RESUMEN
The aim of this study was to assess the diagnostic value and the usefulness of sono hysterosalpingography (SHG) in the detection of uterine abnormalities and tubal patency, compared with other diagnostic methods among patient with infertility. In a prospective study, 86 patients in the initial stage of the infertility treatment were examined by SHG using saline NaCl infundibular and Echovist as contrast media. Further status of the tubes and uterine cavity was assessed by the "gold standards", laparoscopy and hysteroscopy. Sensitivity, specificity, positive predictive value and the negative predictive value of SHG using NaCl infundibular for evaluation of the uterine cavity were 98.8%, 92.5%, 91.4% and 92%, respectively. Sensitivity, specificity, positive predictive value and the negative predictive value of SHG for the assessment of the tubal status were 97.6%, 89.2%, 76.3% and 77.4%, respectively. There were no evident complications during or after the procedure. Sono hysterosalpingography is useful in making decisions regarding further procedures for the diagnosis and treatment of infertility. This method is simple, safe and cheap for early assessment of the reproductive status of uterine cavity and fallopian tubes and perspective as a routine, first-line infertility investigation.
Asunto(s)
Trompas Uterinas/fisiopatología , Infertilidad Femenina/epidemiología , Enfermedades Uterinas/diagnóstico por imagen , Enfermedades Uterinas/epidemiología , Adulto , Medios de Contraste , Femenino , Humanos , Histerosalpingografía/métodos , HisteroscopíaRESUMEN
The aims of present study were to evaluate the quality of women's life (QoL) after surgical treatment of stress urinary incontinence (SUI) and to compare long follow-up results of two different procedures. Quality of life questionnaire represents a useful and cheap tool in the investigation of outcomes of the surgical treatment of stress incontinence. By providing an objective measure of the impact of results on women's lives, quality of life questionnaires allow more comprehensive understanding of disease severity and its effect on psychosocial function. In addition, they have an increasingly important role in clinical research, allow comparing two and more different methods of treatment. QoL of patients after TVT was significantly higher, then after pubovaginal sling using short skin flap (subjective cure 80% versus 66% after 48 months follow up). These benefits in QoL, coupled with the minimally invasive nature of the procedure, suggest that TVT could become a favored treatment option in women with SUI.
Asunto(s)
Procedimientos Quirúrgicos Ginecológicos/métodos , Colgajos Quirúrgicos , Incontinencia Urinaria/cirugía , Femenino , Estudios de Seguimiento , Humanos , Periodo Posoperatorio , Prevalencia , Calidad de Vida/psicología , Estrés Psicológico , Encuestas y CuestionariosRESUMEN
Labor pain relief (anaesthesia) aims at making the patient comfortable, keep her from pain and stress and at the same time keep the baby from the difficulties caused by the stress of the mother. Our work aimed at introducing the methods of anaesthesia, defining their efficiency, selecting the time and method of anaesthesia in order to improve child birth process or timely intervention. All modern methods of labor pain relief have been established in the clinic: pharmacological, transcutaneous electrical nerve stimulation (TENS), and regional anaesthesia (RA). RA makes 65% of all the pain relief cases, while 20% chooses other types of anaesthesia. Epidural sets of size 18-20 g and spinal syringes of size 25-26 g of Terumo and Braun, as well as 2% lidocaine and fentanyl were used. The statistics of the cases of anaesthesia given in our clinic proves that any method that helps the mother is approved. In 1999 cases of anaesthesia made 6.4%. RA was made only to 5 women. In 2003 82 patients (24%) chose pain relief with different methods. 33 of them (40.2%) chose RA and 49 of them (59.8%)--combined anaesthesia. Spinal anesthesia (SA) in caesarean section was administered to 11 (5%) patients. Total of 200 patients (60%) have been anaesthetized during the years of 2005-2006. 55 caesarean sections (25%) were performed with SA. Exclusive quality of pain relief, absolute relaxation, high assessment of infants by Apgar scale, excellent responses from the patients, absolutely favourable health condition of the woman during the first twenty four hours after the delivery and post operation period make RA an integral part of an obstetrical hospital.