Javier Pizarro-Berdichevsky

Pontificia Universidad Católica de Chile | UC · División Gineco-Obstetricia

Introducción: El clítoris es una de las estructuras vulvares menos examinadas, pese a su relevancia en la vida sexual y sus importantes relaciones anatómicas. Las adherencias del capuchón del clítoris han sido descritas y clasificadas según la exposición del glande, siendo relacionadas con trastornos del deseo sexual. La inervación del clítoris dep...

Introducción: El síndrome de vejiga hiperactiva (VHA) afecta hasta al 43% de las mujeres. La terapia escalonada incluye cambios de hábitos, fármacos y neuromodulación. Hasta el 40% de las pacientes llegan a requerir terapia avanzada alternativa, como toxina botulínica (TB). Objetivo: Reportar los resultados del tratamiento con toxina botulínica en...

Objetivo: Se presenta una serie de casos de reparación por vía vaginal de fístula vesicovaginal (FVV) de nuestro centro. Material y métodos: Estudio observacional descriptivo. Se evaluaron todas las pacientes con reparación quirúrgica de FVV en el Centro de Innovación de Piso Pélvico del Hospital Sótero del Río entre 2016 y 2022. Resultados: Se r...

Objetivo: Presentar una serie de casos de agentes de abultamiento (AA) de nuestro centro. Material y métodos: Estudio retrospectivo. Se evaluaron todos los casos operados con AA entre 2017 y 2022. La inyección de AA se realizó en quirófano, bajo sedación con anestesia local periuretral o raquídea. La inyección se realizó con uretroscopia, 0,5 cc e...

Introducción: La TVT (tension-free vaginal tape) es una cirugía efectiva, pero no exenta de riesgos. Las complicaciones vasculares ocurren en un 0,9-1,7%; solo el 0,33% se presentan como hematoma masivo, en general asociado a la lesión de variante anatómica corona mortis (CM). Objetivo: Reportar tres tipos de manejo en pacientes con hematomas masi...

The sudden loss of smell is among the earliest and most prevalent symptoms of Covid-19 when measured with a clinical psychophysical test. Research has shown the potential impact of frequent screening for olfactory dysfunction, but existing tests are expensive and time-consuming. We developed a low-cost ($0.50/test) rapid psychophysical olfactory te...

Introducción y objetivos: La incontinencia de orina de esfuerzo (IOE) es una patología muy frecuente. El tratamiento estándar corresponde al uso de cintas medio uretrales. Dentro de las técnicas quirúrgicas clásicas se encuentra la colposuspensión de Burch (CSB), poco frecuente en la actualidad. El objetivo de este estudio es describir las caracter...

The infectiousness and presymptomatic transmission of COVID-19 hinder pandemic control efforts worldwide. Therefore, the frequency of testing, accessibility, and immediate results are critical for reopening societies until an effective vaccine becomes available for a substantial proportion of the population. The loss of sense of smell is among the...

Purpose: One risk of removal of a tined sacral neuromodulation lead is breakage, resulting in a retained lead fragment. This study reports lead breakage rate, risk factors and outcomes of retained fragments. Materials and methods: We report on 464 tined lead removals from 2002 to 2018. Clinical and surgical factors were reviewed and appropriate...

Objective: To determine if using one 250 mL bottle of intravesical contrast followed by sterile saline alters interpretation of fluoroscopic images during fluoro-urodynamics MATERIALS AND METHODS: Subjects were randomized to receive 250 mL of intravesical contrast followed by sterile saline until maximal cystometric capacity (MCC) versus non-dilut...

Purpose: To determine the safety of sacral neuromodulation (SNM) in patients during lumbosacral 1.5 T magnetic resonance imaging (MRI). Methods: We prospectively recruited SNM-implanted patients requiring lumbosacral 1.5 T MRI. Before imaging, patients completed validated urinary symptom questionnaires and a survey regarding their usual SNM sens...

Purpose: To determine the utility of motor responses during Sacral Neuromodulation (SNM) lead placement by testing the hypothesis that a greater number of motor responses during intraoperative electrode testing is associated with more durable therapy. Materials and methods: A retrospective review of all SNM lead placements at a large academic ce...

Introduction: Sacral neuromodulation (SNM) devices (Medtronic, Minneapolis, MN, USA) are not approved to undergo magnetic resonance imaging (MRI) of sites other than the head. When MRIs are required, devices are often removed prior to imaging. We reviewed the prevalence of device removal for MRI at a large academic institution and the subsequent c...

Purpose To use functional magnetic resonance imaging(fMRI) for identifying changes in brain activity during sacral neuromodulation(SNM) in women with overactive bladder(OAB) who were responsive to therapy. Materials and Methods Women with non−neurogenic refractory OAB who responded to SNM, had a stable program for at least 3 months, with no subseq...

Proper recognition and management of apical prolapse is imperative in maximizing surgical outcomes in women with multi-compartment pelvic organ prolapse. Sacrospinous ligament fixation is a safe and effective, transvaginal and extraperitoneal procedure for apical prolapse. However, the sacrospinous ligament is an anatomically vulnerable location, w...

Introduction and hypothesisLittle is known regarding the use of various techniques for sling tensioning. Our objective was to determine which techniques are most commonly used by surgeons and surgeons’ views on sling tensioning. Methods An Internet-based survey designed to assess the use of various tensioning evaluation methods, different sling ten...

Device infection is one of the most common complications of sacral nerve stimulator placement and occurs in approximately 3–10% of cases. Infection is a serious complication, as it often requires complete explantation of the device. Not much is known regarding risk factors for and methods of preventing infection in sacral nerve stimulation. Multipl...

Purpose: To investigate the influence of patient age on sacral nerve stimulation(SNS) trial outcomes, device implantation, and treatment durability. Materials and methods: A database of all SNS procedures between 2012-2014 at a high-volume institution was analyzed for associations of age with SNS indication, trial stimulation success, device rev...

IntroductionVaginal stenosis is an unfortunate complication that can occur after pelvic radiation therapy for gynecologic or colorectal malignancies. Treatment is challenging and can require significant reconstructive surgery. The objective of this video is to present a case of vaginal stenosis after radiation and describe vaginal reconstruction wi...

Aim of the videoThe aim of this video is to make vaginal hysterectomy (TVH), vaginal salpingoophorectomy and uterosacral ligament (USL) colpopexy approachable by showing the key procedural steps from both the vaginal and abdominal perspectives. Methods This production shows TVH with salpingoophorectomy and USL colpopexy that was performed on a cada...

Introduction and hypothesisUrethral perforations after synthetic midurethral sling (MUS) placement are uncommon. Transvaginal removal is an option. The objective of this English and Spanish video is to demonstrate removal of an MUS that had perforated the urethra and the concomitant urethral reconstruction. MethodsA 66-year-old woman with a history...

Background: There is no consensus of the relationship between depressive symptoms (DS) and pelvic organ prolapse (POP) symptoms and quality of life (QoL). Our hypothesis was that women with DS and POP have worse symptoms and QoL than those without DS and POP. Aim: Our aim was to compare two groups of POP patients, those with depressive symptoms...

As the surgical correction of pelvic organ prolapse (POP) has continued to evolve, robotic-assisted abdominal sacrocolpopexy (RASC) has gained increasing popularity. Studies have shown equivalent subjective and objective outcomes compared to the "gold standard" abdominal sacrocolpopexy. Additionally, this approach is associated with a shorter hospi...

Pelvic organ prolapse (POP) is a elastolytic disorder resulting in herniation of pelvic organs As in women, lysyl oxidase-like 1 (Loxl1) knockout (KO) mice develop POP with increasing age and parity, and have disorganized elastin composition. Stem-cell based therapies have potential and can work by paracrine secretions of growth factors & cytokines...

Pelvic organ prolapse is a common disease in elderly patients. The most important symptom is vaginal bulge (bulge sensation or the sensation of something coming down through the vaginal introitus). This symptom is not different than in the general population. Diagnosis can be confirmed using just vaginal examinations to identify the presence of pro...

INTRODUCTION AND OBJECTIVES Lysyl Oxidase-Like 1 (Loxl1) knockout (KO) mice develop pelvic organ prolapse (POP) with increasing age and parity, like women. Stem-cell based therapies have potential and can work by paracrine secretions of growth factors & cytokines collected from cell culture media. We hypothesized that concentrated conditioned media...

INTRODUCTION AND OBJECTIVES Although the safety and efficacy of synthetic sling surgery has been thoroughly investigated, little is known regarding surgeon preferences and use of various techniques for sling tensioning. Our objective was to determine which techniques are most commonly used by surgeons and surgeons' attitudes toward the issue of pro...

Introduction and hypothesis: The Prolapse Quality of Life (P-QOL) questionnaire is a specific health-related quality of life (HRQL) instrument to assess the impact of POP on women. It has been validated in English-speaking women and to date has been translated into several other languages. However, currently there is no Spanish translation of the...

Background: Pelvic organ prolapse (POP) is a common disease. Vaginal pessaries are a treatment option. Some specialists prefer surgery as the treatment of choice. Objective: To describe the subjective response and complications associated with the use of pessaries in patients ≤65 years old with POP in Dr. Sotero del Rio Hospital. Methods: Retrospec...

Introduction and hypothesis: At our institution many symptomatic patients must wait months or years for surgery. Our aim was to determine the rates of clinically significant pelvic organ prolapse (POP) progression and identify risk factors associated with POP progression. Methods: Data from a prospectively maintained database of POP patients eva...

Background: Pelvic organ prolapse (POP) is a common disease. Vaginal pessaries are a treatment option. Some specialists prefer surgery as the treatment of choice. Objective: To describe the subjective response and complications associated with the use of pessaries in patients ≤65 years old with POP in Dr. Sotero del Rio Hospital. Methods: Retrospec...

Genital prolapse affects up to 50 % of multiparous women and has an impact on quality of life (QoL) for many. Vaginal obliterative techniques are relevant in older patients who are not sexually active. We performed Labhardt's colpoperineocleisis in such patients. The objective was the evaluation of subjective outcomes of this technique using PGI-I....

Introduction: The treatment of ovarian cancer is consists principally in radical surgery followed by chemotherapy. Patients generally respond well to first line chemotherapy (70%) but consistently relapse within 18 months, with successive rounds of chemotherapy delivering extremely low patient benefit. Despite every cancer being unique, generally a...

The use of the type 2 diabetics drug metformin has been correlated with enhanced progression-free survival in ovarian cancer. The literature has speculated that this enhancement is due to the high concentration of metformin directly causing cancer cell death. However, this explanation does not fit with clinical data reporting that the women exposed...

Our laboratory has implemented an in vitro assay to estimate the response to chemotherapy in ovarian cancer cells pertaining to individual patients. In two selected patients, we determined the correlation between an in vitro assay of cells from suspected ovarian cancer ascites, with the clinical chemotherapy response. Cancer cells isolated from per...

In vitro cell response to chemotherapeutic agents, to personalize ovarian cancer treatment. Report of two cases Our laboratory has implemented an in vitro assay to estimate the response to chemotherapy in ovarian cancer cells pertaining to individual patients. In two selected patients, we determined the correlation between an in vitro assay of cell...

Background: It is estimated that between 25-50% of women will suffer from a pelvic floor disorder during their lifetime. Sexual function is a complex and multidimensional concept. It has been suggested that to greater symptoms of pelvic floor disorders, women have major problems in sexual response. Objective: To describe the sexual function of a gr...

Antecedentes: Se estima que entre 25-50% de las mujeres sufrirá de alguna alteración del piso pélvico durante su vida. La función sexual es un concepto complejo y multidimensional. Se ha planteado que a mayor sintomatología de alteraciones de piso pélvico, las mujeres presentan mayores inconvenientes en su respuesta sexual. Objetivo: Describir la f...

Introduction: Genital prolapse affects up to 50% of multiparous women, impacting their quality of life and selfimage. At our Institution Labhardt's colpoperineocleisis is usually proposed to older patients, without sexual activity, regardless the type or grade of prolapse. Objective: To evaluate the results with this technique and identify potentia...

Background: It is estimated that between 25- 50% of women will suffer from a pelvic floor disorder during their lifetime. Sexual function is a complex and multidimensional concept. It has been suggested that to greater symptoms of pelvic floor disorders, women have major problems in sexual response. Objective: To describe the sexual function of a g...

Antecedentes: El riesgo de desarrollar prolapso genital aumenta con la edad, con un efecto negativo en la calidad de vida. Objetivo: Describir el efecto de los trastornos del piso pélvico en la calidad de vida en las distintas dimensiones, sin mediar intervenciones. Método: Se realizó una búsqueda en las bases de datos Pubmed, Cinhal, Proquest y Sc...

Introducción: El prolapso genital impacta negativamente la calidad de vida y autoimagen de la mujer. Rutinariamente indicamos la colpoperineocleisis de Labhardt a pacientes de edad avanzada y sin actividad sexual. Objetivo: Evaluar los resultados con esta técnica e identificar posibles factores de riesgo que predigan la falla. Métodos: Análisis ret...

Surgery often involves a multidisciplinary approach with gynae-cological laparoscopic surgeon and urologist. The surgery itself is technically difficult as the nodule is densely adherent to both bladder and uterus. This presentation of the surgery demonstrates an example of such case.

Human mismatch repair (MMR) genes encode highly conserved interacting proteins that correct replication errors predisposing to hereditary gastrointestinal and genitourinary malignancies. A subset of sporadic genitourinary tumors also exhibits MMR deficiency and can be identified by measuring the frequency of microsatellite instability (MSI) in canc...