RESUMO
OBJECTIVE: To compare CO(2) and normal saline as distention media in office diagnostic hysteroscopy. METHODS: The outcome of more than 6000 office hysteroscopies was analyzed. We used carbon dioxide or saline as distension medium. Minor hysteroscopic techniques were performed when indicated. RESULTS: The major indication was abnormal uterine bleeding (45%). Satisfactory hysteroscopy was achieved in 92. 4% with CO(2) and in 98.3% with saline (P<0.05). Local anesthesia was used in 54 patients (1.5%) with CO(2) and in three patients (0. 1%) with saline (P<0.001). Four hundred and two women (16.3%) underwent hysteroscopic procedures under saline hysteroscopy. Endometrial polyps were removed in 281 patients, 75 IUDs were removed, 14 fibroids were extracted, uterine septa were excised in 11 cases and mild and moderate adhesions were transected in 21 patients. CONCLUSION: Saline office diagnostic hysteroscopy offers at least all the advantages of the CO(2) hysteroscopy, and gives the possibility to easily 'find and treat in situ' many of the lesions observed.
Assuntos
Procedimentos Cirúrgicos Ambulatórios , Procedimentos Cirúrgicos Ambulatórios/métodos , Dióxido de Carbono , Histeroscopia/métodos , Pneumoperitônio Artificial/métodos , Cloreto de Sódio , Hemorragia Uterina/diagnóstico , Hemorragia Uterina/cirurgia , Procedimentos Cirúrgicos Ambulatórios/instrumentação , Anestesia Local , Feminino , Humanos , Leiomioma/complicações , Seleção de Pacientes , Pneumoperitônio Artificial/instrumentação , Pólipos/complicações , Resultado do Tratamento , Hemorragia Uterina/etiologia , Neoplasias Uterinas/complicações , Útero/anormalidadesRESUMO
A case of ovarian sex cord tumor with annular tubules (SCTAT) is described in a patient with Peutz-Jeghers syndrome. The patient had undergone surgery at age 19 years for intestinal invagination caused by intestinal polyposis, and the subsequently had seven pregnancies. Of the four children surviving at the time of this study, all had intestinal polyposis. The ovarian tumor was discovered during a routine examination, although the patient had suffered moderate menstrual disorders and hypermenorrhea for several months previously. Eight years after surgery the patient remains free of symptoms. A review of the bibliography shows that sex cord tumors with annular tubules are very rare. Initially described by Scully in 1970, these usually benign tumors appear frequently in patients with Peutz-Jeghers syndrome. They are considered to originate from granulosa cells, and grow in patterns reminiscent of Sertoli cells.
