[Laparoscopic hysterectomy as first-line procedure in the treatment of women with benign uterine pathology]. / La histerectomía laparoscópica como procedimiento de primera línea en el tratamiento de mujeres con patología benigna del útero.

BACKGROUND: It is estimated that a total of 600,000 abdominal hysterectomies, vaginal and laparoscopic there are performed in USA, these figures make the hysterectomy the first ranked surgery. In our country, since the first description of the technique in 1989, laparoscopic hysterectomy (HL) has developed and evolved. However, the learning curve for mastering this procedure results in larger and more complex complications than other approaches. MATERIAL AND METHOD: Retrospective, longitudinal and descriptive study were carried out, the collection of data took place from the clinical records of patients who underwent total laparoscopic hysterectomy during January 1, 2007 through December 31 of the same year. It was performed in women older than 18 years with benign uterine pathology. Body mass index greater than 30 Kg/m2, uterus greater than 16 weeks of gestational age or more than 500 grams, illnesses than compromise life of patients o women that did not return to post-surgical evaluation were excluded. RESULTS: There were performe 75 laparoscopic hysterectonies, 72 underwent without any complication. The average hospital stay was 3 days. We founded 3 major surgical complications, a case of bleeding from the surgical area that was immediately attended by laparoscopic Vicril-00 single stitching. Also were founded 2 urinary lesions: 1 complex lesion of the trigonous. The follow up of this case was torpid it were needed to derivate for 15 day with a latex foley catheter after the secondary repair and was unsuccessfully. Thereafter a urogynecological team programed laparotomy for the final fistulectomy. And the third case of accident was referred to a ureteral section, was diagnosed by the leaking at opaquedye from the abdominal x ray, and the patient was programed to laparotomy to performed a termino-terminal anastomosis. CONCLUSIONS: Laparoscopic hysterectomy is a reliable treatment option for benign uterine pathology. We believe that this surgical technique should be offered as the regular way to perform the hysterectomy.

[Results and complications following the placement of the transobturator tension free tape for the treatment of stress urinary incontinence]. / Resultados y complicaciones posteriores a la colocación de la cinta transobturadora libre de tensión en el tratamiento de pacientes con incontinencia urinaria de esfuerzo.

OBJECTIVE: Evaluate the complications and short term sucess rate of the transobturator tape for the treatment of stress urinary incontinence. MATERIAL AND METHODS: It is a retrospective study of the transobturator tapes perform in 2005 and 2006. All the procedures were done with epidural anesthesia. The success rate, the immediate, short-term and long term complications were recorded at the first, second and third year. RESULTS: 28 women were included in the study, 54% of them with stress urinary incontinence. 25% were solely transobturator procedures. mong the complications were 2 vesical puntures, 1 periurethral fascia trauma and 5 urinary retention during the first 24 hours. In the 1 and 2 year follow-up were 2 cases of overactive detrusor. Objective sucess was 90% and subjective sucess was 92%. CONCLUSIONS: Transobturator tape is a highly successful and a low morbility procedure.