RESUMO
The endometriosis has been observed in 10% of the women in reproductive age and it is found in pelvis in most of the cases. However, occasionally it is located on nonpelvic organs and infrequently in diaphragmatic location. Two cases of diaphragmatic endometriosis with symptoms are presented and treated with CO2 laser successful. There are a few reports of laparoscopic treatment of diaphragmatic endometriosis. The patients with clinical diagnosis of endometriosis and nonpelvic symptoms have the possibility of the disease in nonpelvic organs. The adequate treatment will be in benefit of the patient.
Assuntos
Dióxido de Carbono/uso terapêutico , Endometriose/cirurgia , Terapia a Laser/métodos , Adulto , Diafragma/patologia , Diafragma/cirurgia , Feminino , Humanos , Laparoscopia , Pelve/cirurgiaRESUMO
The osseous metaplasia of the endometrium is very rare cause of infertility. The hysteroscopic approach is a effective method to recover the fertility in most of the cases in a short period. The case of a infertile woman who was previous studied and has indications for laparoscopic and hysteroscopic approach. The infertility workup showed a intracavitary calcification on ultrasonography. During the surgery, the diagnosis of endometriosis and osseous metaplasia of the endometrium were done and treated with histologic confirmation. The patient conceived in her second spontaneous cycle. The hysteroscopy is the first approach in the treatment and should be doing with laparoscopy for the detection of other causes of infertility.
Assuntos
Endometriose/diagnóstico por imagem , Endométrio/patologia , Histeroscopia , Infertilidade Feminina/diagnóstico , Metaplasia/diagnóstico por imagem , Ossificação Heterotópica/diagnóstico por imagem , Adulto , Endometriose/complicações , Endometriose/cirurgia , Endométrio/diagnóstico por imagem , Endométrio/cirurgia , Feminino , Humanos , Infertilidade Feminina/diagnóstico por imagem , Infertilidade Feminina/etiologia , Metaplasia/cirurgia , Ossificação Heterotópica/cirurgia , Gravidez , Resultado da Gravidez , Resultado do Tratamento , UltrassonografiaRESUMO
The use of the laparoscopic approach in the initial evaluation of the infertile couple without obvious disease is controversial; for these reason some centers has been done the initial treatment with ovarian stimulation (OS). The present article analyze two groups, the first for patients with OS for 4 cycles and laparoscopic approach after that and the second group with initial laparoscopy and medical treatment if they need it. Both groups has a OS after the laparoscopic procedure. The analysis of the prognosis of the OS before the laparoscopy and the impact in the reproductive outcome is done. The results shows that the OS does not have deleterious effects of the pregnancy rates if it is used before the procedure. However, the pregnancy are present early in the second group P < 0.05. In conclusion, in infertile woman without obvious disease that indicate the laparoscopy, the initial use of OS before the laparoscopy does not have a deleterious impact on the pregnancy rates.
Assuntos
Infertilidade Feminina/terapia , Síndrome de Hiperestimulação Ovariana/etiologia , Indução da Ovulação/efeitos adversos , Adulto , Feminino , Humanos , Infertilidade Feminina/complicações , Laparoscopia , Gravidez , Prognóstico , Resultado do TratamentoRESUMO
The experience obtained in 44 cases, in which amniocentesis was practiced for genetic diagnostic purpose in the private center in México City is presented. Indications, morbility and results are similar to those reported in the literature, is considered that this method should be offered to the couples who receive information about it and have maternal age 35 or older, antecedent of family chromosomal disease, alteration in maternal serum screening or family anguish. This is a safe method and easy to perform with a high sensibility and specificity, this is the first report in a private center in México that analyzes technique.
Assuntos
Amniocentese , Síndrome de Down/diagnóstico , Testes Genéticos/métodos , Idade Materna , Adulto , Aberrações Cromossômicas/genética , Estudos Transversais , Síndrome de Down/genética , Feminino , Marcadores Genéticos , Humanos , México , Gravidez , Diagnóstico Pré-NatalRESUMO
In obstetrics, the uterine tamponade has been used for the control of acute uterine bleeding. However, the control of the acute hemorrhage from the nonpuerperal uterus is more difficult. Four cases are presented with uterine bleeding during dilation and evacuation without response to medical treatment. They were treated with the use of the Foley catheter for 12 to 24 hrs. There were not complications. The uterine tamponade with Foley catheter is a therapeutic option before the radical surgical treatment.
Assuntos
Oclusão com Balão , Cateterismo , Metrorragia/etiologia , Aborto Espontâneo/complicações , Doença Aguda , Adulto , Cesárea/efeitos adversos , Dilatação e Curetagem/efeitos adversos , Feminino , Humanos , Metrorragia/terapia , Gravidez , Resultado do TratamentoRESUMO
It presents three cases of Mullerian anomalies with septate uterus and cervical duplication and longitudinal vaginal septum. There are a few previous cases reported. The cases are discussed and the literature is revised.
Assuntos
Anormalidades Múltiplas/diagnóstico por imagem , Colo do Útero/anormalidades , Ductos Paramesonéfricos/anormalidades , Útero/anormalidades , Vagina/anormalidades , Anormalidades Múltiplas/cirurgia , Adulto , Colo do Útero/diagnóstico por imagem , Feminino , Humanos , Histerossalpingografia , Ductos Paramesonéfricos/cirurgia , Paridade , Gravidez , Resultado da Gravidez , Resultado do Tratamento , Vagina/cirurgiaRESUMO
The laparoscopically assisted vaginal hysterectomy offers the possibility to convert abdominal to vaginal approach give to the patient the benefits of ti. The analysis of the first 20 cases in our institution is done and are compared with abdominal and vaginal approaches in some parameters including costs, indications and hospitalization days. The laparoscopically assisted vaginal hysterectomy offers to the patient the benefits of the vaginal approach with hospital stay similar and cost and operative time higher than those for either vaginal and abdominal hysterectomy. The exact role of the laparoscopically assisted vaginal hysterectomy on daily practice still is pending.
Assuntos
Histerectomia Vaginal , Histerectomia/métodos , Laparoscopia , Complicações Neoplásicas na Gravidez/cirurgia , Neoplasias Uterinas/cirurgia , Adulto , Feminino , Hospitais Militares , Humanos , México , Pessoa de Meia-Idade , Gravidez , Resultado do TratamentoRESUMO
Endometriosis is rarely found by the general surgeon and sometimes it may seem a surgical disease. Two cases with abdominal pain, requiring surgical treatment, are presented. The first case gave history of dysmenorrhea and dyspareunia, she was admitted with acute abdomen due to acute appendicitis, and laparoscopic appendectomy was performed without complications; she had slight endometriosis at left utero-sacrum ligament and histopathological report showed endometriosis at the appendix. The second patient presented with incomplete obstruction related to ileocecal damage that it was resected with an histopathological report of endometriosis at cecum, ileon and appendix. The patient presented with endometriosis, degree IV, and had medical treatment with gestrinohn, during six months; latter on, HTA+SOB, was done, she received hormonal therapy. Endometriosis may be a cause for acute abdomen in women, and it should be considered in the differential diagnosis.