RESUMEN
O transplante de medula óssea (TMO) é um procedimento indicado para o tratamento de doenças hematológicas, que afetam muitas mulheres jovens. O aperfeiçoamento dos cuidados durante o TMO proporciona altos índices de cura e de sobrevida. No entanto, pode deixar sequelas em vários órgãos e sistemas, entre eles o sistema reprodutor e os órgãos genitais, impactando negativamente a qualidade de vida das receptoras do TMO. O objetivo desta publicação foi realizar uma revisão narrativa sobre o tema e propor um protocolo assistencial que torne acessível os cuidados relacionados à saúde sexual e reprodutiva a esse grupo especial de mulheres, baseado em dados clínicos de um ambulatório de assistência ginecológica às mulheres transplantadas no Hospital Amaral Carvalho, em Jaú, no interior de São Paulo.(AU)
Bone marrow transplantation (BMT) is indicated for the treatment of hematological diseases which affect many young women. The improvement of care during BMT procedures provides higher cure and survival rates. however, it can cause sequelae in various organs and systems, including the reproductive system and genitals, negatively impacting quality of life. The purpose of this publication is to present a narrative review related to this theme and to propose a healthcare protocol that allows sexual and reproductive care in this special group of patients, based on the clinical experience of a gynecological outpatient clinic at the Amaral Carvalho Hospital, in Jaú (SP) which specifically care for these women.(AU)
Asunto(s)
Humanos , Femenino , Complicaciones Posoperatorias , Trasplante de Médula Ósea/efectos adversos , Protocolos Clínicos , Factores de Riesgo , Terapia de Inmunosupresión/efectos adversos , Insuficiencia Ovárica Primaria/fisiopatología , Enfermedades Urogenitales Femeninas/fisiopatología , Enfermedad Injerto contra Huésped/fisiopatologíaRESUMEN
OBJECTIVE: The aim of the study was to determine the most used methods for assessing genitourinary syndrome of menopause by the latest studies on the subject, and to critically assess their differences and comparability. METHODS: A narrative review of the literature was conducted, employing the terms genitourinary syndrome, vaginal atrophy, urogenital atrophy, and atrophic vaginitis, to analyze methods used to assess treatment efficacy. Only controlled randomized clinical trials assessing improvement of genitourinary syndrome of menopause, conducted in the last 5 years, and considering all types of treatment, were selected. RESULTS: Of the 37 studies included, 24 combined both objective and subjective methods thereby ensuring reproducibility and efficacy of symptom relief of the treatment analyzed. The vaginal maturation index was the most used objective method, followed by vaginal pH. One study used histological and immunohistochemistry tests. Regarding subjective methods, the "Most bothering Symptom" and other questionnaires as the Female Sexual Function Index for sex life, the Verbal Rating Scale, among others, were used. CONCLUSIONS: Despite the heterogeneity observed, particularly for subjective assessment of symptoms, there was a tendency to standardize methods and to use an objective method together with a subjective, which seems to be fundamental to guarantee reproducibility and comparability of results of each treatment analyzed. Histological and immunohistochemistry tests may be an option as an objective method in further studies, to better assess thickness, vascularization, among other parameters.
Asunto(s)
Atrofia/fisiopatología , Enfermedades Urogenitales Femeninas/fisiopatología , Menopausia , Disfunciones Sexuales Fisiológicas/etiología , Enfermedades Vaginales/fisiopatología , Atrofia/tratamiento farmacológico , Atrofia/etiología , Femenino , Enfermedades Urogenitales Femeninas/complicaciones , Enfermedades Urogenitales Femeninas/tratamiento farmacológico , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación , Disfunciones Sexuales Fisiológicas/complicaciones , Síndrome , Enfermedades Vaginales/complicaciones , Enfermedades Vaginales/tratamiento farmacológico , Salud de la MujerRESUMEN
Este artigo apresenta relatos de sete distintas patologias de origem reprodutiva ainda não descritas em cutias (Dasyprocta aguti Linnaeus, 1758) fêmeas, que afetaram a fertilidade ou resultaram na morte do animal. Descreveu-se a natureza, a localização e a frequência das alterações patológicas macroscópicas e histológicas dos órgãos que compõem o sistema reprodutivo de cutias fêmeas, criadas sob condições de cativeiro no semiárido do Brasil. Foram avaliados através do exame anatomopatológico o aparelho reprodutivo de trinta e nove cutias mortas naturalmente e encaminhadas ao Laboratório de Patologia Veterinária, no período de fevereiro de 2010 a maio de 2015. Destas, constatou-se alterações patológicas no sistema reprodutivo de 10 (25,6 %). No total, 13 alterações foram observadas, sendo que, em alguns animais haviam a coexistência de mais de uma alteração. Assim, as alterações patológicas encontradas foram: endometrite (n=4; 30,8%), piometra (n=3; 23%), retenção de placenta (n=2; 15,4%), maceração fetal (n=1; 7,7%), mumificação fetal (n=1; 7,7%), parto distócico (n=1; 7,7%) e ovários afuncionais (n=1; 7,7%).(AU)
This paper presents seven distinct reports diseases with reproductive origins that are not yet described in females agoutis (Dasyprocta aguti Linnaeus, 1758), affecting fertility or resulted in the animal's death. The nature, location and frequency of macroscopic and histological pathological changes of the organs that compose the reproductive system of female agoutis, created under conditions of captivity in the semiarid region of Brazil, are described in this article. Were evaluated by pathological examination of the reproductive tract of thirty-nine naturally dead agoutis and sent to the Veterinary Pathology Laboratory in February 2010 to May 2015. From these, it was found pathological alterations in the reproductive system of 10 (25.6%). A total of 13 abnormalities were observed, and in some animals had the coexistence of more than one alteration. Thus, the pathological changes were: endometritis (n=4, 30.8%), pyometra (n=3; 23%), retained placenta (n=2; 15.4%), fetal maceration (n=1, 7.7%), fetal mummification (n=1, 7.7%), dystocia (n=1, 7.7%) and afuncionais ovary (n=1, 7.7%).(AU)
Asunto(s)
Animales , Femenino , Dasyproctidae/fisiología , Enfermedades Urogenitales Femeninas/fisiopatología , Enfermedades Urogenitales Femeninas/veterinaria , Endometritis/veterinaria , Muerte Fetal , Ovario/fisiopatología , Retención de la Placenta/veterinaria , Piómetra/veterinariaRESUMEN
Este artigo apresenta relatos de sete distintas patologias de origem reprodutiva ainda não descritas em cutias (Dasyprocta aguti Linnaeus, 1758) fêmeas, que afetaram a fertilidade ou resultaram na morte do animal. Descreveu-se a natureza, a localização e a frequência das alterações patológicas macroscópicas e histológicas dos órgãos que compõem o sistema reprodutivo de cutias fêmeas, criadas sob condições de cativeiro no semiárido do Brasil. Foram avaliados através do exame anatomopatológico o aparelho reprodutivo de trinta e nove cutias mortas naturalmente e encaminhadas ao Laboratório de Patologia Veterinária, no período de fevereiro de 2010 a maio de 2015. Destas, constatou-se alterações patológicas no sistema reprodutivo de 10 (25,6 %). No total, 13 alterações foram observadas, sendo que, em alguns animais haviam a coexistência de mais de uma alteração. Assim, as alterações patológicas encontradas foram: endometrite (n=4; 30,8%), piometra (n=3; 23%), retenção de placenta (n=2; 15,4%), maceração fetal (n=1; 7,7%), mumificação fetal (n=1; 7,7%), parto distócico (n=1; 7,7%) e ovários afuncionais (n=1; 7,7%).(AU)
This paper presents seven distinct reports diseases with reproductive origins that are not yet described in females agoutis (Dasyprocta aguti Linnaeus, 1758), affecting fertility or resulted in the animal's death. The nature, location and frequency of macroscopic and histological pathological changes of the organs that compose the reproductive system of female agoutis, created under conditions of captivity in the semiarid region of Brazil, are described in this article. Were evaluated by pathological examination of the reproductive tract of thirty-nine naturally dead agoutis and sent to the Veterinary Pathology Laboratory in February 2010 to May 2015. From these, it was found pathological alterations in the reproductive system of 10 (25.6%). A total of 13 abnormalities were observed, and in some animals had the coexistence of more than one alteration. Thus, the pathological changes were: endometritis (n=4, 30.8%), pyometra (n=3; 23%), retained placenta (n=2; 15.4%), fetal maceration (n=1, 7.7%), fetal mummification (n=1, 7.7%), dystocia (n=1, 7.7%) and afuncionais ovary (n=1, 7.7%).(AU)
Asunto(s)
Animales , Femenino , Dasyproctidae/fisiología , Enfermedades Urogenitales Femeninas/fisiopatología , Enfermedades Urogenitales Femeninas/veterinaria , Endometritis/veterinaria , Piómetra/veterinaria , Retención de la Placenta/veterinaria , Muerte Fetal , Ovario/fisiopatologíaRESUMEN
La involución del tracto genital femenino refleja su integración con los cambios que sufre el eje hipotálamo-hipofisario-ovárico. El descenso de los niveles de estradiol conlleva una serie de efectos adversos, incluidos los relativos a las vías urinarias inferiores. El cambio más importante es la atrofia vaginal: la mucosa vaginal se vuelve más fina y seca, lo cual puede producir incomodidad vaginal, sequedad, quemazón, prurito y dispareunia. El epitelio vaginal puede presentar cambios inflamatorios y ser un factor que contribuya a los síntomas urinarios, tales como frecuencia, urgencia, disuria, incontinencia, e infecciones recurrentes. Por otra parte, se ha sugerido que los niveles bajos de estrógenos pueden afectar los tejidos periuretrales y contribuir a la laxitud de la pelvis y la incontinencia de esfuerzo. Relacionados con el hipoestrogenismo, los cambios en el pH y la flora vaginal pueden predisponer a las mujeres posmenopáusicas a las infecciones del tracto urinario. La terapia hormonal local en forma de cremas, comprimidos o supositorios es la base del tratamiento de la atrofia genital. Además, otras vías de administración de hormonas, tanto local como sistémica, también han demostrado ser válidas. Sin embargo, a pesar de que los beneficios del reemplazo con estrógenos en la prevención de la atrofia vaginal y la reducción de la incidencia de los síntomas están bien establecidos, este tipo de tratamiento está contraindicado en algunas mujeres y no es una opción aceptable para otras. Pero además, la ruta óptima de administración del tratamiento hormonal, el régimen, las dosis, y las alternativas no hormonales para mejorar los síntomas y la calidad de vida de la población posmenopáusica no han sido completamente estudiados. Esta revisión se centra en los cambios del envejecimiento vaginal e intenta presentar una sinopsis de la fisiopatología y el tratamiento de la atrofia vaginal y la vaginitis atrófica. (AU)
Asunto(s)
Humanos , Femenino , Enfermedades Urogenitales Femeninas/fisiopatología , Enfermedades Urogenitales Femeninas/terapia , Genitales Femeninos/patología , Genitales Femeninos/fisiología , Vaginitis/diagnóstico , Vaginitis/terapiaRESUMEN
La involución del tracto genital femenino refleja su integración con los cambios que sufre el eje hipotálamo-hipofisario-ovárico. El descenso de los niveles de estradiol conlleva una serie de efectos adversos, incluidos los relativos a las vías urinarias inferiores. El cambio más importante es la atrofia vaginal: la mucosa vaginal se vuelve más fina y seca, lo cual puede producir incomodidad vaginal, sequedad, quemazón, prurito y dispareunia. El epitelio vaginal puede presentar cambios inflamatorios y ser un factor que contribuya a los síntomas urinarios, tales como frecuencia, urgencia, disuria, incontinencia, e infecciones recurrentes. Por otra parte, se ha sugerido que los niveles bajos de estrógenos pueden afectar los tejidos periuretrales y contribuir a la laxitud de la pelvis y la incontinencia de esfuerzo. Relacionados con el hipoestrogenismo, los cambios en el pH y la flora vaginal pueden predisponer a las mujeres posmenopáusicas a las infecciones del tracto urinario. La terapia hormonal local en forma de cremas, comprimidos o supositorios es la base del tratamiento de la atrofia genital. Además, otras vías de administración de hormonas, tanto local como sistémica, también han demostrado ser válidas. Sin embargo, a pesar de que los beneficios del reemplazo con estrógenos en la prevención de la atrofia vaginal y la reducción de la incidencia de los síntomas están bien establecidos, este tipo de tratamiento está contraindicado en algunas mujeres y no es una opción aceptable para otras. Pero además, la ruta óptima de administración del tratamiento hormonal, el régimen, las dosis, y las alternativas no hormonales para mejorar los síntomas y la calidad de vida de la población posmenopáusica no han sido completamente estudiados. Esta revisión se centra en los cambios del envejecimiento vaginal e intenta presentar una sinopsis de la fisiopatología y el tratamiento de la atrofia vaginal y la vaginitis atrófica.
Asunto(s)
Humanos , Femenino , Enfermedades Urogenitales Femeninas/fisiopatología , Enfermedades Urogenitales Femeninas/terapia , Genitales Femeninos/fisiología , Genitales Femeninos/patología , Vaginitis/diagnóstico , Vaginitis/terapiaRESUMEN
PROBLEM: Untreated celiac disease (CD) is often associated with early miscarriages, infertility, and alterations in menstrual cycle. Tissue transglutaminase (tTG) antibodies could be involved by interfering with tTG transamidating activity and/or biological functions mediated by its interaction with fibronectin (FN). METHOD OF STUDY: The correlation between the presence of extra-digestive disorders and the reactivity of sera against tTG-FN and its effects on tTG transamidating activity was analyzed in a group or 50 women with recently diagnosed CD. RESULTS: Heterogeneous behavior was observed among serum samples derived from patients with different complaints, suggesting that differences in fine specificity patterns could condition clinical outcome. Sera from women with gynecological and/or obstetric problems induced significant inhibition of in vitro enzymatic activity in comparison with those without these kinds of disorders. CONCLUSIONS: The significant correlation observed between serum effects and clinical profile suggests a putative involvement of tTG-specific antibodies in gynecological and/or obstetric disorders during active CD.
Asunto(s)
Autoanticuerpos/sangre , Autoanticuerpos/inmunología , Enfermedad Celíaca/complicaciones , Enfermedades Urogenitales Femeninas/fisiopatología , Complicaciones del Embarazo/fisiopatología , Transglutaminasas/metabolismo , Adolescente , Adulto , Autoinmunidad , Enfermedad Celíaca/sangre , Enfermedad Celíaca/diagnóstico , Femenino , Enfermedades Urogenitales Femeninas/inmunología , Fibronectinas/metabolismo , Humanos , Persona de Mediana Edad , Embarazo , Complicaciones del Embarazo/inmunología , Transglutaminasas/inmunología , Adulto JovenRESUMEN
BACKGROUND: Few studies have addressed the impact of menopausal symptom severity over quality of life (QoL) in Latin American women with different ethnics. OBJECTIVE: To assess menopausal symptom severity and the QoL among postmenopausal Colombian women with three different ethnicities. METHOD: Data of healthy naturally occurring postmenopausal Hispanic, indigenous and black women aged 40-59 years who participated in a cross-sectional study filling out the Menopause Rating Scale (MRS) and a general questionnaire was analysed. RESULTS: A total of 579 women were included, 153 Hispanic, 295 indigenous and 131 Afro-descendent. Hispanic women had an average age of 55.3 +/- 3.3 years. Indigenous and black women were less educated than the Hispanic ones (2.2 +/- 1.8 and 4.6 +/- 4.4 vs. 6.4 +/- 3.5 years, p < 0.0001). Hispanic women displayed lower total MRS scores (better QoL) when compared to indigenous and black women. Urogenital scoring was worse among indigenous women compared to Hispanic and black women. Black women presented higher MRS psychological and somatic scorings than Hispanic and indigenous women. After adjusting for confounding factors, indigenous and black women continued to display a higher risk for impaired QoL, total MRS score > 16 (OR: 3.11, 95% CI: 1.30-7.44 and OR: 5.29, 95% CI: 2.52-11.10, respectively), which was significantly higher among indigenous women due to urogenital symptoms (OR: 102.75, 95% CI: 38.33-275.47) and black women due to psychological (OR: 6.58, 95% CI: 3.27-13.27) and somatic symptoms (OR: 3.88, 95% CI: 1.83-8.22). CONCLUSION: In this postmenopausal Colombian series, menopausal symptoms in indigenous (urogenital) and black (somatic/psychological) women were more severe (impaired QoL) when compared to Hispanic ones.
Asunto(s)
Población Negra , Hispánicos o Latinos , Grupos de Población , Posmenopausia , Calidad de Vida , Adulto , Población Negra/psicología , Colombia , Estudios Transversales , Femenino , Enfermedades Urogenitales Femeninas/etnología , Enfermedades Urogenitales Femeninas/etiología , Enfermedades Urogenitales Femeninas/fisiopatología , Hispánicos o Latinos/psicología , Humanos , Persona de Mediana Edad , Posmenopausia/psicología , Índice de Severidad de la Enfermedad , Encuestas y CuestionariosRESUMEN
OBJECTIVE: There is a common belief that seat pressure during cycling can compress specific neurovascular tissues over the perineum leading to genital pathologies. This topic has seldom been discussed for women. The present study was conducted to verify the effect of trunk position and saddle design on saddle pressure in both men and women. METHODS: Recreational cyclists (11 men and 11 women) were evaluated while seated on a bicycle. Saddle pressure was measured with F-scan insoles adapted for two saddle models (with and without a hole), and two trunk positions (upright and forwards). Pressure values were compared between trunk positions and saddles employing ANOVA. RESULTS: There were no statistical differences comparing saddle pressure between the two trunk positions for women. For men a statistical difference between the trunk positions for the saddle with a hole was found. Thus, the trunk forwards shift seems to affect the values of saddle pressure only for men using the 'holed' saddle. CONCLUSION: Saddle pressure for men was influenced by saddle design and trunk position only. This result indicates that the masculine anatomy may influence saddle pressure during bicycle.
Asunto(s)
Traumatismos en Atletas/etiología , Ciclismo , Ergonomía , Enfermedades Urogenitales Femeninas/etiología , Enfermedades Urogenitales Masculinas/etiología , Postura , Adulto , Traumatismos en Atletas/fisiopatología , Diseño de Equipo , Femenino , Enfermedades Urogenitales Femeninas/fisiopatología , Humanos , Masculino , Enfermedades Urogenitales Masculinas/fisiopatología , Presión , Factores de Riesgo , Factores Sexuales , Equipo Deportivo , Adulto JovenRESUMEN
The pathological alteration of the nervous system in diabetic patients is extensive and frequently severe. The prevalence of the diabetic neuropathy reach high levels with the evolution of the diabetes, often showing frequencies higher than 50% in several groups of patients. The neurological lesion in this pathological situation is extensive in the diabetic patient, including widely the peripheral nervous system with its components sensory, motor and autonomic: with typical symptoms and in accordance with the pathogenesis of metabolic origin and/or microvascular disease. The autonomic nervous system is a main regulator of many systems in the human body. Then its lesion can promote significant alterations in the function of the cardiovascular, respiratory, gastrointestinal, urogenital system, that can be related to increased motality. This review anlyses the abnormalities related to lesion of the autonomic nervous system, particularly in type 1 diabetic patients, trying to characterize the risk of morbidity and mortality.
Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Diabetes Mellitus Tipo 1/complicaciones , Neuropatías Diabéticas/etiología , Enfermedades del Sistema Nervioso Autónomo/etiología , Enfermedades del Sistema Nervioso Autónomo/patología , Regulación de la Temperatura Corporal/fisiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/patología , Enfermedades Cardiovasculares/fisiopatología , Enfermedad Crónica , Diabetes Mellitus Tipo 1/patología , Diabetes Mellitus Tipo 1/fisiopatología , Angiopatías Diabéticas/patología , Angiopatías Diabéticas/fisiopatología , Neuropatías Diabéticas/patología , Neuropatías Diabéticas/fisiopatología , Diagnóstico Diferencial , Femenino , Enfermedades Urogenitales Femeninas/etiología , Enfermedades Urogenitales Femeninas/patología , Enfermedades Urogenitales Femeninas/fisiopatología , Enfermedades Gastrointestinales/etiología , Enfermedades Gastrointestinales/patología , Enfermedades Gastrointestinales/fisiopatología , Humanos , Masculino , Enfermedades Urogenitales Masculinas/etiología , Enfermedades Urogenitales Masculinas/patología , Enfermedades Urogenitales Masculinas/fisiopatología , Factores de RiesgoRESUMEN
O acometimento patológico do sistema nervoso no diabetes melito é muito amplo e, freqüentemente, bastante grave. A prevalência de neuropatia diabética atinge níveis elevados com a evolução temporal do diabetes, chegando, geralmente, a freqüências acima de 50 por cento de lesão neurológica em diferentes grupos de pacientes analisados em nosso meio e no exterior. A lesão neurológica nesta situação patológica é extensa no organismo humano diabético, envolvendo amplamente todo o sistema nervoso periférico nos seus componentes sensitivo-motor e autonômico: com clínica característica e concordante com as hipóteses patogênicas de natureza metabólica e/ou microvascular. O sistema nervoso autonômico é o elemento fundamental na regulação da função da maior parte dos sistemas ou órgãos no organismo, portanto, a sua lesão pode trazer importantes alterações para as funções cardiovascular, respiratória, digestiva, urinária e genital, podendo influir na função vital de alguns desses órgãos ou sistemas. Este artigo aborda as alterações decorrentes da lesão do sistema nervoso autonômico, especialmente nos pacientes diabéticos tipo 1, procurando dimensionar o risco de morbimortalidade.
The pathological alteration of the nervous system in diabetic patients is extensive and frequently severe. The prevalence of the diabetic neuropathy reach high levels with the evolution of the diabetes, often showing frequencies higher than 50 percent in several groups of patients. The neurological lesion in this pathological situation is extensive in the diabetic patient, including widely the peripheral nervous system with its components sensory, motor and autonomic: with typical symptoms and in accordance with the pathogenesis of metabolic origin and/or microvascular disease. The autonomic nervous system is a main regulator of many systems in the human body. Then its lesion can promote significant alterations in the function of the cardiovascular, respiratory, gastrointestinal, urogenital system, that can be related to increased motality. This review anlyses the abnormalities related to lesion of the autonomic nervous system, particularly in type 1 diabetic patients, trying to characterize the risk of morbidity and mortality.
Asunto(s)
Femenino , Humanos , Masculino , Enfermedades del Sistema Nervioso Autónomo/fisiopatología , Diabetes Mellitus Tipo 1/complicaciones , Neuropatías Diabéticas/etiología , Enfermedades del Sistema Nervioso Autónomo/etiología , Enfermedades del Sistema Nervioso Autónomo/patología , Regulación de la Temperatura Corporal/fisiología , Enfermedad Crónica , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/patología , Enfermedades Cardiovasculares/fisiopatología , Diagnóstico Diferencial , Diabetes Mellitus Tipo 1/patología , Diabetes Mellitus Tipo 1/fisiopatología , Angiopatías Diabéticas/patología , Angiopatías Diabéticas/fisiopatología , Neuropatías Diabéticas/patología , Neuropatías Diabéticas/fisiopatología , Enfermedades Urogenitales Femeninas/etiología , Enfermedades Urogenitales Femeninas/patología , Enfermedades Urogenitales Femeninas/fisiopatología , Enfermedades Gastrointestinales/etiología , Enfermedades Gastrointestinales/patología , Enfermedades Gastrointestinales/fisiopatología , Enfermedades Urogenitales Masculinas/etiología , Enfermedades Urogenitales Masculinas/patología , Enfermedades Urogenitales Masculinas/fisiopatología , Factores de RiesgoRESUMEN
OBJECTIVE: Somatosensory evoked potential (SSEP) is an electrophysiological test used to evaluate sensory innervations in peripheral and central neuropathies. Pudendal SSEP has been studied in dysfunctions related to the lower urinary tract and pelvic floor. Although some authors have already described technical details pertaining to the method, the standardization and the influence of physiological variables in normative values have not yet been established, especially for women. The aim of the study was to describe normal values of the pudendal SSEP and to compare technical details with those described by other authors. MATERIALS AND METHODS: The clitoral sensory threshold and pudendal SSEP latency was accomplished in 38 normal volunteers. The results obtained from stimulation performed on each side of the clitoris were compared to ages, body mass index (BMI) and number of pregnancies. RESULTS: The values of clitoral sensory threshold and P1 latency with clitoral left stimulation were respectively, 3.64 ± 1.01 mA and 37.68 ± 2.60 ms. Results obtained with clitoral right stimulation were 3.84 ± 1.53 mA and 37.42 ± 3.12 ms, respectively. There were no correlations between clitoral sensory threshold and P1 latency with age, BMI or height of the volunteers. A significant difference was found in P1 latency between nulliparous women and volunteers who had been previously submitted to cesarean section. CONCLUSIONS: The SSEP latency represents an accessible and reproducible method to investigate the afferent pathways from the genitourinary tract. These results could be used as normative values in studies involving genitourinary neuropathies in order to better clarify voiding and sexual dysfunctions in females.
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Embarazo , Clítoris/fisiología , Potenciales Evocados Somatosensoriales/fisiología , Enfermedades Urogenitales Femeninas/diagnóstico , Diafragma Pélvico/fisiología , Umbral Sensorial/fisiología , Índice de Masa Corporal , Clítoris/inervación , Estimulación Eléctrica , Electrodos , Electromiografía , Enfermedades Urogenitales Femeninas/fisiopatología , Índice de Embarazo , Estudios Prospectivos , Disfunciones Sexuales Fisiológicas/diagnósticoRESUMEN
OBJECTIVE: Somatosensory evoked potential (SSEP) is an electrophysiological test used to evaluate sensory innervations in peripheral and central neuropathies. Pudendal SSEP has been studied in dysfunctions related to the lower urinary tract and pelvic floor. Although some authors have already described technical details pertaining to the method, the standardization and the influence of physiological variables in normative values have not yet been established, especially for women. The aim of the study was to describe normal values of the pudendal SSEP and to compare technical details with those described by other authors. MATERIALS AND METHODS: The clitoral sensory threshold and pudendal SSEP latency was accomplished in 38 normal volunteers. The results obtained from stimulation performed on each side of the clitoris were compared to ages, body mass index (BMI) and number of pregnancies. RESULTS: The values of clitoral sensory threshold and P1 latency with clitoral left stimulation were respectively, 3.64 +/- 1.01 mA and 37.68 +/- 2.60 ms. Results obtained with clitoral right stimulation were 3.84 +/- 1.53 mA and 37.42 +/- 3.12 ms, respectively. There were no correlations between clitoral sensory threshold and P1 latency with age, BMI or height of the volunteers. A significant difference was found in P1 latency between nulliparous women and volunteers who had been previously submitted to cesarean section. CONCLUSIONS: The SSEP latency represents an accessible and reproducible method to investigate the afferent pathways from the genitourinary tract. These results could be used as normative values in studies involving genitourinary neuropathies in order to better clarify voiding and sexual dysfunctions in females.