RESUMO
All successful operations for relief of genuine stress urinary incontinence (SUI) have three objectives: elevation and retropubic maintenance during stress of the urethrovesical junction. The present study was realized at the Urogynecologic Service of the "Luis Castelazo Ayala" hospital IMSS to evaluate the results in a two years follow up of 597 patients that suffered from SUI treated by retropubic urethropexy, from February 1984 to May 1991. Patients were studied according to the service norms, previously published. We realized four types of procedures: Pereyra (379 cases), Burch (90 cases), Marchall-Marchetti-Kratz (60 cases) and Powell surgery (68 cases). Vaginal approach was realized in cases of pelvigenital statics disturbances like cysto- or rectocele; and abdominal approach was indicated in patients with enlarged uterus or pelvic masses. The complications rate was 15.3%. Success rate was 87.06% for all procedures and not statistic significance was found (p > or = 0.1 and X2 = 6.15), the best rate to the Burch and Pereyra procedures. We conclude the most important tip to successful rate in SUI surgery is correct choice of the procedure according to the patient.
Assuntos
Uretra/cirurgia , Bexiga Urinária/cirurgia , Incontinência Urinária por Estresse/cirurgia , Adulto , Idoso , Distribuição de Qui-Quadrado , Feminino , Seguimentos , Humanos , Métodos , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
Posterm pregnancy still is a topic full of controversies in many aspects, such as diagnosis, perinatal risk and management. This paper suggests that a great number of fetuses from prolonged pregnancies, still grow after term, secondary to a persistent and adequate placental function; it's demonstrated, by comparing the distribution of newborn weights between term and posterm pregnancies. In the posterm group a significant increase in the incidence of hypertrophic newborns, is found. Dismature newborns, products of the placentary insufficiency in posterm pregnancy, although the point of interest of obstetricians, pediatricians and perinatologists because of its high rates of morbimortality, constitute a minority in comparison with fetus of posterm pregnancies with high newborn weights. It is possible that fetal hypertrophy by it self may be another cause of morbimortality in posterm pregnancies (because of dystocias, prolonged labor, altered fetopelvic relations, increased rates of cesarean sections, and others) that must be determined in future longterm, prospective analysis.
Assuntos
Peso ao Nascer , Desenvolvimento Embrionário e Fetal , Gravidez Prolongada , Feminino , Idade Gestacional , Humanos , Gravidez , Estudos Prospectivos , Estatística como AssuntoRESUMO
Se informa el caso clinico de una paciente con tumoracion ovarica (quiste dermoide), con imagem ultraecosonografica de embarazo ectopico. En la trompa contralateral existia un embarazo ectopico roto y organizado que no fue diagnosticado mediante el estudio ultraecosonografico. Este caso confirma una vez mas la importancia de la clinica y ubica perfectamente a la ultraecosonografia como auxiliar de diagnostico a la vez que demuestra el inconveniente de aceptar imagenes patognomonicas