Early ultrasound-guided drainage of tubo-ovarian abscesses versus conservative treatment: a retrospective cross-sectional study.

OBJECTIVE: To compare the short and long-term benefits (the length of hospital stay, surgical complications, and early clinical improvement) of adding early ultrasound-guided drainage to broad-spectrum antibiotic treatment. METHODOLOGY: Patients undergoing tubo-ovarian abscess treatment between January 2017 and June 2022 in a tertiary hospital were retrospectively evaluated. Of the patients studied, 50 subjects were treated with antibiotics alone and 63 underwent guided drainage. Twenty-one individuals underwent early drainage within 72 hours of admission, and 42 underwent guided drainage after this period. RESULTS: There was no statistical difference in the length of hospital stay between the groups simultaneously, averaging 6.4 days for the controls, 5.1 days for the early drainage group, and 9.6 days for the late drainage group (p = 0.290). In the multiple linear regression with the length of hospital stay outcome and adjusting for potential confounding factors, there was an average reduction of 2.9 days in the hospital stay (p = 0.04) for the early drainage group (< 72 hours) compared to the controls. Early clinical improvement and an expected drop in CRP were more frequent in patients who underwent drainage. Length of hospital stay increases with abscess diameter: 0.4 [(95% CI 0.1 - 0.7) (p = 0.05)] days per centimeter, regardless of other variables. CONCLUSIONS: Ultrasound-guided drainage of tubo-ovarian abscesses associated with antibiotic therapy is an effective treatment, with few complications, and may lead to clinical improvement especially when performed early.

Diagnostic accuracy of pelvis multiparametric MRI against CT virtual hysterosalpingography: a prospective study of tubal patency through female infertility assessment.

OBJECTIVE: To evaluate the diagnostic accuracy of MRI-hysterosalpingogram (HSG) with semiquantitative dynamic contrast-enhanced perfusion, against the virtual multislice CT hysterosalpingogram (VHSG) as a reference standard. METHODS AND MATERIALS: In this prospective study, 26 women (age >18 years) searching for infertility causes and with VHSG physician request. Thereafter, the assessment performance of both techniques was determined by two reader analyses. k statistics were used for the assessment of tubal patency. Receiver operating characteristic (ROC) analysis was used to compare the capability for tubal patency assessment between both exams on a per-patient and per-tube basis. The McNemar test was used to compare the diagnostic accuracy measures. RESULTS: Tubal patency, uterine morphological, ovarian, and extrauterine abnormalities were evaluated through both exams in all 26 women. There was no significant difference between diagnostic performance measurements between the methods. The ROC curve of VHSG was 0.852 for both per-patient and per-tube analyses, and one and 0.938 for MRI-HSG. Sensitivity and specificity for per-patient and per-tube for VHSG were 95.2 and 97.7, 80 and 87.5%, and for MRI-HSG 100% for both analyses and 100 and 87.5%, respectively. CONCLUSION: This study demonstrates the feasibility of diagnosing tubal patency through MRI, using a semi-quantitative dynamic contrast-enhanced perfusion sequence, and the satisfactory diagnosing of the uterine morphology, ovarian abnormalities, and ovarian and deep endometriosis. ADVANCES IN KNOWLEDGE: Multiparametric MRI with a perfusion real-time sequence as a HSG method can be used in the evaluation not only for uterine and ovarian abnormilities but also tubal patency.

Effects of hydrosalpinx on endometrial implantation failures: evaluating salpingectomy in women undergoing in vitro fertilization / Efeitos do hydrosalpinx no falho de implantação endometrial: Avaliar a salpingectomia nas mulheres em curso de fertilização in vitro

Abstract Hydrosalpinx is a disease characterized by the obstruction of the salpinx, with progressive accumulation in the shape of a fluid-filled sac at the distal part of the tuba uterina, and closed to the ovary. Women with hydrosalpinges have lower implantation and pregnancy rates due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Evidence suggests that the presence of hydrosalpinx reduces the rate of pregnancy with assisted reproductive technology. The main aim of the present is review to make an overview of the possible effects of hydrosalpinx on in vitro fertilization (IVF).We conducted a literature search on the PubMed, Ovid MEDLINE, and Google Scholar data bases regarding hydrosalpinx and IVF outcomes. Hydrosalpinx probably has a direct toxic effect on sperm motility and on the embryos. In addition, the increasing liquid inside the salpinges could alter the mechanisms of endometrial receptivity. The window of endometrial receptivity is essential in the implantation of blastocysts, and it triggers multiple reactions arising from the endometrium as well as the blastocysts. Hydrosalpinx could influence the expression of homeobox A10 (HOXA10) gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of HOXA10; therefore, it may be one mechanism by which tubal

Effects of Hydrosalpinx on Endometrial Implantation Failures: Evaluating Salpingectomy in Women Undergoing in vitro fertilization.

Hydrosalpinx is a disease characterized by the obstruction of the salpinx, with progressive accumulation in the shape of a fluid-filled sac at the distal part of the tuba uterina, and closed to the ovary. Women with hydrosalpinges have lower implantation and pregnancy rates due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Evidence suggests that the presence of hydrosalpinx reduces the rate of pregnancy with assisted reproductive technology. The main aim of the present is review to make an overview of the possible effects of hydrosalpinx on in vitro fertilization (IVF). We conducted a literature search on the PubMed, Ovid MEDLINE, and Google Scholar data bases regarding hydrosalpinx and IVF outcomes. Hydrosalpinx probably has a direct toxic effect on sperm motility and on the embryos. In addition, the increasing liquid inside the salpinges could alter the mechanisms of endometrial receptivity. The window of endometrial receptivity is essential in the implantation of blastocysts, and it triggers multiple reactions arising from the endometrium as well as the blastocysts. Hydrosalpinx could influence the expression of homeobox A10 (HOXA10) gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of HOXA10; therefore, it may be one mechanism by which tubal removal could result in improved implantation rates in IVF. In addition, salpingectomy does not affect the ovarian response, nor reduces the antral follicle count. Further studies are needed to establish the therapeutic value of fluid aspiration under ultrasonographic guidance, during or after oocyte retrieval, in terms of pregnancy rate and ongoing pregnancy.

Torsión aislada de la trompa de Falopio, con necrosis de un quiste paratubárico: una urgencia ginecológica infrecuente / Isolated torsion of the Fallopian tube, with necrosis of a paratubal cyst: an infrequent gynecological emergency

INTRODUCCIÓN: La torsión aislada de la trompa de Falopio ocurre en aproximadamente una de cada 50.000 a 1.500.000 mujeres, por ende, es una afección extremadamente rara. Fue originalmente descrita por Bland-Sutton en 1890. El cuadro clínico suele ser inespecífico y puede simular una amplia variedad de dolencias. CASO CLÍNICO: Paciente de 18 años de edad que acude al servicio de urgencias por dolor abdominal intenso, la cual se decide ingresar por cuadro agudo doloroso abdominal de posible etiología ginecológica, se realiza laparoscopía de urgencia por la posibilidad de un cuadro de torsión quística, durante esta se observa una imagen laparoscópica de la trompa izquierda violácea y torcida, además un quiste paratubárico hemorrágico, de color violacio; por las características laparoscópicas de la trompa y el quiste paratubárico que se relacionan con necrosis de estos elementos, se decide realizar a la paciente una anexectomía total izquierda con cistectomía del quiste paratubárico. DISCUSIÓN: La rotación de la trompa alrededor de su pedículo vascular es el evento fisiopatológico descrito, lo que provoca inicialmente la obstrucción del retorno venoso y linfático, con el consiguiente edema, ingurgitación y trombosis. Si la torsión progresa, y no se resuelve, se ve comprometida la vascularización arterial y se desencadena la necrosis del órgano y, finalmente la instauración de peritonitis, la conducta se basa en la viabilidad de la trompa: si no tiene signos de necrosis, la conducta indicada es destorcerla, si ya aparecieron signos de necrosis deberá ser extirpada.

INTRODUCTION: Isolated torsion of the Fallopian tube occurs in approximately one in every 50,000 to 1,500,000 women, therefore, it is an extremely rare condition. It was originally described by Bland-Sutton in 1890. The clinical picture is usually nonspecific and can mimic a wide variety of ailments. CLINICAL CASE: An 18-year-old patient who came to the emergency service for intense abdominal pain, which was decided to enter due to acute abdominal pain of possible gynecological etiology, an emergency laparoscopy was performed due to the possibility of a cystic torsion condition, During this, a laparoscopic image of the violaceous and crooked left tube is observed, as well as, a hemorrhagic paratubal cyst, violet in color; Due to the laparoscopic characteristics of the tube and the paratubal cyst that are related to necrosis of these elements, it was decided to perform a total left adnexectomy with cystectomy of the paratubal cyst. DISCUSSION: Rotation of the tube around its vascular pedicle is the described pathophysiological event, which initially causes obstruction of venous and lymphatic return, with the consequent edema, engorgement and thrombosis. If the torsion progresses and does not resolve, the arterial vascularization is compromised and the necrosis of the organ is triggered and, finally, the establishment of peritonitis, the behavior is based on the viability of the tube: if there are no signs of necrosis, the indicated conduct is to untwist it, if signs of necrosis have already appeared, it must be removed.

Increased prevalence of endocervical Mycoplasma and Ureaplasma colonization in infertile women with tubal factor.

OBJECTIVE: Most women suffering from tubal factor infertility do not have a history of pelvic inflammatory disease, but rather have asymptomatic upper genital tract infection. Investigating the impacts of such infections, even in the absence of clinically confirmed pelvic inflammatory disease, is critical to understanding the tubal factor of infertility. The aim of this study was to investigate whether the presence of endocervical bacteria is associated with tubal factors in women screened for infertility. METHODS: This retrospective cross-sectional study involved 245 women undergoing hysterosalpingography (HSG), screened for endocervical colonization by Chlamydia trachomatis, Neisseria gonorrhea, Ureaplasma urealyticum and Mycoplasma hominis, as part of a routine female infertility investigation between 2016 and 2017. RESULTS: endocervical bacterial colonization by Chlamydia trachomatis, Ureaplasma urealiticum, Mycoplasma hominis and other bacteria corresponded to 3.7%, 9.0%; 5.7% and 9.8%, respectively. There was no colonization by Neisseria gonorrhea. The prevalence of tubal factor was significantly higher in patients with positive endocervical bacteria colonization, regardless of bacterial species. When evaluating bacteria species individually, the women who were positive for endocervical Mycoplasma hominis had significantly higher rates of tubal factor. Associations between endocervical bacterial colonization and tubal factor infertility were confirmed by multiple regression analysis adjusted for age and duration of infertility. CONCLUSION: Besides the higher prevalence of Mycoplasma and Ureaplasma infectious agents, the findings of this study suggest the possible association of endocervical bacterial colonization - not only Chlamydia trachomatis and Neisseria gonorrhea, but also Mycoplasma species with tubal performance.

Bilateral but not unilateral tubal obstruction is associated with positive chlamydia serology.

OBJECTIVE: To assess the association between positive Chlamydia trachomatis (C. trachomatis) serology and unilateral or bilateral tubal obstruction. METHODS: This was a cross sectional study that evaluated the association of positive C. trachomatis serology (Immunofluorescence Indirect Serology, IIF or Enzyme Immune Essay, EIE), in two infertile groups: A. 243 patients (27 with unilateral obstruction and 216 without it). B. 247 patients (31 with bilateral obstruction and 216 without it). The exclusion criteria were tubal ligation (tubectomy) and tubal surgery. The statistical test (SPSS 17.0) was the Chi-Square with a p=5%. Tubal obstruction was diagnosed through hysterosalpingography (HSG). RESULTS: The mean age of the patients without obstruction was 33.6 years, SD 4.9. The mean age of the patients with unilateral obstruction was 33.7 years SD 4.9. The mean age of the patients with bilateral obstruction was 33.6 years, SD 4.9. There was no statistically significant difference between the age groups. In group A (unilateral obstruction versus serology) the Chi-Square was 0.02 (p=n.s.) and the Attributable Risk (AR) = 0.7%. In Group B (bilateral obstruction versus serology) the Chi-Square test was 9.87 (p<0.005) and the AR = 14.8%. CONCLUSION: This study found a strong and statistically significant association between bilateral tubal obstruction and C. trachomatis positive serology. The power of the test was 86%. There was no association between unilateral obstruction and positive serology.

Influence of a mannose-binding lectin gene polymorphism and exposure to Chlamydia trachomatis on fallopian tube obstruction in Brazilian woman.

PURPOSE: Factors influencing fallopian tube occlusion in women with a lower genital tract infection remain incompletely elucidated. We evaluated whether a polymorphism in the mannose-binding lectin (MBL) gene at codon 54 influences the occurrence of fallopian tube blockage in relation to exposure to Chlamydia trachomatis. METHODS: In a case-control study at The Hospital das Clínicas, University of São Paulo, Brazil, 75 women with hysterosalpingography-documented tubal occlusion and 75 women with patent fallopian tubes were analyzed for detection of single-nucleotide polymorphism in codon 54 of the MBL gene and for IgG anti-C. trachomatis antibodies in their sera. Both groups were matched for age, race, and sexual variables. RESULTS: Prior exposure to C. trachomatis, as evidenced by the presence of IgG antibodies, was comparable in both groups. Detection of the polymorphic MBL allele was more prevalent in women with blocked tubes (p < 0.01), regardless of whether or not there was evidence of prior chlamydial exposure. CONCLUSION: The level of MBL-related innate immunity influences the consequences of infection by C. trachomatis or other microbes.

Endometriosis III and IV as a risk factor for tubal obstruction in infertile women.

OBJECTIVE: A previous study carried out among infertile women with tubal obstruction identified a relative risk of 2.5 for Chlamydia trachomatis seropositivity. However, endometriosis may also be associated with increased risk. This study aimed to evaluate the risk of tubal obstruction associated with endometriosis III/IV among women submitted to assisted reproductive procedures. METHODS: A case-control study was performed among 144 women with and without tubal obstruction. We calculated the odds ratio with 95% CI regarding the association of endometriosis III/IV and tubal obstruction. Calculations were performed using the SPSS v.17.0 package. RESULTS: The mean age was 33.7 years (4.76 SD), and the mean infertility duration time was 66.7 months (120.6 SD). The total prevalence of endometriosis was 20/144 (13%). Among 144 women, the risk group with tubal obstruction and endometriosis III/IV comprised 7out of 20 (35%), compared with the group without such risk, that comprised 22 out of 124 (17%). The X2 test was 3.19 with a p-value of 0.07. The odds ratio (OR) was 2.5 (95% CI: 0.647-9.639). CONCLUSION: Although the OR was 2.5, there was no significant difference between the groups with and without endometriosis III/IV. Further studies are needed to increase the sample size.

Torsión aislada de trompa de falopio en niñas prepúberes / Isolated torsion of the fallopian tube in premenarcheal girls

La torsión aislada de la trompa de Falopio es una causa poco común de dolor abdominal agudo. Se describen dos casos clínicos de niñas prepúberes de 10 y 13 años de edad, con manifestaciones clínicas compatibles con apendicitis aguda, en quienes se evidenció torsión de la trompa derecha con signos de necrosis en la intervención quirúrgica. La existencia de esta entidad debe ser considerada en niñas con dolor abdominal agudo para evitar la lesión irreversible de la trompa.

Isolated torsion of the fallopian tube is a rare cause of abdominal pain. We report on two premenarcheal girls, ages 10 and 13 years, who presented with clinical manifestations compatible with acute appendicitis, in whom, torsion of the right tube with signs of necrosis was evidenced during surgical intervention. This condition should be considered in all girls with acute abdominal pain to avoid irreversible damage to the tube.

The impact of HSF on endometrium

Summary Objective: We conducted the research in order to explore the impact of hydrosalpinx fluid (HSF) on endometrium. Method: HSF group: 261 patients with HSF scheduled to undergo laparoscopic surgery 3 to 7 days after menstruation in our center. Hysteroscopy would also be performed in order to observe the endometrial morphology during the surgery. Sixty (60) patients would be randomly selected for endometrial biopsy in order to detect the inflammatory cytokines TNF-a and IL-2 mRNA. Non-HSF group: 210 patients with no evidence of HSF due to chronic salpingitis or pelvic adhesion. IVF-ET treatment was performed after eliminating the factor of male infertility and hysteroscopy was conducted before the treatment. Fifty (50) patients underwent endometrial biopsy in order to detect TNF-a and IL-2 mRNA. Results: Hysteroscopy was performed in 261 patients with HSF and 210 patients without HSF. The incidence rate of endometritis manifestation among these two groups of patients was 37.2% (97/261) and 20.5% (43/210), respectively. The incidence rate of endometritis in the patients with HSF is significantly higher than in the patients without HSF (p<0.05). Sixty (60) patients from the HSF group and 50 patients from the non-HSF group were regrouped according to inflammatory and normal manifestation after the endometrial biopsy. There were 49 patients in the inflammatory manifestation group and 61 patients in the normal manifestation group. RT-PCR technology was adopted to detect the expression of inflammatory cytokines TNF-a and IL-2 mRNA in endometrial tissue. The level of TNF-a mRNA expression in endometrial tissues with inflammatory manifestation was higher than in normal endometrium (76.75±11.95 vs. 23.45±9.75, p<0.01). There are significant differences between them. The level of IL-2 mRNA expression in endometrial tissues with inflammatory manifestation was higher than that found in normal endometrium (80.56±13.35 vs. 35.12±8.35, p<0.01). There are significant differences between them. Conclusion: Chronic endometritis is related to HSF and may therefore affect endometrial receptivity.

Terapia Su Jok en pacientes con diagnóstico de hidrosalpinx / Su Jok therapy in patients with hydrosalpinx diagnosis

Se realizó un estudio cuasiexperimental de 56 pacientes con diagnóstico de hidrosalpinx, que acudieron a la consulta de Medicina Natural y Tradicional del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba - remitidas de las consultas de Ginecología e Infertilidad -, desde septiembre de 2014 hasta diciembre de 2015, para evaluar la respuesta a la terapia Su Jok. Entre las variables analizadas figuraron: edad, factores de riesgo, manifestaciones clínicas, síndromes tradicionales, evolución clínica y respuesta al tratamiento. En la casuística predominaron las féminas de 30-39 años, la enfermedad inflamatoria pélvica y las infecciones de trasmisión sexual como antecedentes patológicos (71,4 por ciento), el dolor y la secreción vaginal como síntomas principales, así como el estancamiento de Qi de hígado, Qi de riñón no firme y frío-humedad en bazo como síndromes más frecuentes. Finalmente, se logró una evolución favorable y una respuesta adecuada al tratamiento

A quasi-experiment of 56 patients with hydrosalpinx diagnosis that went to the Natural and Traditional Medicine Service of Dr Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba - referred from the Gynecology and Infertility Services -, was carried out from September, 2014 to December, 2015, to evaluate the response to Su Jok therapy. Among the analyzed variables there were: age, risk factors, clinical features, traditional syndromes, clinical course and response to the treatment. In the case material there was a prevalence of women aged 30-39, pelvic inflammatory disease and sexually transmitted infections as pathological history (71.4 percent), pain and vaginal secretion as main symptoms, as well as Qi liver stagnation, not firm Qi kidney and coldness-humidity in spleen as most frequent syndromes. Finally, there was a favorable clinical course and an appropriate response to the treatment

Tubocutaneous Fistula due to Endometriosis - A Differential Diagnosis in Cutaneous Fistulas with Cyclic Secretion.

The development of a tubocutaneous fistula due to endometriosis in a post-cesarean section surgical scar is a rare complication that generates significant morbidity in the affected women. Surgery is the treatment of choice in these cases. Hormonal therapies may lead to an improvement in symptoms, but do not eradicate such lesions. In this report, we present a 34-year-old patient with a cutaneous fistula in the left iliac fossa with cyclic secretion. Anamnesis, a physical examination, and supplementary tests led us to suggest endometriosis as the main diagnosis, which was confirmed after surgical intervention.

Tubocutaneous Fistula due to Endometriosis - A Differential Diagnosis in Cutaneous Fistulas with Cyclic Secretion / Fístula tubocutânea secundária à endometriose - diagnóstico diferenciado em fístulas cutâneas com secreção cíclica

ABSTRACT The development of a tubocutaneous fistula due to endometriosis in a post-cesarean section surgical scar is a rare complication that generates significant morbidity in the affected women. Surgery is the treatment of choice in these cases. Hormonal therapies may lead to an improvement in symptoms, but do not eradicate such lesions. In this report, we present a 34-year-old patient with a cutaneous fistula in the left iliac fossa with cyclic secretion. Anamnesis, a physical examination, and supplementary tests led us to suggest endometriosis as the main diagnosis, which was confirmed after surgical intervention.

RESUMO O desenvolvimento de fístula tubocutânea secundária à endometriose em cicatriz cirúrgica após cesariana é uma complicação rara, que gera importante morbidade às mulheres acometidas. A cirurgia é o tratamento de escolha nesses casos. Terapias hormonais podem conduzir a uma melhora dos sintomas, mas, de forma alguma, levam à erradicação de tais lesões. No presente relato, temos uma paciente de 34 anos de idade que apresentava uma fístula cutânea em fossa ilíaca esquerda com secreção cíclica. Anamnese, exame físico e exames complementares nos levaram a aventar como principal hipótese diagnóstica a endometriose, que foi confirmada após intervenção cirúrgica.

The impact of HSF on endometrium.

OBJECTIVE: We conducted the research in order to explore the impact of hydrosalpinx fluid (HSF) on endometrium. METHOD: HSF group: 261 patients with HSF scheduled to undergo laparoscopic surgery 3 to 7 days after menstruation in our center. Hysteroscopy would also be performed in order to observe the endometrial morphology during the surgery. Sixty (60) patients would be randomly selected for endometrial biopsy in order to detect the inflammatory cytokines TNF-a and IL-2 mRNA. Non-HSF group: 210 patients with no evidence of HSF due to chronic salpingitis or pelvic adhesion. IVF-ET treatment was performed after eliminating the factor of male infertility and hysteroscopy was conducted before the treatment. Fifty (50) patients underwent endometrial biopsy in order to detect TNF-a and IL-2 mRNA. RESULTS: Hysteroscopy was performed in 261 patients with HSF and 210 patients without HSF. The incidence rate of endometritis manifestation among these two groups of patients was 37.2% (97/261) and 20.5% (43/210), respectively. The incidence rate of endometritis in the patients with HSF is significantly higher than in the patients without HSF (p<0.05). Sixty (60) patients from the HSF group and 50 patients from the non-HSF group were regrouped according to inflammatory and normal manifestation after the endometrial biopsy. There were 49 patients in the inflammatory manifestation group and 61 patients in the normal manifestation group. RT-PCR technology was adopted to detect the expression of inflammatory cytokines TNF-a and IL-2 mRNA in endometrial tissue. The level of TNF-a mRNA expression in endometrial tissues with inflammatory manifestation was higher than in normal endometrium (76.75±11.95 vs. 23.45±9.75, p<0.01). There are significant differences between them. The level of IL-2 mRNA expression in endometrial tissues with inflammatory manifestation was higher than that found in normal endometrium (80.56±13.35 vs. 35.12±8.35, p<0.01). There are significant differences between them. CONCLUSION: Chronic endometritis is related to HSF and may therefore affect endometrial receptivity.

[Prevalence of infections (Chlamydia, Ureaplasma and Mycoplasma) in patients with altered tuboperitoneal factor]. / Prevalencia de infecciones (Chlamydia, Ureaplasma y Mycoplasma) en pacientes con factor tuboperitoneal alterado.

OBJECTIVE: To determine the prevalence of Chlamydia, Ureaplasma and Mycoplasma in patients with peritoneal tubal factor infertility and altered. MATERIAL AND METHODS: A descriptive, observational, retrospec- tive, transversal, infertility patients Juarez Hospital of Mexico 2013 to 2015. Study included patients with infertility diagnosis and detection of antibodies (IgG) by ELISA for Chlamydia and vaginal cultures for Mycoplasma and Ureaplasma, hysterosalpingography and histerolapa- roscopia with chromotubation RESULTS: 46 patients with a mean age of 32.5 years. It was found that 36% were positive for these infections (n = 17): Chlamydia in 8.7% (n = 4), Ureaplasma in 21.7% (n = 10) and Mycoplasma in 6.5% (n = 3). Chlamydia patients and bilateral tubal occlusion (OTB) in 5.8% (n = 1), Ureaplasma and OTB (n = 5) were identified in 29.4% of them with pelvic inflammatory disease (PID) and tubal obstruction Ureaplasma right (OTD) in 5.8% (n = 1), Ureaplasma and tubal patency but with loose adhesions in 5.8% (n = 1) and Mycoplasma with OTB in 11.1% (n = 2), p = 0.425. Hysterosalpingography showed a sensitivity of 59% and specificity of 79%. CONCLUSIONS: Although there was no association of variables, Ureaplasma infection was more common in patients with infertility and tubal damage.

Comparative study of the clinical features of patients with a tubo-ovarian abscess and patients with severe pelvic inflammatory disease.

OBJECTIVE: To determine the clinical characteristics that indicate the presence of tubo-ovarian abscess (TOA) among patients with severe pelvic inflammatory disease (PID). METHODS: An observational cohort study was performed from October 2011 to March 2013. The study included all patients with a diagnosis of TOA and PID admitted to a university hospital in Mexico. A complete medical history and physical examination were performed, and laboratory studies were reviewed. A logistic regression analysis was performed on variables with statistical significance. RESULTS: Overall, 26 patients with PID and TOA (TOA group) and 26 with PID without TOA (PID group) were included in the study. Significant differences between patients with TOA and PID were found with regard to the patients' age (39.3years vs 33.1years; P=0.04), educational level (only elementary, 13 [50%] vs 5 [19%]; P=0.14), presentation with fever (23 [88%] vs 16 [62%]; P=0.025), white blood cell count (21.8×10(9)/L vs 14.9×10(9)/L; P<0.001), number of deliveries (2.2 vs 1.1; P=0.01), and presence of diarrhea (16 [62%] vs 5 [19%]; P<0.001). The triad of fever, leukocytosis, and diarrhea was positively related to the presence of TOA. CONCLUSION: The triad of fever, leukocytosis, and diarrhea should alert clinicians to the possibility of TOA formation in patients with PID.

Bilateral hydrosalpinx in a mare - a case report / Hidrossalpinge bilateral em égua - relato de caso

During a research visit for tissue collection at an abattoir located in Pelotas, Brazil, one female genital tract showed both enlarged oviducts. The reproductive tract was collected and analyzed. Occluded uterine tubes and an increase in the organ volume due to the large amount of fluid in the organ lumen were the macroscopic findings. Three samples, corresponding to isthmus, ampulla and infundibulum from each uterine tube and one sample from the endometrium were collected. Samples were fixed in Bouin's solution and processed in light microscopy. Microscopically a decrease in the number of folds and also an increase in the lumen of the organ were observed, mainly in the ampulla and infundibulum. The epithelial lining of the uterine tubes ranged from ciliated to simple squamous. Inflammatory cells were observed between the epithelial cells and in the lamina propria. Hydrosalpinx is difficult to diagnose and can be a cause of infertility in the mare.

Durante uma visita de pesquisa para coleta de tecido em um abatedouro localizado na cidade de Pelotas, Brasil, foi observado um trato genital com aumento do tamanho dos ovidutos. O trato reprodutivo foi coletado e analisado. Os achados macroscópicos observados foram tubas uterinas ocluídas e com aumento do volume do órgão devido à grande quantidade de líquido na luz do órgão. Três amostras, correspondendo a istmo, ampola e infundíbulo, e uma amostra do endométrio foram coletadas. As amostras foram fixadas em solução de Bouin e processadas para microscopia de luz. Microscopicamente foi observada uma diminuição no número de pregas e um aumento do lúmen do órgão, principalmente na ampola e no infundíbulo. O epitélio de revestimento das tubas uterinas variou de cilíndrico ciliado a pavimentoso simples. Células inflamatórias foram observadas entre as células epiteliais e na lâmina própria das tubas uterinas. A hidrossalpinge é difícil de ser diagnosticada e pode ser uma causa de infertilidade na égua.