Urinary tract Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 2009;31(11):540-546
DOI 10.1590/S0100-72032009001100003
PURPOSE: to verify the association between ultrasonographic signs during gestation and post-delivery evolution in fetuses with bilateral obstructive uropathies, followed up in an expectant way. METHODS: fetuses with bilateral obstructive uropathies presenting severe oligoamnios and narrow thorax have been compared with fetuses with bilateral obstructive uropathies without those alterations, concerning the presence or absence of cysts in both kidneys, and the presence or absence of parenchymal hyperechogenicity in both kidneys. Cases of neonatal death were compared with cases of neonatal discharge from the nursery, regarding the same renal echographic aspects mentioned above, the presence of severe oligoamnios and narrow thorax. The sensitivity, specificity, positive and negative predictive value of the presence of bilateral renal cysts, bilateral renal hyperechogenicity, severe oligoamnios and narrow fetal thorax for the neonatal death were calculated. RESULTS: severe oligoamnios and narrow thorax were more frequent (p=0.03; p<0.001) in fetuses with bilateral renal cysts, as compared to those with echographically normal renal parenchyma. Neonatal death was more frequent among cases with severe oligoamnios (p<0.001), narrow thorax (p<0.001) and bilateral renal cysts (p<0.002), when respectively compared with cases without those alterations. The best values of sensitivity, specificity, positive and negative predictive value for the death of neonatal/breastfeeding infants were obtained using the echographic aspect of narrow thorax, and were 81.8, 100, 100 and 79.3%, respectively. CONCLUSIONS: in cases of fetuses with bilateral obstructive uropathies followed up in an expectant way, the ultrasonographic signs more associated to bad prognosis are severe oligoamnios, narrow fetal thorax and presence of bilateral renal cysts.
Summary
Rev Bras Ginecol Obstet. 2009;31(11):540-546
DOI 10.1590/S0100-72032009001100003
PURPOSE: to verify the association between ultrasonographic signs during gestation and post-delivery evolution in fetuses with bilateral obstructive uropathies, followed up in an expectant way. METHODS: fetuses with bilateral obstructive uropathies presenting severe oligoamnios and narrow thorax have been compared with fetuses with bilateral obstructive uropathies without those alterations, concerning the presence or absence of cysts in both kidneys, and the presence or absence of parenchymal hyperechogenicity in both kidneys. Cases of neonatal death were compared with cases of neonatal discharge from the nursery, regarding the same renal echographic aspects mentioned above, the presence of severe oligoamnios and narrow thorax. The sensitivity, specificity, positive and negative predictive value of the presence of bilateral renal cysts, bilateral renal hyperechogenicity, severe oligoamnios and narrow fetal thorax for the neonatal death were calculated. RESULTS: severe oligoamnios and narrow thorax were more frequent (p=0.03; p<0.001) in fetuses with bilateral renal cysts, as compared to those with echographically normal renal parenchyma. Neonatal death was more frequent among cases with severe oligoamnios (p<0.001), narrow thorax (p<0.001) and bilateral renal cysts (p<0.002), when respectively compared with cases without those alterations. The best values of sensitivity, specificity, positive and negative predictive value for the death of neonatal/breastfeeding infants were obtained using the echographic aspect of narrow thorax, and were 81.8, 100, 100 and 79.3%, respectively. CONCLUSIONS: in cases of fetuses with bilateral obstructive uropathies followed up in an expectant way, the ultrasonographic signs more associated to bad prognosis are severe oligoamnios, narrow fetal thorax and presence of bilateral renal cysts.
Summary
Rev Bras Ginecol Obstet. 2002;24(9):573-577
DOI 10.1590/S0100-72032002000900002
Objective: to study the effects of oral or transdermal estrogen replacement on the lower urinary tract and vagina in postmenopausal women. Methods: we studied 25 postmenopausal women evaluating the oral or transdermic estrogen replacement effects on the vaginal cells and urinary sediment during 3 months. The patients were randomly distributed into 2 groups: Group I, n = 14, treated orally with 0.625 mg equine conjugated estrogen plus 5 mg medroxyprogesterone acetate, daily for 3 months; Group II, n = 11, treated transdermally with 50 mug 17-ß-estradiol, once a week, plus 5 mg medroxyprogesterone. Daily, for 3 months, urinary samples were collected from the first miction in the morning after urogenital antisepsis into sterile tubes. The sample was centrifuged and the sediment was smeared. Vaginal and urinary smears were then fixed in absoluted alcohol and stained by the method of Shorr. Results: the patients who used the oral route presented maturation of the vaginal cells (from 45.4 to 65.5% after 2 months of treatment, maintaing 62% afterwards) but this did not occur with urinary cells (56.4 before treatment versus 60.4% at the end of the period). The transdermal route promoted maturation of vaginal and urinary cells. Conclusion: we have concluded that transdermal estrogens have satisfactory effects both on vaginal and urethral sites. However, with the oral route we did not find the expected results in the urinary tract in all cases.
Summary
Rev Bras Ginecol Obstet. 2002;24(9):573-577
DOI 10.1590/S0100-72032002000900002
Objective: to study the effects of oral or transdermal estrogen replacement on the lower urinary tract and vagina in postmenopausal women. Methods: we studied 25 postmenopausal women evaluating the oral or transdermic estrogen replacement effects on the vaginal cells and urinary sediment during 3 months. The patients were randomly distributed into 2 groups: Group I, n = 14, treated orally with 0.625 mg equine conjugated estrogen plus 5 mg medroxyprogesterone acetate, daily for 3 months; Group II, n = 11, treated transdermally with 50 mug 17-ß-estradiol, once a week, plus 5 mg medroxyprogesterone. Daily, for 3 months, urinary samples were collected from the first miction in the morning after urogenital antisepsis into sterile tubes. The sample was centrifuged and the sediment was smeared. Vaginal and urinary smears were then fixed in absoluted alcohol and stained by the method of Shorr. Results: the patients who used the oral route presented maturation of the vaginal cells (from 45.4 to 65.5% after 2 months of treatment, maintaing 62% afterwards) but this did not occur with urinary cells (56.4 before treatment versus 60.4% at the end of the period). The transdermal route promoted maturation of vaginal and urinary cells. Conclusion: we have concluded that transdermal estrogens have satisfactory effects both on vaginal and urethral sites. However, with the oral route we did not find the expected results in the urinary tract in all cases.
