RESUMEN
PURPOSE: Approximately 21 days after an abortion, ovulation occurs in 50 % of women. Installation of an IUD directly after induced or spontaneous abortion offers immediate contraceptive protection. The purpose of the present study was to weigh up contraceptive safety and adverse reactions of IUD inserted directly after first-trimester abortion under general or paracervical anesthesia as against the fitting of IUD in the days of the next menstrual cycle without anesthesia. METHOD: During the period May 1987 to October 2010, 73 women (Group A) underwent an immediate post-abortion insertion IUD after a first-trimester spontaneous or induced abortion under general or local paracervical anesthesia and 69 participants (Group B) received IUD during the next menstrual cycle without anesthesia. Questionnaires were completed by all the women of the study with respect to the effects of IUD. The women were examined every 3 months for 1 year after the fitting of the IUD in the out-patient department of the University Obstetrics Gynecological Department of Alexandroupolis, Democritus University of Thrace, Greece. RESULTS: The demographic characteristics of the women of the two groups were similar. The age of the women ranged between 19 and 44 years, while 61.98 % were women with one or two children and 38.02 % were women with three or more children. During the first menstrual cycles, with the exception of vaginal hemorrhages (5 %) and adnexitis (1 %), no serious adverse reactions were noted. During the transvaginal ultrasonography checks in both groups, no observation was made of any dislocation of the IUD, except for two cases in the subgroup of those women with paracervical anesthesia and one case in the women of Group B. As concerns the questionnaire with regard to the women's subjective evaluation of IUD, satisfactory answers were given. CONCLUSIONS: There were no differences between the two groups either with respect to the security of the supplied contraceptive methods or to the development of side effects.
Asunto(s)
Aborto Inducido , Aborto Espontáneo , Dispositivos Intrauterinos/efectos adversos , Menstruación/fisiología , Adulto , Anticoncepción/métodos , Femenino , Estudios de Seguimiento , Grecia , Humanos , Expulsión de Dispositivo Intrauterino/etiología , Dispositivos Intrauterinos/estadística & datos numéricos , Periodo Posoperatorio , Embarazo , Primer Trimestre del Embarazo , Estudios Retrospectivos , Factores de Riesgo , Factores Socioeconómicos , Encuestas y Cuestionarios , Factores de Tiempo , Hemorragia Uterina/complicaciones , Adulto JovenRESUMEN
OBJECTIVE: The aim of this comparative study was to ascertain the efficacy of the Sulmycin® Implant E, an antiseptic sponge, on the incidence of peri- and postoperative morbidity in patients subjected to vaginal hysterectomy. MATERIAL AND METHODS: This eleven-year study included 228 patients undergoing vaginal hysterectomy. The patients were divided into two groups. Group A included 169 participants with benign diseases (fibroids, dysfunctional uterine bleeding and prolapse) and group B included 59 patients with early stage endometrial cancer or atypical hyperplasia. Women of both groups were further divided into three subgroups: (a) receiving a single dose of intravenous cefuroxime (2 gr) (group A: 55, group B: 19), (b) receiving three doses of intravenous cefuroxime (2 gr) (group A: 54, group B: 19), and (c) locally placed a collagen sponge containing gentamycin (Sulmycin® Implant E) (group A: 60, group B: 21). RESULTS: The number of postoperative infections (mainly urinary tract infections) did not differ between women of the three subgroups of patients in both groups. There were no important differences affecting the postoperative hospitalization, healing procedure and adhesion of the cuff between women of the three subgroups in both groups. CONCLUSION: The local chemoprophylaxis with Sulmycin® Implant E, a collagen sponge containing gentamycin and placed on the vaginal cuff, is well tolerated and equally effective as intravenous antibiotics.
Asunto(s)
Antibacterianos/uso terapéutico , Profilaxis Antibiótica , Cefuroxima/uso terapéutico , Colágeno/administración & dosificación , Gentamicinas/administración & dosificación , Histerectomía Vaginal/métodos , Adulto , Anciano , Antibacterianos/administración & dosificación , Cefuroxima/administración & dosificación , Femenino , Humanos , Infusiones Intravenosas , Persona de Mediana Edad , Estudios Retrospectivos , Estadísticas no Paramétricas , Adulto JovenRESUMEN
AIM: The aim of this study was to investigate the impact of radical lymphadenectomy as a prognostic factor in the management of uterine sarcomas. METHODS: Sixty patients with histologically-proven uterine sarcomas were recruited for this study. The patients were evaluated retrospectively, during the time period from September 1990 to June 2008, in the Department of Obstetrics and Gynecology of Aschaffenburg Clinic in Germany. The normality of the quantitative variables was tested using the Kolmogorov-Smirnov test. RESULTS: Of 60 patients, 35 (58.3%) underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and pelvic or para-aortic lymphadenectomy. The excision of iliac nodes was the strongest and most independent factor (ß = 0.64, P = 0.000) associated with survival. Recurrence of disease developed in 14 out of 25 patients (56%) who did not receive lymphadenectomy, but in only 10 out of 35 patients (29%) who underwent lymphadenectomy. The mean survival in years after surgery plus lymphadenectomy was 5.28 years, while in patients who did not undergo lymphadenectomy it was 1.56 years. CONCLUSIONS: Removal of lymphatic tissue in patients with early-stage uterine sarcoma significantly decreases the recurrence rate of the disease and improves the postoperative survival. However, there is a need for further prospective randomized controlled trials to investigate the adequate surgical management of uterine sarcomas and to clarify the prognostic value of lymphadenectomy at the initial surgery.
Asunto(s)
Escisión del Ganglio Linfático , Ganglios Linfáticos/cirugía , Recurrencia Local de Neoplasia/prevención & control , Sarcoma/cirugía , Neoplasias Uterinas/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Histerectomía , Ganglios Linfáticos/patología , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Sarcoma/mortalidad , Sarcoma/patología , Tasa de Supervivencia , Resultado del Tratamiento , Neoplasias Uterinas/mortalidad , Neoplasias Uterinas/patologíaRESUMEN
A unicornuate uterus is a rare congenital malformation of the female genital tract, which appears in about 1/1000 women and is characterized by significant anatomic variability. In the most common type, a noncommunicating rudimentary horn coexists with the unicornuate uterus. The diagnosis of this anomaly is usually delayed, as it remains asymptomatic until adolescence and its initial symptoms are atypical. As a result, it is often diagnosed after the appearance of severe complications, such as haematometra, endometriosis, infertility and ectopic pregnancy. We report a case of a teenage girl presenting with dysmenorrhoea, endometriosis and haematometra secondary to a noncommunicating rudimentary horn. The diagnosis of the anomaly was based on magnetic resonance imaging (MRI) and laparoscopy. The excision of the symptomatic rudimentary horn and the ipsilateral fallopian tube was also performed laparoscopically. A review of the literature follows, focusing mainly on the diagnosis and laparoscopic management of a unicornuate uterus and its complications in adolescence. Laparoscopy is an accurate diagnostic tool, which also carries significant advantages in effective surgical management of congenital uterine anomalies, especially in young women.
Asunto(s)
Endometriosis/cirugía , Hematómetra/cirugía , Útero/anomalías , Adolescente , Amenorrea/etiología , Amenorrea/cirugía , Endometriosis/etiología , Femenino , Hematómetra/etiología , Humanos , Imagen por Resonancia Magnética , Enfermedades Uterinas/complicaciones , Enfermedades Uterinas/diagnóstico , Enfermedades Uterinas/cirugía , Útero/cirugíaRESUMEN
The major problem with myomectomy is excessive bleeding from increased uterine blood supply, and this can be a life-threatening condition and prolong postoperative stay. The aim of our study was to evaluate our experience in symptomatic myoma excision with bipolar electrode by mini-laparotomy; we compared 67 procedures with bipolar electrode, in normal saline as distension fluid, to 42 cases performed with unipolar electrode. All participants were pre-menopausal women who had symptomatic myomas Asunto(s)
Pérdida de Sangre Quirúrgica/prevención & control
, Electrocoagulación/métodos
, Laparotomía/métodos
, Leiomioma/cirugía
, Adulto
, Electrodos
, Estudios de Factibilidad
, Femenino
, Humanos
, Laparotomía/efectos adversos
, Persona de Mediana Edad
, Complicaciones Posoperatorias
, Periodo Posoperatorio
, Embarazo
, Índice de Embarazo
, Estudios Retrospectivos
, Prevención Secundaria
, Útero/irrigación sanguínea
RESUMEN
Hysteroscopic evaluation of endometrial cavity is widely used in cases of abnormal uterine bleeding. The aim of the present study is to compare the hysteroscopic and histological findings in women suffering from postmenopausal bleeding. Between 1990 and 2009, 425 women aged 47-83 years were included in the study. None of the women had received hormonal therapy or had any malignancy in the past. All women underwent diagnostic hysteroscopy and histologic sampling of the endometrial cavity. Hysteroscopy was successfully completed in 423 women and was suggestive of malignant lesions in 23 cases, which were confirmed histologically. The hysteroscopic findings in three cases were suggestive of atrophic endometrium, atypical hyperplasia and endometrial carcinoma, and the histologic diagnosis confirmed endometrial carcinoma (two cases) and one uterine sarcoma. Hysteroscopy proves to be a safe and effective technique in the diagnosis and management of abnormal uterine bleeding.
Asunto(s)
Neoplasias Endometriales/diagnóstico , Histeroscopía/métodos , Hemorragia Uterina/diagnóstico , Neoplasias Uterinas/diagnóstico , Anciano , Anciano de 80 o más Años , Hiperplasia Endometrial/diagnóstico , Hiperplasia Endometrial/patología , Neoplasias Endometriales/patología , Endometrio/patología , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Posmenopausia , Sarcoma/diagnóstico , Sarcoma/patología , Hemorragia Uterina/etiología , Neoplasias Uterinas/patologíaRESUMEN
Choriocarcinoma is the most malignant tumor of gestational trophoblastic neoplasia. Choriocarcinoma presenting as postpartum hemorrhage and spontaneous uterine perforation with intra-abdominal hemorrhage is very rare. We present a 29-year-old woman with spontaneous uterine rupture due to choriocarcinoma following a live birth pregnancy. The long time interval (2 years) between the previous live birth pregnancy and the diagnosis of the disease, the acute onset of the disease by uterine rupture as the first symptom and the negative urine hCG test are presented and discussed in this case report.