Search

Objetivo: Presentamos nuestra experiencia en la inserción de un nuevo método de esterilización permanente vía histeroscópica, Essure. Se revisa el procedimiento de inserción, complicaciones, tolerancia, grado de satisfacción y aceptación de usuaria. Método: Entre enero y febrero de 2005 se realizaron 5 esterilizaciones con Essure en la Unidad de Ginecología y Obstetricia de Clínica Las Condes. Resultados: Se colocó el dispositivo en ambas trompas exitosamente en todas las pacientes. Rango de tiempo operatorio: 10-30 minutos. No hubo complicaciones intraoperatorias. Todas expresaron buena tolerancia y un alto grado de satisfacción frente al procedimiento de inserción histeroscópico. Lo recomendarían por su rapidez, carácter ambulatorio y ausencia de dolor. Durante el postoperatorio un caso presentó metrorragia leve y algia pélvica moderada. Conclusiones: Nuestra primera experiencia en la inserción del dispositivo intra tubario mostró ser un procedimiento bien tolerado y con buena aceptación por las pacientes Objective: We presented our experience in Essure insertion, a new hysteroscopic permanent sterilization method. We reviewed insertion procedure, complications, degree of tolerance and acceptance by user. Method: Between January and February 2005 five sterilizations cases with Essure were made in Las Condes Clinic. Results: The device in both tubes in all women was placed. Operative time was between 10 and 30 minutes. Intraoperative complications did not appear. All patients expressed very good tolerance and a high degree of satisfaction with insertion procedure. The reason because they would recommend it was: rapidity, ambulatory and absence of pain. During postoperative time one case presented weighs uterus bleeding and moderate pain. Conclusion: Our first experience in hysteroscopic intra Fallopian tube device insertion showed a procedure with very good tolerance and acceptance by the patients

The artilce evaluates a method for measuring intratubal (oviduct) pressure. A small balloon is introduced into the tubal lumen to which a small polyethylene tube is attached with the other end inserted through a catheter into the oviduct and a closed nonelastic water circuit is established. 10 women dropped out of the study because of method failure. Recordings were obtained from 20 patients once or twice a week for 20 to 50 days. Spontaneous contractions were observed though their role in ovarian transport is unknown. Measurements could be obtained up to 10 mm Hg and occasionally up to 20 mm Hg. Patient follow-up for 6 months after the catheters were removed showed anovulatory cycles in 3 women and 1 woman became pregnant after tubal ligation. The observed patterns of measurement were consistent with those reported in other studies using the same technique.

The effects of oxytocin, administered by either rapid or slow iv injection, on fallopian tube contractility were studies. Single iv doses were shown to consistently induce several contractions with a mean intensity of 10 mm Hg and hypertonia of varying duration. The oxytocin-induced bursts were synchronous in both tubes while normal spontaneous contractions are asynchronous. The tubes showed a high sensitivity to even small doses of oxytocin. The minimum does (threshold dose) of oxytocin eliciting tubal response in the patients was 250 mU. The intensity and duration of oxytocin-induced contractions were dose-dependent with the maximal responses obtained with oxytocin doses of 5 IU or less. The highest sensitivity was during the proliferative stage of the ovarian cycle. Continuous iv infusions of oxytocin ranging from 20 to 40 mU/minute increased tubal activity during administration. It was determined that the sensitivity of the human fallopian tube to oxytocin was higher than that of the nongravid uterus and lower than that of the mammary gland during lactation.