Abstract Struma ovarii is a form of mature teratoma consisting predominantly of thyroid tissue. In 5% of the cases, it may occur with ascites (20%) and pleural effusion, constituting the Pseudo-Meigs Syndrome. We describe the case of a 62-year-old woman monitored at a Pulmonology consultation for dyspnea on moderate exertion and parapneumonic pleural effusion with a one-year evolution of non-malignant etiology. Ascites and solid adnexal lesion with increased cancer antigen-125 (1475.8 U/ml) were diagnosed . Histological examination revealed a lesion with characteristics of struma ovarii, with no signs of malignancy. Being a benign disease case, the prognosis is excellent.

Resumo Struma ovarii é uma forma de teratoma maduro constituído predominantemente por tecido tiróideu. Pode cursar com ascite (20%) e derrame pleural, constituindo o Síndrome de Pseudo-Meigs, presente em 5% dos casos. Descreve-se o caso de uma mulher de 62 anos vigiada em consulta de Pneumologia por dispneia para médios esforços e derrame pleural parapneumónico com um ano de evolução, de etiologia não maligna. Diagnosticada ascite e lesão anexial sólida com Cancer Antigen-125 aumentado (1475.8 U/ml). O exame histológico revelou lesão com características de struma ovarii, sem sinais de malignidade. Tratando-se de um caso de patologia benigna o prognóstico é excelente.

Resumo Objetivo A esterilização feminina é um procedimento cirúrgico que auxilia as mulheres na paragem permanente de utilização de métodos contraceptivos. Os objetivos desde estudo foram comparar a aplicabilidade, complicações e eficácia da salpingectomia vs. eletrocoagulação e secção tubar na esterilização feminina em regime de ambulatório. Métodos Realizou-se um estudo retrospectivo e observacional que incluiu mulheres submetidas a procedimentos de esterilização por laparoscopia no Serviço de Cirurgia de Ambulatório da ULSAM, durante três anos. A análise estatística foi realizada com recurso ao SPSS, aplicando o teste exato de Fisher, o teste de Mann-Whitney e Regressão Linear. Resultados Foram realizados 221 procedimentos cirúrgicos por laparoscopia, incluindo 79 (35,7%) salpingectomias totais bilaterais e 142 (64,3%) procedimentos por eletrocoagulação e secção tubar bilateral. A maioria dos procedimentos foram realizados por um interno de formação específica (n = 162; 73,3%), com 40% (n = 33) de salpingectomias. O tempo operatório foi significativamente inferior no grupo da eletrocoagulação (42,2 vs. 52,7 min, p < 0,001). Em relação à segurança e à eficácia não se observaram diferenças estatisticamente significativas entre os dois grupos, com um caso de gravidez após eletrocoagulação e secção tubar. Conclusão A salpingectomia é uma alternativa segura e com alta taxa de eficácia quando comparada com eletrocoagulação e secção tubar.

Abstract Objective Female sterilization is a surgical procedure that aims women to permanently stop the use of conception. The benefits, risks and cost-effectiveness are important issues. The purpose of this study was comparing the applicability, complications and efficacy of salpingectomy versus electrocoagulation and tubal occlusion by laparoscopy in the Ambulatory Surgery Unit. Methods We performed a retrospective and observational study that included women undergoing laparoscopic sterilization procedures at our Ambulatory Surgery Unit, during three years. Statistical analysis was performed using SPSS, applying the Fisher exact test, the Mann-Whitney test, and Linear Regression. Results Two hundred and twenty-one laparoscopic surgical procedures were performed, including 79 (35.7%) bilateral total salpingectomies and 142 (64.3%) electrocoagulation and bilateral tubal occlusion procedures. The majority of the procedures were performed by a resident (n = 162; 73.3%), with 40% (n = 33) of salpingectomies. The surgical time, independently the type of surgeon, was significantly shorter in the tubal occlusion (42.2 vs. 52.7 min, p < 0.001). Safety and efficacy endpoints were not significantly different between the two groups, with a case of pregnancy in tubal occlusion group. Conclusion Salpingectomy is a safe and effective alternative comparing with electrocoagulation and tubal occlusion.

Abstract Introduction and Objectives: Tocology knowledge is crucial in obstetrician's decisions and actions. The aim of this research is to assess the experience of Portuguese Gynecology and Obstetrics residents in performing operative vaginal delivery. Study design, population and methodology: Observational and transversal study with collecting an anonymous online survey with 47 questions, performed to 2nd to 6th year residents of Gynecology and Obstetrics. Results: 82 responses to the survey were obtained. The mean age of the sample was 29.3±0.248 years and 92.7% (n=76) of the participants were female. About half of the participants (53.7%, n=44) were working in a central hospital. The vacuum was the instrument most frequently used by the residents (95.1%). When asked about their level of confidence in performing an instrumented delivery, 6th-year residents (n=20) gave, on average, on a 1 to 9 scale, a score of 4.25±0.56 for the use of forceps and 8.05 ±0.22 for the use of vacuum (p<0.001). In this sample, 90.2% of the residents had the opportunity to undergo practical training in instrumented deliveries during the residency. Regarding maternal morbidity, the main concern using forceps are obstetric anal sphincter injuries (74.4%) and using vacuum are vaginal lacerations (32.9%). Conclusions: This survey allowed to characterize and to assess the residents experience, as well as their limitations, on performing operative vaginal deliveries. The knowledge acquired is essential to adapt and homogenize training plans, whenever needed.

Endometriosis is defined as endometrial tissue outside the uterine cavity. Pelvic locations of the disease are more prevalent, but it also occurs in many extra-pelvic locations. Abdominal wall endometriosis is usually associated with the presence of scars, more often after cesarean or histerectomy (secondary abdominal wall endometriosis). Primary abdominal wall endometriosis is a rare condition, and occurs in patients with no abdominal scars. We present a case of a 44-year-old woman, nulliparous, with no personal history of abdominal surgery. She complained of an umbilical mass with 3,5cm which was painful and had a bloody drainage during menses. She underwent surgery with excision of the mass. The pathology findings of endometrial glands and stroma confirmed the clinical assumption of endometriosis. Inspection of the pelvis showed no pelvic endometriosis.