Publications by authors named "Tirso Perez Medina"

Hysteroscopy is a key gynecological procedure for diagnosing and treating endometrial conditions. While hysteroscopy is often performed in office settings without sedation, patients frequently report significant pain during the procedure. This study aims to evaluate the efficacy of paracervical anesthesia with mepivacaine compared to placebo in managing pain during office hysteroscopy.

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Introduction: The diagnostic workflow for endometrial carcinoma in postmenopausal asymptomatic women remains an ongoing dilemma. Whereas an ultrasonographic endometrial thickness greater than 4.0 or 5.

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Objective: To evaluate whether transvaginal radiofrequency (RF) ablation of fibroids is a technique that can be offered to women with reproductive desires.

Design: Unicentric, prospective, observational study.

Setting: University Hospital.

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Introduction: Usefulness of hysteroscopy before assisted reproductive technique (ART) was considered debatable. However, over the last decade, several new trials have been added to available literature. We aimed to assess the impact of diagnostic and operative hysteroscopy on reproductive outcomes of infertile women with and without intrauterine abnormalities.

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Purpose: To evaluate the agreement rate between hysteroscopy and pathological examination in case of chronic endometritis.

Methods: A retrospective observational study carried out at Gynecology and Obstetrics Department, Puerta de Hierro Hospital, Autónoma University of Madrid, Spain, from January 2021 to June 2022 was performed by obtaining data from 115 medical records of women who underwent office hysteroscopies that was compared with the findings of final histological examination of endometrial biopsy. Cohen's kappa index was used to evaluate this agreement rate.

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Background: Forty percent of women will experience prolapse in their lifetime. Vaginal pessaries are considered the first line of treatment in selected patients. Major complications of vaginal pessaries rarely occur.

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Background: To date hysteroscopy is the gold standard technique for the evaluation and management of intrauterine pathologies. The cervical canal represents the access route to the uterine cavity. The presence of cervical stenosis often makes entry into the uterine cavity difficult and occasionally impossible.

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: Vulvodynia is defined as a chronic idiopathic vulvar pain condition. This study aimed to investigate the effect of central sensitization on the prognosis of neuromodulator treatment for vulvodynia. A total of 105 patients with vulvodynia who underwent pelvic mapping pain exploration were included and scored according to the Convergence PP Criteria for pelvic pain and central sensitization.

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This practice guideline provides updated evidence for the gynecologist who performs endometrial biopsy (EB) in gynecologic clinical practice. An international committee of gynecology experts developed the recommendations according to AGREE Reporting Guideline. An adequate tissue sampling is mandatory when performing an EB.

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(1) Background: The objective was to compare the exploration of chronic pelvic pain syndrome (CPPS) patients in different locations and establish the role of physical examination in CPPS patients. (2) Methods: We reviewed clinical data from 107 female patients with CPPS unresponsive to conventional therapies at Puerta de Hierro University Hospital Madrid, Spain, from May 2018 to June 2022. Patients were classified into three groups: (a) pelvic pain; (b) anorectal pain; or (c) vulvar/perineal pain.

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: Hysteroscopic endometrial resection (ER) or global endometrial ablation (GEA) are feasible methods to treat heavy menstrual bleeding (HMB). The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to assess patient's quality of life (QoL) in women treated with ER/GEA compared to hysterectomy. : Electronic searches in MEDLINE Scopus, ClinicalTrials.

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(1) Background: To establish similarities in the risk of axillary lymph node metastasis between different groups of women with breast cancer according to immunohistochemical (IHC) parameters. (2) Methods: Data was collected retrospectively, from 2000 to 2013, of 1058 node-positive breast tumours. All patients were divided according to the St Gallen 2013 criteria and IHC features.

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Objective: This study aimed to evaluate the risk of endometrial carcinoma and atypical endometrial hyperplasia in asymptomatic postmenopausal women concerning the endometrial thickness measured by stratified threshold categories used for performing subsequent endometrial sampling and histologic evaluation.

Data Sources: MEDLINE, Scopus, ClinicalTrials.gov, SciELO, Embase, the Cochrane Central Register of Controlled Trials, LILACS, conference proceedings, and international controlled trials registries were searched without temporal, geographic, or language restrictions.

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Neoadjuvant chemotherapy allows a minimally invasive approach for interval debulking in patients with ovarian cancer considered unresectable to no residual disease by laparotomy at diagnosis. The aim of the study was to evaluate the type of surgical approach at interval debulking (ID) after three courses of carboplatin and taxol in patients with unresectable ovarian cancer at diagnosis compared with the type of surgical approach at primary debulking (PD). A secondary objective was to compare the perioperative outcomes of MIS vs.

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Article Synopsis
  • - Granulomatosis with polyangiitis (GPA) is a rare vasculitis that can mimic gynecological cancer, and this study aimed to review cases with gynecological involvement, which occurs in less than 1% of GPA patients.
  • - The research included 17 studies and found that a significant number of clinicians initially suspected cancer in GPA patients; however, bleeding was the primary gynecological symptom, with other areas like the ears, nose, throat, and lungs frequently affected as well.
  • - The study highlights that GPA should be considered when cervical or vaginal masses appear cancerous but test negative for malignancy, suggesting the need for rheumatology consultation in such cases.
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  • A study was conducted comparing the pain and anxiety levels experienced during two fertility tests: hysterosalpingo-foam sonography (HyFoSy) and hysterosalpingography (HSG), among 210 women trying to conceive.
  • Results showed that women undergoing HyFoSy reported significantly lower pain (median score of 2) and anxiety levels compared to those who had HSG (median pain score of 5 and higher anxiety scores).
  • The findings suggest that HyFoSy is a more tolerable option for women facing fertility challenges, providing both less pain and reduced anxiety during the procedure.
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Background: Although several treatments are currently available for chronic pelvic pain, 30-60% of patients do not respond to them. Therefore, these therapeutic options require a better understanding of the mechanisms underlying endometriosis-induced pain. This study focuses on pain management after failure of conventional therapy.

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  • COVID-19 confinement has impacted the lifestyle of pregnant women, leading to increased risks of complications like perineal trauma during childbirth.
  • A study was conducted with 98 pregnant women, dividing them into an intervention group (virtual exercise program) and a control group, to assess the impact on perineal injuries and episiotomy rates.
  • Results showed that the intervention group had significantly lower rates of episiotomies (12% vs. 38%) and perineal tears (52% vs. 73%), suggesting that supervised virtual exercise can reduce these complications during delivery.
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  • The study aimed to evaluate mechanical strategies used to prevent intrauterine adhesions from recurring after hysteroscopic adhesiolysis and assess their impact on fertility outcomes.
  • Researchers conducted a thorough search of various databases for randomized trials related to this issue and defined strict inclusion and exclusion criteria to ensure the quality of studies included.
  • Results showed that using a copper intrauterine device with an intrauterine balloon or hyaluronic acid gel was effective in preventing the recurrence of adhesions, with hyaluronic acid gel showing the most promise for improving fertility outcomes.
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Purpose: Aberrant right subclavian artery is an anatomical variation with a prevalence of around 0.5-1.5% of the general population, being more frequently found among people with chromosomopathies, especially, trisomy 21.

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Article Synopsis
  • The study aimed to evaluate whether identifying an aberrant right subclavian artery in prenatal ultrasounds improves the detection of chromosomal, genetic, or morphological abnormalities.
  • Analyzing 257 cases from 2011 to 2018, researchers found that the presence of this arterial anomaly had little impact on diagnosing conditions like trisomy 21 or other abnormalities after the first trimester.
  • The conclusion indicates that thorough screening in the first trimester is crucial, as the detection of an aberrant right subclavian artery does not enhance diagnostic outcomes in the second trimester.
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To compare the obstetric results achieved after hysteroscopic office metroplasty (HOME-DU) in infertile and recurrent pregnancy loss (RPL) patients diagnosed with dysmorphic uterus, women hysteroscopically diagnosed with dysmorphic uterus who underwent uterine-enlargement metroplasty were prospectively enrolled from June 2016 until April 2020. Patients were followed up and obstetric outcomes were recorded (pregnancy and live birth rate). Sixty-three women (30 infertile; 33 RPL) were enrolled, of which 48 became pregnant post-HOME-DU, with an overall pregnancy rate of 76.

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Background: The first reports of the Chinese experience in the management of newborns of mothers with SARS-CoV 2 infection did not recommend mother-baby contact or breastfeeding. At present, the most important International Societies, such as WHO and UNICEF, promote breastfeeding and mother-baby contact as long as adequate measures to control COVID-19 infection are followed. In cases where maternal general health conditions impede direct breastfeeding or in cases of separation between mother and baby, health organizations encourage and support expressing milk and safely providing it to the infants.

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Introduction: The aim of this study is to report our clinical experience in the management of pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the first 30 days of the coronavirus disease (COVID-19) pandemic.

Material And Methods: We reviewed clinical data from the first 60 pregnant women with COVID-19 whose care was managed at Puerta de Hierro University Hospital, Madrid, Spain from 14 March to 14 April 2020. Demographic data, clinical findings, laboratory test results, imaging findings, treatment received, and outcomes were collected.

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