Función sexual antes y después de la reparación quirúrgica del prolapso genital / Sexual function of women with genital prolapse before and after of surgical repair

Objetivo: comparar la función sexual (FS) de mujeres con prolapso genital (PG) antes y después de su reparación quirúrgica. Métodos: investigación de tipo comparativa y aplicada, con diseño cuasi experimental, prospectivo y de campo, donde se evaluó la FS de mujeres con diagnóstico de PG antes y después del tratamiento quirúrgico con técnicas convencionales, mediante el Cuestionario Sexual para Prolapso genital e Incontinencia Urinaria versión corta (PISQ-12). Resultados: al comparar la FS antes y después de la cirugía reparadora del PG, se determinó que tanto la puntuación total del PISQ-12 (15,90 +/- 6,51 vs. 32,17 +/- 3,62) como las puntuaciones de las dimensiones respuesta sexual (5,87 +/- 2,80 vs. 10,97 +/- 2,80) y limitaciones sexuales femeninas (4,88 +/- 3,90 vs. 16,77 +/- 3,00) fueron significativamente más altas luego de la intervención quirúrgica (p<0,001), a excepción del indicador intensidad del orgasmo (0,80 +/- 0,71 vs. 0,87+/- 0,73; p= 0,722) y la dimensión limitaciones sexuales de la pareja (4,37 +/- 2,14 vs. 3,56 +/- 2,70; p=0,815) donde sus puntuaciones antes y después del tratamiento quirúrgico no fueron estadísticamente significativas (p>0,05). Conclusiones: Lls mujeres con PG presentan una pobre FS, la cirugía reparadora del PG por técnicas convencionales mejoró significativamente la FS de las pacientes con disfunción del piso pélvico, permitiéndoles obtener a estas mujeres una vida sexual más placentera, con mejoría de su calidad de vida.

Objective: to compare sexual function (SF) of women with genital prolapse (GP) before and after surgical repair. Methods: this is a comparative and applied research with quasi-experimental, prospective and field design, which evaluated the SF of women diagnosed with PG before and after surgical treatment with conventional techniques, by the short version of the Prolapse and Incontinence Sexual Questionnaire (PISQ-12). Results: when comparing the SF before and after surgical repair of GP, it was determined that both the total score of PIQS-12 (15.90 +/- 6.51 vs. 32.17 +/- 3.62) and the scores of the dimensions: sexual response (5.87 +/- 2.80 vs. 10.97 +/- 2.80) and female sexual limitations (4.88 +/- 3.90 vs. 16.77 +/- 3.00) were significantly higher after surgery (p<0.001), except the indicator: orgasm intensity (0.80 +/- 0.71 vs. 0.87 +/- 0.73, p = 0.722) and the dimension partner's sexual limitations (4.37 +/- 2,14 vs. 3.56 +/- 2.70, p=0.815) where their scores before and after surgery showed no statistically significant differences (p>0.05). Conclusions: women with GP exhibit a poor SF, surgical repair of GP by conventional techniques significantly improves the SF of patients with pelvic floor dysfunction, allowing these women get sexual life more pleasant, which will impact on improving their quality of life.

[Mycoplasma genitalium detection and correlation with clinical manifestations in population of the Zulia State, Venezuela]. / Detección de Mycoplasma genitalium y correlación con manifestaciones clínicas en una población del estado Zulia, Venezuela.

Diverse studies demonstrate an association between Mycoplasma genitalium and urogenital pathologies. The aim of this study was to investigate the prevalence of M. genitalium in patients attending gynecological evaluation in private clinics (n = 172). DNA amplification assays of the genes 16S rRNA and MgPa were utilized. The prevalence of M. genitalium in the study population was 7.5%. M. genitalium was detected in 12.1% and 4.1% of the symptomatic and asymptomatic patients, respectively (p = 0.047). The infection was diagnosed in patients with cervicitis (17.2%) and mucopurulent secretion (16.6%) and the highest prevalence of infections was registered in the 31-40 years age group. No significant association between the presence of M.genitalium and individual clinical manifestations or the patients age was showed (p > 0.05). The high prevalence of M. genitalium infections, mostly in patients with clinical manifestations showed in this study, warrants the application of diagnostic strategies in the population to investigate the clinical meaning of these microorganisms and to reevaluate therapeutic schemes against non-gonococcal and non-chlamydial infections.

Detección de Mycoplasma genitalium y correlación con manifestaciones clínicas en una población del estado Zulia, Venezuela / Mycoplasma genitalium detection and correlation with clinical manifestations in population of the Zulia State, Venezuela

Diverse studies demonstrate an association between Mycoplasma genitalium and urogenital pathologies. The aim of this study was to investigate the prevalence of M. genitalium in patients attending gynecological evaluation in private clinics (n = 172). DNA amplification assays of the genes 16S rRNA and MgPa were utilized. The prevalence of M. genitalium in the study population was 7.5 percent. M. genitalium was detected in 12.1 percent and 4.1 percent of the symptomatic and asymptomatic patients, respectively (p = 0.047). The infection was diagnosed in patients with cervicitis (17.2 percent) and mucopurulent secretion (16.6 percent) and the highest prevalence of infections was registered in the 31-40 years age group. No significant association between the presence of M.genitalium and individual clinical manifestations or the patients age was showed (p > 0.05). The high prevalence of M. genitalium infections, mostly in patients with clinical manifestations showed in this study, warrants the application of diagnostic strategies in the population to investigate the clinical meaning of these microorganisms and to reevaluate therapeutic schemes against non-gonococcal and non-chlamydial infections.

Diversos estudios demuestran una asociación entre Mycoplasma genitalium y patologías urogenitales. El objetivo de este trabajo fue investigar la prevalencia de infecciones por M. genitalium en pacientes atendidas en clínicas privadas (n = 172). Se utilizaron ensayos de amplificación de genes 16S rARN y MgPa. La prevalencia de M. genitalium en esta población fue 7,5 por ciento. Mycoplasma genitalium fue detectado en 12,1 y 4,1 por ciento) de las pacientes sintomáticas y asintomáticas, respectivamente (p = 0,047). La infección se diagnosticó en pacientes con cervicitis (17,2 por ciento) y con secreción mucopurulenta (16,6 por ciento) y la mayor prevalencia de infecciones se registró en el grupo etario de 31 a 40 años. No se encontró asociación significativa entre la presencia de M. genitalium y manifestaciones clínicas individuales o edad de las pacientes (p > 0,05). La alta prevalencia de infecciones por M. genitalium, principalmente en pacientes con manifestaciones clínicas demostrada en este estudio, demanda la aplicación de estrategias diagnósticas en la población para investigar el significado clínico de estos microorganismos y reevaluar esquemas terapéuticos contra infecciones no gonocóccicas y no clamidiales.

Distal-end esophagostomy of the excluded esophagus in the palliation of upper and mid-esophageal carcinoma.

The gastric bypass of the excluded esophagus in the palliative treatment of carcinoma of the esophagus carries a considerable mortality. One of the most significant events that contributes to this mortality is the disruption of the distal closure of the excluded esophagus. In order to avoid this, a distal-end esophagostomy accompanying the gastric bypass procedure was created in six patients with advanced carcinoma of the upper and middle third of the esophagus. This distal esophagostomy is carried out by extrapleural dissection and is developed to the back, at the level of the eighth rib, just lateral and adjacent to the spinal muscles. Operative survival of all these sick patients proves this to be a safe operation that avoids the fatal complication described.

Gastric vascular pedicle patch esophagoplasty for stricture.

Three patients with Barrett's esophagus and strictures between the middle and distal thirds of the esophagus, of 5 to 26 years duration at the time of the plasty, were treated with an infradiaphragmatic Nissen fundoplication and gastric vascular pedicle patch esophagoplasty, based on the right gastroepiploic vessels. Follow-up for 2 patients has been 6 and 7 years; both patients are asymptomatic except for periodic mild dysphagia in 1. The third patient developed cancer after 1 symptom-free year, and had esophagectomy with colon interposition. The results of this operation justify its use in recalcitrant lower intrathoracic esophageal strictures that do not respond to antireflux operation or dilation.