You searched for:"Marair Gracio Ferreira Sartori"
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Rev Bras Ginecol Obstet. 2022;44(12):1081-1082
Summary
Rev Bras Ginecol Obstet. 2022;44(12):1110-1116
The aim of this study was to evaluate the use of vaginal molds, made with three-dimensional (3D) printing, for conservative treatment through vaginal dilation in patients with vaginal agenesis (VA).
A total of 16 patients with a diagnosis of VA (Mayer-Rokitansky-Küster-Hauser syndrome, total androgen insensitivity syndrome, and cervicovaginal agenesis) from the Federal University of São Paulo were selected. Device production was performed in a 3D printer, and the polymeric filament of the lactic polyacid (PLA) was used as raw material. A personalized treatment was proposed and developed for each patient.
There were 14 patients who reached a final vaginal length of 6 cm or more. The initial total vaginal length (TVL) mean (SD) was 1.81(1.05) and the final TVL mean (SD) was 6.37 (0.94); the difference, analyzed as 95% confidence interval (95% CI) was 4.56 (5.27–3.84) and the effect size (95% CI) was 4.58 (2.88–6.28).
The 3D printing molds for vaginal dilation were successful in 87.5% of the patients. They did not present any major adverse effects and offered an economical, accessible, and reproducible strategy for the treatment of VA.
Summary
Rev Bras Ginecol Obstet. 2008;30(3):127-134
DOI 10.1590/S0100-72032008000300005
PURPOSE: to compare sling operations of aponeurosis and tension-free vaginal tape (TVT) for the correction of stress urinary incontinence (SUI) regarding: the rates of subjective and objective healing, the mobility of the bladder neck with ultrasonography, the variation of the absorbent test, the urodynamic alterations and the incidence of complications. METHODS: eighty patients with SUI were selected. Among them, 61 underwent a TVT surgery and 19, an abdominal rectum sling operation of aponeurosis. Average age, index of body mass and parity were 50.1 years old, 29.7 kg/m² and 4.1 deliveries (median=3) for the patients with aponeurosis sling, and 51.7 years old, 28.1 kg/m² and 4.1 deliveries (median=3) for the ones with TVT. All of them have undergone anamnesis, physical examination, bladder neck ultrasonography, absorbent test and urodynamic evaluation before and at least six months after the surgery. After 15 or 19 months and after about four or five years, they were again interviewed concerning the surgery results. RESULTS: after six months, 96.7% of the women with TVT and 89.5% of the ones with sling thought they were healed in the subjective evaluation. Nevertheless, after 15 to 19 months, the TVT Group kept the same subjective healing rate, while among the Sling Group the rate decreased to 77.8%. There was a significant decrease in the mobility of the neck bladder that was similar in both groups and an improvement in the absorbent test. At the end of the urodynamic study, 93.4% of the women from the TVT Group and 78.9% of the ones from the Sling Group were classified as having an objective healing. The average time of bladder probing was higher in the Sling Group. Urinary retention was observed in 42.1% of the sling cases and in 9.8% of the TVT's. The rates of late healing were 90% for TVT and 55.6% for sling. CONCLUSIONS: TVT surgery provided better subjective healing after 15 or 19 months, but the rate of objective healing was the same in both techniques at that time. Among the complications detected, the urinary retention was higher in the Sling Group, in the post-surgery period.
Summary
Rev Bras Ginecol Obstet. 2009;31(1):17-21
DOI 10.1590/S0100-72032009000100004
PURPOSE: to evaluate risk factors for the development of genital prolapse in the Brazilian population. METHODS: case-control study involving 316 patients submitted to prolapse staging, according to the pelvic organ prolapse quantification system. The patients were divided into two groups: in the Case Group there were 107 patients with prolapse at stage III or IV, and in the Control Group, 209 women at stage 0 or I. In the anamnesis, the selected women have been questioned about the presence of possible risk factors for genital prolapse, such as: age, menopause age, parturition, delivery type (vaginal, caesarean section or forceps), occurrence of fetal macrosomia, family history of genital dystopia in first degree relatives, chronic cough and intestinal constipation. RESULTS: The variables that were different between the groups were: age, body mass index, parturition, number of vaginal, caesarean section or forceps deliveries, newborn weight and positive family history for prolapse. Race, menopause age, chronic cough and intestinal constipation did not present differences between the groups. After logistic regression, only three variables have been shown to be independent risk factors: presence of at least one vaginal delivery, fetal macrosomia and positive family history for dystopia. Cesarean section was shown to be a protective factor. CONCLUSION: in the Brazilian population, the independent risk factor for genital prolapse were: personal antecedent of at least one vaginal delivery, fetal macrosomia and family history of dystopia.
Summary
Rev Bras Ginecol Obstet. 2022;44(2):194-200
To analyze the existing scientific literature to find out if the coronavirus disease 2019 (COVID-19) pandemic has an effect on gynecological health.
We performed an integrative review of articles published between April 2020 and April 2021 on the PubMed, SciELO, and LILACS databases, using COVID-19 and the following relevant terms: Menstrual change; Ovarian function; Violence against women; Contraception; HPV; Mental health; and Urogynecology.
Among the eligible studies found, editorials and primary research articles, which describe the dynamics between severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection (the cause of the COVID-19 pandemic) and gynecological health, were included.
Through qualitative synthesis, data were extracted from the included publications and from guidelines of national and international societies of gynecology.
The 34 publications included in the present study showed that some factors of the SARS-CoV-2 infection, and, consequently, the COVID-19 pandemic, might be associated with menstrual abnormalities, effects on contraception, alterations in steroid hormones, changes in urogynecological care, effects on women’s mental health, and negative impact on violence against women.
The COVID-19 pandemic has significantly impacted the health of women. The scientific community encourages the development of recommendations for specialized care for women and strategies to prevent and respond to violence during and after the COVID-19 pandemic.
Summary
Rev Bras Ginecol Obstet. 2002;24(4):227-231
DOI 10.1590/S0100-72032002000400003
Purpose: to evaluate the variations in vascular anatomy by assessing the number of vessels of the proximal and distal urethra, of the vesicourethral canal and of the bladder, during and after pregnancy in rats. Method: thirty female rats, with a positive test for pregnancy, were divided into three groups of 10 animals each: GI - rats on the 10th day of pregnancy; GII - rats on the 20th day of pregnancy; GIII - rats on the 5th day of puerperium; a control group (GIV) composed of 10 rats in the estrous phase. The vessels were stained by the method of Masson and counted with a 25-dot integration ocular, coupled to a light microscope, with an objective of 40X. The studied regions were proximal and distal urethra, vesicourethral canal and bladder. Results: there was no significant variation in the vessel number in the bladder, in the vesicourethral canal and in the proximal urethra during gestation. In the distal urethra of the group IV there were 13.7 vessels, less than that observed in the pregnant groups (20.5 to 24.4 vessels). Conclusion: the pregnant rats had a larger number of vessels in the distal urethra than those in the estrous phase. There were no differences regarding the other sites.
Summary
Rev Bras Ginecol Obstet. 2005;27(5):235-242
DOI 10.1590/S0100-72032005000500002
PURPOSE: the proposal of the present study was to translate and to validate King's Health Questionnaire (KHQ) for Brazilian women with urinary incontinence. METHODS: a hundred and thirty-four patients with urinary incontinence, confirmed by urodynamic study, were enrolled from the outpatient clinic of Uroginecology. Initially, we translated the KHQ into the Brazilian Portuguese language in agreement with international criteria. Due to language and cultural differences we performed a cultural, structural, conceptual, and semantic adaptation of the KHQ, in order to make sure that patients were able to fully understand the questions. All patients answered the KHQ twice on the same day, within an interval of 30 min, applied by two different interviewers. After 7 to 14 days, on a second visit, the questionnaire was applied again. Reliability (intra- and interobserver internal consistency), construct and discriminative validity were tested. RESULTS: several cultural adaptations were necessary until we reached the final version. The intra-observer internal consistency (alpha of Cronbach) of the several dimensions varied from moderate to high (0.77-0.90), and the interobserver internal consistency varied from 0.66 to 0.94. Moderate to strong correlation was detected among the specific KHQ urinary incontinence dominions and clinical urinary incontinence manifestations known to affect the quality of life of these patients. CONCLUSION: KHQ was adapted to the Portuguese language and to the Brazilian culture, showing great reliability and validity. It should be included and used in any Brazilian urinary incontinence clinical trial.
Summary
Rev Bras Ginecol Obstet. 2018;40(5):239-241