Complicaciones del uso del pesario con soporte y sin soporte en el prolapso genital completo

  • Franklin J. Espitia De La Hoz

Resumen

RESUMEN
Introducción: La prevalencia del prolapso genital se ha incrementado; a menudo cursa de forma asintomática, se suele presentar con síntomas de un “bulto” vaginal. Las opciones de tratamiento incluyen ejercicios del suelo pélvico, manejo expectante, el uso de dispositivos mecánicos y corrección quirúrgica. Objetivo: Evaluar las complicaciones inmediatas y tardías del uso del pesario sin soporte y con soporte, en el manejo conservador del prolapso genital completo. Materiales y métodos: Estudio descriptivo, observacional, transversal y comparativo. Se revisaron 108 historias clínicas de las pacientes atendidas por prolapso genital completo y se evaluaron a las que se les manejó de forma conservadora con pesarios con soporte (Grupo A: 9) y sin soporte (Grupo B: 18). Los dos grupos se compararon tomando en cuenta el aumento de secreción vaginal, aparición de erosión y úlceras vaginales, impactación, fístulas, atipias citológicas, incarceración, hidronefrosis, infección vaginal y complicaciones intestinales. Resultados: Se analizaron 27 pacientes en total, 9 manejadas con pesarios con soporte y 18 con pesarios sin soporte. Hubo diferencia significativa en cuanto al aumento de secreción vaginal con menor secreción en uso del pesarios sin soporte (p =0,045). Se encontró diferencia en la aparición de erosión y úlceras vaginales (p < 0,05). Conclusiones: Hay diferencia significativa en cuanto al aumento de la secreción vaginal y la aparición de erosión y úlceras vaginales en el uso de pesarios sin soporte en comparación con el uso de pesarios con soporte. MÉD UIS. 2015;28(3):309-15.

Palabras clave: Pesarios. Indicaciones. Tratamientos Conservadores del Órgano. Prolapso de Órgano Pélvico. Prolapso Uterino.

ABSTRACT
Introduction: The prevalence of genital prolapse has increased; often it is asymptomatic, usually presents with symptoms of a vaginal “bulge”. Treatment options include pelvic floor exercises, expectant management, the use of mechanical devices and surgical correction.
Objectives: Evaluate the immediate and late complications of the use of pessary without support and with support in the conservative management of the entire genital prolapse. Materials and Methods: Descriptive, observational, transversal and comparative study. 108 medical records of patients treated by complete genital prolapse were reviewed and evaluated which were managed conservatively with pessaries supported (Group A: 9) and unsupported (Group B: 18). The two groups are compared taking into account the increased vaginal discharge, vaginal appearance of erosion and ulcers, impaction, fistulas, cytologic atypia, incarceration, hydronephrosis, vaginal infection and intestinal complications. Results: 27 patients were analyzed in total, 9 handled pessaries supported and 18 unsupported pessaries. There was significant difference in terms of vaginal discharge increasment with less secretion in unsupported use of pessaries (p = 0.045). A difference was found in the occurrence of erosion and vaginal ulcers (p < 0.05 ). Conclusions: There is a significant difference in terms of vaginal discharge increasment and occurrence of erosion and ulcers vaginal pessaries using unsupported compared with using supported pessaries. MÉD UIS. 2015;28(3):309-15.

Palabras clave: Peasrios, Indicaciones, Tratamientos Conservadores del Organo, Polapso de organo Pélvico, Prolapso Uterino

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Biografía del autor/a

Franklin J. Espitia De La Hoz

Médico especialista en Ginecología y Obstetricia. Universidad Militar Nueva Granada. Uroginecología y reconstrucción del piso pélvico. Fundación
Universitaria de Ciencias de la Salud. Bogotá. Universidad Estatal de Campinas. Campinas. Brasil. Unidad de Ginecología Urológica. Clínica La Sagrada
Familia. Armenia. Quindío. Colombia.

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Publicado
2015-12-03
Sección
Artículo original