RESUMO
BACKGROUND: It is estimated that a total of 600,000 abdominal hysterectomies, vaginal and laparoscopic there are performed in USA, these figures make the hysterectomy the first ranked surgery. In our country, since the first description of the technique in 1989, laparoscopic hysterectomy (HL) has developed and evolved. However, the learning curve for mastering this procedure results in larger and more complex complications than other approaches. MATERIAL AND METHOD: Retrospective, longitudinal and descriptive study were carried out, the collection of data took place from the clinical records of patients who underwent total laparoscopic hysterectomy during January 1, 2007 through December 31 of the same year. It was performed in women older than 18 years with benign uterine pathology. Body mass index greater than 30 Kg/m2, uterus greater than 16 weeks of gestational age or more than 500 grams, illnesses than compromise life of patients o women that did not return to post-surgical evaluation were excluded. RESULTS: There were performe 75 laparoscopic hysterectonies, 72 underwent without any complication. The average hospital stay was 3 days. We founded 3 major surgical complications, a case of bleeding from the surgical area that was immediately attended by laparoscopic Vicril-00 single stitching. Also were founded 2 urinary lesions: 1 complex lesion of the trigonous. The follow up of this case was torpid it were needed to derivate for 15 day with a latex foley catheter after the secondary repair and was unsuccessfully. Thereafter a urogynecological team programed laparotomy for the final fistulectomy. And the third case of accident was referred to a ureteral section, was diagnosed by the leaking at opaquedye from the abdominal x ray, and the patient was programed to laparotomy to performed a termino-terminal anastomosis. CONCLUSIONS: Laparoscopic hysterectomy is a reliable treatment option for benign uterine pathology. We believe that this surgical technique should be offered as the regular way to perform the hysterectomy.
Assuntos
Histerectomia/métodos , Laparoscopia , Doenças Uterinas/cirurgia , Adulto , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Paraurethral cyst or Skene cysts are rare at any age but particularly in newborns. In infants typically present as cystic formations, raised similar to a dermoid cyst. The treatment is established based on the findings, pathology and the age of the patient may be observational, puncture the cyst or surgical. We present a newborn with acute renal failure secondary to skene's cysts.
Assuntos
Injúria Renal Aguda/etiologia , Cistos/complicações , Doenças Uretrais/complicações , Cistos/congênito , Feminino , Humanos , Recém-Nascido , Doenças Uretrais/congênitoRESUMO
The Mayer-Rokitansky-Kuster-Hauser is a rare congenital anomaly characterized by lack of vaginal and uterine development variable and normal ovaries. It results from agenesis or hypoplasia Müller duct system. Cervicovaginal agenesis as part of the complex syndrome, is even rarer. We report two cases: adolescent patient with primary amenorrhea, cervicovaginal agenesis and chronic pelvic pain, and a 28-year-old patient with primary amenorrhea, congenital absence of uterus and vagina.
Assuntos
Anormalidades Múltiplas/patologia , Amenorreia/etiologia , Transtornos 46, XX do Desenvolvimento Sexual , Anormalidades Múltiplas/diagnóstico por imagem , Anormalidades Múltiplas/embriologia , Anormalidades Múltiplas/epidemiologia , Anormalidades Múltiplas/cirurgia , Adolescente , Adulto , Anormalidades Congênitas , Endometriose/etiologia , Feminino , Humanos , Histerectomia , Incidência , Rim/anormalidades , Rim/diagnóstico por imagem , Rim/embriologia , Rim/patologia , Rim/cirurgia , Ductos Paramesonéfricos/anormalidades , Ductos Paramesonéfricos/diagnóstico por imagem , Ductos Paramesonéfricos/embriologia , Ductos Paramesonéfricos/patologia , Ductos Paramesonéfricos/cirurgia , Dor Pélvica/etiologia , Fenótipo , Somitos/anormalidades , Somitos/diagnóstico por imagem , Somitos/embriologia , Somitos/patologia , Somitos/cirurgia , Coluna Vertebral/anormalidades , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/embriologia , Coluna Vertebral/patologia , Coluna Vertebral/cirurgia , Estruturas Criadas Cirurgicamente , Ultrassonografia , Útero/anormalidades , Útero/diagnóstico por imagem , Útero/embriologia , Útero/patologia , Útero/cirurgia , Vagina/anormalidades , Vagina/diagnóstico por imagem , Vagina/embriologia , Vagina/patologia , Vagina/cirurgiaRESUMO
Transverse vaginal septum is a congenital Mullerian malformation resulting from a failure of the fusion or canalization of the urogenital sinus and the Müllerian ducts. It may cause hematocolpos, dyspareunia and infertility in adult patients. In some cases, it is associated with congenital malformations such as coarctation of the aorta or atrial septal defects. A case of a transverse vaginal septum identified during a vaginal check-up of a 39-week pregnant patient during labour is reported. A cesarean surgery was performed with no complications. Septal defect was diagnosed due to heart murmur. It was decided to treat the transverse vaginal septum as soon as the puerperium was over. The patient left the hospital after proper response to treatment.
Assuntos
Complicações na Gravidez , Vagina/anormalidades , Feminino , Humanos , Gravidez , Complicações na Gravidez/diagnóstico , Adulto JovemRESUMO
The placenta accreta is the second leading cause of obstetric hemorrhage, which often require the implementation of emergency obstetric hysterectomy increased morbidity and mortality. We present a surgical alternative to hysterectomy obstetric allowed us to reduce to zero until our rate of maternal deaths from obstetric hemorrhage. Improving surgical times, associated morbidity, without altering perinatal outcomes.
Assuntos
Placenta Acreta/cirurgia , Feminino , Humanos , Gravidez , Adulto JovemRESUMO
The placenta accreta is the second leading cause of obstetric hemorrhage in the world. In many occasions it is necessary to make an obstetric hysterectomy, a circumstance that increases morbidity, and maternal mortality. Communicates a surgical alternative to hysterectomy obstetric that has enabled us to reduce until the time to zero our rate of maternal deaths by obstetric hemorrhage, in addition to reducing the surgical time and the associated morbidity, without changing the perinatal outcome.
Assuntos
Cesárea/métodos , Histerectomia/métodos , Placenta Acreta/cirurgia , Recesariana/métodos , Emergências , Exsanguinação/etiologia , Exsanguinação/mortalidade , Exsanguinação/prevenção & controle , Feminino , Hemostasia Cirúrgica/métodos , Humanos , Recém-Nascido , Paridade , Placenta Prévia/cirurgia , Gravidez , Hemorragia Uterina/etiologia , Hemorragia Uterina/mortalidade , Hemorragia Uterina/prevenção & controle , Adulto JovemRESUMO
Leiomyomas of the bladder and urethra are extremely rare. Depending on their location and size, they can produce diverse clinical manifestations. At urethral level in particular, formed near the vaginal wall, symptoms include recurrent urinary tract infections, voiding dysfunction, foreign body sensation, heaviness and dyspareunia. We present two cases of urethral leiomyomas, one expressed during pregnancy, which resolved successfully with surgical resection without damage to the urinary tract and no recurrence so far.
Assuntos
Leiomioma/cirurgia , Complicações Neoplásicas na Gravidez/cirurgia , Neoplasias Uretrais/cirurgia , Adulto , Feminino , Humanos , Leiomioma/diagnóstico , Gravidez , Complicações Neoplásicas na Gravidez/diagnóstico , Neoplasias Uretrais/diagnóstico , Adulto JovemRESUMO
We report the case of a 17 year old patient with partial molar pregnancy and coexistent live fetus of 13 gestational weeks diagnosed by ultrasound, which required the termination of pregnancy for maternal decompensation.
Assuntos
Mola Hidatiforme/cirurgia , Neoplasias Uterinas/cirurgia , Aborto Terapêutico , Ameaça de Aborto/etiologia , Adolescente , Feminino , Humanos , Mola Hidatiforme/diagnóstico por imagem , Masculino , Gravidez , Gravidez Múltipla , Ultrassonografia , Hemorragia Uterina/etiologia , Neoplasias Uterinas/diagnóstico por imagemRESUMO
OBJECTIVE: Evaluate the complications and short term sucess rate of the transobturator tape for the treatment of stress urinary incontinence. MATERIAL AND METHODS: It is a retrospective study of the transobturator tapes perform in 2005 and 2006. All the procedures were done with epidural anesthesia. The success rate, the immediate, short-term and long term complications were recorded at the first, second and third year. RESULTS: 28 women were included in the study, 54% of them with stress urinary incontinence. 25% were solely transobturator procedures. mong the complications were 2 vesical puntures, 1 periurethral fascia trauma and 5 urinary retention during the first 24 hours. In the 1 and 2 year follow-up were 2 cases of overactive detrusor. Objective sucess was 90% and subjective sucess was 92%. CONCLUSIONS: Transobturator tape is a highly successful and a low morbility procedure.
Assuntos
Slings Suburetrais/efeitos adversos , Incontinência Urinária por Estresse/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
It is presented the case of the second pregnancy of a 36 year-old patient with antecedent of preeclampsia that was solved, at full-term, with a Caesarean operation by means of which was obtained a healthy new born. The patient began her prenatal control at 29th week. Ultrasound made at her admittance showed a fetus with an approximated weight of 451 grams. The patient was hospitalized until completing protocol of study for restriction of severe fetal growth. At 34.5 weeks, an ultrasonographical control showed an alteration in venous duct; for that reason it was decided to interrupt pregnancy abdominally. There were no surgical complications and was obtained a phenotypically normal new born, male, weight of 820 grams and size of 33 cm, who was referred to the Instituto Nacional de Perinatologia. At 43.3 weeks he was discharged from hospital with a weight of 1,840 grams. At the present he's fed with fortified milk.