Descripción de la función sexual en mujeres con alteraciones de piso pélvico en un hospital público de Santiago / Sexual function of a group of women with any pelvic floor disorder in a public hospital of Santiago, Chile

Antecedentes: Se estima que entre 25-50 por ciento de las mujeres sufrirá de alguna alteración del piso pélvico durante su vida. La función sexual es un concepto complejo y multidimensional. Se ha planteado que a mayor sintomatología de alteraciones de piso pélvico, las mujeres presentan mayores inconvenientes en su respuesta sexual. Objetivo: Describir la función sexual de un grupo de mujeres que presentan algún tipo de trastorno de piso pélvico. Método: Estudio descriptivo a 195 mujeres con diagnóstico de alteraciones de piso pélvico utilizando un cuestionario que incluía evaluación de aspectos sociodemográficos y de la función sexual con instrumento PISQ-12. Para el análisis se utilizaron medidas de tendencia central y dispersión. Resultados: 73,7 por ciento de las mujeres refieren tener algún grado de insatisfacción con su vida sexual actual afectando principalmente el área del deseo sexual. Dentro de las limitaciones en la relación sexual reportadas se encuentran: orgasmos menos frecuentes (70,5 por ciento), dispareunia (89,5 por ciento), problemas de erección (40 por ciento) y eyaculación precoz (47,4 por ciento) en sus parejas. Conclusión: Las mujeres reportan niveles de insatisfacción con su vida sexual, disminución de su deseo sexual, dolor durante la relación sexual y disminución de la intensidad del orgasmo. Es importante incorporar en la atención de este grupo de mujeres una evaluación sistemática de la función sexual, centrándose no solo en la respuesta sexual femenina, sino que también identificando aquellas limitaciones de la mujer y de la pareja que pueden estar influyendo en su satisfacción sexual.

Background: It is estimated that between 25- 50 percent of women will suffer from a pelvic floor disorder during their lifetime. Sexual function is a complex and multidimensional concept. It has been suggested that to greater symptoms of pelvic floor disorders, women have major problems in sexual response. Objective: To describe the sexual function of a group of women with any pelvic floor disorder in a public hospital of Santiago, Chile. Method: A descriptive study of 195 women diagnosed with pelvic floor disorders using a questionnaire that included assessment of sociodemographic and sexual function instrument PISQ-12. For the analysis used measures of central tendency and dispersion. Results: 73.7 percent of referred women have some degree of dissatisfaction with their current sex life mainly affecting the area of sexual desire. Within the limitations in sexual intercourse reported are: less intense orgasms (70.5 percent), dyspareunia (89.5 percent), erectile dysfunction (40 percent) and premature ejaculation (47.4 percent) in their partners. Conclusion: Women report levels of dissatisfaction with their sex life, decreased sexual desire, pain during intercourse and decreased intensity of orgasm. It is important to incorporate in the care of these women a systematic assessment of sexual function focusing not only on the female sexual response, but also identifying those limitations of women and couples that may be influencing women's sexual satisfaction.

Resultados de una serie en corrección del prolapso de cúpula vaginal / Results from a vaginal cupula prolapsed correction

OBEJTIVOS: teniendo en cuenta como punto de partida las exigencias actuales en calidad de vida para pacientes en décadas avanzadas y las posibilidades de corrección quirúrgica para defectos del suelo pélvico, se realizó un estudio para evaluar resultados en pacientes tratadas en el Hospital Ramón González Coro entre el mes de febrero 2003 hasta octubre del 2007. También se propuso la caracterización de un grupo de pacientes con prolapso de cúpula vaginal tratadas por cirugía, así como la descripción de algunas variables clínicas, modalidades de tratamiento y eventos evolutivos. MÉTODOS: se hizo un estudio de tipo descriptivo retrospectivo para lo cual se tuvieron en cuenta las variables edad, paridad, tiempo de evolución, particularidades quirúrgicas y complicaciones. RESULTADOS: se presentaron resultados prometedores utilizando abordajes vaginales y abdomino- perineales, con solamente 9,6 por ciento de recidivas, aunque el seguimiento es de solo 4 años. Las complicaciones alcanzaron un 16,1 por ciento y el promedio de tiempo quirúrgico no rebasó los 150 min. CONCLUSIONES: se concluye que la reparación del prolapso de cúpula vaginal resulta una alternativa exitosa y de poco riesgo siempre que se respeten los criterios de individualizar la técnica requerida para cada paciente en particular

OBJECTIVES: Considering as a starting point the present demands in the quality of life for patients in advanced decades and the possibilities of surgical repair of pelvic floor, we made a study to assess results from patients seen in Ramón González Coro Gynecology and Obstetrics Hospital from February, 2003 to October,2007. Also we proposed the characterization of a group of patients diagnosed with vaginal cupula prolapse treated by surgery as well as the description of some clinical variables, treatment modalities and evolution events. METHODS: A retrospective and descriptive study was conducted taking into account the following variables: age, parity, course time, surgical distinctive features and complications. RESULTS There were promising results using vaginal and abdominal-perineal approaches, with only a 9,6 percent of relapses, although with a 4-years the follow-up. Complications were of 16,1 percent and the average surgical time was of only 150 minutes. CONCLUSIONS: We conclude that vaginal cupula prolapse is a successful option and with a low risk considering always the individual criteria of the required technique for each patient in particular

Reparación del piso pélvico en prolapso genital completo por vía laparoscópica / Repair of the pelvic floor in complete genital prolapse by laparoscopic route

Se presenta la experiencia inicial de 7 pacientes que fueron intervenidas por vía laparoscópica, portadoras de prolapso genital moderado y severo, en quienes se logró una reparación del piso pélvico utilizando una malla de polipropilen. En las 7 pacientes se logró un buen resultado anatómico y sin complicaciones quirúrgicas. Se corrigieron los defectos del compartimiento anterior y posterior. Es una técnica factible de realizar por vía laparoscópica y que corresponde fielmente a la vía alta abierta y que conserva una baja morbilidad.

Genital prolapse in women of Bhaktapur, Nepal.

Genital prolapse is one of the commonest reproductive morbidity in developing country. Common predisposing factors are multiparity, early postpartum sternous activity, advanced age and menopause. This study conducted in Bhaktapur district in five months included 1337 women aged 20 and above. The prevalence of female genital prolapse found to be 7.55%. Maximum numbers of women were having children eight and more (48.51%). Only 1.9% of women with genital prolapse were nulliparous. Home delivery is still common in Bhaktapur, 79% of women with genital prolapse had all children born at home without help. Regarding post partum activity majority of them (64.3%) told that they took rest at least one month after delivery but 26.73% started working in field in 2-3 weeks after delivery. The use of pessary is 25% among female with genital prolapse but only a few were following medical advice to change the ring. Nine women were having impacted ring in situ for years.

Uterovaginal prolapse

This cross-sectional study included 160 patients with uterovaginal prolapse managed in Unit - I, Lady Willingdon Hospital, Lahore from January 2001 to December, 2002. Vaginal hysterectomy was done in 103 patients, Manchester repair operation in 18, anterior and posterior repair in 10 patients, posterior repair in 6 patients, ring pessary insertion in 3 patients and sling operation in 2 patients. One nulliparous girl who had Manchester repair and 1 elderly woman who had sling operation for post-hystrectomy vault prolapse had recurrence. These patients became asymptomatic after second operation. There was no mortality

Prolapso genital en el Hospital Universitario de Cartagena / Genital prolapse at the University Hospital of Cartagena

El prolapso genital es una condición frecuente en la práctica clínica, definido como el descenso de las estructuras genitales y/o elementos relacionados con él, por debajo del nivel que normalmente ocupan. La fascia endopélvica une los órganos a las paredes pélvicas, mientras los músculos del piso pélvico, cierran la pelvis y elevando los órganos, evitan la distención de los ligamentos aponeuróticos. 102 pacientes que fueron ingresadas al Hospital Universitario de Cartagena con prolapso genital son estudiadas. Edades: 32-80 años. X=55.8+o- 12.3 años. 74.5 por ciento tenían prolapso Grado III. La paridad promedio fue de 7 partos y ninguna era nulípara. El tipo de prolapso más frecuente fue el cistorectocele, seguido del prolapso genital total. El 30.2 por ciento de las cirugías ginecológicas que se realizan en este Hospital son procedimientos por corrección del prolapso genital. No se presentaron accidentes intraoperatorios y las complicaciones a los 30 días post-quirúrgicas fueron del 11.8 por ciento. La estancia hospitalaria fue de 3-8 días. El origen de los transtornos del piso pélvico se considera multifactorial, dándose gran valor al traumatismo obstétrico y más recientemente a los estados hipoestrogénicos post-menopáusicos. Hacen falta más estudios para precisar la influencia de los estados nutricionales y la tendencia familiar en el prolapso genital

Surgical management of genital prolapse in an industrial hospital.

Surgical management of 200 cases of genital prolapse was reviewed and analysed. Forty per cent cases had 3rd degree uterine prolapse, 42 per cent had 2nd degree uterine prolapse and 18 per cent had 1st degree uterine prolapse. Fothergill operation was performed in 91 cases (45.5%). Vaginal hysterectomy with pelvic floor repair was performed in 70 cases (35%) and was the choice of treatment in pre-and postmenopausal patients.

Histological study of the endometrium in menopausal women with breast carcinoma

The first reference concerning the multiple primary malignant neoplasms was made by Bilroth, 1880 and since then a large number of studies have been published. Furthermore, an increasing incidence of simultaneous cancers are currently observed (16,18). At the same time, several retrospective populational studies evidenced the association between breast and endometrium carcinoma. It is well known that both uterus and breast are hormone-dependent organs and are likely to be influenced by the same oncogenic stimulus, either of endocrine nature or dietary origin (2, 3, 14). The risk of developing endometrial carcinoma is higher in patients already affected by breast neoplasm and is much more evident in older women within the first five years following the diagnosis of breast tumor. Conversely, patients with endometrial carcinoma may present a second mammary neoplasm and the relative risk is around 2.0 (1, 17). Although the existence of a correlation between these two primary malignant neoplasms is clearly observed, the absence of systematic studies directed to the screening of endometrial cancer in women with breast carcinoma is surprising. This study deals with histological analysis of the endometrium of postmenopausal patients with breast cancer and aims to determine the possible changes that might have occurred in the onset of the disease