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, Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(6):409-411
, Endometrial tuberculosis is a rare diagnosis in the postmenopausal period, and it can mimic a carcinoma. The present article describes the case of a 54-year-old female patient with weight loss, abdominal pain, and ascites. An ultrasonography showed endometrial thickening, and a video hysteroscopy revealed a uterine cavity with formations with cotton aspect covering the entire endometrial surface and the tubal ostia. An anatomopathological evaluation diagnosed endometrial tuberculosis. The treatment was with a standardized therapeutic scheme (ethambutol, isoniazid, pyrazinamide and rifampicin), and the patient evolved with clinical improvement and normal uterine cavity at hysteroscopy. Considering the lack of pathognomonic hysteroscopic findings of the disorder, it is important to disclose the images of the case.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(6):409-411
, Endometrial tuberculosis is a rare diagnosis in the postmenopausal period, and it can mimic a carcinoma. The present article describes the case of a 54-year-old female patient with weight loss, abdominal pain, and ascites. An ultrasonography showed endometrial thickening, and a video hysteroscopy revealed a uterine cavity with formations with cotton aspect covering the entire endometrial surface and the tubal ostia. An anatomopathological evaluation diagnosed endometrial tuberculosis. The treatment was with a standardized therapeutic scheme (ethambutol, isoniazid, pyrazinamide and rifampicin), and the patient evolved with clinical improvement and normal uterine cavity at hysteroscopy. Considering the lack of pathognomonic hysteroscopic findings of the disorder, it is important to disclose the images of the case.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):205-209
DOI 10.1590/S0100-72032013000500003
PURPOSE: To investigate the impact of pregnancy on female sexual function. METHODS: An analytical, cross-sectional study was conducted on 181 non-pregnant and 177 pregnant women aged 18 to 45 years. The study included premenopausal, sexually active women with a steady partner and excluded those taking antidepressants or with a diagnosis of depression. Eleven of these women (6.2%) were in the first trimester, 50 (28.2%), in the second trimester and 116 (65.5%), in the third trimester of pregnancy. The evaluation consisted of an interview in which the Female Sexual Function Index (FSFI) was applied. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 16.0. The nonparametric Mann-Whitney test was used to compare the mean FSFI values of pregnant and non-pregnant women. RESULTS: Sexual dysfunction was 40.4% among pregnant women and 23.3% among non-pregnant women, with a significant difference between the scores of the studied groups (p=0.01). The difference in the mean global FSFI values between the groups was also significant (p<0.0001). There were significant differences between pregnant and non-pregnant women regarding desire (p<0.0001), excitation (p=0.003), lubrication (p=0.02), orgasm (p=0.005) and satisfaction (p=0.03). The same was not observed regarding pain. CONCLUSION: We conclude that pregnancy negatively influences female sexual function, particularly the desire and excitement domains, revealing the importance of addressing the issue by professionals dealing with pregnant women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(5):205-209
DOI 10.1590/S0100-72032013000500003
PURPOSE: To investigate the impact of pregnancy on female sexual function. METHODS: An analytical, cross-sectional study was conducted on 181 non-pregnant and 177 pregnant women aged 18 to 45 years. The study included premenopausal, sexually active women with a steady partner and excluded those taking antidepressants or with a diagnosis of depression. Eleven of these women (6.2%) were in the first trimester, 50 (28.2%), in the second trimester and 116 (65.5%), in the third trimester of pregnancy. The evaluation consisted of an interview in which the Female Sexual Function Index (FSFI) was applied. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 16.0. The nonparametric Mann-Whitney test was used to compare the mean FSFI values of pregnant and non-pregnant women. RESULTS: Sexual dysfunction was 40.4% among pregnant women and 23.3% among non-pregnant women, with a significant difference between the scores of the studied groups (p=0.01). The difference in the mean global FSFI values between the groups was also significant (p<0.0001). There were significant differences between pregnant and non-pregnant women regarding desire (p<0.0001), excitation (p=0.003), lubrication (p=0.02), orgasm (p=0.005) and satisfaction (p=0.03). The same was not observed regarding pain. CONCLUSION: We conclude that pregnancy negatively influences female sexual function, particularly the desire and excitement domains, revealing the importance of addressing the issue by professionals dealing with pregnant women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(7):143-149
DOI 10.1590/S0100-72032011000700005
PURPOSE: To determine the main contraceptive methods adopted by users of the public and private health sectors in the city of Aracaju (SE), Brazil, with a secondary focus on orientations for their use and reasons for interruption. METHODS: A cross-sectional study was conducted on 210 women, 110 from the public service and 100 from the private sector. The data were collected by applying a questionnaire to sexually active patients who agreed to sign a consent form. The software Statistical Package for Social Sciences (SPSS) version 15.0 was used for statistical analysis, with the 
test for categorical variables and the Student's t-test for independent samples. RESULTS: The overall prevalence of contraceptive use in this study was 83.3%. The main methods used in the public and private sectors, were the hormonal (41 and 24%, p=0.008) and permanent (20 and 26%, p=0.1) ones, respectively. The rate of condom use was 17.3% in the public sector and 12% in the private sector, with no significant difference (p=0.12). Medical orientation about the correct use of the method chosen and/or indicated was provided to 37.3% of users from the public sector and to 48% of users from the private sector. Discontinuation of the use of contraceptive methods was 14.5% in the public sector and 12.0% in the private sector, mainly because of side effects and the desire to become pregnant. CONCLUSIONS: The main contraceptive methods adopted by users of the public and private sectors were hormonal contraception and permanent contraception. It is important to highlights the low frequency of use of male condoms in the two groups studied.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(7):143-149
DOI 10.1590/S0100-72032011000700005
PURPOSE: To determine the main contraceptive methods adopted by users of the public and private health sectors in the city of Aracaju (SE), Brazil, with a secondary focus on orientations for their use and reasons for interruption. METHODS: A cross-sectional study was conducted on 210 women, 110 from the public service and 100 from the private sector. The data were collected by applying a questionnaire to sexually active patients who agreed to sign a consent form. The software Statistical Package for Social Sciences (SPSS) version 15.0 was used for statistical analysis, with the test for categorical variables and the Student's t-test for independent samples. RESULTS: The overall prevalence of contraceptive use in this study was 83.3%. The main methods used in the public and private sectors, were the hormonal (41 and 24%, p=0.008) and permanent (20 and 26%, p=0.1) ones, respectively. The rate of condom use was 17.3% in the public sector and 12% in the private sector, with no significant difference (p=0.12). Medical orientation about the correct use of the method chosen and/or indicated was provided to 37.3% of users from the public sector and to 48% of users from the private sector. Discontinuation of the use of contraceptive methods was 14.5% in the public sector and 12.0% in the private sector, mainly because of side effects and the desire to become pregnant. CONCLUSIONS: The main contraceptive methods adopted by users of the public and private sectors were hormonal contraception and permanent contraception. It is important to highlights the low frequency of use of male condoms in the two groups studied.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(3):139-143
DOI 10.1590/S0100-72032010000300007
PURPOSE: to identify if there is a difference in the prevalence of sexual dysfunction and in the sexual domain scores between a group of women attended at a public service and a group attended at a private service, and to investigate if there is an association between sexual dysfunction, family income and educational status. METHODS: transversal study including 201 sexually active women aged from 18 to 45 years, 90 of them from a public service and 111 from private services. We evaluated age, marital status, use of hormonal contraception, income and educational status, and all women were submitted to the Female Sexual Function Index (FSFI), an instrument for the evaluation of their sexuality. The Statistical Package for Social Sciences, version 15.0, was used for statistical analysis. The χ2 test was applied for categorical variables and the Student's t-test to independent samples. RESULTS: there was no significant difference regarding the prevalence of sexual dysfunction between groups (public versus private) (20 and 23.4%, p=0.5), or concerning the domain scores, desire (3.9±1.3 and 3.8±1.0, p=0.6), sexual arousal (4.5±0.8 and 4.4±0.9, p=0.5), lubrication (5.2±1.2 and 5.0±0.9, p=0.1), orgasm (5.0±1.2 and 4.9±1.1, p=0.5), satisfaction (5.2±1.2 and 5.1±1.0, p=0.9), and pain (5.3±1.1 and 5.2±1.0, p=0.8). Sexual dysfunction was detected in 28% of the women with income between two and four minimum wages, in 17.5% of those with an income of five wages or more, and in 14.3% among those with an income of one wage or less (p=0,1). The dysfunction occurred in 30.2% of women with elementary education, in 24.2% of those with high school education and in 13.4% of those with higher education (p=0.09). CONCLUSIONS: There was no significant difference in the prevalence of sexual dysfunction or in the sexual domain scores between groups, nor was there an association with income or education status.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(3):139-143
DOI 10.1590/S0100-72032010000300007
PURPOSE: to identify if there is a difference in the prevalence of sexual dysfunction and in the sexual domain scores between a group of women attended at a public service and a group attended at a private service, and to investigate if there is an association between sexual dysfunction, family income and educational status. METHODS: transversal study including 201 sexually active women aged from 18 to 45 years, 90 of them from a public service and 111 from private services. We evaluated age, marital status, use of hormonal contraception, income and educational status, and all women were submitted to the Female Sexual Function Index (FSFI), an instrument for the evaluation of their sexuality. The Statistical Package for Social Sciences, version 15.0, was used for statistical analysis. The χ2 test was applied for categorical variables and the Student's t-test to independent samples. RESULTS: there was no significant difference regarding the prevalence of sexual dysfunction between groups (public versus private) (20 and 23.4%, p=0.5), or concerning the domain scores, desire (3.9±1.3 and 3.8±1.0, p=0.6), sexual arousal (4.5±0.8 and 4.4±0.9, p=0.5), lubrication (5.2±1.2 and 5.0±0.9, p=0.1), orgasm (5.0±1.2 and 4.9±1.1, p=0.5), satisfaction (5.2±1.2 and 5.1±1.0, p=0.9), and pain (5.3±1.1 and 5.2±1.0, p=0.8). Sexual dysfunction was detected in 28% of the women with income between two and four minimum wages, in 17.5% of those with an income of five wages or more, and in 14.3% among those with an income of one wage or less (p=0,1). The dysfunction occurred in 30.2% of women with elementary education, in 24.2% of those with high school education and in 13.4% of those with higher education (p=0.09). CONCLUSIONS: There was no significant difference in the prevalence of sexual dysfunction or in the sexual domain scores between groups, nor was there an association with income or education status.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(10):519-524
DOI 10.1590/S0100-72032007001000005
PURPOSE: to identify the impact of pelvic reconstructive surgery on female sexual function, as well as the changes in vaginal anatomy, and to detect possible correlations between them. METHODS: a prospective, descriptive study, including 43 sexually active women with genital dystopy, undergoing surgery for pelvic organ prolapse, conducted between October 2004 and September 2006. The women completed the same multiple-choice questionnaire regarding sexual function, and analogic scales to quantify the degree of desire, arousal and satisfaction, and were clinically assessed using the pelvic organ prolapse quantification (POP-Q) staging system, before the surgery and three and six months after it. Statistical analysis was performed through the Bowker test for symmetry, Wilcoxon test, Student t test, chi2 and analysis of variance (ANOVA) as appropriate, with statistical significance set at 5% (p<0.05). RESULTS: all 43 women completed the follow-up at three and six months after the surgery, but two of them lost their partners after the surgery. Quality of sexual life improved significantly (p=0.03). Symptoms such as dyspareunia (25.6% before versus 17.1% after surgery), discomfort (27.9 versus 0%), embarrassment (20.9% versus 0%) and fear (2.3% versus 0%) significantly improved (p<0.001). Analogical scales scores regarding desire (5 versus 7, p=0.001), arousal (6 versus 8, p<0.001) and satisfaction with sexual life (5 versus 7, p<0.001) also improved. There was a statistically significant improvement (p<0.001) of the POP-Q stages after the surgery. However, there was no statistically significant correlation between changes in vaginal dimensions and changes in sexual function. CONCLUSIONS: after pelvic reconstructive surgery, there was a significant improvement in the quality of sexual life and of the POP-Q stages. However, there was no correlation between them.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(10):519-524
DOI 10.1590/S0100-72032007001000005
PURPOSE: to identify the impact of pelvic reconstructive surgery on female sexual function, as well as the changes in vaginal anatomy, and to detect possible correlations between them. METHODS: a prospective, descriptive study, including 43 sexually active women with genital dystopy, undergoing surgery for pelvic organ prolapse, conducted between October 2004 and September 2006. The women completed the same multiple-choice questionnaire regarding sexual function, and analogic scales to quantify the degree of desire, arousal and satisfaction, and were clinically assessed using the pelvic organ prolapse quantification (POP-Q) staging system, before the surgery and three and six months after it. Statistical analysis was performed through the Bowker test for symmetry, Wilcoxon test, Student t test, chi2 and analysis of variance (ANOVA) as appropriate, with statistical significance set at 5% (p<0.05). RESULTS: all 43 women completed the follow-up at three and six months after the surgery, but two of them lost their partners after the surgery. Quality of sexual life improved significantly (p=0.03). Symptoms such as dyspareunia (25.6% before versus 17.1% after surgery), discomfort (27.9 versus 0%), embarrassment (20.9% versus 0%) and fear (2.3% versus 0%) significantly improved (p<0.001). Analogical scales scores regarding desire (5 versus 7, p=0.001), arousal (6 versus 8, p<0.001) and satisfaction with sexual life (5 versus 7, p<0.001) also improved. There was a statistically significant improvement (p<0.001) of the POP-Q stages after the surgery. However, there was no statistically significant correlation between changes in vaginal dimensions and changes in sexual function. CONCLUSIONS: after pelvic reconstructive surgery, there was a significant improvement in the quality of sexual life and of the POP-Q stages. However, there was no correlation between them.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(10):607-611
DOI 10.1590/S0100-72032006001000007
Cervical pregnancy is a rare condition in which the egg is implanted in the cervical canal causing it to distend as the egg grows. Cervical pregnancy constitutes less than 1% of all ectopic pregnancies. Painless hemorrhage is a habitual clinical characteristic and on physical examination a very vascularized hypertrophic cervix is observed with a tissue surpassing the external orifice. Ultrasonography may be used as a complementary diagnostic tool to show directly the presence of a gestational sac. A successful management of a viable seven-week gestation cervical pregnancy is reported herein. Feticide was performed with a single intraamniotic methotrexate injection (25 mg) guided by transvaginal ultrasonography. Systemic methotrexate in a single dose intramuscular (50 mg/m²) was associated. The conservative management of cervical ectopic pregnancy with methotrexate was effective and safe.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(10):607-611
DOI 10.1590/S0100-72032006001000007
Cervical pregnancy is a rare condition in which the egg is implanted in the cervical canal causing it to distend as the egg grows. Cervical pregnancy constitutes less than 1% of all ectopic pregnancies. Painless hemorrhage is a habitual clinical characteristic and on physical examination a very vascularized hypertrophic cervix is observed with a tissue surpassing the external orifice. Ultrasonography may be used as a complementary diagnostic tool to show directly the presence of a gestational sac. A successful management of a viable seven-week gestation cervical pregnancy is reported herein. Feticide was performed with a single intraamniotic methotrexate injection (25 mg) guided by transvaginal ultrasonography. Systemic methotrexate in a single dose intramuscular (50 mg/m²) was associated. The conservative management of cervical ectopic pregnancy with methotrexate was effective and safe.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(10):613-618
DOI 10.1590/S0100-72032005001000008
PURPOSE: to evaluate the results of 14 cases of laparoscopic surgical treatment of patients with deep endometriosis of the rectovaginal septum in the Sector of Gynecological Endoscopy of the 'Hospital do Servidor Público Estadual "Francisco Morato de Oliveira"'. METHODS: a retrospective analysis was accomplished with data from the records, associated with postoperative evaluation of the patients operated between February 2002 and February 2004. The patients' age varied from 33 to 44 years, with a mean of 38.4. The parity ranged from 0 to 3, with a mean of 1.1. The main preoperative symptoms were: dysmenorrhea in 14 (100%), deep dyspareunia in 12 (85.7%), non-ciclic pelvic pain in 10 (71.4%), pain at defecation in two (14.3%), rectal bleeding in two (14.3%), and infertility in two (14.3%). The plasma level of CA-125 ranged from 3.6 to 100.3 U/mL, with a mean of 52.9 U/mL. RESULTS: the histological examination of the lesions of the rectovaginal septum was compatible with endometriosis in nine (64.3%) patients. Concerning painful symptoms, there was total regression in seven (50%) patients, partial regression (more than 80% relief) in two (14.3%), no improvement in four (28.6%), and worsening in one (7.1%). The incidence of complications was 14.3%: a ureter lesion associated with lesion of the sigmoid and a lesion of the rectum diagnosed on the 8th postoperative day. Conclusion: it can be concluded that endometriosis of the rectovaginal septum can be treated through laparoscopic surgery with low morbidity, leading to a complete or almost complete relief of the symptoms in most of the patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(10):613-618
DOI 10.1590/S0100-72032005001000008
PURPOSE: to evaluate the results of 14 cases of laparoscopic surgical treatment of patients with deep endometriosis of the rectovaginal septum in the Sector of Gynecological Endoscopy of the 'Hospital do Servidor Público Estadual "Francisco Morato de Oliveira"'. METHODS: a retrospective analysis was accomplished with data from the records, associated with postoperative evaluation of the patients operated between February 2002 and February 2004. The patients' age varied from 33 to 44 years, with a mean of 38.4. The parity ranged from 0 to 3, with a mean of 1.1. The main preoperative symptoms were: dysmenorrhea in 14 (100%), deep dyspareunia in 12 (85.7%), non-ciclic pelvic pain in 10 (71.4%), pain at defecation in two (14.3%), rectal bleeding in two (14.3%), and infertility in two (14.3%). The plasma level of CA-125 ranged from 3.6 to 100.3 U/mL, with a mean of 52.9 U/mL. RESULTS: the histological examination of the lesions of the rectovaginal septum was compatible with endometriosis in nine (64.3%) patients. Concerning painful symptoms, there was total regression in seven (50%) patients, partial regression (more than 80% relief) in two (14.3%), no improvement in four (28.6%), and worsening in one (7.1%). The incidence of complications was 14.3%: a ureter lesion associated with lesion of the sigmoid and a lesion of the rectum diagnosed on the 8th postoperative day. Conclusion: it can be concluded that endometriosis of the rectovaginal septum can be treated through laparoscopic surgery with low morbidity, leading to a complete or almost complete relief of the symptoms in most of the patients.