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[PMID]:28624115
[Au] Autor:Vatsa R; Bharti J; Roy KK; Kumar S; Sharma JB; Singh N; Singhal S; Meena J
[Ad] Endereço:Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
[Ti] Título:Evaluation of amnion in creation of neovagina in women with Mayer-Rokitansky-Kuster-Hauser syndrome.
[So] Source:Fertil Steril;108(2):341-345, 2017 Aug.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the outcome of amnion vaginoplasty in cases of vaginal agenesis due to Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome managed at the authors' institution. DESIGN: Retrospective study. SETTING: Tertiary care hospital. PATIENT(S): Fifty women with MRKH who underwent neovaginoplasty. INTERVENTION(S): Modified McIndoe's vaginoplasty was done in all the patients, using human amnion graft. MAIN OUTCOME MEASURE(S): Functional status assessed by Female Sexual Function Index, anatomic status (length and width of neovagina), and epithelialization of vagina. RESULT(S): Mean (±SD) vaginal length after surgery was 8.2 ± 1 cm. Mean vaginal length at 6-month follow-up in sexually active patients was significantly longer as compared with the patients who were not sexually active after surgery (8.4 ± 1.04 cm vs. 6.6 ± 2.4 cm). Mean Female Sexual Function Index score was 30.8 ± 2.1. Vaginal biopsy showed complete epithelialization of vaginal mucosa. CONCLUSION(S): In a developing nation like India, McIndoe's method with amnion graft seems to be a promising option owing to its low cost, easy availability, and safety, ease of the procedure not requiring any special instrument, physiologic outcome with respect to epithelialization of the vagina without hair growth, and satisfying functional outcome.
[Mh] Termos MeSH primário: Transtornos 46, XX do Desenvolvimento Sexual/cirurgia
Âmnio/patologia
Âmnio/transplante
Colpotomia/métodos
Anormalidades Congênitas/cirurgia
Ductos Paramesonéfricos/anormalidades
Estruturas Criadas Cirurgicamente/patologia
Vagina/cirurgia
[Mh] Termos MeSH secundário: Transtornos 46, XX do Desenvolvimento Sexual/diagnóstico
Transtornos 46, XX do Desenvolvimento Sexual/patologia
Adolescente
Adulto
Anormalidades Congênitas/diagnóstico
Anormalidades Congênitas/patologia
Feminino
Seres Humanos
Ductos Paramesonéfricos/patologia
Ductos Paramesonéfricos/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Estudos Retrospectivos
Resultado do Tratamento
Vagina/anormalidades
Vagina/patologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170825
[Lr] Data última revisão:
170825
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170619
[St] Status:MEDLINE


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[PMID]:28192248
[Au] Autor:Barski D; Arndt C; Gerullis H; Yang J; Boros M; Otto T; Kolberg HC
[Ad] Endereço:Department of Urology, Lukas Hospital, Neuss, Germany. Electronic address: dbarski@lukasneuss.de.
[Ti] Título:Transvaginal PVDF-mesh for cystocele repair: A cohort study.
[So] Source:Int J Surg;39:249-254, 2017 Mar.
[Is] ISSN:1743-9159
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Optimized biocompatibility of new materials is a major requirement for transvaginal meshes for pelvic organ prolapse (POP) repair. Polyvinylidene fluoride (PVDF) presented good characteristics in prior animal experiments and clinical use in humans. METHODS: Between 01/2012 and 04/2016 37 women underwent transvaginal repair of symptomatic prolapse of the anterior vaginal wall (cystocele) with PVDF-mesh in a single institution. A chart review for recurrence, continence, peri- and early postoperative complications was performed. Referring practitioners were interviewed by telephone and mail. Additionally patient reported outcome and satisfaction were measured by Patient Global Improvement Inventory (PGI-I) scale. RESULTS: 34 women were eligible for a mean follow up of 19 months. The functional outcome improved significantly. One symptomatic vault prolapse (2.9%) and two reoperations for incontinence (5.9%) occurred. Two mesh exposures (5.9%) occurred and were treated conservatively. No other severe complications were registered. 87.5% of treated women felt very much better or much better and would undergo the surgery again. A cohort study including development steps in accordance with the IDEAL system is presented. CONCLUSIONS: For the first time we report on effectivity and safety of transvaginal application of PVDF-mesh in real-life practice. A prospective long-term evaluation in a registry is justified.
[Mh] Termos MeSH primário: Cistocele/cirurgia
Telas Cirúrgicas
[Mh] Termos MeSH secundário: Adulto
Idoso
Materiais Biocompatíveis
Estudos de Coortes
Colpotomia/instrumentação
Colpotomia/métodos
Feminino
Seres Humanos
Meia-Idade
Satisfação do Paciente
Polivinil
Complicações Pós-Operatórias
Próteses e Implantes
Reoperação
Estudos Retrospectivos
Resultado do Tratamento
Incontinência Urinária/cirurgia
Vagina/cirurgia
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biocompatible Materials); 0 (Polyvinyls); 24937-79-9 (polyvinylidene fluoride)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170509
[Lr] Data última revisão:
170509
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170214
[St] Status:MEDLINE


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[PMID]:28063908
[Au] Autor:Beran BD; Shockley M; Arnolds K; Escobar P; Zimberg S; Sprague ML
[Ad] Endereço:Section of Minimally Invasive Gynecology, Department of Gynecology, Cleveland Clinic Florida, Weston, Florida. Electronic address: beranb@ccf.org.
[Ti] Título:Laser Angiography with Indocyanine Green to Assess Vaginal Cuff Perfusion during Total Laparoscopic Hysterectomy: A Pilot Study.
[So] Source:J Minim Invasive Gynecol;24(3):432-437, 2017 Mar - Apr.
[Is] ISSN:1553-4669
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY OBJECTIVE: To determine feasibility of using laser angiography with indocyanine green (ICG) to assess vaginal cuff vascular perfusion during total laparoscopic hysterectomy (TLH). DESIGN: Pilot feasibility trial (Canadian Task Force classification II-2). SETTING: Academic-affiliated hospital. PATIENTS: Twenty women undergoing TLH for benign disease. INTERVENTIONS: Participants underwent 1:1 randomization of energy method used for colpotomy (ultrasonic vs monopolar) and vaginal cuff closure suture (barbed vs nonbarbed). After intravenous administration of ICG, laser angiography was used to capture images of the vaginal cuff before and after closure. Three reviewers analyzed fluorescent images of vaginal cuffs to determine percent of cuff perimeter with adequate perfusion when open and length of vaginal cuff adequately perfused when closed. MEASUREMENTS AND MAIN RESULTS: ICG fluorescence was visible at the vaginal cuff in all participants. Mean time to appearance of ICG in the pelvis after administration was 19.8 ± 6.8 seconds (mean ± SD) preclosure, and 26.0 ± 22.2 seconds postclosure. With ultrasonic energy 67.5% ± 17.4% of open cuff perimeter and 74.4% ± 20.5% of closed cuff length were adequately perfused, whereas with monopolar energy use 59.1% ± 17.4% of the open cuff perimeter and 66.3% ± 15.4% of closed cuff length were adequately perfused. Cuffs closed with barbed suture showed adequate perfusion along 71.5% ± 15.1% of the length, whereas those closed with nonbarbed suture showed 68.9% ± 20.9% adequate perfusion. When normalized to cervical cup circumference, ultrasonic energy required 1.0 ± .2 s/mm, whereas monopolar energy required .8 ± .3 s/mm (p = .162). Linear regression showed no association of normalized time of energy activation to percentage of perimeter of open cuff (R = .007) or length of closed cuff (R = .005) with adequate perfusion. No complications related to intravenous ICG administration occurred. CONCLUSION: Laser angiography with ICG allows evaluation of vascular perfusion at the vaginal cuff during TLH. This technique may facilitate future prospective studies examining causes for vaginal cuff dehiscence, a complication with potential for severe morbidity.
[Mh] Termos MeSH primário: Angiografia/métodos
Histerectomia/efeitos adversos
Verde de Indocianina
[Mh] Termos MeSH secundário: Adulto
Idoso
Colpotomia
Estudos de Viabilidade
Feminino
Seres Humanos
Histerectomia Vaginal/métodos
Laparoscopia/efeitos adversos
Lasers
Meia-Idade
Projetos Piloto
Estudos Prospectivos
Suturas
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
IX6J1063HV (Indocyanine Green)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170109
[St] Status:MEDLINE


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[PMID]:28027972
[Au] Autor:Wang X; Chen Y; Hua K
[Ad] Endereço:Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, and Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Shanghai, China.
[Ti] Título:Pelvic Symptoms, Body Image, and Regret after LeFort Colpocleisis: A Long-Term Follow-Up.
[So] Source:J Minim Invasive Gynecol;24(3):415-419, 2017 Mar - Apr.
[Is] ISSN:1553-4669
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY OBJECTIVE: To evaluate the impact of LeFort colpocleisis on body image, regret, and pelvic floor symptoms long-term after surgery. DESIGN: Retrospective study (Canadian Task Force classification II-2). SETTING: Tertiary university-affiliated hospital. PATIENTS: Between April 2011 and April 2015, 334 patients underwent LeFort colpocleisis. INTERVENTION: LeFort colpocleisis. MEASUREMENT AND MAIN RESULTS: Patient characteristics (e.g., age, body mass index, parity, blood loss, and length of operation), comorbidities, and complications were obtained from medical records. The Chinese version of the Pelvic Floor Distress Inventory Questionnaire (PFDI-20) was used to evaluate self-perceived quality of life. A modified body image scale was used to assess self-image. Regret was assessed by the following question: "Do you regret choosing to undergo colpocleisis for pelvic organ prolapse (yes or no)?" In total, 278 women responded and were considered for statistical evaluation. Of these women, 234 (84%) had at least 1 comorbid condition. After a median 3-year follow-up (range, 1.5-4.5), only 1 woman had experienced recurrent prolapse and required a second surgery. The mean and total body image scores improved significantly from preoperation (p < .001). Approximately 97% of the patients were satisfied with their decision to undergo surgery, and none of the patients regretted their decision. Pelvic symptoms improved significantly from baseline (i.e., preoperation) to follow-up according to the following measures: PFDI-20, 67.5 ± 23.1 versus 23.8 ± 15.0 (p < .001); Pelvic Organ Prolapse Distress Inventory-6, 33.2 ± 19.6 versus 11.4 ± 10.6 (p < .001); Colorectal-Anal Distress Inventory-8, 10.8 ± 10.3 versus 3.6 ± 5.3 (p < .001); and Urinary Distress Inventory-6, 23.5 ± 18.5 versus 8.8 ± 9.7 (p < .001). CONCLUSIONS: LeFort colpocleisis is a highly effective surgical treatment option for pelvic organ prolapse that improves both pelvic floor symptoms and body image. The high satisfaction and low regret in the long term after surgery indicate that LeFort colpocleisis is an excellent option for appropriate patients.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos em Ginecologia/psicologia
Prolapso de Órgão Pélvico/cirurgia
Vagina/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Imagem Corporal
China/epidemiologia
Colpotomia
Emoções
Feminino
Seguimentos
Seres Humanos
Diafragma da Pelve
Distúrbios do Assoalho Pélvico/epidemiologia
Complicações Pós-Operatórias/epidemiologia
Qualidade de Vida
Estudos Retrospectivos
Inquéritos e Questionários
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161229
[St] Status:MEDLINE


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[PMID]:27793386
[Au] Autor:Baekelandt J; Vercammen J
[Ad] Endereço:Department of Obstetrics and Gynaecology, Imelda Hospital, Bonheiden, Belgium. Electronic address: Jan.baekelandt@imelda.be.
[Ti] Título:IMELDA transvaginal approach to ectopic pregnancy: diagnosis by transvaginal hydrolaparoscopy and treatment by transvaginal natural orifice transluminal endoscopic surgery.
[So] Source:Fertil Steril;107(1):e1-e2, 2017 Jan.
[Is] ISSN:1556-5653
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To demonstrate a new minimally invasive approach for the diagnosis and treatment of ectopic pregnancy. DESIGN: Stepwise explanation of the technique using original video footage. SETTING: Hospital. PATIENT(S): Since 2014, 15 patients were treated transvaginally for ectopic pregnancy and pregnancy of unknown location (PUL). INTERVENTION(S): In case of a diagnosis of ectopic pregnancy on ultrasound, a 2.5-cm colpotomy is made under general anesthesia, and the ectopic pregnancy is treated by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) salpingectomy or salpingostomy. In case of a PUL on ultrasound, transvaginal hydrolaparoscopy (TVHL), an established technique for fertility exploration under local or general anesthesia, is used to investigate. If a tubal pregnancy is confirmed on TVHL, the colpotomy is extended to a 2.5-cm incision, and the ectopic pregnancy is treated transvaginally by vNOTES. If the TVHL investigation of the pelvis is negative (fallopian tubes and ovaries are normal), the procedure is stopped and the patient is followed up further. If the TVHL is inconclusive, the NaCl is drained and CO is insufflated (requiring general anesthesia) through the 4-mm TVHL port to improve visualization. Again, an ectopic pregnancy is then treated by vNOTES, and in case of a negative investigation the procedure is stopped and the patient is followed up further. MAIN OUTCOME MEASURE(S): Successful diagnosis and treatment of ectopic pregnancies. RESULT(S): All patients were successfully operated without complications or conversions to standard laparoscopy. Twelve patients were treated by vNOTES for ectopic pregnancy. Three TVHL explorations for PUL were negative, and these patients were followed up; two patients developed a normal intrauterine pregnancy, and the third patient was treated with methotrexate for persistent asymptomatic raised hCG levels. CONCLUSION(S): Transvaginal hydrolaparoscopy and vNOTES are complementary techniques enabling gynecologic surgeons to explore PUL and treat ectopic pregnancies via minimally invasive transvaginal access without abdominal incisions. A negative TVHL investigation leaves only a 4-mm perforation in the pouch of Douglas that does not require suturing. The IMELDA technique for the investigation and treatment of PUL and ectopic pregnancy is a novel approach that requires further investigation. It can provide improved patient comfort and better cosmetic results.
[Mh] Termos MeSH primário: Colpotomia
Laparoscopia/métodos
Cirurgia Endoscópica por Orifício Natural/métodos
Gravidez Ectópica/diagnóstico
Gravidez Ectópica/cirurgia
Salpingectomia/métodos
Salpingostomia/métodos
Vagina/cirurgia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Valor Preditivo dos Testes
Gravidez
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170714
[Lr] Data última revisão:
170714
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161030
[St] Status:MEDLINE


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[PMID]:27607872
[Au] Autor:Balgobin S; Hamid CA; Carrick KS; Montoya TI; Schaffer JI; Corton MM
[Ad] Endereço:Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, and the Department of Pathology, University of Texas Southwestern Medical Center, Dallas, and the Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery, Texas Tech University Health Sciences Center, El Paso, Texas.
[Ti] Título:Distance From Cervicovaginal Junction to Anterior Peritoneal Reflection Measured During Vaginal Hysterectomy.
[So] Source:Obstet Gynecol;128(4):863-7, 2016 Oct.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To quantify the distance of the dissection plane from the cervicovaginal junction to the anterior peritoneal reflection for vaginal hysterectomy. METHODS: This is a descriptive study examining the dissection plane for anterior colpotomy in 22 surgical patients undergoing vaginal hysterectomy and in nine cadaver specimens. Intraoperatively, the distance from the vaginal incision to the anterior peritoneal reflection was measured on the uterus after removal. In nine of these patients, this distance was also measured before anterior peritoneal incision. Embalmed cadavers with intact pelvic viscera were dissected and the distance of the same dissection plane was measured. RESULTS: Median (interquartile range) surgical patient age was 51.5 (42-63) years and the main surgical indications were abnormal uterine bleeding and pelvic organ prolapse. In these patients, the median (interquartile range) distance from cervicovaginal incision to anterior peritoneal reflection was 3.4 (2.6-3.7) cm. In cadavers, the median (interquartile range) age was 81 (72-86) years with a measured distance of 2.7 (2.4-2.9) cm. CONCLUSION: When performing a vaginal hysterectomy, surgeons can expect a median (range) dissection distance of 3.4 (1.8-4.6) cm from initial incision to the peritoneal reflection for anterior colpotomy.
[Mh] Termos MeSH primário: Colo do Útero/anatomia & histologia
Colpotomia/métodos
Histerectomia Vaginal/métodos
Peritônio/anatomia & histologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170523
[Lr] Data última revisão:
170523
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160909
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000001653


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[PMID]:27391241
[Au] Autor:Tan YH; Lim YM; Ng YW; Tiong HY
[Ad] Endereço:1 Department of Obstetrics and Gynaecology, National University of Singapore , Singapore, Singapore .
[Ti] Título:Taking a Step Forward in Laparoscopic Donor Nephrectomy: Transvaginal Retrieval of Donor's Kidney.
[So] Source:J Laparoendosc Adv Surg Tech A;26(9):721-4, 2016 Sep.
[Is] ISSN:1557-9034
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Laparoscopic donor nephrectomy has been broadly recognized as the gold standard for kidney procurement used in kidney transplantation where it is not uncommon for donors to experience discomfort and aesthetic dissatisfaction over larger incision site. Natural orifice transluminal endoscopic surgery is a surgical approach that allows scarless intraabdominal operations through natural orifices, such as the vagina. In this case report, we describe the first case of transvaginal retrieval of donor's kidney at the National University Hospital, Singapore. A 51-year-old Malay lady with no significant medical history volunteered to a living-related kidney donor. Perioperative antibiotics were administered. A 12 mm Excel port was placed over the left iliac fossa with camera insertion. Two additional ports were inserted over the left rectus sheath edge and left costal margin under direct vision. An additional 5 mm port at the left loin was placed for lateral retraction. A vaginal probe was then inserted to facilitate posterior colpotomy and transection of the left uterosacral ligament. Pneumoperitoneum was subsequently maintained with a LiNA McCartney(®) Tube. A 15 mm Endocatch(®) bag was inserted for retrieval of the kidney. The left kidney was placed in the Endocatch bag after transection of the hilar vessels where the kidney was retrieved vaginally with ease. Colpotomy was closed vaginally using Vicryl-0 continuous suture. Total blood loss was noted as 50 mL with warm ischemia time being 7 minutes and the entire retrieval taking totally 20 minutes. Postoperative recovery was uneventful and the donor was discharged stable 3 days postoperation. The transplanted kidney retained normal graft function. Colpotomy retrieval for donor nephrectomy presents an innovative method for specimen retrieval with minimal disruption of donor anatomy. Doing away with laparotomy for kidney retrieval has indeed shown a reduction in recovery time, reduced postoperative pain, and better cosmetic outcome.
[Mh] Termos MeSH primário: Transplante de Rim
Laparoscopia/métodos
Cirurgia Endoscópica por Orifício Natural/métodos
Nefrectomia/métodos
Coleta de Tecidos e Órgãos/métodos
[Mh] Termos MeSH secundário: Colpotomia
Feminino
Seres Humanos
Doadores Vivos
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160709
[St] Status:MEDLINE
[do] DOI:10.1089/lap.2016.0284


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[PMID]:27132427
[Au] Autor:Kwon YS; You SK; Im KS; Kim AS
[Ti] Título:Rectovaginal fistula caused by retained colpotomy cup after surgery.
[So] Source:Clin Exp Obstet Gynecol;43(2):271-3, 2016.
[Is] ISSN:0390-6663
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:Colpotomizer instruments are commonly used in laparoscopic hysterectomy to easily manipulate the uterus. This is the case of a forgotten colpotomy cup retained in the vagina for five years, which led to a rectovaginal fistula. A 54-year-old woman without knowledge of presence of the foreign body visited with chronic abdominal pain and foul odorous discharge. Rectovaginal fistula caused by the retained forgotten colpotomy cup was found upon examination.
[Mh] Termos MeSH primário: Colpotomia/instrumentação
Corpos Estranhos/complicações
Histerectomia/instrumentação
Fístula Retovaginal/etiologia
Vagina
[Mh] Termos MeSH secundário: Dor Abdominal
Feminino
Corpos Estranhos/diagnóstico
Corpos Estranhos/cirurgia
Seres Humanos
Laparoscopia
Meia-Idade
Fístula Retovaginal/cirurgia
Útero
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1607
[Cu] Atualização por classe:160502
[Lr] Data última revisão:
160502
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160503
[St] Status:MEDLINE


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[PMID]:27094100
[Au] Autor:Cetin C; Soysal C; Khatib G; Urunsak IF; Cetin T
[Ad] Endereço:Department of Obstetrics and Gynecology, Cukurova University School of Medicine, Adana, Turkey.
[Ti] Título:Annular hymenotomy for imperforate hymen.
[So] Source:J Obstet Gynaecol Res;42(8):1013-5, 2016 Aug.
[Is] ISSN:1447-0756
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:AIM: Imperforate hymen is the most common obstructive anomaly of the female genital tract. Conventional surgical treatment for this condition is the cruciate incision made on the hymen. The aim of this study was to evaluate a novel technique that preserves virginity after hymenotomy using electrocautery. METHODS: Patients diagnosed with imperforate hymen and treated with annular hymenotomy between 2009 and 2013 were included in this retrospective cohort study. Annular incision was done using electrocautery on the hymen whilst sparing the intact hymenal tissue circumferentially at least 5 mm from the base. RESULTS: Fifteen patients were included in the study. Mean age of patients was 14.2 ± 2.2 years. The median operation time was 5 min (3-9 min). No complications occurred. During the follow-up examinations, none of the patients had hymenal closure and all had regular menstrual bleeding. CONCLUSION: This novel technique showed complete success without any observed complication. This technique might be a good alternative for patients seeking to preserve virginity after surgery.
[Mh] Termos MeSH primário: Colpotomia/métodos
Eletrocoagulação/métodos
Hímen/anormalidades
Distúrbios Menstruais/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Feminino
Seres Humanos
Hímen/cirurgia
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170421
[Lr] Data última revisão:
170421
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160421
[St] Status:MEDLINE
[do] DOI:10.1111/jog.13010


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[PMID]:26883862
[Au] Autor:de Castro EB; Juliato CR; Piedemonte LA; dos Santos Júnior LC
[Ad] Endereço:Department of Gynecology and Obstetrics, Universidade Estadual de Campinas, Campinas, SP, Brazil.
[Ti] Título:Impact of Sacrospinous Colpopexy Associated with Anterior Colporrhaphy for the Treatment of Dome Prolapse on all Three Vaginal Compartments.
[So] Source:Rev Bras Ginecol Obstet;38(2):77-81, 2016 Feb.
[Is] ISSN:1806-9339
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the results of sacrospinous colpopexy surgery associated with anterior colporrhaphy for the treatment of women with post-hysterectomy vaginal vault prolapse. METHODS: This prospective study included 20 women with vault prolapse, Pelvic Organ Prolapse Quantification System (POP-Q) stage ≥ 2, treated between January 2003 and February 2006, and evaluated in a follow-up review (more than one year later). Genital prolapse was evaluated qualitatively in stages and quantitatively in centimeters. Prolapse stage < 2 was considered to be the cure criterion. Statistical analysis was performed using the Wilcoxon test (paired samples) to compare the points and stages of prolapse before and after surgery. RESULTS: Evaluation of the vaginal vault after one year revealed that 95% of subjects were in stage zero and that 5% were in stage 1. For cystocele, 50% were in stage 1, 10% were in stage 0 (cured) and 40% were in stage 2. For rectocele, three women were in stage 1 (15%), one was in stage 2 (5%) and 16 had no further prolapse. The most frequent complication was pain in the right buttock, with remission of symptoms in all three cases three months after surgery. CONCLUSIONS: In this retrospective study, the surgical correction of vault prolapse using a sacrospinous ligament fixation technique associated with anterior colporrhaphy proved effective in resolving genital prolapse. Despite the low complication rates, there was a high rate of cystocele, which may be caused by posterior vaginal shifting due to either the technique or an overvaluation by the POP-Q system.
[Mh] Termos MeSH primário: Colpotomia
Prolapso Uterino/cirurgia
Vagina/cirurgia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Gravidez
Estudos Prospectivos
Estudos Retrospectivos
Resultado do Tratamento
Prolapso Uterino/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160218
[St] Status:MEDLINE



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