Belinda Breech

20 statements · 1 topic

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▶ Ep 2 · 44:02
I think that um we all as gynecologists have met young women who potentially present with an isolated vaginal septum, a longitudinal vaginal septum, who may not have had other associated anorectal or uh urogenital anomalies. Thus they weren't having other surgeries performed, and I would say in those cases we don't need to do anything about the vaginal septum
quote · Cloaca
▶ Ep 2 · 35:40
from a urologic standpoint, I worry more about the distance from the bladder neck to the confluence of the common channel as far as potential uh continence
quote · Cloaca

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Belinda's statements about Cloaca 20 statements

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Cloaca - Case Presentations

▶ Ep 2 · 1:00
quote I was just gonna say ovarian cyst. I think that's the highest on my differential ↗
▶ Ep 2 · 1:10
quote We suspect the baby probably has hydrocopos, the antenatal ultrasounds, as well as the combined finding on the abdominal film, um, demonstrating that there is some distortion of the structures in the pelvis ↗
▶ Ep 2 · 3:38
epidemiological Approximately 28% of female patients with cloaca have hydrocolpos, with the majority having bilateral hemivaginas ↗
▶ Ep 2 · 4:10
quote I think it's important. Obviously I'm a gynecologist, so in all of my discussions I will be migrating towards the gynecologic and reproductive sequelae or manifestation. So you will find that my slides are always favoring the reproductive parts. ↗
▶ Ep 2 · 4:40
quote the importance on this slide is that more than half of the patients did not receive timely diagnosis and treatment ↗
▶ Ep 2 · 4:40
clinical More than half of patients with hydrocolpos did not receive timely diagnosis and treatment, leading to sequelae including infection, sepsis, recurrent UTIs, and rupture ↗
▶ Ep 2 · 5:50
quote 69.4% of our patients with hydrocopos had a common channel length that was greater than 3 centimeters, so it was more than 2/3 of the patients ↗
▶ Ep 2 · 5:50
epidemiological 69.4% of patients with hydrocolpos had common channel length greater than 3 centimeters ↗
▶ Ep 2 · 6:00
quote there is a strong association of reproductive anomalies and duplication in patients who have hydrocopos ↗
▶ Ep 2 · 6:20
quote I'm hoping that the pediatric surgeon would be thinking, wow, hydrocopos may make me think I need to assess the utero vaginal anomaly on the other side to make sure that there is not just a single vagina, but there could be two that may need to be drained ↗
▶ Ep 2 · 7:50
clinical When duplicated vaginas are present, the cervices are typically at the same level, requiring careful identification to avoid trauma during septum division ↗
▶ Ep 2 · 8:10
quote It's important to know that the cervix on the other side is likely at the exact same level and to not traumatize that cervix for future childbearing in the future ↗
▶ Ep 2 · 31:42
quote when looking at that imaging, you want to see, do you have enough rectum and colon to bring down ↗
▶ Ep 2 · 32:00
quote if you think you need to potentially replace vagina or do something that requires more work, do you typically get proximal imaging of The colon ↗
▶ Ep 2 · 35:20
quote the majority of the patients that we've seen at our center have kind of been in about 1.5 to 2 centimeters ↗
▶ Ep 2 · 35:20
epidemiological In congenital adrenal hyperplasia patients with urogenital sinus, the majority have urethral length of approximately 1.5 to 2 centimeters ↗
▶ Ep 2 · 35:40
quote from a urologic standpoint, I worry more about the distance from the bladder neck to the confluence of the common channel as far as potential uh continence ↗
▶ Ep 2 · 44:02
opinion In cloacal malformations requiring extensive surgery, vaginal septum should be divided during primary repair for patient comfort with menstruation and sexual function, as it does not extend the procedure or increase fistula risk ↗
▶ Ep 2 · 44:02
quote I think that um we all as gynecologists have met young women who potentially present with an isolated vaginal septum, a longitudinal vaginal septum, who may not have had other associated anorectal or uh urogenital anomalies. Thus they weren't having other surgeries performed, and I would say in those cases we don't need to do anything about the vaginal septum ↗
▶ Ep 2 · 44:50
quote these are patients who are having. An extensive surgery, we're just talking about going from the perineum to the abdomen back to the perineum, it would seem a reasonable time to unify the vaginas that we know would be more comfortable for her sexually, more comfortable for menstrual hygiene. ↗