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      Función sexual antes y después de la reparación quirúrgica del prolapso genital

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          Abstract

          Objetivo: Comparar la función sexual (FS) de mujeres con prolapso genital (PG) antes y después de su reparación quirúrgica. Métodos: Investigación de tipo comparativa y aplicada, con diseño cuasi experimental, prospectivo y de campo, donde se evaluó la FS de mujeres con diagnóstico de PG antes y después del tratamiento quirúrgico con técnicas convencionales, mediante el Cuestionario Sexual para Prolapso genital e Incontinencia Urinaria versión corta (PISQ-12). Resultados: Al comparar la FS antes y después de la cirugía reparadora del PG, se determinó que tanto la puntuación total del PISQ-12 (15,90 ± 6,51 vs. 32,17 ± 3,62) como las puntuaciones de las dimensiones respuesta sexual (5,87 ± 2,80 vs. 10,97 ± 2,80) y limitaciones sexuales femeninas (4,88 ± 3,90 vs. 16,77 ± 3,00) fueron significativamente más altas luego de la intervención quirúrgica (p<0,001), a excepción del indicador intensidad del orgasmo (0,80 ± 0,71 vs. 0,87± 0,73; p= 0,722) y la dimensión limitaciones sexuales de la pareja (4,37 ± 2,14 vs. 3,56 ± 2,70; p=0,815) donde sus puntuaciones antes y después del tratamiento quirúrgico no fueron estadísticamente significativas (p>0,05). Conclusiones: Las mujeres con PG presentan una pobre FS, la cirugía reparadora del PG por técnicas convencionales mejoró significativamente la FS de las pacientes con disfunción del piso pélvico, permitiéndoles obtener a estas mujeres una vida sexual más placentera, con mejoría de su calidad de vida.

          Translated abstract

          Objective: To compare sexual function (SF) of women with genital prolapse (GP) before and after surgical repair. Methods: This is a comparative and applied research with quasi-experimental, prospective and field design, which evaluated the SF of women diagnosed with PG before and after surgical treatment with conventional techniques, by the short version of the Prolapse and Incontinence Sexual Questionnaire (PISQ-12). Results: When comparing the SF before and after surgical repair of GP, it was determined that both the total score of PIQS-12 (15.90 ± 6.51 vs. 32.17 ± 3.62) and the scores of the dimensions: sexual response (5.87 ± 2.80 vs. 10.97 ± 2.80) and female sexual limitations (4.88 ± 3.90 vs. 16.77 ± 3.00) were significantly higher after surgery (p<0.001), except the indicator: orgasm intensity (0.80 ± 0.71 vs. 0.87 ± 0.73, p = 0.722) and the dimension partner's sexual limitations (4.37 ± 2,14 vs. 3.56 ± 2.70, p=0.815) where their scores before and after surgery showed no statistically significant differences (p>0.05). Conclusions: Women with GP exhibit a poor SF, surgical repair of GP by conventional techniques significantly improves the SF of patients with pelvic floor dysfunction, allowing these women get sexual life more pleasant, which will impact on improving their quality of life.

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          Most cited references58

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          EthoLog 2.2: a tool for the transcription and timing of behavior observation sessions.

          EthoLog is a tool that aids in the transcription and timing of behavior observation sessions--experimental or naturalistic, from video/audio tapes or registering real time. It was created with Visual Basic and runs on Windows (3.x/9x). The user types the key codes for the predefined behavioral categories, and EthoLog registers their sequence and timing and saves the resulting data in ASCII output files. A sequential analysis matrix can be generated from the sequential data. The output files may be edited, converted to plain text files for printing, or exported to a spreadsheet program, such as MS Excel, for further analyses.
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            The financial burden of stress urinary incontinence among women in the United States.

            Stress urinary incontinence (SUI) is a common medical problem affecting 25% to 50% of women in the United States. This article reviews the literature on the current systems- and population-based costs of management of SUI in women. A PubMed search was conducted to seek studies examining the cost of various management options. Both nonsurgical and surgical management can effectively improve symptoms of SUI at a wide spectrum of costs. Over $12 billion are spent annually, an amount that continues to grow. Patients pay out-of-pocket for 70% of conservative management, amounting to a significant individual financial burden. Systems-based cost of SUI management continues to rise with the aging population. Costs to both individuals and systems may be mitigated if more patients are treated with intent to cure and as surgical management transitions from inpatient to outpatient procedures. © Springer Science+Business Media, LLC 2011
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              Rectocele repair: a randomized trial of three surgical techniques including graft augmentation.

              This study was undertaken to compare outcomes of 3 different rectocele repair techniques. One hundred six women with stage II or greater posterior vaginal wall prolapse were randomly assigned to either posterior colporrhaphy (n = 37), site-specific rectocele repair (n = 37), or site-specific rectocele repair augmented with a porcine small intestinal submucosa graft (Fortagen, Organogenesis, Inc, Canton, MA; n = 32). Subjects underwent a physical examination and completed 3 validated pelvic floor instruments at baseline and 6 months, 1 year, and 2 years after surgery. Anatomic failure was defined as pelvic organ prolapse quantitation system (POPQ) point Bp > or = -2 at 1 year. Of 106 subjects who enrolled, 105 underwent surgery and of those 105, 98 subjects returned (93%) with a mean follow-up of 17.5 +/- 7 months. After 1 year, those subjects who received graft augmentation had a significantly greater anatomic failure rate (12/26; 46%) than those who received site-specific repair alone (6/27; 22%) or posterior colporraphy (4/28; 14%), P = .02. There was a significant improvement in prolapse and colorectal scales and overall summary scores of the Pelvic Floor Distress Inventory short form 20 (PFDI-20), the Pelvic Floor Impact Questionnaire short form 7 (PFIQ-7) after surgery in all groups (P < .001 for each) with no differences between groups. The proportion of subjects with functional failures was 15% overall, and not significantly different between groups. There was no significant change in the rate of dyspareunia 1 year after surgery and there were no differences between groups. Overall sexual function as measured by the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) improved significantly in all groups postoperatively (P < . 001), with no differences between groups. Posterior colporraphy and site-specific rectocele repair result in similar anatomic and functional outcomes. The addition of a porcine-derived graft does not improve anatomic outcomes. All 3 methods of rectocele repair result in significant improvements in symptoms, quality of life, and sexual function.
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                Author and article information

                Journal
                rchog
                Revista chilena de obstetricia y ginecología
                Rev. chil. obstet. ginecol.
                Sociedad Chilena de Obstetricia y Ginecología (Santiago, , Chile )
                0048-766X
                0717-7526
                2013
                : 78
                : 2
                : 102-113
                Affiliations
                [02] orgnameUniversidad del Zulia orgdiv1Programa de Postgrado Venezuela
                [04] orgnameUniversidad del Zulia orgdiv1Facultad de Medicina orgdiv2Escuela de Medicina Venezuela
                [01] orgnameUniversidad del Zulia orgdiv1Departamento de Morfofisiopatología Venezuela
                [03] orgnameUniversidad del Zulia orgdiv1Facultad de Medicina orgdiv2Departamento de Obstetricia y Ginecología Venezuela
                Article
                S0717-75262013000200006 S0717-7526(13)07800200006
                10.4067/S0717-75262013000200006
                51291e47-e061-47ad-b558-c7a3c1d66752

                This work is licensed under a Creative Commons Attribution 4.0 International License.

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                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 12
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                SciELO Chile

                Categories
                Trabajos Originales

                quality of life,función sexual,Cirugía reparadora,Repair surgery,sexual function,prolapso genital,calidad de vida,genital prolapse

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