The following report describes the case of an ectopic pregnancy with contralateral corpus luteum after spontaneous conception. The patient was a 33-yearold female (gravida 3, segmentary C sections 3), with positive pregnancy test, and an Intrauterine Device (IUD). The patient was asymptomatic. At vaginal ultrasound, we observed an anteverted uterus of normal shape and size, a 20 x 12 mm intramural myoma and an irregular endometrial thickness of 16.5 mm, with no intrauterine sac. An ectopic pregnancy in the left Fallopian tube and a contralateral corpus luteum were detected, possibly as consequence of ovum pick up through the opposite tube (oocyte transmigration). Further laparoscopic and histopathologic studies confirmed our findings, and the ectopic pregnancy was successfully removed. In conclusion, oocyte transmigration is a common event and should be account when we wish to provide medical advice to patients with a single Fallopian tube trying to conceive. There are real chances for a patient to become pregnant even when only a single tube is present.
RESUMEN AUTOAUMENTO VESICAL POR LAPAROSCOPIA. MODELO EXPERIMENTAL EN CONEJOS (ORYCTOLAGUS CUNICULUS)Introducción: La vejiga pequeña y contraída representa un cuadro clínico de difícil terapéutica y no siempre efectiva. Se presenta la cirugía preservadora de urotelio como una opción que permite el aumento de la capacidad vesical. Nuestro objetivo fue evaluar la factibilidad del conejo (Oryctolagus cuniculus) como modelo experimental de enseñanza, entrenamiento y aplicación de técnica para el autoaumento vesical por laparoscopia.Material y Métodos: Cinco conejos (Oryctolagus cuniculus), machos, New Zealand, fueron intervenidos laparoscópi-camente por técnica transperitoneal de tres puertos, realizándose autoaumento vesical mediante detrusorectomía. Se realizó cistometría simple preoperatoria y postoperatoria inmediata, mediata y tardía, para verificar modificaciones de capacidad vesical.Resultados: 5 conejos machos fueron operados en un tiempo promedio de 68,8 minutos (rango 44-120). Se realizó medición de la capacidad vesical preoperatoria con promedio de 25.8cc (7-52) disminuyendo la postoperatoria inmediata en un 33%. Se verificó aumento de capacidad vesical postoperatoria de 72% y 52% para el séptimo y decimoquinto día, respectivamente. Estos porcentajes fueron estadísticamente significativos con 95% de confianza. Se presentaron 2 lesiones vesicales como complicación transoperatoria y un absceso como complicación postoperatoria.Conclusiones: El modelo animal en conejos para la técnica de autoaumento vesical por laparoscopia es un modelo factible para enseñanza, entrenamiento y aplicación.Palabras clave: Laparoscopia. Autoaumento vesical. Modelo experimental. ABSTRACT LAPAROSCOPIC VESICAL AUTOAUGMENTATION: AN ANIMAL MODEL IN RABBITS (ORYCTOLAGUS CUNICULUS)Introduction: Small contracted bladder remains a challenge in clinical urological practice and treatment options are not always effective. Urothelium sparing surgical techniques represent a reasonable therapeutical option. We aimed to evaluate the feasibility of a rabbit model (Oryctolagus cuniculus) in the teaching and training setting for laparoscopic vesical autoaugmentation.Methods: Transperitoneal laparoscopic bladder autoaugmentation was performed in five New Zealand male rabbits (Oryctolagus cuniculus). A three port technique was used for all cases. Circumferential detrusorectomy was performed with vascular pedicles sparing, subsequently submucosal detailed blunt dissection allowed the creation of a bladder diverticulum which was verified intraoperatively. Eye-ball cystometry was performed preoperatively and postoperatively to verify bladder capacity variations. Postoperatively cystometry was done immediately after the procedure and 7 and 15 days postoperatively. Statistical analysis was performed with T-student model. A p-value < 0.05 was considered of significance for the analysis. Surgical procedure and perioperative animal care was minutely precised according to the Guidelines of the Institute of Laboratory Animal Resources, Commission on Life Scien...
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