RESUMEN
BACKGROUND: Tubal pathology is one of the main causes of infertility. In the routine fertility work-up, our ability to evaluate tubal function is limited to tubal patency and peritubal adhesions. AIMS: To assess the value of sonohysteroography (SHG) in evaluation of tubal patency in infertile patients and to compare its results with hysterosalpingography and laparoscopy. methods: In this prospective study, 40 consecutive women were underwent three methods of exploration of tubal patency: hysterosalpingography, sonohysteroography and laparoscopy with dye test, within a period of 6 months. RESULTS: The Mean age of our patients was 32 ± 5 years. Of the 40 women who were recruited, 30 had primary and 10 had secondary infertility. Altogether 80 tubes were exanimated by these 3 methods. Sonosalpingography showed patency in 51(63.7%) tubes, hysterosalpingography in 47 (58.7%) tubes, and laparoscopy in 52 (65%) tubes. Sonosalpingography and laparoscopy agreed in 70 out of 80 tubes (concordance, 87.5%). As regards the appearance of the right and left tubes, the results of sonohysterography agreed with laparoscopy in 75% and 87.5%, respectively, while HSG agreed with laparoscopy in 64% and 54% respectively. CONCLUSION: SHG is useful in the assessment of tubal patency and its implication in the fertility workup as a simple and fast procedure can minimize costes and abus of sophisticated techniques.
Asunto(s)
Pruebas de Obstrucción de las Trompas Uterinas , Trompas Uterinas/diagnóstico por imagen , Adulto , Femenino , Humanos , Histerosalpingografía , Infertilidad Femenina/etiología , Laparoscopía , Estudios Prospectivos , UltrasonografíaRESUMEN
BACKGROUND: Recent developments in ultrasound have led to a new exploration technique: hydrosonography. AIM: To evaluate diagnostic performance of hysterosonography in the assessment of the uterine cavity, by comparing it with standard transvaginal ultrasound and particularly with diagnostic hysteroscopy. METHODS: This is a prospective study over a period of nine months from 1st January to 30 September 2009. Transvaginal ultrasound was performed for all patients followed by hydrosonography then by diagnostic hysteroscopy. RESULTS: Sixty-two patients underwent three examinations. The mean age of our patients was 42.2 years. Bleeding disorders of the menstrual cycle were the most common reasons for seeking. Referring to the pathological examination, hysteroscopy is the most accurate technique in the diagnosis of endometrial hyperplasia and intracavitary masses, followed by hydrosonography then by transvaginal ultrasound. The concordance between hydrosonography and hysteroscopy in the diagnosis of submucosal fibroids and hyperplasia of the endometrium is very good (K> 0.8). CONCLUSION: The hysterosonography seems a relevant exam, allowing a complete assessment of the uterine cavity.
Asunto(s)
Endosonografía/métodos , Útero/diagnóstico por imagen , Adulto , Anciano , Medios de Contraste/administración & dosificación , Femenino , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Enfermedades Uterinas/diagnóstico , Adulto JovenRESUMEN
OBJECTIVES: To assess the postoperative morbidity of a technique for caesarean section without closing the visceral and parietal peritoneum. PATIENTS AND METHODS: We conducted a prospective cohort study randomized 252 patients over a period of four months (from March 1 to June 30, 2009). We studied the early postoperative morbidity. RESULTS: Among the 252 patients, 137 were included in the group "with peritonisation" and 115 in the group "without peritonisation". Clinical and hematology maternal characteristics were comparable in both groups. The duration of intervention was reduced significantly in the absence of peritonisation (31.1 instead of 41.4 minutes; P<0.001). The postoperative pain was less but not significant between h0 and h12, however it is significant at h18, h24 and h30 in the absence of peritonisation (respectively 2.37 versus 2.81; P=0.030; 1.98 versus 2.37; P<0.001 and 1.38 versus 1.72; P=0.018). Resumption of transit was significantly faster "without peritonisation" (24.3 versus 24.7 hours; P<0.001). However, there is no significant difference between the two groups as regards the immediate postoperative complications. CONCLUSION: The absence of visceral and parietal peritoneum shortens the operative time and favors an earlier resumption of transit. It also decreases pain symptoms. We therefore recommend not to suture the parietal and visceral peritoneum during cesarean section.
Asunto(s)
Cesárea/métodos , Cesárea/tendencias , Peritoneo/cirugía , Técnicas de Sutura/tendencias , Simplificación del Trabajo , Adulto , Antibacterianos/uso terapéutico , Cesárea/estadística & datos numéricos , Estudios de Cohortes , Femenino , Tránsito Gastrointestinal/fisiología , Humanos , Tiempo de Internación/estadística & datos numéricos , Morbilidad , Dolor Postoperatorio/epidemiología , Periodo Perioperatorio , Complicaciones Posoperatorias/epidemiología , Embarazo , TúnezRESUMEN
Aggressive angiomyxomas are rare soft tissue tumours. They are mainly found females. Steeper and Rosai described these tumors for the first time in 1983. The diagnosis and the treatment are difficult. The recurrence is frequent. The authors report a case of aggressive angiomyxoma of the vagina and the pelvis, diagnosed in a 34-old-woman. They discuss clinical symptoms and different signs allowing the diagnosis. Therapeutic management is also discussed.
Asunto(s)
Mixoma , Neoplasias Vaginales , Adulto , Femenino , Estudios de Seguimiento , Humanos , Mixoma/diagnóstico , Mixoma/diagnóstico por imagen , Mixoma/patología , Mixoma/cirugía , Factores de Tiempo , Tomografía Computarizada por Rayos X , Vagina/patología , Neoplasias Vaginales/diagnóstico , Neoplasias Vaginales/diagnóstico por imagen , Neoplasias Vaginales/patología , Neoplasias Vaginales/cirugíaRESUMEN
Three ureterovaginal fistulas occurred following laparoscopic hysterectomy in two patients. Inadvertent burn of the distal ureter by a unipolar electrocautery was thought to be the cause. Avoidance of unipolar cautery to achieve hemostasis of uterine arteries would have prevented these urologic complications.