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Biomedical subjects

Tirso Perez-Medina

Publications and source records attributed to Tirso Perez-Medina.

4 recordsLinked to original sources

Laparoscopic creation of a neovagina in Mayer-Rokitansky-Küster-Hauser syndrome by modified Vecchietti's procedure.

OBJECTIVE: The objective was to apply Vecchietti's principles to laparoscopy for the creation of a neovagina in patients diagnosed with Rokitansky syndrome. STUDY DESIGN: The setting was a university tertiary hospital. The design was a descriptive study to describe the outcome in 18 patients diagnosed with Rokitansky syndrome after laparoscopic creation of a neovagina applying Vecchietti's principles and implementing some useful modifications. RESULTS: In 17 patients the result was considered successful when a new neovagina measuring at least 10cm long was obtained. Less satisfactory in the 18th patient was when a shortened neovagina was found at the 2-year follow-up as the patient did not follow the postoperative recommendations. CONCLUSION: Laparoscopic creation of a neovagina is a safe, minimally invasive treatment with good functional and sexual results.

Adolescent↗

Endometrial intraepithelial neoplasia diagnosed at endometrial resection.

The literature has no reported cases of isolated endometrial intraepithelial neoplasia found at endometrial resection. If endometrial cancer is occult it might not be detected at diagnostic hysteroscopy or during resection, especially if destructive techniques are used. A 51-year-old woman had history of menorrhagia, with diagnostic hysteroscopy showing benign functional endometrium and diagnosed as dysfunctional uterine bleeding. Endometrial resection was performed and the pathologic examination in one stripe of resected tissue found focal, isolated endometrial intraepithelial neoplasia. This case reinforces the importance of pathologic tissue examination after endometrial ablation. Care must be taken when performing second-generation nonhysteroscopic ablation techniques, as even with direct visualization a premalignant lesion can be missed.

Carcinoma in Situ↗

Predicting atypia inside endometrial polyps.

OBJECTIVE: To evaluate the efficacy of color Doppler exploration for assessing atypia inside endometrial polyps. METHODS: A prospective study was conducted in a tertiary university hospital. Eight hundred six patients with endometrial polyps were studied with color Doppler sonography, and the resistive index inside the polyp stalk was obtained. The patients were then referred for hysteroscopic resection, and pathologic analysis was performed. RESULTS: Thirty-five polyps with sonographic indications of atypia were pathologically confirmed. Sonographic indications of atypia inside 16 polyps were not confirmed. Three nonquestionable endometrial polyps had atypia inside them. CONCLUSIONS: Low Doppler resistance is highly predictive of atypia inside endometrial polyps.

Endometrial Neoplasms↗

Tibolone and risk of endometrial polyps: a prospective, comparative study with hormone therapy.

OBJECTIVE: To assess the incidence of endometrial polyps during postmenopausal replacement therapy with tibolone, using an appropriate control group. DESIGN: A total of 485 postmenopausal women were included in this open, prospective, comparative study for a duration of 36 months. Of this group, 249 women received 2.5 mg/day of tibolone and 244 women served as controls, receiving continuous-combined estrogen-progestogen therapy (HT). Transvaginal ultrasound, hysteroscopy, and directed biopsies were performed before treatment was initiated and at the end of the study. RESULTS: Two hundred twenty-one of the women receiving tibolone and 203 receiving continuous-combined HT completed the study. Endometrial polyps were detected in 74 women (33.4%) from the tibolone group and in 22 women (10.8%) from the HT group (P < 0.01). The vaginal bleeding rate did not differ between the groups. The frequency of atrophic polyps was significantly higher in the tibolone group (P < 0.01). No difference was found in the size of the polyps. CONCLUSIONS: Tibolone increases by threefold the risk for endometrial polyps.

Adult↗