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Original Article
Accuracy of Transvaginal Ultrasonography, Hysteroscopy and Uterine Curettage in Evaluating Endometrial Pathologies
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(10):506-511
10-01-2016
Summary
Original ArticleAccuracy of Transvaginal Ultrasonography, Hysteroscopy and Uterine Curettage in Evaluating Endometrial Pathologies
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(10):506-511
10-01-2016Views154Abstract
Objective
To evaluate the accuracy of transvaginal ultrasonography, hysteroscopy and uterine curettage in the diagnosis of endometrial polyp, submucous myoma and endometrial hyperplasia, using as gold standard the histopathological analysis of biopsy samples obtained during hysteroscopy or uterine curettage.
Methods
Cross-sectional study performed at the Hospital Universitário de Brasília (HUB). Data were obtained from the charts of patients submitted to hysteroscopy or uterine curettage in the period from July 2007 to July 2012.
Results
One-hundred and ninety-one patients were evaluated, 134 of whom underwent hysteroscopy, and 57, uterine curettage. Hysteroscopy revealed a diagnostic accuracy higher than 90% for all the diseases evaluated, while transvaginal ultrasonography showed an accuracy of 65.9% for polyps, 78.1% for myoma and 63.2% for endometrial hyperplasia. Within the 57 patients submitted to uterine curettage, there was an accuracy of 56% for polyps and 54.6% for endometrial hyperplasia.
Conclusion
Ideally, after initial investigation with transvaginal ultrasonography, guided biopsy of the lesion should be performed by hysteroscopy, whenever necessary, in order to improve the diagnostic accuracy and subsequent clinical management.
Key-words accuracyEndometrial hyperplasiaEndometrial polypHysteroscopysubmucous myomaTransvaginal ultrasonographyuterine curettageSee moreViews154
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleAccuracy of Transvaginal Ultrasonography, Hysteroscopy and Uterine Curettage in Evaluating Endometrial Pathologies
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(10):506-511
10-01-2016Views154Abstract
Objective
To evaluate the accuracy of transvaginal ultrasonography, hysteroscopy and uterine curettage in the diagnosis of endometrial polyp, submucous myoma and endometrial hyperplasia, using as gold standard the histopathological analysis of biopsy samples obtained during hysteroscopy or uterine curettage.
Methods
Cross-sectional study performed at the Hospital Universitário de Brasília (HUB). Data were obtained from the charts of patients submitted to hysteroscopy or uterine curettage in the period from July 2007 to July 2012.
Results
One-hundred and ninety-one patients were evaluated, 134 of whom underwent hysteroscopy, and 57, uterine curettage. Hysteroscopy revealed a diagnostic accuracy higher than 90% for all the diseases evaluated, while transvaginal ultrasonography showed an accuracy of 65.9% for polyps, 78.1% for myoma and 63.2% for endometrial hyperplasia. Within the 57 patients submitted to uterine curettage, there was an accuracy of 56% for polyps and 54.6% for endometrial hyperplasia.
Conclusion
Ideally, after initial investigation with transvaginal ultrasonography, guided biopsy of the lesion should be performed by hysteroscopy, whenever necessary, in order to improve the diagnostic accuracy and subsequent clinical management.
Key-words accuracyEndometrial hyperplasiaEndometrial polypHysteroscopysubmucous myomaTransvaginal ultrasonographyuterine curettageSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Original Article
The Apocrine Profile of Triple-negative Breast Carcinomas in Patients Aged 45 Years or Younger: favorable but rare features
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(10):512-517
10-01-2016
Summary
Original ArticleThe Apocrine Profile of Triple-negative Breast Carcinomas in Patients Aged 45 Years or Younger: favorable but rare features
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(10):512-517
10-01-2016Views157Abstract
Objective
Triple-negative breast carcinomas (TNBCs) represent a heterogeneous group of neoplasias, even though they generally exhibit a clinically more aggressive phenotype, and are more prevalent in young women. To date, targeted therapies for this group of tumors have not been defined. The aim of this study was to evaluate the frequency of the apocrine subtype in TBNCs from premenopausal patients as defined by the immunohistochemical expression of the androgen receptor (AR) and its association with: histological type; tumor grade; proliferative activity; epidermal growth factor receptor (EGFR) expression; and a basal-like phenotype.
Methods
A total of 118 tumor samples from patients aged 45 years or younger were selected and reviewed according to histological type and grade. Ki-67 expression was also evaluated. Immunohistochemical expression of the AR, basal cytokeratin ⅚, and EGFR expression were analyzed in tissue microarrays. The apocrine subset was defined by AR-positive expression. The basal-like phenotype was characterized by cytokeratin ⅚ and/or EGFR expression.
Results
An apocrine profile was identified in 6/118 (5.1%) cases. This subset of cases also exhibited a lower rate of Ki-67 expression (17.5% versus 70.0%, p= 0.02), and a trend toward a lower histological grade (66.7% versus 27.9%, p= 0.06).
Conclusions
The apocrine subtype of TNBCs is rare among premenopausal women, and it tends to present as carcinomas of lower grade and lower proliferative activity, suggesting a less aggressive biological phenotype.
Key-words androgen receptorapocrineBreast cancerepidermal growth factor receptor Ki-67Immunohistochemistrytriple-negativeSee moreViews157This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleThe Apocrine Profile of Triple-negative Breast Carcinomas in Patients Aged 45 Years or Younger: favorable but rare features
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(10):512-517
10-01-2016Views157Abstract
Objective
Triple-negative breast carcinomas (TNBCs) represent a heterogeneous group of neoplasias, even though they generally exhibit a clinically more aggressive phenotype, and are more prevalent in young women. To date, targeted therapies for this group of tumors have not been defined. The aim of this study was to evaluate the frequency of the apocrine subtype in TBNCs from premenopausal patients as defined by the immunohistochemical expression of the androgen receptor (AR) and its association with: histological type; tumor grade; proliferative activity; epidermal growth factor receptor (EGFR) expression; and a basal-like phenotype.
Methods
A total of 118 tumor samples from patients aged 45 years or younger were selected and reviewed according to histological type and grade. Ki-67 expression was also evaluated. Immunohistochemical expression of the AR, basal cytokeratin ⅚, and EGFR expression were analyzed in tissue microarrays. The apocrine subset was defined by AR-positive expression. The basal-like phenotype was characterized by cytokeratin ⅚ and/or EGFR expression.
Results
An apocrine profile was identified in 6/118 (5.1%) cases. This subset of cases also exhibited a lower rate of Ki-67 expression (17.5% versus 70.0%, p= 0.02), and a trend toward a lower histological grade (66.7% versus 27.9%, p= 0.06).
Conclusions
The apocrine subtype of TNBCs is rare among premenopausal women, and it tends to present as carcinomas of lower grade and lower proliferative activity, suggesting a less aggressive biological phenotype.
Key-words androgen receptorapocrineBreast cancerepidermal growth factor receptor Ki-67Immunohistochemistrytriple-negativeSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
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Original Article
Reference Ranges of Fetal Cerebral Lateral Ventricle Parameters by Ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):428-435
09-01-2016
Summary
Original ArticleReference Ranges of Fetal Cerebral Lateral Ventricle Parameters by Ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):428-435
09-01-2016Views165See moreAbstract
Objectives
This study was done to evaluate the normal fetal cerebral lateral ventricle dimensions with transabdominal ultrasonography. The atrial width (AW), ventricle-tochoroid measurement (V-C), ventricle-to-hemisphere ratio (VHR), and combined anterior horn measurement (CAHM) were taken.
Methods
This was a cross-sectional study involving 400 normal singleton pregnant subjects whose gestational ages were between 14 and 40 weeks. Transabdominal sonography was performed to obtain the values of the fetal cerebral lateral ventricle (FCLV) parameters. Data were reported as mean standard deviation (SD) for continuous variables. The degrees of correlation between FCLV parameters and the estimated gestational age (EGA) were obtained using Pearson's correlation. Regression equations were used to generate the reference limits for the FCLV measurements.
Results
The values of AW, V-C measurements and CAHM increased with advancing gestation. The mean values of the AW, V-C and CAHM from 14 to 40 weeks increased from 6.60 0.94 mm to 9.75 0.07 mm (R2 = 0.114), 0.80 0.00 mm to 1.90 0.14 mm (R2= 0.266), and 6.95 0.06 mm to 23.07 4.02 mm (R2= 0.692) respectively, while the mean VHR decreased from 61.20 1.60% to 42.84 2.91% (R2 = 0.706) over the same period.
Conclusion
The AW, V-C, and CAHM increase, while VHR decreases with advancing gestation.
Views165This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleReference Ranges of Fetal Cerebral Lateral Ventricle Parameters by Ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):428-435
09-01-2016Views165See moreAbstract
Objectives
This study was done to evaluate the normal fetal cerebral lateral ventricle dimensions with transabdominal ultrasonography. The atrial width (AW), ventricle-tochoroid measurement (V-C), ventricle-to-hemisphere ratio (VHR), and combined anterior horn measurement (CAHM) were taken.
Methods
This was a cross-sectional study involving 400 normal singleton pregnant subjects whose gestational ages were between 14 and 40 weeks. Transabdominal sonography was performed to obtain the values of the fetal cerebral lateral ventricle (FCLV) parameters. Data were reported as mean standard deviation (SD) for continuous variables. The degrees of correlation between FCLV parameters and the estimated gestational age (EGA) were obtained using Pearson's correlation. Regression equations were used to generate the reference limits for the FCLV measurements.
Results
The values of AW, V-C measurements and CAHM increased with advancing gestation. The mean values of the AW, V-C and CAHM from 14 to 40 weeks increased from 6.60 0.94 mm to 9.75 0.07 mm (R2 = 0.114), 0.80 0.00 mm to 1.90 0.14 mm (R2= 0.266), and 6.95 0.06 mm to 23.07 4.02 mm (R2= 0.692) respectively, while the mean VHR decreased from 61.20 1.60% to 42.84 2.91% (R2 = 0.706) over the same period.
Conclusion
The AW, V-C, and CAHM increase, while VHR decreases with advancing gestation.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
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Original Article
Neurological Outcome in Fetuses with Mild and Moderate Ventriculomegaly
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):436-442
09-01-2016
Summary
Original ArticleNeurological Outcome in Fetuses with Mild and Moderate Ventriculomegaly
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):436-442
09-01-2016Views164See moreAbstract
Introduction
Ventriculomegaly (VM) is one the most frequent anomalies detected on prenatal ultrasound. Magnetic resonance imaging (MRI) may enhance diagnostic accuracy and prediction of developmental outcome in newborns.
Purpose
The aim of this study was to assess the correlation between ultrasound and MRI in fetuses with isolated mild and moderate VM. The secondary aim was to report the neurodevelopmental outcome at 4 years of age.
Methods
Fetuses with a prenatal ultrasound (brain scan) diagnosis of VM were identified over a 4-year period. Ventriculomegaly was defined as an atrial width of 10- 15 mm that was further divided as mild (10.1-12.0 mm) and moderate (12.1-15.0 mm). Fetuses with VM underwent antenatal as well as postnatal follow-ups by brain scan and MRI. Neurodevelopmental outcome was performed using the Griffiths Mental Development Scales and conducted, where indicated, until 4 years into the postnatal period.
Results
Sixty-two fetuses were identified. Ventriculomegaly was bilateral in 58% of cases. A stable dilatation was seen in 45% of cases, progression was seen in 13%, and regression of VM was seen in 4.5% respectively. Fetal MRI was performed in 54 fetuses and was concordant with brain scan findings in 85% of cases. Abnormal neurodevelopmental outcomes were seen in 9.6% of cases.
Conclusion
Fetuses in whom a progression of VM is seen are at a higher risk of developing an abnormal neurodevelopmental outcome. Although brain scan and MRI are substantially in agreement in defining the grade of ventricular dilatation, a low correlation was seen in the evaluation of VM associated with central nervous system (CNS) or non-CNS abnormalities.
Views164This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleNeurological Outcome in Fetuses with Mild and Moderate Ventriculomegaly
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):436-442
09-01-2016Views164See moreAbstract
Introduction
Ventriculomegaly (VM) is one the most frequent anomalies detected on prenatal ultrasound. Magnetic resonance imaging (MRI) may enhance diagnostic accuracy and prediction of developmental outcome in newborns.
Purpose
The aim of this study was to assess the correlation between ultrasound and MRI in fetuses with isolated mild and moderate VM. The secondary aim was to report the neurodevelopmental outcome at 4 years of age.
Methods
Fetuses with a prenatal ultrasound (brain scan) diagnosis of VM were identified over a 4-year period. Ventriculomegaly was defined as an atrial width of 10- 15 mm that was further divided as mild (10.1-12.0 mm) and moderate (12.1-15.0 mm). Fetuses with VM underwent antenatal as well as postnatal follow-ups by brain scan and MRI. Neurodevelopmental outcome was performed using the Griffiths Mental Development Scales and conducted, where indicated, until 4 years into the postnatal period.
Results
Sixty-two fetuses were identified. Ventriculomegaly was bilateral in 58% of cases. A stable dilatation was seen in 45% of cases, progression was seen in 13%, and regression of VM was seen in 4.5% respectively. Fetal MRI was performed in 54 fetuses and was concordant with brain scan findings in 85% of cases. Abnormal neurodevelopmental outcomes were seen in 9.6% of cases.
Conclusion
Fetuses in whom a progression of VM is seen are at a higher risk of developing an abnormal neurodevelopmental outcome. Although brain scan and MRI are substantially in agreement in defining the grade of ventricular dilatation, a low correlation was seen in the evaluation of VM associated with central nervous system (CNS) or non-CNS abnormalities.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
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Original Article
Cultural Adaptation of the Patient Satisfaction Questionnaire and Validation of Its Use in the Portuguese Language for Women with Chronic Pelvic Pain
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):443-449
09-01-2016
Summary
Original ArticleCultural Adaptation of the Patient Satisfaction Questionnaire and Validation of Its Use in the Portuguese Language for Women with Chronic Pelvic Pain
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):443-449
09-01-2016Views103See moreAbstract
Objectives
to translate and adapt the Patient Satisfaction Questionnaire (PSQ) to Portuguese and to assess its psychometric properties based on internal consistency, test-retest, factor analysis and divergent and convergent construct validities.
Methods
The study involved 218 participants and was approved by the local Research Ethics Committee. All participants gave written informed consent and their anonymity was ensured. The instrument was translated and culturally adapted for use in the Portuguese language. The internal consistency and factorial analysis were assessed by patients and physicians. Convergent and divergent validities were also assessed specifically for the patient group, as well as test-retest reliability. The Portuguese versions of the Patient Health Questionnaire (PHQ-9) and State-Trait Anxiety Inventory (STAI) were used for the analysis of the convergent validity. In addition, we applied a questionnaire of clinical and demographic data for the analysis of the divergent validity.
Results
The adapted version of the PSQ showed good Cronbach’s α and test-retest values, and the results of the convergent construct validity between the PSQ and the PHQ-9 (r = 0.34; p = 0.02) and the STAI (r = 0.47; p = 0.001) were negative, significant and moderate correlations. Divergent validity showed significant correlations only with race and education. The Brazilian Portuguese versionof the PSQ proved to be a valid and reliable instrument, with psychometric properties suitable for the assessment of satisfaction among patients with chronic pelvic pain and their physicians in Brazil. The questionnairemay allow the homogenization of reports on this topic in the international literature.
Views103This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleCultural Adaptation of the Patient Satisfaction Questionnaire and Validation of Its Use in the Portuguese Language for Women with Chronic Pelvic Pain
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):443-449
09-01-2016Views103See moreAbstract
Objectives
to translate and adapt the Patient Satisfaction Questionnaire (PSQ) to Portuguese and to assess its psychometric properties based on internal consistency, test-retest, factor analysis and divergent and convergent construct validities.
Methods
The study involved 218 participants and was approved by the local Research Ethics Committee. All participants gave written informed consent and their anonymity was ensured. The instrument was translated and culturally adapted for use in the Portuguese language. The internal consistency and factorial analysis were assessed by patients and physicians. Convergent and divergent validities were also assessed specifically for the patient group, as well as test-retest reliability. The Portuguese versions of the Patient Health Questionnaire (PHQ-9) and State-Trait Anxiety Inventory (STAI) were used for the analysis of the convergent validity. In addition, we applied a questionnaire of clinical and demographic data for the analysis of the divergent validity.
Results
The adapted version of the PSQ showed good Cronbach’s α and test-retest values, and the results of the convergent construct validity between the PSQ and the PHQ-9 (r = 0.34; p = 0.02) and the STAI (r = 0.47; p = 0.001) were negative, significant and moderate correlations. Divergent validity showed significant correlations only with race and education. The Brazilian Portuguese versionof the PSQ proved to be a valid and reliable instrument, with psychometric properties suitable for the assessment of satisfaction among patients with chronic pelvic pain and their physicians in Brazil. The questionnairemay allow the homogenization of reports on this topic in the international literature.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
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Original Article
Early Experience of Robotic Hysterectomy for Treatment of Benign Uterine Disease
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):450-455
09-01-2016
Summary
Original ArticleEarly Experience of Robotic Hysterectomy for Treatment of Benign Uterine Disease
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):450-455
09-01-2016Views84See moreAbstract
Objectives
To demonstrate the initial experience of robotic hysterectomy to treat benign uterine disease at a university hospital in Brazil.
Methods
A cross-sectional study was conducted to review data from the first twenty patients undergoing robotic hysterectomy at our hospital. The surgeries were performed from November 2013 to August 2014, all of them by the same surgeon. The patients were reviewed for preoperative characteristics, including age, body mass index (BMI), indications for the hysterectomy and previous surgeries. Data of operative times, complications, postoperative pain and length of hospital stay were also collected.
Results
The total operating room time was 252.9 minutes, while the operative time was 180.7 minutes and the console time was 136.6 minutes. Docking time was 4.2 minutes, and the average undocking time was 1.9 minutes. There was a strong correlation between the operative time and the patient's BMI (r = 0.670 ; p = 0.001). The console time had significant correlation with the uterine weight and the patient's BMI (r = 0.468; p = 0.037). A learning curve was observed during docking and undocking times.
Conclusion
Despite its high cost, the robotic surgery is gaining more space in gynecological surgery. By the results obtained in our hospital, this surgical proposal proved to be feasible and safe. Our initial experience demonstrated a learning curve in some ways.
Views84This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleEarly Experience of Robotic Hysterectomy for Treatment of Benign Uterine Disease
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):450-455
09-01-2016Views84See moreAbstract
Objectives
To demonstrate the initial experience of robotic hysterectomy to treat benign uterine disease at a university hospital in Brazil.
Methods
A cross-sectional study was conducted to review data from the first twenty patients undergoing robotic hysterectomy at our hospital. The surgeries were performed from November 2013 to August 2014, all of them by the same surgeon. The patients were reviewed for preoperative characteristics, including age, body mass index (BMI), indications for the hysterectomy and previous surgeries. Data of operative times, complications, postoperative pain and length of hospital stay were also collected.
Results
The total operating room time was 252.9 minutes, while the operative time was 180.7 minutes and the console time was 136.6 minutes. Docking time was 4.2 minutes, and the average undocking time was 1.9 minutes. There was a strong correlation between the operative time and the patient's BMI (r = 0.670 ; p = 0.001). The console time had significant correlation with the uterine weight and the patient's BMI (r = 0.468; p = 0.037). A learning curve was observed during docking and undocking times.
Conclusion
Despite its high cost, the robotic surgery is gaining more space in gynecological surgery. By the results obtained in our hospital, this surgical proposal proved to be feasible and safe. Our initial experience demonstrated a learning curve in some ways.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
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Original Article
Creation of a Neovagina by Laparoscopic Modified Vecchietti Technique: Anatomic and Functional Results
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):456-464
09-01-2016
Summary
Original ArticleCreation of a Neovagina by Laparoscopic Modified Vecchietti Technique: Anatomic and Functional Results
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):456-464
09-01-2016Views201Abstract
Purpose
To evaluate the anatomic and functional results of a laparoscopic modified Vecchietti technique for the creation of a neovagina in patients with congenital vaginal aplasia.
Methods
Retrospective study of nine patients with congenital vaginal aplasia submitted to the laparoscopic Vecchietti procedure, in our department, between 2006 and 2013. The anatomical results were evaluated by assessing the length, width and epithelialization of the neovagina at the postoperative visits. The functional outcome was evaluated using the Rosen Female Sexual Function Index (FSFI) questionnaire and comparing the patients' results to those of a control group of 20 healthy women. The statistical analysis was performed using SPSS Statistics version 19.0 (IBM, Armonk, NY, USA), Student t-test, Mann-Whitney U test and Fisher exact test.
Results
The condition underlying the vaginal aplasia was Mayer-Rokitansky-KüsterHauser syndrome in eight cases, and androgen insensitivity syndrome in one case. The average preoperative vaginal length was 2.9 cm. At surgery, the mean age of the patients was 22.2 years. The surgery was performed successfully in all patients and no intra or postoperative complications were recorded. At the first postoperative visit (6 to 8 weeks after surgery), the mean vaginal length was 8.1 cm. In all cases, the neovagina was epithelialized and had an appropriate width. The mean FSFI total and single domain scores did not differ significantly from those of the control group: 27.5 vs. 30.6 ( total); 4.0 vs. 4.2 (desire); 4.4 vs. 5.2 (arousal); 5.2 vs. 5.3 (lubrication); 4.2 vs. 5.0 ( orgasm); 5.3 vs. 5.5 (satisfaction) and 4.4 vs. 5.4 ( comfort ).
Conclusions
This modified laparoscopic Vecchietti technique is a simple, safe and effective procedure, which allows patients with congenital vaginal aplasia to have a satisfactory sexual activity, comparable to that of normal controls.
Key-words androgen insensitivity syndromeGynecologic surgeryLaparoscopymayer-rokitanskyküster-hauser syndromeminimally invasive surgerySexualitySee moreViews201This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleCreation of a Neovagina by Laparoscopic Modified Vecchietti Technique: Anatomic and Functional Results
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):456-464
09-01-2016Views201Abstract
Purpose
To evaluate the anatomic and functional results of a laparoscopic modified Vecchietti technique for the creation of a neovagina in patients with congenital vaginal aplasia.
Methods
Retrospective study of nine patients with congenital vaginal aplasia submitted to the laparoscopic Vecchietti procedure, in our department, between 2006 and 2013. The anatomical results were evaluated by assessing the length, width and epithelialization of the neovagina at the postoperative visits. The functional outcome was evaluated using the Rosen Female Sexual Function Index (FSFI) questionnaire and comparing the patients' results to those of a control group of 20 healthy women. The statistical analysis was performed using SPSS Statistics version 19.0 (IBM, Armonk, NY, USA), Student t-test, Mann-Whitney U test and Fisher exact test.
Results
The condition underlying the vaginal aplasia was Mayer-Rokitansky-KüsterHauser syndrome in eight cases, and androgen insensitivity syndrome in one case. The average preoperative vaginal length was 2.9 cm. At surgery, the mean age of the patients was 22.2 years. The surgery was performed successfully in all patients and no intra or postoperative complications were recorded. At the first postoperative visit (6 to 8 weeks after surgery), the mean vaginal length was 8.1 cm. In all cases, the neovagina was epithelialized and had an appropriate width. The mean FSFI total and single domain scores did not differ significantly from those of the control group: 27.5 vs. 30.6 ( total); 4.0 vs. 4.2 (desire); 4.4 vs. 5.2 (arousal); 5.2 vs. 5.3 (lubrication); 4.2 vs. 5.0 ( orgasm); 5.3 vs. 5.5 (satisfaction) and 4.4 vs. 5.4 ( comfort ).
Conclusions
This modified laparoscopic Vecchietti technique is a simple, safe and effective procedure, which allows patients with congenital vaginal aplasia to have a satisfactory sexual activity, comparable to that of normal controls.
Key-words androgen insensitivity syndromeGynecologic surgeryLaparoscopymayer-rokitanskyküster-hauser syndromeminimally invasive surgerySexualitySee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 
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Original Article
Association between Number of Formed Embryos, Embryo Morphology and Clinical Pregnancy Rate after Intracytoplasmic Sperm Injection
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):465-470
09-01-2016
Summary
Original ArticleAssociation between Number of Formed Embryos, Embryo Morphology and Clinical Pregnancy Rate after Intracytoplasmic Sperm Injection
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):465-470
09-01-2016Views143See moreAbstract
Introduction
Infertility has a high prevalence in the general population, affecting 5 to 15% of couples in reproductive age. The assisted reproduction techniques ( ART ) include in vitro manipulation of gametes and embryos and are an important treatment indicated to these couples. It is well accepted that the implantation rate is positively influenced by the morphology of transferred embryos. However, we question if, apart from the assessment of embryo morphology, the number of produced embryos per cycle is also related to pregnancy rates in the first fresh transfer cycle.
Purpose
To evaluate the clinical pregnancy rate according to the number of formed embryos and the transfer of top quality embryos ( TQEs ).
Methods
In a retrospective cohort study, between January 2011 and December 2012 , we evaluated women who underwent intracytoplasmic sperm injection (ICSI), aged < 40 years, andwith at least 1 formed embryo fresh transferred in cleavagestage. These women were stratified into 3 groups according to the number of formed embryos (1 embryo, 2-3 and ≥ 4 embryos). Each group was divided into 2 subgroups according to the presence or not of at least 1 transferred TQE (1 with TQE; 1 without TQE; 2-3 with TQE, 2-3 without TQE; ≥4with TQE; ≥4withoutTQE). The clinicalpregnancy rateswerecomparedineach subgroup based on the presence or absence of at least one transferred TQE.
Results
During the study period, 636 women had at least one embryo to be transferred in thefirst fresh cycle (17.8% had 1 formed embryo [32.7% with TQEversus 67.3% without TQE], 42.1% of women had 2-3 formed embryos [55.6% with TQE versus 44.4% without TQE], and 40.1%ofpatientshad ≥4 formedembryos[73.7%withTQEversus26.3%withoutTQE]).The clinical pregnancy rate was significantly higher in the subgroup with ≥4 formed embryos with at least 1 transfered TQE (45.2%) compared with the subgroup without TQE (28.4%).
Conclusions
Having at least two available embryos and at least one TQE for embryo transfer are predictors of the pregnancy rates.
Views143This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleAssociation between Number of Formed Embryos, Embryo Morphology and Clinical Pregnancy Rate after Intracytoplasmic Sperm Injection
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):465-470
09-01-2016Views143See moreAbstract
Introduction
Infertility has a high prevalence in the general population, affecting 5 to 15% of couples in reproductive age. The assisted reproduction techniques ( ART ) include in vitro manipulation of gametes and embryos and are an important treatment indicated to these couples. It is well accepted that the implantation rate is positively influenced by the morphology of transferred embryos. However, we question if, apart from the assessment of embryo morphology, the number of produced embryos per cycle is also related to pregnancy rates in the first fresh transfer cycle.
Purpose
To evaluate the clinical pregnancy rate according to the number of formed embryos and the transfer of top quality embryos ( TQEs ).
Methods
In a retrospective cohort study, between January 2011 and December 2012 , we evaluated women who underwent intracytoplasmic sperm injection (ICSI), aged < 40 years, andwith at least 1 formed embryo fresh transferred in cleavagestage. These women were stratified into 3 groups according to the number of formed embryos (1 embryo, 2-3 and ≥ 4 embryos). Each group was divided into 2 subgroups according to the presence or not of at least 1 transferred TQE (1 with TQE; 1 without TQE; 2-3 with TQE, 2-3 without TQE; ≥4with TQE; ≥4withoutTQE). The clinicalpregnancy rateswerecomparedineach subgroup based on the presence or absence of at least one transferred TQE.
Results
During the study period, 636 women had at least one embryo to be transferred in thefirst fresh cycle (17.8% had 1 formed embryo [32.7% with TQEversus 67.3% without TQE], 42.1% of women had 2-3 formed embryos [55.6% with TQE versus 44.4% without TQE], and 40.1%ofpatientshad ≥4 formedembryos[73.7%withTQEversus26.3%withoutTQE]).The clinical pregnancy rate was significantly higher in the subgroup with ≥4 formed embryos with at least 1 transfered TQE (45.2%) compared with the subgroup without TQE (28.4%).
Conclusions
Having at least two available embryos and at least one TQE for embryo transfer are predictors of the pregnancy rates.
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Original Article Archives - Page 4 of 55 - Revista Brasileira de Ginecologia e Obstetrícia
