Recent advances: Gynaecology

Kelleher, Con; Braude, Peter

doi:10.1136/bmj.319.7211.689

Cited by 8 publications

(3 citation statements)

References 41 publications

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“…Gynecological surgery refers to surgery on the female reproductive system. This includes procedures for benign conditions, cancer, infertility, and incontinence [21].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for mild depression in older women with overactive bladder syndrome—A cross sectional study

et al. 2020

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BackgroundStudies demonstrate an association between severe depression and overactive bladder syndrome (OAB). However, mild depression is constantly overlooked. The aim of this study was to evaluate the clinical and sociodemographic factors associated with mild depression in women with OAB. MethodsCross-sectional study involving 241 women over 60 years old in Brasilia, Brazil. All patients were subjected to an interview followed by questionnaires and physical examination. The clinical and sociodemographic variables analyzed were age, body mass index, physical activity level, OAB symptoms, presence of gynecological surgery, fecal incontinence, systemic arterial hypertension, Diabetes Mellitus, anxiety (Beck Anxiety Scale). The Geriatric Depression Scale-15 (GDS-15) was used to identify depression. Univariate logistic regression was used to assess the correlation between mild depression and the variables chosen. Variables with a p-value less than 0.2 were included in the multivariate logistic regression analysis. The level of confidence was set at 95%. Results121 volunteers suffered from mild depression. The multivariate analysis demonstrated that gynecological surgery (p < .001) and anxiety (p < .001) are factors associated with mild depression. Older women with a history of gynecological surgery and a GDS-15 score of 2.04 were 1.08 times more likely to develop mild depression compared to older women with no history of gynecological surgery.

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“…Gynecological surgery refers to surgery on the female reproductive system. This includes procedures for benign conditions, cancer, infertility, and incontinence [21].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for mild depression in older women with overactive bladder syndrome—A cross sectional study

et al. 2020

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“…Gynecological surgery refers to surgery on the female reproductive system usually performed by gynecologists. It includes procedures for benign conditions, cancer, infertility and incontinence [1]. Gynecological conditions are seen in the non-pregnant and early pregnant state up to 20 weeks gestation.…”

Section: Introductionmentioning

confidence: 99%

Anesthetic Techniques for Gynecological Surgeries in Benue State University Teaching Hospital (BSUTH), Makurdi, Nigeria

Efu

Hembah-Hilekaan

Ojabo

et al. 2020

EJMED

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Background: Gynecological surgery refers to surgery on the female reproductive system usually performed by gynecologists. It includes procedures for benign conditions, cancer, infertility and incontinence. Gynecological conditions are seen in the non-pregnant and early pregnant state up to 20 weeks gestation. . Just like every other surgery, they require anesthesia for the elimination of surgical pain and the surgical methods to a great extent, determine the choice of anesthesia employed. Anesthesia is usually in the form of regional, especially the neuroaxial type, or general anesthesia. This study was conducted to ascertain the anesthetic techniques employed for gynecological surgeries in the Benue State University Hospital (BSUTH), Makurdi, Nigeria and complications arising there from. Methodology: A retrospective and descriptive study of case files of patients that underwent gynecological surgeries between January 2016 and December 2018 in BSUH, Makurdi was carried out. A total of 156 case files of eligible patients were retrieved from the records department of BSUTH after approval from relevant authorities. Relevant information were extracted from the patients’ folders and transferred into a prepared proforma. The data collected were analyzed using SPSS version 25 using simple statistics. Result: A total of 156 cases were evaluated. The age bracket with the most number is that between 21 and 30 years which recorded 54 (34.6%). This was followed by the age group between 31 and 40 years which were 51, making up 32.7% of the study population. Uterine fibroid was the most recorded diagnosis with 36 cases accounting for 23.1% of the study population. This was followed by ruptured ectopic gestation which was observed to 23, representing 14.7% of the study group. Cancer (Ca) of the cervix recorded 22, amounting to 14.1% of the study group. Exploratory laparotomy was carried out 44 times accounting for 28.2% of the procedures. This was followed by myomectomy and examination under anesthesia (EUA) with 26, representing 14.7% of the variables each. Of the 156 anesthetic procedures undertaken, 56 (35.9%) were sub-arachnoid block (SAB). This was followed closely by general anesthesia with endotracheal intubation (GA/ETT) with 55 (35.3%). General anesthesia with face mask (GA/FM) came third with 35 (22.4%). Twenty-four episodes of complications were observed out of which pain occurred 10 times accounting for 41.7% of the variables. Hypotension occurred 8 times representing 33.3% of the variables. Accordingly, 24 modalities were employed for the management of complications of anesthetic techniques of which IV administration of ephedrine was done 8 times representing 33.3% of the variables. This was followed by IV administration of pentazocine that was done 5 times accounting for 20.9% of the variables. Conclusion: As a result of the vast array of gynecological diseases observed in this study, GA with tracheal intubation and GA with face mask together make up the anesthetic technique of choice for gynecological surgeries. The prominence of SAB as an anesthetic technique is not unexpected because many gynecological lesions are sub-umbilical in location, thus making them amenable to the technique which also possesses a lot of advantages. In addition, complications observed were few and included mainly pain and hypotension, none of which was life-threatening.

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“…Las condiciones en las que se prestan los servicios de salud en la actualidad han hecho que se busque disminuir los costos; por lo anterior, los tratamientos quirúrgicos ambulatorios o de poca estancia hospitalaria han ido ganando espacio en la práctica diaria de la profesión médica 7 . La ginecología no es ajena a esta tendencia y es así que gracias a la sensibilidad y especificidad de la b-hCG cuantitativa y la ecografía trasvaginal (95-99% y 95 _100% respectivamente) en él diagnostico del embarazo ectópico ha hecho que la laparoscopia de urgencia y posterior laparotomía, sean desplazadas por la laparoscopia operatoria electiva o por el tratamiento médico de esta entidad [8][9] ; en estas condiciones se tiene una paciente estable hemodinámicamente y en excelentes condiciones para ser llevada a la laparoscopia operatoria y resolver su patología. Consecuentemente, las condiciones postoperatorias son las mejores y esta paciente puede darse de alta 3-6 horas después del procedimiento, como se demuestra a continuación en la serie que se presenta.…”

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Embarazo ectópico: manejo laparoscópico ambulatorio

Saavedra¹,

Newball²,

Díaz³

2001

Rev. Colomb. Obstet. Ginecol.

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En un período de 5 años fueron operados por laparoscopia 122 embarazos ectópicos en la Clínica los Andes de la ciudad de Santiago de Cali.El diagnóstico al momento de la laparoscopia se clasificó así: Ístmico 18 casos (14,8%), ampular 88 (72,6%), cornual 4 (3,2%) fímbrico 12 (9,8%.)El grupo de edad en el cual esta patología se presentó con mayor frecuencia fue entre los 25 y 34 años, 80 casos.El tipo de procedimiento quirúrgico laparoscópico realizado fue: salpingotomia 88 casos (72%), salpinguectomia 19 (15,6%), reseción cornual 3 (2,5%), extracción fímbrica 12 (9,8%).En el 81% de los pacientes se utilizó vasopresina, y el 96,7% de éstos fueron manejados ambulatoriamente, presentándose en el 2,5% de los casos un embarazo ectópico persistente.De este trabajo se puede concluir que el manejo laparoscópico del embarazo ectópico es virtualmente posible en todos los pacientes con esta patología, demostrándose que en manos expertas y con los recursos adecuados esta técnica es segura y menos costosa que la cirugía abierta y el tratamiento médico.

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Recent advances: Gynaecology

Cited by 8 publications

References 41 publications

Risk factors for mild depression in older women with overactive bladder syndrome—A cross sectional study

Risk factors for mild depression in older women with overactive bladder syndrome—A cross sectional study

Anesthetic Techniques for Gynecological Surgeries in Benue State University Teaching Hospital (BSUTH), Makurdi, Nigeria

Embarazo ectópico: manejo laparoscópico ambulatorio

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