Information about the effects of pituitary hyperprolactinemia on endometrium, especially in levels coexisting with absence of amenorrhea in women, is scarce. The interference of high prolactin levels on endometrial morphology was thus investigated in young post-pubertal and adult mice rendered hyperprolactinemic by long-term treatment with metoclopramide (MC). No remarkable differences have been noticed upon light microscopy examination of the endometria comparing young to adult cycling MC-treated mice, except on the max/min diameter ratio, which in young animals was lower than in adults (ANOVA, p < 0.01). Both young and adult MC-treated mice presented an increased number of endometrial glands than their respective controls (ANOVA, p < 0.01). However, young MC-treated animals showed the highest values of endometrial thickness index compared to other groups (ANOVA, p < 0.01). Our results indicate that MC-induced hyperprolactinemia causes mouse endometrium proliferation, mainly in young animals.
Data have shown that hyperprolactinemia induced by metoclopramide determines endometrial proliferation and interferes with the ovarian function, mainly in the progesterone production.
Objective: To evaluate the applicability of the technique of vaginal hysterectomy in non-prolapsed uterus. Methods: A retrospective cohort study with 220 patients submitted to vaginal hysterectomy from January 2004 to July 2010 by the Vaginal Surgery and Pelvic Floor Team. Patients mean age was 44.4 years and they had on average three births (0-10 deliveries). The surgery was performed even in cases of previous abdominal surgery, and cesarean section was prevalent in 54.6% of patients. Results: The mean uterus weight was 278.9g. The mean operative time was 93 minutes, and length of hospital stay was 24 hours after surgery in 65% of cases. There were no cases of visceral injury. The mean postoperative complication was cellulitis of the vaginal vault that occurred in 11 cases (5%) that received antibiotics. Mean blood loss corresponded to 1.4g/dL hemoglobin. From the analyzed sample, vaginal hysterectomy by vaginal route was feasible in 96.8% of patients, and abdominal conversion was necessary in 3.2%.
Conclusion:Vaginal hysterectomy is a minimally invasive surgery, with fewer complications, and low morbidity. We believe that this procedure should be indicated to treat gynecological benign diseases. o tempo de internação foi de 24 horas pós-operatórias em 65% dos casos. Não houve nenhum caso de lesão visceral. A complicação pós-operatória mais frequente foi celulite de cúpula, que ocorreu em 11 casos (5%), sendo tratadas com antibioticoterapia. A perda sanguínea foi, em média, de 1,4g/dL de hemoglobina. Foi possível a realização da histerectomia pela via vaginal em 96,8% das pacientes da amostra estudada e em 3,2% foi necessária a conversão para via abdominal. Conclusão: A histerectomia vaginal é uma cirurgia por orifício natural, minimamente invasiva, com baixas frequência de complicações e morbidade, sendo factível e segura para o tratamento de afecções uterinas benignas.
Keywords
We present the concept of natural orifice surgery and of scarless operations, with their access routes, their multidisciplinary character, and challenges to their development. We point out the intra-and postoperative advantages. We emphasize the use of the vaginal route and posterior colpotomy in the application of natural orifice surgery in vaginal hysterectomies and surgical access to adnexa, which includes tubal ligation. We highlight the need for mastering these surgical modalities, which can bring great advantages to patients in Brazil.Keywords: Surgical procedures, minimally invasive; Colpotomy; Hysterectomy, vaginal; Sterilization, tubal; Ovarian cysts
ResUmoApresentamos, neste artigo, o conceito das cirurgias por orifícios naturais e das cirurgias "sem cicatriz", as suas vias de acesso, seu caráter multidisciplinar e os desafios de seu desenvolvimento. Apontamos as vantagens intra e pós-operatórias. Enfocamos a via vaginal e a colpotomia posterior na aplicação das cirurgias por orifícios naturais em histerectomias vaginais e acessos cirúrgicos aos anexos nos quais se inclui a laqueadura tubárea. Reforçamos a necessidade de nos inteirarmos destas modalidades de cirurgia que poderão trazer grandes vantagens para as pacientes no Brasil.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.