Workshop for Basic Gynaecological Examinations: Improving Medical Student Learning through Clinical Simulation.

INTRODUCTION: This study was designed to evaluate whether the Workshop on Basic Principles for Clinical Gynaecological Exploration, offered to medical students, improves theoretical-practical knowledge, safety, confidence, global satisfaction and the achievement of the proposed objectives in the area of gynaecological clinical examinations. MATERIALS AND METHODS: This was a quasi-experimental pre-post-learning study carried out at the Gynaecology and Obstetrics department of Gregorio Marañón Hospital in Madrid (Spain). The volunteer participants were 4th-year students earning a degree in Medicine during the 2020-2021 and 2021-2022 academic years. The study period was divided into the following stages: pre-workshop, intra-workshop and 2 weeks post-workshop. In the pre-workshop stage, students completed a brief online course to prepare for the workshop. The effectiveness of the workshop was evaluated through multiple-choice tests and self-administered questionnaires to assess self-assurance, self-confidence, self-satisfaction and the achievement of the objectives. RESULTS: Of the 277 students invited in both academic years, 256 attended the workshop (92.4%), with a total participation in the different stages of the study greater than 70%. A total of 82.5% of the students in the 2020-2021 academic year and 80.6% of students in the 2021-2022 academic year did not have any type of experience performing gynaecological clinical examinations. Between the pre-workshop and 2 weeks post-workshop stages, there was significant improvement in theoretical-practical knowledge (improvement mean = 1.38 and 1.21 in 2020-2021 and 2021-2022 academic years, respectively). The security and confidence of the students prior to the workshop were low (average scores less than 5 points) in both academic years. However, post-workshop scores for satisfaction and the achievement of objectives were high in the two academic years; all the values approached or exceeded 8 points. CONCLUSIONS: Our students, after outstanding participation, evaluated the BPCGE, and improved their theoretical and practical knowledge, as well as their skills in a gynaecological clinical examination. Moreover, in their view, after the workshop, they felt very satisfied, far outreaching the proposed aims. In addition, excellent results were maintained over time, year after year.

Gynecological management of patients diagnosed with fanconi anemia / Manejo ginecológico de la paciente diagnosticada de anemia de fanconi

We present the gynecological and clinical management of women diagnosed with Fanconi anemia at our hospital, which is a reference center in Spain. Fanconi anemia is considered a rare disease. It is an autosomal recessive chromosomal instability syndrome in which more than 20 genes are affected. The disease involves progressive bone marrow failure, various congenital abnormalities, and an increased predisposition to cancer; hence the importance of a gynecological management protocol

Presentamos el manejo clínico ginecológico que llevamos a cabo en nuestro hospital de las pacientes mujeres diagnosticadas con anemia de Fanconi; siendo nuestro hospital uno de los hospitales de referencia en nuestro país. La anemia de Fanconi, considerada como una de las enfermedades raras, es una enfermedad autosómica recesiva, con inestabilidad cromosómica. En la actualidad se han descrito más de 20 genes afectados. Clínicamente hay una insuficiencia medular progresiva, diversas anomalías congénitas e incremento a la predisposición a producir cáncer; de allí la importancia de protocolizar la actuación de manejo de estas pacientes desde el punto de vista ginecológico

Análisis prospectivo de LEEP realizados sin anestesia en la consulta de patología cervical / Prospective analyses of outpatient LEEP carried out in cervical pathology clinic without anesthesia

Objetivo: determinar si la técnica Loop Electrosurgical Excision Procedure es un procedimiento efectivo y seguro para realizarlo en consulta ambulatoria de patología cervical. Material y métodos: estudio observacional prospectivo que incluye 156 pacientes que se les realiza Loop Electrosurgical Excision Procedure en consulta ambulatoria, sin anestesia, durante un periodo de seguimiento de 84 meses (7 años). Se excluyen 24 pacientes. Se analizan diferentes variables epidemiológicas, técnica, estado de bordes quirúrgicos, complicaciones y tolerancia al dolor. Resultados: la edad media de las pacientes fue de 35,7 años con inicio de la actividad sexual 17,9 años y 9 parejas sexuales de media. El diámetro mayor de las piezas analizadas fue de 1,7 cm. En el 18 pacientes (13,6%) los bordes quirúrgicos fueron reportados "afectos". Presentamos en 3 casos (2,3%) daño de la mucosa vaginal y un caso (0,8%) hemorragia tardía. La tolerancia al dolor fue satisfactoria en 121 pacientes (91,7%) y solo 1 paciente (0,8%) precisó de anestésico local. Discusión: el Loop Electrosurgical Excision Procedure es un procedimiento que puede ser realizado en consulta bajo imagen colposcopica en forma segura, efectiva y sin anestesia (AU)

Objective: To determine if cervical conization realized by leep procedure is an effective and safe procedure in an outpatient cervical pathology clinic. Material and methods: Prospective cohort study which includes 156 patients, who experienced a Loop Electrosurgical Excision Procedure procedure in an outpatient clinic without anesthesia, in a 84 months follow-up period (7 years). 24 patients are excluded. Different epidemiological variables and techniques were analyzed, as well as excision margins state, complications and pain tolerance. Results: The patients average age were 35.7 years old, with an onset of sexual activity median age of 17.9 years and a average number 9 sexual partners. The largest diameter of the analyzed pieces was 1.7 cm. In 18 patients (13.6%), excision margins were reported as "affected". In 3 cases (2.3%) the vaginal mucosa became damaged and one patient (0.8%) had late bleeding. The pain tolerance was satisfactory in 91.7% cases and local anaesthetic was administered to one patient only (0.8%). Discussion: Loop Electrosurgical Excision Procedure procedure can be carried out in an outpatient clinic under colposcopic vision being a safe, effective and without need of anesthesia procedure (AU)

Histerectomía laparoscópica por morcelación tipo CASH (Clasical, Abdominal, Semm, Histerectomy) / Laparoscopic hysterectomy by morcelation, CASH type (Classical, Abdominal, Semm, Histerectomy)

Se realizó histerectomía laparoscópica por morcelación tipo Classical Abdominal Semm Hysterectomy (CASH) sin salpingooferectomía bacterial, en 17 pacientes se utilizaron 4 punciones con aplicación de sutura intra y extracorpórea en 13 pacientes y aplicación de grapas de 35 mm. (endopath) en 4 y remoción de canal endocervical y endometrio por morcelación vaginal, las ventajas de este procedimiento es su baja pérdida de sangre la mínima posibilidad de lesión en urétero o vejiga y la disminución del riesgo de infección por contaminación vaginal así como un periodo de recuperación rápido y con mínimo dolor

Hallazgos laparoscópicos de endometriosis en mujeres con dismenorrea, dolor pélvico y esterilidad: informe preliminar / Endometriosis laparoscopic findings in women with dysmenorrhea, pelvic pain and sterility: preliminary report

Se realizó laparoscopia en pacientes con dismenorrea, esterilidad y dolor pélvico con el objeto de evaluar la prevalencia de endometriosis en nuestro medio, tomando para tal efecto la población de pacientes derechohabientes, femeninas, en edad reproductiva, del hospital del ISSSTE en la ciudad de Veracruz, Ver. México. Los porcentajes de endometriosis presentaron similitud con los informes publicados en las revistas internacionales con excepción de la dismenorrea donde nuestros resultados fueron más altos. Se analizaron en todos los casos las mismas variables: edad, vida sexual activa (V.S.A.), método anticonceptivo, menarquia (men), ciclo mentrual, partos y abortos así como otros hallazgos laparoscópicos. Cada uno de los casos de endometriosis se clasificó según la Revisión de la America Fertility Society (R.A.F.S.) de Endometriosis