuntos
Fasciite/etiologia , Músculo Esquelético/patologia , Slings Suburetrais/efeitos adversos , Incontinência Urinária por Estresse/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Coxa da Perna
4.
Ceska Gynekol ; 78(6): 522-7, 2013 Dec.
Artigo em Tcheco | MEDLINE | ID: mdl-24372429

RESUMO

OBJECTIVE: To find out the level of the diagnostic effort of gynaecologists which is focused on the issue of vulvovaginal discomfort. DESIGN: Pilot questionnaire study. SETTINGS: Department of Obstetrics and Gynecology, Department of Clinical Microbiology, University Hospital and Medical Faculty Hradec Králové, Charles University, Prague, Department of Biological and Medici Sciences, FaF UK in Hradec Králové. METHODS AND RESULTS: The evaluation of selected parametres of entrance questionnaire in patients with chronic vulvovaginal discomfort (itching, burning, discharge, vulvodynia more than 4 times a year). It has been confirmed, with the questionnaires, that almost no gynaecologists are interested in the issue of this matter. CONCLUSION: After evaluating the questionnaires a diversion of patient-tailored attitude has been found out, which can lead to negative consequences, particularly, in the future. Overuse of antibacterial and antimycotic medication and blind treatment have been prevailing.


Assuntos
Candidíase Vulvovaginal/diagnóstico , Técnicas de Diagnóstico Obstétrico e Ginecológico , Antibacterianos/uso terapêutico , Candidíase Vulvovaginal/tratamento farmacológico , Candidíase Vulvovaginal/epidemiologia , República Tcheca/epidemiologia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Reprodutibilidade dos Testes , Estudos Retrospectivos , Inquéritos e Questionários
5.
Ceska Gynekol ; 78(6): 528-30, 2013 Dec.
Artigo em Tcheco | MEDLINE | ID: mdl-24372430

RESUMO

OBJECTIVE: To describe a case of uterovesical fistula after cesarean section with symptoms of vulvovaginal discomfort. DESIGN: Case report. SETTING: Department of Urology, Department of Obstetrics and Gynecology, University Hospital and Medical Faculty in Hradec Kralove, Charles University Prague. CONCLUSION: Uterovesical fistula is a rare and unusual complication of cesarean section. Uterovesical fistula is tough to diagnose because of unspecific symptoms. A multidisciplinary approach is necessary for its successful diagnosis and treatment.


Assuntos
Cesárea/efeitos adversos , Fístula da Bexiga Urinária/etiologia , Doenças Uterinas/etiologia , Adulto , Diagnóstico Diferencial , Feminino , Fístula/diagnóstico , Fístula/etiologia , Humanos , Gravidez , Fatores de Tempo , Fístula da Bexiga Urinária/diagnóstico , Doenças Uterinas/diagnóstico
6.
Ceska Gynekol ; 78(6): 537-44, 2013 Dec.
Artigo em Tcheco | MEDLINE | ID: mdl-24372432

RESUMO

OBJECTIVE: To analyze experimental and clinical data on diabetes mellitus (DM) related to infections with focus on vaginal mycosis. To evaluate a role of DM in the epidemiology of vulvovaginal candidiasis. DESIGN: Review. SETTING: Department of Clinical Microbiology, Department of Biological and Medical Sciences, Faculty of Pharmacy, Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Kralove. METHODS: Review of literature data. RESULTS: DM is a risk factor for fungal infections caused by yeasts (Candida albicans), members of Mucorales fungi, some dimorphic fungi (Coccidioides) and agents of onychomycosis. DM is usually associated only with increased colonization of the anatomical sites (oral cavity, vagina), and/ or with an intensified symptomatology of infection (onychomycosis, mucormycosis). Diabetic patients with oropharyngeal and vulvovaginal candidiasis have frequently changed etiology spectrum. The patients with VVC and DM, especially of older age or with prone to relapses, have tendency to shift of the spectrum to non-albicans species, mainly C. glabrata. Treatment of VVC in diabetic patients can be complicated owing to unfavourable antifungal susceptibility profile (C. glabrata) and/ or adverse interactions between some azole antifungals and sulfonylurea-based antidiabetics. CONCLUSION: Diabetes mellitus is often cited as a risk factor, although in many cases there is a lack of reliable and clinically relevant information. This does not mean that this disease can be underestimated. On the contrary, it is necessary to get the DM as soon as possible under control and thus prevent complications when infection develops. Individual approach should be applied to the diabetic patients at risk of an infection. Yeast colonization and development of vaginal infection is complex process primarily dependent on sexual hormones, indigenous microbiota and finely tuned mechanisms of local immunity. Role of DM consists in the fact that it is one of the important co-factors that can change the setup of the vaginal environment in favour of yeasts and thus promote or facilitate the development of VVC.


Assuntos
Candidíase Vulvovaginal/epidemiologia , Diabetes Mellitus , Candidíase Vulvovaginal/etiologia , Feminino , Saúde Global , Humanos , Incidência , Fatores de Risco
7.
Ceska Gynekol ; 75(6): 521-6, 2010 Dec.
Artigo em Tcheco | MEDLINE | ID: mdl-27534008

RESUMO

OBJECTIVE: A study of vulvodynia and the possibility of its management. SUBJECT: Original study. SETTING: Department of Obstetrics and Gynecology, Teaching Hospital and Medical Faculty Hradec Králové, Charles University, Prague. Department of Neurology, Teaching Hospital and Medical Faculty Hradec Králové, Charles University, Prague. Outpatient psychiatric department Galenus, Hradec Králové. Department of Clinical Microbiology, Teaching Hospital and Medical Faculty Hradec Králové, Charles University, Prague. Department of Biological and Medical Sciences, Faculty of Pharmacy Hradec Králové, Charles University, Prague. METHODS: Analysis and discussion focused on our experience in a long time follow-up of patients with chronic vulvovaginal discomfort and vulvodynia. CONCLUSION: Especially the management of indolent form of vulvodynia would be taken into consideration of idiopathic origin and problematic management. Our study emphasizes the necessity of individual approach. The goal of therapy in this most problematic form is the improving of the actual quality of life. In the case of idiopathic forms of vulvodynia.


Assuntos
Vulvodinia/terapia , Feminino , Humanos , Qualidade de Vida , Vulvodinia/etiologia
8.
Ceska Gynekol ; 75(6): 547-52, 2010 Dec.
Artigo em Tcheco | MEDLINE | ID: mdl-27534013

RESUMO

Problem of mycoses in gynecology is considered very frequent and yeasts are traditionally described as most common cause of vulvovaginal disorders. While acute disorders can be promptly cured in most cases, there is a group of women suffering from those repeatedly. Following article refers to a group of patients in long-term follow-up and shows realistic possibilities of diagnostics, available to out-patient gynecologist. Preliminary results of our pilot project do not confirm yeasts have to be the primary etiologic factor, nevertheless it is logical to be in search of them in these patients.


Assuntos
Candidíase Vulvovaginal/diagnóstico , Doenças Vaginais/microbiologia , Doenças da Vulva/microbiologia , Feminino , Ginecologia/métodos , Humanos
9.
Epidemiol Mikrobiol Imunol ; 57(1): 23-7, 2008 Feb.
Artigo em Tcheco | MEDLINE | ID: mdl-18318395

RESUMO

Vulvovaginal discomfort is generally the most common reason for visiting a gynaecological clinic. The acute complaints are, in most cases, solved by a gynaecologist himself and the decision procedure is based on possibilities arising from outpatient examination. If need be, the evaluation of wet preparation should be carried out. In many cases we have been confronted with discrepant diagnosis where severe difficulties are not accompanied by relevant development of inflammatory changes and thus the diagnosis gives us an impression of quandary. In this case microbiological examination is the logic solution. With regard to changing living conditions we can expect in the future, that clinical symptoms of vulvovaginitis will not be entirely clear. The overview article points out the possibilities, which a gynecologist is able to use within differential diagnosis in the outpatient department. It also emphasis the necessity of interdisciplinary co-operation, particularly in patients with chronic difficulties where erudite evaluation of fixed preparation and culture examination are beneficial.


Assuntos
Vulvovaginite , Feminino , Humanos , Vulvovaginite/diagnóstico , Vulvovaginite/microbiologia , Vulvovaginite/terapia
10.
Ceska Gynekol ; 73(3): 179-84, 2008 Jun.
Artigo em Tcheco | MEDLINE | ID: mdl-18646671

RESUMO

OBJECTIVE: A review of recurrent vulvovaginal candidiasis and the possibility of its treatment. SUBJECT: Original study. SETTING: Department of Obstetrics and Gynaecology, Medical Faculty Hradec Králové, Charles University, Prague. Department of Clinical Microbiology, Medical Faculty Hradec Králové, Charles University, Prague. Department of Biological and Medical Sciences, Faculty of Pharmacy Hradec Králové, Charles University, Prague. Department of Clinical Imunology and Allergology, Medical Faculty Hradec Králové, Charles University, Prague. Department of Psychiatry, Medical Faculty Olomouc, Palacky University, Olomouc. METHODS: Analysis and discussion focused especially on our results and experience in a long time followup of patients with confirmed recurrent vulvovaginal candidiasis. CONCLUSION: Owing to the multifactorial character of etiopathogenesis, the management of recurrent vulvovaginal candidiasis would be taken into consideration the complexity of the disease, not only the treatment of individual episodes with antimycotics.


Assuntos
Candidíase Vulvovaginal/terapia , Candidíase Vulvovaginal/tratamento farmacológico , Candidíase Vulvovaginal/prevenção & controle , Feminino , Humanos , Recidiva
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