[Urologic lesions in gynecologic and uro-gynecologic surgery. Two years of hospital experience]. / Lesiones urológicas en la cirugía ginecológica y uroginecológica. Dos años de experiencia institucional.

We are reporting the most frequent urologic injuries of the gynecologic and urogynecologic surgeries at the National Institute of Perinatology in Mexico City. From the period of March 1993 to February 1995. There were performed 3,452 surgeries. Of this, 2,971 were gynecologic and 481 urogynecologic cases. We found 20 patients with injury to the inferior urinary tract. The most frequent type of injury found was by puncture and blunt, in eight cases respectively and cutting in four. The transoperatory diagnostic of injury was performed in 17 patients and in three few days after. The late complications of the injury was urethral vaginal fistula in two, one vesicovaginal communication and one ureterovaginal, one stone formation and one transurethral catheter retention. The more affected organ was the bladder in 18 cases, urether and urethra. The injury to the inferior urinary tract represents 4.15% of the urogynecologic surgical complications, and 0.67% of the gynecological ones. The main aspect in the prognosis of the injury to the inferior urinary tract, is the early diagnostic during the surgical procedures.

[Genuine stress urinary incontinence. An analysis of 2 surgical technics: Pereyra's and Burch's]. / Incontinencia urinaria genuina de esfuerzo. Análisis de dos técnicas quirúrgicas: Pereyra y Burch.

Two hundred and twenty-nine patients operated for genuine stress urinary incontinence by two surgical techniques, were studied. Risk factors were analyzed: age, gesta, para, and added gynecological pathology. They were placed in two groups. Group I formed by operated patients with Pereyra's technique (136), and Group II operated by Burch's technique (93). There were no differences as far as general characteristics of patients in both groups. More frequent added pathologies for Group I were pelvic statics changes, and for Group II, uterine myomatosis. Technically there were no advantages for one technique as compared with the other one, independently of indications for each one.

[Urogenital fistula: our institutional experience]. / Fístula urogenital: experiencia institucional.

We are reporting the institutional experience of March 1992 to May 1993. Eleven patients were studied with a diagnostic of urogenital fistula, one of them was vesico-uterine, two uretero-vaginal and eight vesico-vaginal. Only to eight of the patients surgery correction was realized, one of them was aboarded by vaginal tract and seven by abdominal tract. Of the patients with abdominal aboarded, two cases were ureteroneocystostomies. The failure of the surgery was presented in two cases, both with abdominal aboarded. These data clears up that the urogenital fistula is a frequent complication in patients that are submitted to surgical gynecological procedures. The surgical success probably depends more of the surgical technique rather than aboarded tract.

[The correlation of the findings between the urological clinical history and urodynamic evaluation in urinary incontinence]. / Correlación de los hallazgos entre la historia clínica urológica y la evaluación urodinámica en incontinencia urinaria.

Patient's histories of urinary incontinence and results of several standard clinical tests, were correlated with final diagnosis obtained by multichannel urodynamic testing. One hundred and thirty one histories of women with urinary incontinence who were in the Urogynecology Clinics of the Instituto Nacional de Perinatología in the period from july to december 1992, were evaluated including dates of standardized questionnaire and structural clinical examination with the urodynamic testing to obtain a final diagnosis. Although the objective urinary loss and the cystocele II-III were significantly associated with genuine stress incontinence and mixed incontinence, in patients with detrusor instability did not. Women with complaints of urinary incontinence, especially those for whom surgery is contemplated, should undergo complete urodynamic evaluation.

[Quantification of deoxyribonucleic acid and collagen as biological markers in uterine leiomyoma]. / Cuantificación de ácido desoxirribonucléico y colágena como marcadores bioquímicos de leiomiomatosis uterina.

The uterine leiomyomas (UL) are tumors compound by smooth muscle connective tissue. Growth depends mainly of two basic mechanisms: hypertrophy of myometrial cells and connective tissue deposit. The quantification of the basic elements of the tumor permits to try its application as biochemical markers of disease, auxiliary diagnostic criteria, or in medical therapeutical monitorization, alternative that lately has become very important. In the present study 33 patients are included, in two groups. Group I women with uterine leiomyomatosis (n = 17) and Group II (n = 16) without UL. A prospective, double blind, transversal of cases and control study. Connective tissue concentration was evaluated based on collagen determination. The evaluation of muscular tissue was done by desoxyribonucleic acid (DNA) measurement. The results showed a significant increase in connective tissue concentration (until 500%) and a significant diminution of cellularity (DNA) in women with UL, as compared with control group. The main biochemical and clinical implications of these findings, are commented upon.