Anal and urinary dysfunctions are usually associated and have a great impact on a woman's QoL. An integrated approach across specialties should lead to improved patient care. Therefore, our study is relevant because it emphasizes the importance of urogynecologists routinely investigating such symptoms. To do so, standardized questionnaires should be included in the evaluation of all these patients.

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Both modalities can be used as a method to assess pelvic floor dysfunction. The EDF using 3D anorectal and endovaginal approaches showed advantages in identification of the anal sphincters and pubodefects (partial or total). There was good correlation between the two techniques, and a TLUS rectocele classification based on size that corresponds to the established classification using EDF was established.

OBJECTIVETo analyze the costs of hysterectomies performed in Brazil due to benign conditions, and to assess its hospital admittance and mortality rates.METHODSA retrospective cohort was carried out from January 2010 to December 2014, analyzing all hysterectomies (n = 428,346) registered on the DATASUS database between January 2010 and December 2014. Data were collected through a structured questionnaire and analyzed using the SPSS 20.0 for Windows.RESULTSHospital admissions were 300,231 for total abdominal hysterectomies, 46,056 for vaginal hysterectomies, 29,959 for subtotal abdominal hysterectomies and 1,522 for laparoscopic hysterectomies. Mortality rates were 0.26%, 0.09%, 0.07% and 0.05% for subtotal, total abdominal, laparoscopic, and vaginal hysterectomies, respectively. Among the procedures studied, total abdominal hysterectomies had the most costs (R$217,802,574.77), followed by vaginal hysterectomies (R$24,173,490.00), subtotal abdominal hysterectomies (R$19.253.300,00) and laparoscopic hysterectomies (R$794,680.40).CONCLUSIONSTotal abdominal hysterectomies had the highest overall costs mainly because it was the most commonly performed technique. Mortality rates were greatest in subtotal abdominal hysterectomies; this, however, may be due to bias related to missing data in our database.

PFM function assessed by bidigital palpation in postmenopausal women was not sufficiently sensitive to differentiate between women with vs. women without PFM dysfunction and was not related with specific quality of life in women with urinary incontinence and pelvic organ prolapse, respectively. These data should be used to reinforce the widespread recommendation that PFM training is essencial in PFD treatment.

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These results suggest that the severity of posterior vaginal wall prolapse is not correlated with constipation or anal incontinence, but Pb and Gh + Pb measurements are correlated with constipation and SF-36 scores.

OBJETIVOS: A resistência bacteriana aos antimicrobianos comumente utilizados na prática médica para tratamento das infecções do trato urinário (ITU) vem crescendo nos últimos anos, acarretando maiores gastos com a saúde da mulher. Os objetivos deste estudo são traçar o perfil epidemiológico dos uropatógenos e o perfil de susceptibilidade antimicrobiana desses microorganismos nas urinoculturas positivas de mulheres, acima de 18 anos, atendidas ambulatorialmente em um hospital terciário de Fortaleza entre os anos de 2010 a 2013, além de prover um perfil da produção da enzima beta-lactamase de espectro estendido (ESBL) nas cepas de E. coli isoladas nos anos de 2010 a 2012. METODOLOGIA: Realizado estudo retrospectivo transversal no Hospital Geral de Fortaleza (HGF), coletando-se um total de 2.852 urinoculturas e obtendo-se dados acerca da prevalência de uropatógenos e o perfil de susceptibilidade antimicrobiana destes microorganismos. A identificação das espécies bacterianas e testes de antibiograma foram realizados utilizando-se a metodologia automatizada Vitek 2 ( bioMérieux). A produção de betalactamases de espectro estendido também foi detectada pelo Vitek 2, seguindo os critérios do CLSI (Clinical Laboratory Standards Institute).  RESULTADOS: Do total 2.852 urinoculturas positivas, 1.193 (41,8%) eram de mulheres com idade superior a 18 anos de demanda ambulatorial. Dessas amostras, Escherichia coli foi o agente mais prevalente (59,8%). Observa-se incidência crescente isolamento de E. coli durante o período estudado (p<0.001).  As cepas de E. coli encontradas  apresentaram  taxas elevadas de resistência para ampicilina (de 52 a 67%) , sulfametoxazol-trimetropim ( 43 a50%) , ciprofloxacino ( 26 a 35%) e cefalotina ( 22 a 30%) no período estudado. Do total de 713 cepas de E. coli isoladas, 71 (9,9%) foram produtoras ESBL. Observou-se importante  tendência  de crescimento  no período avaliado, variando de 10,7% em 2010 a 18,6% em 2012. CONCLUSÕES: E. coli foi o principal agente de infecção urinária em mulheres adultas na comunidade, com elevadas taxas de resistência aos antimicrobianos mais utilizados.As taxas crescentes de produção de ESBL por esse patógena são alarmantes, dificultando o tratamento dessas infecções.