RESUMO
Objectives: Vaginal balloon inflation simulates the compressive forces on the pelvic floor during the second phase of natural delivery. The foremost use of this animal model of vaginal distention (VD) is to study the mechanisms underlying urinary incontinence. As damage to the pelvic floor during natural birth is a common cause of fecal incontinence, the present paper aimed to investigate the effect of VD on defecation behavior in adult rats. Methods: Vaginal distention was performed in 8 rats for 2 hours, and in 3 rats for 4 hours, and sham inflation was performed in 4 rats. With the use of a latrine box in the rat home-cage and 24/7 video tracking, the defecation behavior was examined. The time spent in and outside the latrine was monitored for two weeks preoperatively and three weeks postoperatively, and a defecation behavior index (DBI; range: 0 [continent] to 1 [incontinent]) was defined. Pelvic floor tissue was collected postmortem and stained with hematoxylin and eosin. Results: Vaginal balloon inflation for 2 hours resulted in fecal incontinence in 29% of the animals (responders) whereas the DBI scores of non-responders (71%) and control animals did not change in the postoperative phase compared with the baseline score. A 4-hour balloon inflation resulted in fecal incontinence in 1 animal and caused a humane endpoint in 2 animals with markedly more tissue damage in the 4-hour responder compared with the 2-hour responders. Conclusions: Vaginal balloon inflation, with an optimum duration between 2 and 4 hours, can be used as a model to study changes in defecation behavior in rats induced by pelvic floor damage. (AU)
Assuntos
Animais , Ratos , Diafragma da Pelve/lesões , Defecação , Entorses e Distensões , Vagina/lesões , Incontinência FecalRESUMO
El sangrado genital en niñas prepúberes es un signo poco frecuente y siempre requiere determinar su causa. Se necesitan una detallada anamnesis y examen físico, con el conocimiento adecuado de la anatomía uroginecológica, y, en muchos casos, estudios de imágenes y exámenes complementarios, para arribar al diagnóstico. Se presenta el caso de una niña de 7 años con sangrado genital, cuyo examen físico y estudios complementarios fueron poco concluyentes, y que requirió un procedimiento invasivo para su resolución. (AU)
Genital bleeding in prepubertal girls is a rare sign and always requires determining its cause. A detailed history and physical examination are needed, with adequate knowledge of urogynecological anatomy, and in many cases, imaging studies and complementary tests, to arrive at the diagnosis. We present the case of a 7-year-old girl with genital bleeding, whose physical examination and complementary studies were inconclusive, requiring an invasive procedure for its resolution. (AU)
Assuntos
Humanos , Feminino , Criança , Hemorragia Uterina/etiologia , Vagina/lesões , Corpos Estranhos/diagnóstico por imagem , Papel , Ultrassonografia , Exame GinecológicoRESUMO
RESUMEN Las lesiones del tracto genital femenino tras relaciones sexuales son un problema frecuente en las urgencias de ginecología, pero poco estudiado salvo su aspecto médico-legal. Su incidencia es desconocida ya que muchas mujeres no llegan a consultar por miedo o pudor. El reconocimiento precoz de estas lesiones y su correcto tratamiento puede evitar la parición de secuelas que acompañarán a nuestra paciente durante el resto de su vida. Presentamos el caso de una paciente de 18 años con un desgarro perineal con mucosa vaginal íntegra tras su primera relación sexual.
ABSTRACT Injuries to the female genital tract after sexual intercourse are a frequent problem in gynecological emergencies, but little studied except for their medico-legal aspect. Its incidence is unknown since many women do not go to their specialist out of fear or embarrassment. Early recognition of these injuries and their correct treatment may prevent the appearance of sequelae that will accompany our patient for the rest of her life. We present the case of an 18-year-old patient with a perineal tear with intact vaginal mucosa after her first sexual intercourse.
Assuntos
Humanos , Feminino , Adolescente , Vagina/lesões , Ferimentos Penetrantes/etiologia , Coito , Vagina/cirurgia , Doenças Vaginais/cirurgia , Doenças Vaginais/etiologia , Ferimentos Penetrantes/cirurgia , Ferimentos Penetrantes/diagnóstico , Fatores de Risco , Lacerações , Mucosa/cirurgia , Mucosa/lesõesRESUMO
AIMS: To evaluate the expression of genes and proteins related to the urethral muscles of female rats after trauma by vaginal distention (VD) and after electrical stimulation therapy (EST). METHODS: We compared the urethras of four groups of 20 animals each: control without trauma (C), 7 (recent-trauma) and 30 days (late-trauma) post-VD, and VD-treated with EST. We evaluated the expression of myogenic regulatory factors MYOD1 and myogenin (MYOG); skeletal muscle myosin heavy chain 1, 2, and 3 (MYH1, MYH2, and MYH3); smooth muscle MYH11; and myosin light chain 9 (MYL9). We used real-time quantitative polymerase chain reaction, Western blot analysis, and immunohistochemistry. RESULTS: MYOD1 and MYOG genes were overexpressed in the recent-trauma group compared with the other groups (P < .05). MYH1 and MYH3 genes were upregulated in the recent-trauma group compared with the control and EST groups (P < .05). The MYH2 gene was overexpressed in the late-trauma group (P < .05), while the MYH2 protein was significantly increased in the EST group compared with control, recent-trauma and late-trauma groups by 5-, 3-, and 2.7-fold change, respectively (P < .05). MYL9 and MYH11 messenger RNA were overexpressed in both trauma groups compared with control and EST groups (P < .05). MYH11 protein was not different among the study groups (P > .05). CONCLUSIONS: EST enhances the recovery of the damaged urethral tissue of rats mainly by acting on the striated-muscle components. The MYH2 pathway underlies the positive effects of EST in the external urethral sphincter.
Assuntos
Terapia por Estimulação Elétrica , Uretra/lesões , Uretra/fisiopatologia , Vagina/lesões , Animais , Feminino , Expressão Gênica , Músculo Estriado/lesões , Músculo Estriado/fisiopatologia , Proteína MyoD/genética , Proteína MyoD/metabolismo , Miogenina/genética , Miogenina/metabolismo , Cadeias Pesadas de Miosina/genética , Cadeias Pesadas de Miosina/metabolismo , Cadeias Leves de Miosina/genética , Cadeias Leves de Miosina/metabolismo , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , Ratos , Ratos Wistar , Recuperação de Função Fisiológica , Transdução de SinaisRESUMO
This study describes the isolation of a leech following the presentation of unusual vaginal bleeding. Vaginal bleeding in children due to a leech bite is very rare. This is the first report of severe bleeding in a virgin 14-year-old girl from Mashhad, Iran due to the presence of a leech in the vagina.
Assuntos
Mordeduras e Picadas de Insetos/complicações , Sanguessugas , Hemorragia Uterina/etiologia , Vagina/lesões , Adolescente , Animais , Feminino , HumanosRESUMO
Objectives: The objective of this study is to determine factors associated with spontaneous perineal laceration in low-risk pregnant women who delivered vaginally without episiotomy in a university maternity hospital in Recife, Pernambuco, Brazil. Methods: A prospective cohort study was conducted with 222 low-risk, full-term pregnant women admitted in labor with a single fetus in cephalic presentation. Women with malformed fetuses were excluded from the study. The variables analyzed were: the frequency and severity of lacerations, the women's biological, sociodemographic, clinical and obstetrical characteristics, neonatal characteristics, and data on their deliveries and procedures. For the data analysis, risk ratios and their 95% confidence intervals were calculated. A significance level of 5% was adopted and multiple regression analysis was performed. Results: Spontaneous first-degree perineal tears were registered in 47% of the women, second-degree tears in 31%, and third degree tears in only 1.8%. There were no cases of fourth-degree tears. Having experienced normal childbirth previously constituted a protective factor against vaginal tearing (OR = 0.46; 95%CI: 0.23-0.91; p = .027). Conclusion: The principal protective factor against spontaneous lacerations was having experienced normal childbirth previously. Intrapartum strategies aimed at protecting the perineum and pelvic floor muscle training during prenatal care should be encouraged in these women.
Assuntos
Parto Obstétrico/efeitos adversos , Lacerações/epidemiologia , Períneo/lesões , Adolescente , Adulto , Brasil/epidemiologia , Estudos de Casos e Controles , Parto Obstétrico/estatística & dados numéricos , Episiotomia , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Lacerações/classificação , Lacerações/etiologia , Paridade , Gravidez , Estudos Prospectivos , Fatores de Risco , Vagina/lesões , Adulto JovemRESUMO
Lactobacilli prevent overproduction of pathogenic microorganisms and contribute protecting vaginal microbiota. Many probiotic microorganisms are categorized as Lactic Acid Bacteria. In this study, it was aimed identifying probiotic characteristics of Lactobacillus crispatus isolated from the vagina of a healthy woman. For this purpose, lactic acid, hydrogen peroxide and proteolytic activity quantities and auto-aggregation, co-aggregation and hydrophobicity abilities of Lactobacillus crispatus, which has been isolated and identified by 16s rRNA sequence analysis, were determined. Additionally, bile salt and acid resistance, along with antibiotic susceptibility of Lactobacillus crispatus were analyzed by the end of 3 hours. Lactic acid, hydrogen peroxide and proteolytic activity quantities of Lactobacillus crispatus were measured 2.275%, 0.334±0.075 µg/mL and 2.131±0,000 mg/mL respectively. The findings include existence of co-aggregation and auto-aggregation ability, but not hydrophobicity. By the end of 3 hours, the viability was preserved in 0.1% and 0.3% bile salt medium and, at pH 3. L. crispatus exhibited resistance to methicillin, metronidazole, oxacillin, and sulfamethoxazole + trimethoprim, but the bacteria exhibited susceptibility to tested the other antibiotics. This study will make an important contribution to the literature about probiotic characteristics of L. crispatus and our strain isolated from the vagina might be considered as a candidate probiotic.
Assuntos
Vagina/lesões , Probióticos/análise , Lactobacillus crispatus/metabolismo , Ácido Láctico/farmacologia , MicrobiotaRESUMO
Abstract This study describes the isolation of a leech following the presentation of unusual vaginal bleeding. Vaginal bleeding in children due to a leech bite is very rare. This is the first report of severe bleeding in a virgin 14-year-old girl from Mashhad, Iran due to the presence of a leech in the vagina.
Assuntos
Humanos , Animais , Feminino , Adolescente , Hemorragia Uterina/etiologia , Vagina/lesões , Mordeduras e Picadas de Insetos/complicações , SanguessugasRESUMO
AIMS: To identify the urethral migration of muscle derived stem cells (MDSCs) after intravenous (IV) injection in rats that underwent vaginal distension (VD) and to analyze the effects of MDSC in the urethra of rats after trauma in regards to: (1) mRNA expression of collagens, Vegf, Ngf, Ki67, Myh11, and Myh2; (2) expression of smooth and striated muscle proteins. METHODS: MDSCs expressing green fluorescent protein (GFP) were injected into the tail vein of rats 3 days after VD. The location of GFP cells was verified at 2 h and at 7 days following IV injection. Urethras of three groups were analyzed: Control, Trauma 7D, and MDSC 7D. Real-time RT-qPCR and immunohistochemistry were performed. RESULTS: MDSCs were identified only after 2 h of the procedure in the urethra. Myh11 gene was overexpressed in the Trauma group in relation to Control. Ki67 gene expression was increased in the MDSC group relative to Trauma and Control. Col1a1 and Col3a1 genes expression were increased in the MDSC group relative to Control. Ngf mRNA level was decreased in the MDSC group in relation to Trauma. Protein expression of Mhy11, Myh2, and Desmin were increased in the MDSC group in relation to Trauma and decreased in the Trauma in relation to Control. CONCLUSION: MDSCs migrated early to the traumatized urethra, but did not integrate into the tissue. MDSC alters the expression of genes related to cell proliferation, neural growth factor and extracellular matrix and the expression of smooth and striated muscle proteins in the traumatized rat urethra.