Você pesquisou por y - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Rev Bras Ginecol Obstet. 2007;29(2):103-112
DOI 10.1590/S0100-72032007000200008
Male infertility affects 10% of couples in the reproductive age worldwide and is treatable in many cases. In addition to other well-described etiologies, genetic causes of male infertility are now more commonly diagnosed. In men with prior vasectomy or varicocele, microsurgical reconstruction of the reproductive tract or varicocelectomy is more cost-effective than sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection if no female fertility risk factors are present. If epididymal obstruction after vasectomy is detected or advanced female age is present, the decision to use either microsurgical reconstruction or sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection should be individualized. Sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection is preferred to surgical treatment when female factors requiring in vitro fertilization are present or when the chance for success with sperm retrieval and intracytoplasmic sperm injection exceeds the chance for success with surgical treatment.
Summary
Rev Bras Ginecol Obstet. 2007;29(2):103-112
DOI 10.1590/S0100-72032007000200008
Male infertility affects 10% of couples in the reproductive age worldwide and is treatable in many cases. In addition to other well-described etiologies, genetic causes of male infertility are now more commonly diagnosed. In men with prior vasectomy or varicocele, microsurgical reconstruction of the reproductive tract or varicocelectomy is more cost-effective than sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection if no female fertility risk factors are present. If epididymal obstruction after vasectomy is detected or advanced female age is present, the decision to use either microsurgical reconstruction or sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection should be individualized. Sperm retrieval with in vitro fertilization and intracytoplasmic sperm injection is preferred to surgical treatment when female factors requiring in vitro fertilization are present or when the chance for success with sperm retrieval and intracytoplasmic sperm injection exceeds the chance for success with surgical treatment.
Summary
Rev Bras Ginecol Obstet. 2007;29(2):113-113
Summary
Rev Bras Ginecol Obstet. 2007;29(2):113-113
Summary
Rev Bras Ginecol Obstet. 2007;29(2):113-113
Summary
Rev Bras Ginecol Obstet. 2007;29(2):113-113
Summary
Rev Bras Ginecol Obstet. 2007;29(2):61-66
Summary
Rev Bras Ginecol Obstet. 2007;29(2):61-66
Summary
Rev Bras Ginecol Obstet. 2007;29(2):67-73
DOI 10.1590/S0100-72032007000200002
PURPOSE: to evaluate the teaching and the practice of hysterectomy in the Brazilian regions and to compare them with data of international literature. METHODS: questionnaires about nine issues on benign hysterectomy indications, surgical procedures, use of antibiotic prophylaxis, suture of the vaginal vault and complications were sent to the 132 Gynecological and Obstetrics Residency Services of Brazil, registered by the Ministry of the Education and Culture in 2003. Data were computed and statically analyzed, with the use of the Friedman's, Kruskal-Wallis's and chi2 tests, according to the characteristics of the variables. RESULTS: 48.5% of the questionnaires were answered or justified when there were no answers, mainly in the Southeastern region (62%). The main surgical hysterectomy procedure was the abdominal, varying from 60 to 100% (p<0.001), followed by the vaginal (10 to 40%) and the laparoscopy (6%). In 94% of the cases, laparoscopy was not employed. The main indication for hysterectomy was myomatosis (60.4%; p<0.001), followed by adenomiosis (8.3%) and abnormal uterine bleeding (7.5%). First generation cephalosporin was used for antibiotic prophylaxis in 94% of the cases. There was no significant statistical difference among the threads (simple Catgut®, chrome Catgut® or Vicryl®) used for the suture of the vaginal vault and the development of granuloma in this region, which was the main complication of the procedure (p=0,002). CONCLUSIONS: the surgical procedures, the hysterectomy indications, the threads used to suture the vaginal vault and the complications were similar in the different regions of Brazil and they agreed with the evidence reported in the international literature.
Summary
Rev Bras Ginecol Obstet. 2007;29(2):67-73
DOI 10.1590/S0100-72032007000200002
PURPOSE: to evaluate the teaching and the practice of hysterectomy in the Brazilian regions and to compare them with data of international literature. METHODS: questionnaires about nine issues on benign hysterectomy indications, surgical procedures, use of antibiotic prophylaxis, suture of the vaginal vault and complications were sent to the 132 Gynecological and Obstetrics Residency Services of Brazil, registered by the Ministry of the Education and Culture in 2003. Data were computed and statically analyzed, with the use of the Friedman's, Kruskal-Wallis's and chi2 tests, according to the characteristics of the variables. RESULTS: 48.5% of the questionnaires were answered or justified when there were no answers, mainly in the Southeastern region (62%). The main surgical hysterectomy procedure was the abdominal, varying from 60 to 100% (p<0.001), followed by the vaginal (10 to 40%) and the laparoscopy (6%). In 94% of the cases, laparoscopy was not employed. The main indication for hysterectomy was myomatosis (60.4%; p<0.001), followed by adenomiosis (8.3%) and abnormal uterine bleeding (7.5%). First generation cephalosporin was used for antibiotic prophylaxis in 94% of the cases. There was no significant statistical difference among the threads (simple Catgut®, chrome Catgut® or Vicryl®) used for the suture of the vaginal vault and the development of granuloma in this region, which was the main complication of the procedure (p=0,002). CONCLUSIONS: the surgical procedures, the hysterectomy indications, the threads used to suture the vaginal vault and the complications were similar in the different regions of Brazil and they agreed with the evidence reported in the international literature.
Summary
Rev Bras Ginecol Obstet. 2007;29(2):74-79
DOI 10.1590/S0100-72032007000200003
PURPOSE: to evaluate the association between women's menstrual experience and preferred changes in their menstrual cycles. METHODS: a cross-sectional study design was used. A total of 420 women were interviewed. Participants complied with the following criteria: age (18 to 20, 25 to 34 and 45 to 49 years); schooling (<8 years and >12 years); having menstruated during the three months previous to the study. Subjects were selected in the city of Campinas (SP), in nine private and seven public health services. For data collection, a questionnaire was prepared on the basis of the results of a previous pilot study that consisted of small groups. A data bank was prepared with the information registered in the questionnaires and the analysis was carried out with SAS, version 8.2. For the statistical analysis, the Pearson chi2 test and the Fisher exact test were used to evaluate the association between variables (p<0.05). RESULTS: most subjects preferred greater than once a month intervals between menstruations. There was an association of the typical menstrual intervals experienced by women (p=0.0248) and the degree of interference of menstruation with daily activities (p=0.048) with the preferred interval between menses. However, there was no association between preferred intervals by women and the following characteristics of pain: duration, intensity and use of medication. CONCLUSIONS: the results suggest that women would like intervals longer than one month or to never menstruate.
Summary
Rev Bras Ginecol Obstet. 2007;29(2):74-79
DOI 10.1590/S0100-72032007000200003
PURPOSE: to evaluate the association between women's menstrual experience and preferred changes in their menstrual cycles. METHODS: a cross-sectional study design was used. A total of 420 women were interviewed. Participants complied with the following criteria: age (18 to 20, 25 to 34 and 45 to 49 years); schooling (<8 years and >12 years); having menstruated during the three months previous to the study. Subjects were selected in the city of Campinas (SP), in nine private and seven public health services. For data collection, a questionnaire was prepared on the basis of the results of a previous pilot study that consisted of small groups. A data bank was prepared with the information registered in the questionnaires and the analysis was carried out with SAS, version 8.2. For the statistical analysis, the Pearson chi2 test and the Fisher exact test were used to evaluate the association between variables (p<0.05). RESULTS: most subjects preferred greater than once a month intervals between menstruations. There was an association of the typical menstrual intervals experienced by women (p=0.0248) and the degree of interference of menstruation with daily activities (p=0.048) with the preferred interval between menses. However, there was no association between preferred intervals by women and the following characteristics of pain: duration, intensity and use of medication. CONCLUSIONS: the results suggest that women would like intervals longer than one month or to never menstruate.
Summary
Rev Bras Ginecol Obstet. 2007;29(2):80-84
DOI 10.1590/S0100-72032007000200004
PURPOSE: to relate yeasts identified by laboratory tests to clinical signs and symptoms in patients with vulvovaginal candidiasis, and to investigate the importance of the sexual partners in the recurrence of the infection. METHODS: from July 2001 to July 2003, a sample of 179 patients aged from 18 to 65 years old, with clinical suspicion of fungal vaginitis were analyzed in a prospective study in Great São Paulo. Exclusion criteria included: pregnancy, impaired intrinsic or extrinsic immune response (including Aids), diabetes or immunosuppression; patients undergoing corticosteroid, antibiotic or hormone therapy, in post menopause, with intrauterine device (IUD) or making use of vaginal douches or spemicides. Samples of vaginal and penis secretions from partners of patients with relapse of vaginitis episodes were collected for microscopy and fungal culture. Fungal colonies isolated in CHROMagar Candida were identified by classical methods. Fisher's exact t-test was used to correlate the clinical picture with the yeasts isolated from patients. RESULTS: the most relevant clinical signs and symptoms were pruritus and vaginal discharge followed by erythema and edema, statistically independent from the etiological agent. Direct microscopy revealed yeasts in 77 patients with vulvovaginitis, and 40 Candida spp cultures were obtained. Candida albicans (70%), C. glabrata (20%), C. tropicalis (7,5%) and C. guilliermondii (2,5%) were identified. The yeasts prevalent in partners were C. albicans and C. glabrata. The same species were detected in female and male sex partners in 87% of the cases. CONCLUSIONS: fungal vulvovaginitis was more frequent in women between 18 and 34 years old. No correlation was observed between the species of yeast detected and clinical symptomatology. Sexual partners are important Candida spp reservoirs and may be related to the maintenance of the vulvovaginal candidiasis.
Summary
Rev Bras Ginecol Obstet. 2007;29(2):80-84
DOI 10.1590/S0100-72032007000200004
PURPOSE: to relate yeasts identified by laboratory tests to clinical signs and symptoms in patients with vulvovaginal candidiasis, and to investigate the importance of the sexual partners in the recurrence of the infection. METHODS: from July 2001 to July 2003, a sample of 179 patients aged from 18 to 65 years old, with clinical suspicion of fungal vaginitis were analyzed in a prospective study in Great São Paulo. Exclusion criteria included: pregnancy, impaired intrinsic or extrinsic immune response (including Aids), diabetes or immunosuppression; patients undergoing corticosteroid, antibiotic or hormone therapy, in post menopause, with intrauterine device (IUD) or making use of vaginal douches or spemicides. Samples of vaginal and penis secretions from partners of patients with relapse of vaginitis episodes were collected for microscopy and fungal culture. Fungal colonies isolated in CHROMagar Candida were identified by classical methods. Fisher's exact t-test was used to correlate the clinical picture with the yeasts isolated from patients. RESULTS: the most relevant clinical signs and symptoms were pruritus and vaginal discharge followed by erythema and edema, statistically independent from the etiological agent. Direct microscopy revealed yeasts in 77 patients with vulvovaginitis, and 40 Candida spp cultures were obtained. Candida albicans (70%), C. glabrata (20%), C. tropicalis (7,5%) and C. guilliermondii (2,5%) were identified. The yeasts prevalent in partners were C. albicans and C. glabrata. The same species were detected in female and male sex partners in 87% of the cases. CONCLUSIONS: fungal vulvovaginitis was more frequent in women between 18 and 34 years old. No correlation was observed between the species of yeast detected and clinical symptomatology. Sexual partners are important Candida spp reservoirs and may be related to the maintenance of the vulvovaginal candidiasis.
Summary
Rev Bras Ginecol Obstet. 2007;29(2):85-90
DOI 10.1590/S0100-72032007000200005
PURPOSE: to identify sexual dysfunctions in patients with cancer of the uterine cervix submitted to exclusive radiotherapy, using the high dose rate (HDR) brachytherapy technique. METHODS: a descriptive transversal study from January to June of 2004. The study involved 71 selected patients who had been followed in the pelvis outpatient clinic from the Hospital do Câncer de Pernambuco and selected according to the established profile. Data were collected from a structured questionnaire, complemented by a gynecological exam aimed at investigating complaints of sexual dysfunction after the radiotherapy. Epi-Info 6.04 was the statistical program used to process and analyze the data. Descriptive analysis was done through the mean, median and range. Bivariate analysis was done through the Marginal Homogeneity and McNamara's tests, considering 5% as the level of significance. RESULTS: among the gynecological complications identified, we can highlight fibrosis, stenosis and vaginal atrophy (98.6%, 76.1% and 71.8%, respectively). The sexual dysfunctions identified were: frigidity, lack of lubrication, excitation and orgasm in 76.1% of the cases, lack of sex drive in 40.8% and vaginism in 5.6% of the cases. CONCLUSIONS: sexual dysfunctions are frequent in patients with cancer of the advanced uterine cervix treated with exclusive radiotherapy using the protocol of HDR. Specific attention should be given to the sexual anamnesis and the gynecological exam during these patients' attendance.
Summary
Rev Bras Ginecol Obstet. 2007;29(2):85-90
DOI 10.1590/S0100-72032007000200005
PURPOSE: to identify sexual dysfunctions in patients with cancer of the uterine cervix submitted to exclusive radiotherapy, using the high dose rate (HDR) brachytherapy technique. METHODS: a descriptive transversal study from January to June of 2004. The study involved 71 selected patients who had been followed in the pelvis outpatient clinic from the Hospital do Câncer de Pernambuco and selected according to the established profile. Data were collected from a structured questionnaire, complemented by a gynecological exam aimed at investigating complaints of sexual dysfunction after the radiotherapy. Epi-Info 6.04 was the statistical program used to process and analyze the data. Descriptive analysis was done through the mean, median and range. Bivariate analysis was done through the Marginal Homogeneity and McNamara's tests, considering 5% as the level of significance. RESULTS: among the gynecological complications identified, we can highlight fibrosis, stenosis and vaginal atrophy (98.6%, 76.1% and 71.8%, respectively). The sexual dysfunctions identified were: frigidity, lack of lubrication, excitation and orgasm in 76.1% of the cases, lack of sex drive in 40.8% and vaginism in 5.6% of the cases. CONCLUSIONS: sexual dysfunctions are frequent in patients with cancer of the advanced uterine cervix treated with exclusive radiotherapy using the protocol of HDR. Specific attention should be given to the sexual anamnesis and the gynecological exam during these patients' attendance.