RESUMO
Reportar un caso de evisceración vaginal espontánea en paciente con antecedentes quirúrgicos de histerectomía vaginal y hacer una revisión de la literatura sobre los principales factores de riesgo asociados a la presentación de este evento. Se presenta el caso de una paciente de 74 años multípara de 12 partos vaginales con antecedente ginecológico de histerectomía vaginal en 2012, en el año 2014 una sacroespinocolpopexia con colocación de cinta transobturadora más colporrafia anterior, en 2018 presenta cuadro con asas intestinales protruyendo con signos de isquemia a través de defecto en cúpula vaginal, se realiza resección de intestino delgado y anastomosis termino-terminal, con posterior cierre de defecto por vía abdominal. Se realizó una búsqueda en las bases de datos PubMed, Scielo, Google Scholar y Science Direct para artículos publicados en inglés y español, de los últimos 22 años. Se identificaron 16 títulos que cumplieron con los criterios de selección, los resultados de la revisión muestran factores de riesgo comunes. La evisceración vaginal por dehiscencia de la cúpula vaginal es una patología poco prevalente, el abordaje mínimamente invasivo, que ha aumentado en los últimos años, ha conllevado un aumento de la incidencia, siendo la histerectomía por laparoscopia el de mayor riesgo.
To report a case of spontaneous vaginal evisceration in a patient with a surgical history of vaginal hysterectomy, and to review the literature on the main risk factors associated with the presentation of this event. We present the case of a 74-year-old multiparous patient with 12 vaginal deliveries with a gynecological history of vaginal hysterectomy in 2012, in 2014 a sacrospinocolpopexy with placement of transobturator tape plus anterior colporrhaphy, in 2018 she presented with intestinal loops protruding with signs of ischemia through a defect in the vaginal vault, resection of the small intestine and end-to-end anastomosis were performed, with subsequent closure of the defect through the abdomen. A search was made in the PubMed, Scielo, Google Scholar and Science Direct databases for articles published in English and Spanish, from the last 22 years. 16 titles that met the selection criteria were identified; the results of the review show common risk factors. Vaginal evisceration due to dehiscence of the vaginal vault is a rare pathology, the minimally invasive approach, which has increased in recent years, has led to an increase in incidence, with laparoscopic hysterectomy being of greater risk.
Assuntos
Humanos , Feminino , Idoso , Doenças Vaginais/cirurgia , Doenças Vaginais/etiologia , Histerectomia Vaginal/efeitos adversos , Enteropatias/cirurgia , Enteropatias/etiologia , Prolapso Visceral , Fatores de RiscoRESUMO
BACKGROUND: Graft-versus-host disease (GVHD) is the main complication of allogeneic hematopoietic stem cell transplantation (HSCT). GVHD in the female genital tract can cause sinusorrhagia, dyspareunia, synechia, and even complete vagina occlusion. PURPOSE: This prospective study aimed to evaluate the clinical characteristics and effects of preventive and prompt treatment for genital GVHD in females undergoing HSCT (n = 40). RESULTS: Genital GVHD was diagnosed in 11 of 40 patients (27.5%), and the most common complaint was vaginal dryness (54.6%). The majority of patients (63.6%) presented mild genital GVHD (clinical score 1), with interlabial fissures and lichen-like lesions, while a minority of patients (9.1%) presented advanced genital GVHD (clinical score 3) with the fusion of the small and large lips. The median time of onset of genital GVHD signs was 10 months after HSCT, concomitant with GVHD in the skin and oral cavity. Personalized and topical therapy was effective in most cases (81.8%), and no patient required surgical intervention. CONCLUSION: We confirmed that female genital GVHD affects approximately one-third of females undergoing HSCT, highlighting the importance of periodic gynecological monitoring for early detection and treatment to improve care for these females.
Assuntos
Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Doenças Vaginais , Feminino , Genitália Feminina/patologia , Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/etiologia , Doença Enxerto-Hospedeiro/terapia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Estudos Prospectivos , Doenças Vaginais/diagnóstico , Doenças Vaginais/etiologia , Doenças Vaginais/terapiaRESUMO
The aim of this paper is to describe the distinctive ultrasound findings of a case of vaginal bleeding caused by the presence of a foreign body. We present the case of an infant who consulted for vaginal bleeding and foul-smelling discharge. The ultrasound revealed signs of vaginal distension due to heterogeneous-hematic contents and parietal thickening. At Doppler examination, a striking finding of increased vascularization limited to the upper two-thirds of the vaginal wall was found, which was initially interpreted as a sign of local inflammation suggesting the presence of an underlying foreign body. At direct vaginoscopic examination remains of toilet paper in the vaginal fundus were found. The presence of a foreign body in the vagina is an uncommon cause of discharge and vaginal bleeding in pediatrics, therefore, this etiology should be kept in mind when the adequate clinical context arises. Doppler ultrasound represents a first-line complementary method when this entity is suspected.
Assuntos
Corpos Estranhos , Doenças Vaginais , Criança , Feminino , Corpos Estranhos/diagnóstico por imagem , Humanos , Ultrassonografia/efeitos adversos , Hemorragia Uterina/complicações , Hemorragia Uterina/etiologia , Vagina/diagnóstico por imagem , Doenças Vaginais/etiologiaRESUMO
BACKGROUND: We aimed to evaluate the effects of different therapeutic options to prevent the evolution of vaginal stenosis after pelvic radiotherapy in women with cervical cancer. METHODS: open-label randomized clinical trial of 195 women, stage I-IIIB, aged 18-75 years, using topical estrogen (66), topical testosterone (34), water-based intimate lubricant gel (66), and vaginal dilators (29) to assess the incidence and severity of vaginal stenosis after radiotherapy at UNICAMP-Brazil, from January/2013 to May/2018. The main outcome measure was vaginal stenosis assessed using the Common Terminology Criteria for Adverse Events (CTCAE) scale and percental changes in vaginal volume. The women were evaluated at four different times: shortly after the end of radiotherapy, and four, eight, and 12 months after the beginning of the intervention. Statistical analysis was carried out using Symmetry test, Kruskal-Wallis test and multiple regression. RESULTS: the mean age of women was 46.78 (±13.01) years, 61,03% were premenopausal and 73,84% had stage IIB-IIIB tumors. The mean reduction in vaginal volume in the total group was 25.47%, with similar worsening in the four treatment groups with no statistical difference throughout the intervention period. There was worsening of vaginal stenosis evaluated by CTCAE scale after 1 year in all groups (p < 0.01), except for the users of vaginal dilator (p = 0.37). CONCLUSIONS: there was a reduction in vaginal volume in all treatment groups analyzed, with no significant difference between them. However, women who used vaginal dilators had a lower frequency and severity of vaginal stenosis assessed by the CTCAE scale after one year of treatment. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, RBR-23w5fv . Registered 10 January 2017 - Retrospectively registered.
Assuntos
Braquiterapia/efeitos adversos , Quimiorradioterapia/efeitos adversos , Lesões por Radiação/epidemiologia , Neoplasias do Colo do Útero/radioterapia , Doenças Vaginais/epidemiologia , Administração Tópica , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Quimiorradioterapia/métodos , Constrição Patológica/diagnóstico , Constrição Patológica/epidemiologia , Constrição Patológica/etiologia , Constrição Patológica/prevenção & controle , Dilatação/instrumentação , Dilatação/métodos , Estrogênios Conjugados (USP)/administração & dosagem , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Lesões por Radiação/prevenção & controle , Índice de Gravidade de Doença , Propionato de Testosterona/administração & dosagem , Resultado do Tratamento , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/patologia , Vagina/efeitos dos fármacos , Vagina/patologia , Vagina/efeitos da radiação , Doenças Vaginais/diagnóstico , Doenças Vaginais/etiologia , Doenças Vaginais/prevenção & controle , Adulto JovemRESUMO
RESUMEN Las lesiones del tracto genital femenino tras relaciones sexuales son un problema frecuente en las urgencias de ginecología, pero poco estudiado salvo su aspecto médico-legal. Su incidencia es desconocida ya que muchas mujeres no llegan a consultar por miedo o pudor. El reconocimiento precoz de estas lesiones y su correcto tratamiento puede evitar la parición de secuelas que acompañarán a nuestra paciente durante el resto de su vida. Presentamos el caso de una paciente de 18 años con un desgarro perineal con mucosa vaginal íntegra tras su primera relación sexual.
ABSTRACT Injuries to the female genital tract after sexual intercourse are a frequent problem in gynecological emergencies, but little studied except for their medico-legal aspect. Its incidence is unknown since many women do not go to their specialist out of fear or embarrassment. Early recognition of these injuries and their correct treatment may prevent the appearance of sequelae that will accompany our patient for the rest of her life. We present the case of an 18-year-old patient with a perineal tear with intact vaginal mucosa after her first sexual intercourse.
Assuntos
Humanos , Feminino , Adolescente , Vagina/lesões , Ferimentos Penetrantes/etiologia , Coito , Vagina/cirurgia , Doenças Vaginais/cirurgia , Doenças Vaginais/etiologia , Ferimentos Penetrantes/cirurgia , Ferimentos Penetrantes/diagnóstico , Fatores de Risco , Lacerações , Mucosa/cirurgia , Mucosa/lesõesRESUMO
OBJECTIVE: The aim of this study was to evaluate the efficacy and acceptability of a second generation of vaginal laser treatment, the vaginal erbium laser, as a nonablative photothermal therapy for the management of genitourinary syndrome of menopause in postmenopausal breast cancer survivors. METHODS: The study was performed using an erbium laser crystal yttrium-aluminum-garnet (XS Fotona Smooth, Fotona, Ljubljana, Slovenia) with a wavelength of 2,940ânm. Forty-three postmenopausal breast cancer survivors were treated with three laser applications every 30 days. Symptoms were assessed before the treatment and after 1, 3, 6, 12, and 18 months, using two methods, subjective Visual Analog Scale (VAS) and objective Vaginal Health Index Score (VHIS). The procedures were performed on an outpatient basis without anesthesia or drug use before or after the intervention. RESULTS: From baseline values of 8.5â±â1.0âcm, vaginal dryness VAS scores were 4.4â±â1.2âcm after the third treatment and 5.5â±â1.5âcm 12 months after the treatment (Pâ<â0.01 vs basal values), whereas they were 7.5â±â1.8âcm after 18 months from the last laser application (NS vs basal values). From baseline values of 7.5â±â1.5âcm, dyspareunia VAS values decreased to 4.2â±â0.9âcm after the third treatment and 5.1â±â1.8âcm 12 months from the last laser application (Pâ<â0.01 vs basal values), whereas they were 6.5â±â1.8âcm after 18 months from the last laser application (NS vs basal values). VHIS, from baseline values of 8.1â±â1.3, was 21.0â±â1.4 after the third treatment and 18â±â1.8 12 months from the last laser application (Pâ<â0.01 vs basal values), whereas they were 14.8â±â1.5âcm after 18 months from the last laser application (NS vs basal values). No adverse events were recorded during the study. CONCLUSIONS: This study suggests that the vaginal erbium laser is effective and safe for the treatment of genitourinary syndrome of menopause in breast cancer survivors.
Assuntos
Doenças Urogenitais Femininas/cirurgia , Hipertermia Induzida/métodos , Terapia a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Pós-Menopausa , Adulto , Idoso , Neoplasias da Mama/complicações , Sobreviventes de Câncer , Dispareunia/etiologia , Dispareunia/cirurgia , Feminino , Doenças Urogenitais Femininas/etiologia , Humanos , Pessoa de Meia-Idade , Projetos Piloto , Síndrome , Resultado do Tratamento , Vagina/cirurgia , Doenças Vaginais/etiologia , Doenças Vaginais/cirurgiaRESUMO
La evisceración vaginal es una complicación muy rara. Es más frecuente en mujeres posmenopáusicas y con antecedente de cirugía vaginal, fundamentalmente histerectomía. También puede darse en mujeres premenopáusicas, vinculándose en estos casos a traumatismos, iatrogenia o introducción de cuerpos extraños. El íleon distal es el órgano más frecuentemente eviscerado, aunque el prolapso de epiplón, trompas de Falopio y apéndice también se han descrito. Presentamos el caso de una mujer de 43 años con evisceración transvaginal de epiplón a los seis meses de realizarse una histerectomía abdominal por recidiva de un cáncer escamoso de cérvix.
Vaginal evisceration is a very rare complication. It is more often in postmenopausal women with a history of vaginal surgery, mainly hysterectomy. It can also occur in premenopausal women, linking these cases to trauma, iatrogenic or foreign bodies. The distal ileum is most often gutted organ prolapse, although omentum, fallopian tubes and appendix are also described. We report a 43-year old transvaginal omental evisceration after six months of an abdominal hysterectomy for recurrent squamous cervical cancer.
Assuntos
Humanos , Feminino , Adulto , Doenças Vaginais/diagnóstico , Histerectomia Vaginal/efeitos adversos , Enteropatias/diagnóstico , Omento , Prolapso , Deiscência da Ferida Operatória , Doenças Vaginais/etiologia , Doença Iatrogênica , Enteropatias/etiologiaRESUMO
OHVIRA (Obstructed hemivagina and ipsilateral renal anomaly) by acronym and abbreviations in English or Herlyn Werner Wunderlich syndrome is a rare congenital malformation caused by an alteration in the Mullerian ducts and Wolffian Ducts. Which is characterized by a triad: uterus didelphys, obstructed and ipsilateral renal agenesis hemivagina still uncertain etiology. Patients are usually asymptomatic until menarche where the most common clinical presentation is pelvic pain, followed by a vaginal or abdominal mass, normal menstrual periods, infertility, and vaginal discharge rarely appears. The case of a female patient of 15 years, nubile with chronic fetid vaginal discharge, initially diagnosed and treated as pelvic inflammatory disease occurs, however because it is an exceptional condition with the background of the patient, by complementary studies were conducted where pelvic ultrasound revealed pyocolpos and absence of left kidney, uterus didelphys, blind hemivagina by other imaging studies, where we could integrate Herlyn-Werner-Wunderlich syndrome. In conclusion, abnormalities in the development of the Miillerian ducts are difficult to diagnose early, so you must have the embryological knowledge, conduct thorough clinical assessment and detailed picture in whom the coridition is suspected to identify malformations coexisting urinary tract and vaginal defects with the importance of preserving reproductive success through appropriate planning of surgical approach, given that the fertility rate in these patients is comparable to the average.
Assuntos
Anormalidades Múltiplas , Rim/anormalidades , Vagina/anormalidades , Doenças Vaginais/etiologia , Adolescente , Feminino , Humanos , Supuração/etiologiaRESUMO
BACKGROUND: Vulvo-cervico-vaginal involvement has rarely been reported in pemphigus vulgaris (PV) and has not been reported in pemphigus foliaceus (PF). OBJECTIVES: We sought to evaluate genital lesions and Papanicolaou (Pap) smears in female patients with PV and PF. METHODS: This prospective study includes all consecutive cases of female patients with PV and PF seen from May 2009 to February 2010. Gynecologic examination was performed and Pap smears were collected for cytologic analysis from each patient. RESULTS: A total of 56 patients were given a diagnosis of pemphigus (41 PV and 15 PF). Genital involvement was observed in 9 patients with PV (22%) and the vulva was the most common genital site of involvement. Of these 9 patients, 8 presented with active skin/mucous lesions. Four of 15 patients with PF had genital lesions and vulva was the exclusive site of involvement. Three of 4 patients with PF and genital involvement also showed active cutaneous lesions. Six of 56 patients (5 PV and 1 PF) presented with atypical squamous cells of undetermined significance in Pap smear analysis. Upon further pathologic review, acantholytic cells were seen, confirming the diagnosis of pemphigus. LIMITATIONS: A small number of PF cases were studied. CONCLUSIONS: Vulvar lesions were the second most frequent site of mucous membrane PV. Herein we report the first case to our knowledge of symptomatic genital lesions in a patient with PF. Moreover, acantholytic cells in Pap smears were found in a patient with PF who was in complete remission off therapy with no clinical genital lesions and no circulating anti-desmoglein-1 and anti-desmoglein-3 autoantibodies. Gynecologic evaluation in patients with pemphigus, including a careful evaluation of Pap smears, should be recommended.
Assuntos
Doenças dos Genitais Femininos/etiologia , Pênfigo/complicações , Adulto , Idoso , Feminino , Doenças dos Genitais Femininos/patologia , Humanos , Pessoa de Meia-Idade , Teste de Papanicolaou , Pênfigo/patologia , Estudos Prospectivos , Doenças do Colo do Útero/etiologia , Doenças Vaginais/etiologia , Esfregaço Vaginal , Doenças da Vulva/etiologia , Adulto JovemRESUMO
Las infecciones del aparato genital femenino constituyen un problema importante de la práctica ginecoobstétrica. Son causa de morbilidad, mortalidad materna y neonatal. Entre los factores que explican su frecuencia están: aborto provocado, aumento de intervenciones quirúrgicas e infecciones de transmisión sexual. OBJETIVO: Realizar el diagnóstico y determinar la prevalencia de infecciones vaginales en mujeres que asisten al Laboratorio de Microbiología del Hospital Ginecoobstétrico "Ramón González Coro" con la utilización del Juego de diagnóstico de infecciones vaginales Newvagin C-Kure. MÉTODOS: Se examinaron 150 mujeres, de edades entre 17 y 74 años, de mayo a octubre de 2007. Se utilizó examen directo, criterios de Amsel y cols, así como prueba de aglutinación al látex. RESULTADOS: La prevalencia de las infecciones vaginales estudiadas fue de 62 % al examen directo y de 58,6 % con la prueba de aglutinación al látex. La infección vaginal con mayor prevalencia fue vaginosis bacteriana, seguida de candidiosis vaginal y trichomoniosis vaginal. El grupo de edad con mayor prevalencia de estas infecciones fue el de 28-37 años. La manifestación clínica más frecuente fue la leucorrea. El inicio precoz de las relaciones sexuales, la realización del acto sexual sin protección y el uso de métodos anticonceptivos, estuvieron relacionados con la presencia de estas infecciones vaginales. CONCLUSIONES: El uso del Juego de diagnóstico de infecciones vaginales NEWVAGIN C-Kure, en consultorios de médicos de familia, policlínicos comunitarios y consultas de ginecología resulta ventajoso. La realización del diagnóstico por el personal paramédico, su rapidez y la certeza en la indicación del tratamiento médico son los principales factores a considerar
The infections of female genital tract are a significant problem of gynecologic and obstetric practice. They are cause of morbidity and of mother and neonatal mortality. Among factors explaining its frequency are: provoked abortion, increase of surgical interventions and sexual transmitted infections. OBJECTIVES:To make the diagnosis and to determine the vaginal infections prevalence in women served in Microbiology Laboratory of "Ram¾n Gonzßlez Coro" using the NEWVAGIN C-Cure diagnosis kit. METHODS: Authors examined to 150 women aged between 17 and 24 from May to October, 2007. Direct examination, Amsel et al criteria and latex agglutination test were used. RESULTS: Prevalence of study vaginal infections was of 62 percent in direct examination and of 58.6 percent using the latex agglutination test. The more prevalent vaginal infection was the bacterial vaginosis followed by vaginal candidiasis and vaginal trichomoniasis. The more prevalent age group with these infections was that aged 28-37. More frequent clinical manifestation was the leucorrhea. The early onset of sexual intercourse, the intercourse without protection and the use of contraceptive methods were related to presence of these vaginal infections. CONCLUSIONS: The use of NEWVAGIN C-Kure diagnosis kit for vaginal infections in family consulting room, community polyclinics and Gynecology consultations is very advantageous. Making diagnosis by paramedical staff, its speed and accuracy in prescription of medical treatment are the leading factors to be considered
Assuntos
Humanos , Feminino , Doenças Vaginais/diagnóstico , Doenças Vaginais/epidemiologia , Doenças Vaginais/etiologiaRESUMO
Incidence of Behçet disease in USA is 0.12 in 100,000; but in Mexico there are just two isolated cases. This paper reports a case of a 30 year-old female, who, when 26, had vaginal ulcers. She received antimicrobial therapy during four years. In March 2007 she came to author's hospital with a cervical vaginitis diagnose study, and presenting thorax with venous collateral circulation secondary to superior and inferior cava vein thrombosis. Colposcopy and vaginal wall biopsy were practiced and found chronic ulcer with vascular damage; oral ulcers were found too, and Pathergy test was positive. Currently there is no ocular damage. Patient received azathioprine therapy without improvement, later she received anticoagulant therapy with corticoids and has good evolution.
Assuntos
Síndrome de Behçet/complicações , Úlcera/etiologia , Adulto , Anticoagulantes/uso terapêutico , Azatioprina/uso terapêutico , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/epidemiologia , Feminino , Humanos , Imunossupressores/uso terapêutico , Úlceras Orais/etiologia , Prednisona/uso terapêutico , Gravidez , Síndrome da Veia Cava Superior/etiologia , Úlcera/tratamento farmacológico , Doenças Vaginais/tratamento farmacológico , Doenças Vaginais/etiologia , Veia Cava Inferior , Trombose Venosa/etiologia , Trombose Venosa/prevenção & controleRESUMO
We report a case of vaginal cyst after hysterectomy. Its assessment, manegement and therapy.
Presentamos el caso de una paciente que tuvo un quiste de inclusión vaginal, luego de una histerectomía total. Su estudio, manejo y terapia.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Doenças Vaginais/etiologia , Doenças Vaginais , Histerectomia/efeitos adversos , Cistos/etiologia , Cistos , Epitélio , Doenças Vaginais/classificação , Cistos/classificaçãoRESUMO
Presentamos 3 casos de endometriosis profunda del tabique rectovaginal con compromiso intestinal, en los cuales se realizó resección segmentaria del rectosigmoides para lograr la remoción completa de la enfermedad. Se analiza el cuadro clínico, manejo quirúrgico, complicaciones y seguimiento posterior. Revisamos la literatura a fin de establecer algunas pautas de manejo de esta entidad.
We reported 3 cases of deep endometriosis affecting the rectovaginal space with intestinal disease in which a rectosigmoides resection was required to achieve a complete surgical removal of disease. The clinical course, surgical management, complications and follow-up are analyzed. We review the literature to define some guidelines in the management of this entity.
Assuntos
Humanos , Adulto , Feminino , Endometriose/cirurgia , Endometriose/complicações , Doenças Vaginais/cirurgia , Doenças Retais/cirurgia , Laparoscopia , Colo Sigmoide/cirurgia , Endometriose/diagnóstico , Enteropatias/etiologia , Doenças Vaginais/etiologia , Doenças Retais/etiologia , Complicações Pós-Operatórias , Resultado do TratamentoRESUMO
OBJECTIVE: To analyze the clinical trends of gestational trophoblastic neoplasia (GTN) at the Department of Obstetrics and Gynecology, Hospital Universitario de Caracas (HUC). STUDY DESIGN: A medical record review was performed of epidemiologic, clinical and diagnostic features of 25 cases of GTN at HUC from 1997 to 2004. RESULTS: During the study period, 35,300 deliveries occurred, and 25 patients were diagnosed with GTN; the prevalence was 0.70:1,000 deliveries. The mean age was 29.2 years. Fifty-six percent were posthydatidiform mole (HM), 36% postchoriocarcinoma (CC), 4% postinvasive mole and 4% postabortion with abundant intermediate trophoblast. Vaginal bleeding was the main symptom in patients with CC. Two cases resembled ectopic pregnancy, and another resembled a vaginal endometrioma. Fifty-two percent of cases were at stage Ib; 76% received single-agent chemotherapy. Hysterectomy was performed in 6 cases. Twenty-one patients achieved remission, 2 showed regression and 2 died. CONCLUSION: GTN had a high prevalence because HUC is a reference center. The most common presentation was post-HM GTN. Vaginal bleeding is frequent in CC and can mimic other gynecologic diseases. Chemotherapy is helpful, and hysterectomy can be performed in selected cases at early stages or with severe vaginal bleed-with a good ing. GTN has a good prognosis, and early diagnosis is possible.
Assuntos
Coriocarcinoma/epidemiologia , Doença Trofoblástica Gestacional/epidemiologia , Mola Hidatiforme/epidemiologia , Adulto , Coriocarcinoma/complicações , Gonadotropina Coriônica/sangue , Feminino , Doença Trofoblástica Gestacional/terapia , Hemorragia/etiologia , Humanos , Mola Hidatiforme/complicações , Pessoa de Meia-Idade , Gravidez , Prevalência , Prognóstico , Estudos Retrospectivos , Neoplasias Uterinas/complicações , Neoplasias Uterinas/epidemiologia , Doenças Vaginais/etiologia , Venezuela/epidemiologiaRESUMO
Se presenta un caso de himen imperforado y su resolución quirúrgica llegando a presentar abdomen agudo con secuelas.
Assuntos
Humanos , Feminino , Criança , Hímen/anormalidades , Hímen/cirurgia , Dor Abdominal/etiologia , Doenças Vaginais/cirurgia , Doenças Vaginais/etiologia , Resultado do TratamentoRESUMO
OBJETIVOS: Validar los flujogramas propuestos para diagnóstico y tratamiento sindrómico de Flujo Vaginal Y Dolor Abdominal Bajo, estableciendo su sensibilidad, especificidad, valor predictivo positivo(vpp)en comparación con el diagnóstico etiológico y estudiar la relación existente entre la presencia de flujo vaginal, dolor abdominal bajo y otras ITS con la infección por VIH en población estudiada. METODOS: Es un estudio prospectivo con componentes descriptivos y analíticos, que abarca una muestra de 933 mujeres sexualmente activas, embarazadas o no, que se presentaron espontáneamente con queja de flujo vaginal y/o dolor abdominal bajo a 8 Centros de Salud de la Región Sanitaria Metropolitana durante los meses de octubre de 1999 a noviembre de 2000. Los criterios utilizados para validar los métodos propuestos fueron la sensibilidad, la especificidad y el valor predictivo positivo RESULTADOS:Validez de los flujogramas propuestos: varios flujogramas fueron probados por simulación y validados para flujo vaginal. Cuando se validó el primer flujograma para utilización en el paìs basado tan solo en la evaluación de riesgo, la sensibilidad, especificidad y vpp para cervicitis fueron respectivamente de 16%,94% y 10%. Al agregarse en el segundo flujograma el examen con espéculo con el objetivo de identificar el origen y características de la secreción, la sensibilidad, especificidad y vpp fueron, para cervicitis de 49%,53% y 4%, para tricomoniasis y/o vaginosis bacteriana de 46%,62% y 38%.Al utilizarse las microscopía en el tercer flujograma la sensibilidad, la especificidad y vpp fueron para cervicitis, de 57%,60% y 6% y para tricomoniasis de 90%,100% y100%.En el cuarto flujograma, al utilizarse algunas características específicas de cervicitis y añadiendo la prueba de pH para la vaginitis/vaginosa, la sensibilidad, especificidad y vvp fueron respectivamente para cervicitis de 67%,59% y 6%, para tricomoniasis y/o vaginosis bacteriana de 96%,45% y 47%.Como en el estudio se definieron factores sociodemográficos y comportamiento considerados de riesgo, además de los síntomas y signos asociados, se pudo diseñar un flujograma para flujo vaginal apuntando hacia un balance entre los criterios de validez, pero buscando siempre que la sensibilidad fuera la mas alta posible; al simularse el nuevo flujograma, la sensibilidad fue de 85%, especificidad de 38%, y vpp de 4%...(AU)
Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto , Infecções Sexualmente Transmissíveis/etiologia , Dor Abdominal/diagnóstico , Honduras , Doenças Vaginais/etiologia , Vagina/metabolismoRESUMO
This study aimed to assess the prevalence of bacterial vaginosis (BV) and other cervicovaginal infections, as well as the incidence of complications among new users of IUD, 1 and 6 months after its insertion, in the City of Campinas, Brazil. A total of 223 women who had a TCu-380A IUD inserted from May through November 2001, were included in the study. After the IUD insertion all women were scheduled to two additional visits: after 1 month and after 6 months, when they were interviewed and a pelvic examination was performed, along with a collection of specimens from the vagina and the endocervix for laboratory testing. The Nugent's criterion was used for the BV diagnosis. They were also evaluated with regard to presence of complications possibly related to IUD insertion and use, i.e., abnormal bleeding, dysmenorrhea, expulsion and pelvic inflammatory disease. The prevalence of cervicovaginal infections was 29.1%, BV being the most frequent (19.7%). Dysmenorrhea was more frequent among women with BV than among women without BV (p = 0.03). A trend of abnormal bleeding being more frequent among women with BV was also found. In conclusion, BV after 1 month of IUD insertion was not associated with IUD complications, with the exception of dysmenorrhea.
Assuntos
Infecções por Chlamydia/etiologia , Dispositivos Intrauterinos/efeitos adversos , Doenças do Colo do Útero/etiologia , Doenças Vaginais/etiologia , Adolescente , Adulto , Brasil/epidemiologia , Candida/isolamento & purificação , Candidíase Vulvovaginal/epidemiologia , Candidíase Vulvovaginal/etiologia , Infecções por Chlamydia/epidemiologia , Chlamydia trachomatis/isolamento & purificação , Feminino , Seguimentos , Humanos , Incidência , Prevalência , Doenças do Colo do Útero/epidemiologia , Doenças Vaginais/epidemiologia , Vaginose Bacteriana/epidemiologia , Vaginose Bacteriana/etiologiaRESUMO
BACKGROUND: The involvement of the rectovaginal septum, of rectum and sigmoid by endometriosis leads to intense symptoms as dysmenorrhea, pelvic pain, deep dyspareunia, tenesmus and hematochezia in young and middle aged women during periods. The diagnosis can be made by tipycal history and vaginal examination, rectal examination, barium enema, proctoscopy and so on. The indications of operation include severe clinic symptoms and failed conservative therapy. The treatment of choice for this type of endometriosis is the surgical resection of affected tissue, in order to relieve patient symptoms, and avoid disease progression. The correct assessment as to the presence and extension of the endometriosis-affected sites such as the rectum, uterosacral ligaments and rectovaginal septum is extremely important to provide better results with the surgical treatment of endometriosis. AIM: To describe the main aspects related to rectovaginal septum endometriosis and offer the general surgeon some information about this enigmatic disease. CONCLUSION: Rectovaginal septum endometriosis is a frequent disease, with specific diagnosis and treatment.
Assuntos
Endometriose , Doenças Retais , Doenças Vaginais , Endometriose/diagnóstico , Endometriose/etiologia , Endometriose/cirurgia , Feminino , Humanos , Doenças Retais/diagnóstico , Doenças Retais/etiologia , Doenças Retais/cirurgia , Doenças Vaginais/diagnóstico , Doenças Vaginais/etiologia , Doenças Vaginais/cirurgiaRESUMO
Apesar do corrimento vaginal ser uma das mais antigas e frequentes afecçöes que acometem a saúde física e emocional da mulher, do diagnóstico laboratorial ser relativamente fácil e de baixo custo, das recidivas e reinfecçöes serem constantes, ainda na atualidade, sua abordagem é feita de maneira simplista e empírica, tanto para o diagóstico como para a terapêutica. Este estudo objetiva enfatizar a importåncia de uma abordagem holística no atendimento à mulher com corrimento vaginal, pois acreditamos que tal afecçäo, suas recidivas e reinfecçöes näo estäo exclusivamente associadas a infectividade e virulência do patógeno envolvido, mas também ao contexto socioeconömico e cultural em que a mulher está inserida
Assuntos
Humanos , Feminino , Adulto , Infecções Sexualmente Transmissíveis/economia , Doenças Vaginais/diagnóstico , Doenças Vaginais/economia , Doenças Vaginais/etiologia , Fatores Socioeconômicos , Saúde da MulherRESUMO
El presente estudio clínico epidemiológico se realizó en el consultorio de Ginecología y Obstetricia del Hospital Regional Honorio Delgado de Arequipa, entre los meses de enero a marzo del año 1995. El propósito fue identificar la frecuencia de vaginosis bacteriana tanto en mujeres embarazadas y no embarazadas sexualmente activas. Para cumplir este propósito se examinó por conveniencia a 100 mujeres embarazadas y a 100 no embarazadas. Habiendo encontrado una frecuencia del 41 por ciento en las embarazadas y el 32 por ciento en las no embarazadas, lo que no corraboraría nuestra hipótesis que el proceso reproductivo de la mujer condiciona la vaginosis bacteriana. Para la identificación de los casos me he basado en los criterios de Amsel y Col. como: 1)Presencia de flujo vaginal homogeneo blanco grisáceo; 2)Test de aminas positiva con adición (Hidróxido de potasio al 10 por ciento) se produce olor a pescado; 3) Ph mayor a 4.5; 4)Presencia de células guía. Hemos encontrado que las edades de mayor riesgo son las comprendidas entre los 15 a 34 años de edad, en el (43.9 por ciento) para las mujeres embarazadas y en el (34.4 por ciento) en las no embarazadas. La Vaginosis bacteriana se presentó con más frecuencia en un porcentaje de (56.1 por ciento) en el tercer trimestre de embarazo siguiendo el (29.3 por ciento) para el primer trimestre de embarazo. En cuanto al estado civil la condición conviviente tanto en el grupo de embarazadas y no embarazadas se encontró con mayor predominancia, presentándose en un porcentaje de (56.1 y 59 por ciento), respectivamente a diferencia de las solteras y casadas. En lo concerniente a la paridad, vaginosis bacteriana se presentó en mayor porcenteje con un (37 por ciento) en embarazadas nulíparas y (26.8 por ciento) en las embarazadas que presentaron aborto. A diferencia de las no embarazadas su mayor porcentaje de (56.3 por ciento) presentaron abortos. Hemos constatado que la presencia de células guía y el test de aminas es un valor diagnóstico para vaginosis bacteriana