Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(9)
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(9)
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(9):443-445
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(9):446-451
DOI 10.1590/S0100-72032007000900002
PURPOSE: to evaluate the clinical and epidemiological characteristics of patients with the diagnosis of phantom breast syndrome or with phantom phenomena lonely. METHODS: it was conducted an observational, descriptive and sectional study enrolling 98 patients treated for breast cancer at Hospital São Marcos, Teresina (PI), Brazil. A standardized questionnaire was applied. RESULTS: the phantom breast syndrome was observed in 11.2% of the patients and phantom sensation alone was observed in 30% of the patients. The mean age of the patients was 54 years. Fifty-nine patients were married (60%) and 79.5% were analphabetic or had not concluded the high school. Emotional alterations were present in 67.4%, even though in 66.7% the libido was not changed after surgical procedure. As a relief factor of phantom pain, resting was cited by 90.9% of the patients, while physical exercises were mentioned to exacerbate the symptoms in 63.6% of the cases. The mean grade attributed to the pain in a 0 to 10 scale was 3, ranging from 1 to 7. Only 3% of the patients knew about the existence of this syndrome before the interviews. CONCLUSIONS: phantom phenomena are frequent in mastectomized patients, being necessary more studies to know about its characteristics and effects in these women's quality of life.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(9):452-458
DOI 10.1590/S0100-72032007000900003
PURPOSE: to evaluate and to compare the effectiveness of oxybutynin, electrostimulation (ES) and pelvic floor training (PFT) in the management of women with detrusor overactivity. METHODS: a total of 64 women, 35 to 80 years old, were enrolled in this randomized prospective trial. Patients were randomized in three groups: Oxybutynin (n=22), ES (n=21) and PFT (n=21). There were no statistical differences between the three groups with regards to race (p=0.948), age (p=0.747), hormonal status (p=0.813), time of symptomatology (p=0.789), previous surgery for urinary incontinence (p=0.993), or body mass index (p=0.897). Patients were assessed before and after treatment by urodynamic test, a seven-day voiding diary, and subjective response. The duration of the treatment was twelve weeks. For statistical analyses, the Pearson chi2, analysis of variance (ANOVA) and the paired t-test were used. RESULTS: there was a decrease in the urge-incontinence episodes and in the number of pads required in all groups (p<0.05). There was reduction in the frequency of micturition in the Oxybutynin Group (p=0.014). Oxybutynin and ES Groups had reduction in nocturia episodes (p=0.003 and p=0.036, respectively). There were no significant differences in improvement between the three groups (p>0.05). Urgency was resolved in 14 (63.6%), 11 (52.4%) and 12 (57.1%) patients of the Oxybutynin, ES and PFT Groups, respectively, without differences among the groups (p=0.754). Subjectively, 17 (77.3%), 11 (52.4%) and 16 (76.2%) women who had accomplished oxybutynin, ES and PFT, respectively, were satisfied, without differences among the groups (p = 0.142). Urodynamic was normal in 8 (36.4%), 12 (57.1%) and 11 (52.4%) patients of the Oxybutynin, ES and PFT Groups, respectively. This urodynamic analysis revealed no differences between the three groups (p=0.358). The reduction of urge-incontinence correlated with patient satisfaction (p<0.05). CONCLUSIONS: treatments were equally effective; reduction of urge-incontinence was correlated with patient satisfaction.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(9):459-464
DOI 10.1590/S0100-72032007000900004
PURPOSE: describe epidemiologic profile of patients enrolled in the oocyte reception program at Hospital Regional da Asa Sul (HRAS) in Brasília, Distrito Federal, Brazil, and its main indications. METHODS: prospective descriptive study, in which 330 patients enrolled in the waiting list program were studied. Sixty-seven women, irrespective of their infertility factor and that had not been contemplated by the treatment were included. Thirty women who lived in other cities, 50 patients over 50 years old, 24 patients that didn't want to take part in the study, nine patients that asked to be left out of the program and 150 women that couldn't be found by phone calls were excluded. The 67 patients included were interviewed in order to answer a questionnaire. Their medical handbook was recovered to confirm that the investigation required to establish the cause of infertility had been done. The data was registered and analyzed by SPSS version 12.0 software. RESULTS: the patients' epidemiologic profile is age range 40 to 49 years old (82%), non-white skinned (77,6%), catholic (71,6%), married (59,7%), in high school (76,1%), secondary infertility (53,6%) from which due to tubal sterilization (40,3%) and those ones who started trying to conceive before 35 years old (91%). The main indication to enroll in this oocyte reception program was age and low ovarian reserve. CONCLUSION: the results demonstrated the indiscriminate tubal sterilization. The oocyte reception program benefits women with reserved reproductive prognostic.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(9):465-469
DOI 10.1590/S0100-72032007000900005
PURPOSE: to compare the double-circle (DC) technique to other techniques, with periareolar (PA) and transverse nipple-areolar (TNA) incisions, for the surgical correction of gynecomastia. METHODS: we studied the medical files of 34 patients from the Federal University of Goiás, submitted to the surgical correction of gynecomastia, from 1999 to 2004. Patients were divided according to the surgical technique used. The parametric numeric variables were compared by Tukey test. The chi2 or the Fisher's exact test was used for nominal variables. It was considered significant a p value<0.05. RESULTS: the mean age of the patients was 27.9 (+12.5) years. There were 43 gynecomastias, 34 unilateral (79.1%) and nine (20.9%) bilateral. There were 19 breasts operated (44.2%) using DC, 14 (33.6%) using PA incision, and 10 (23.3%), TNA incision. The mean drain usage was five days for DC and one day for the others (p<0.01). The suction drain was used in 19 cases (100%) of DC and two (22%) in TNA. The other patients used drains of Penrose (p<0.01). The mean surgical time was significantly larger for DC (73 minutes) than for PA (45 minutes) and for TNA (48 minutes). DC was used mainly in voluminous gynecomastias (p=0.04). The complications consisted in three (33%) hematomas in TNA (p<0.01) and one (5%) in DC; one (11%) infection in TNA; two (10%) partial necrosis of the nipple in DC; four (21%) enlarged scars in DC (p=0.04); three (16%) hypertrofic scars (p=0.08) in DC; one (2%) inversion of nipple with TNA. CONCLUSIONS: The DC was used often in voluminous gynecomastias. It was a good and secure operation, although it required a more extensive surgical time and had a larger possibility of distended scars.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(9):470-477
DOI 10.1590/S0100-72032007000900006
PURPOSE: to assess the prevalence of the risk of post-partum depression in women in the post-natal ward of a hospital in São Paulo city, in the southeastern region of Brazil, and analyze the associated factors, including domestic violence (DV). METHODS: this was a descriptive, cross-sectional study. The participants were 133 women with at least 20 weeks of gestation age, who delivered their babies from August to September 2005 in a tertiary maternity in the city of São Paulo (Brazil). They were interviewed using the Portuguese version of the Abuse Assessment Screen for the diagnosis of violence and filled out a self-evaluation questionnaire for post-partum depression (Edinburgh Postnatal Depression Scale). Variables were presented as absolute and relative frequencies. The chi2 or Fisher exact tests were used to analyze possible associations between the variables of interest and post-partum depression. The value of 5% was considered significant. RESULTS: risk for post-partum depression was detected in 24 women (18%). A total of 38.3% of the participants interviewed had a history of abuse. There was an association between DV after they were 15 years old and risk of depression (p=0.036). The prevalence of abuse in the group of women at risk for post-partum depression was 58.3% and this was significantly higher than the 33.9% observed in the control group. CONCLUSIONS: the probability of presenting depression was high among the post-partum women attended at a tertiary maternity in the southeast of Brazil. The DV after they were 15 years old was significantly associated with risk of post-partum depression.