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Anesth Analg 2019 Feb 12. Epub 2019 Feb 12.

From the Department of Anesthesiology.

Background: Postoperative delirium is an important public health concern without effective prevention strategies. This study tested the hypothesis that perioperative epidural use would be associated with decreased risk of delirium through postoperative day 3.

Methods: This was a secondary, observational, nonrandomized analysis of data from The Prevention of Delirium and Complications Associated With Surgical Treatments Trial (PODCAST; NCT01690988). Read More

Lancet Oncol 2019 Feb 7. Epub 2019 Feb 7.

Department of Oncology, Phase 1 Unit, Rigshospitalet, Copenhagen, Denmark.

Background: Tisotumab vedotin is a first-in-human antibody-drug conjugate directed against tissue factor, which is expressed across multiple solid tumour types and is associated with poor clinical outcomes. We aimed to establish the safety, tolerability, pharmacokinetic profile, and antitumour activity of tisotumab vedotin in a mixed population of patients with locally advanced or metastatic (or both) solid tumours known to express tissue factor.

Methods: InnovaTV 201 is a phase 1-2, open-label, dose-escalation and dose-expansion study done at 21 centres in the USA and Europe. Read More

Cureus 2018 Nov 30;10(11):e3657. Epub 2018 Nov 30.

Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA.

Mucinous cystadenomas are a common benign neoplasm of the ovaries that can grow much larger than other adnexal masses. We report a case of a 28-year-old female who presented with one month of increasing abdominal distension and upper abdominal pain; she was found to have a 30-centimeter (cm) adnexal mass. Pathology showed a benign mucinous cystadenoma with no evidence of malignancy. Read More

Am J Obstet Gynecol 2019 Feb 6. Epub 2019 Feb 6.

Ottawa Hospital Research Institute; University of Ottawa, Department of Obstetrics and Gynecology.

Endometriosis is a common gynecologic condition, affecting approximately 10% of reproductive aged women. It commonly presents with pelvic pain, painful periods, and infertility and can significantly impact one's quality of life. Early exploration into the pathophysiology of this condition identified race as a risk factor for endometriosis, with the condition predominantly identified in white women. Read More

Reg Anesth Pain Med 2019 Feb 7. Epub 2019 Feb 7.

Anesthesiology, Hospital for Special Surgery, New York City, New York, USA.

Enhanced recovery after surgery (ERAS) protocols for gynecologic (GYN) surgery are increasingly being reported and may be associated with superior outcomes, reduced length of hospital stay, and cost savings. The Agency for Healthcare Research and Quality, in partnership with the American College of Surgeons and the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality, has developed the Safety Program for Improving Surgical Care and Recovery, which is a nationwide initiative to disseminate best practices in perioperative care to more than 750 hospitals across five major surgical service lines in a 5-year period. The program is designed to identify evidence-based process measures shown to prevent healthcare-associated conditions and hasten recovery after surgery, integrate those into a comprehensive service line-based pathway, and assist hospitals in program implementation. Read More

Am J Case Rep 2019 Feb 8;20:167-170. Epub 2019 Feb 8.

Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.

BACKGROUND Uterine leiomyoma, or uterine fibroid, is the most common gynecologic neoplasm and its management usually results in a good clinical outcome. This report is of a rare case of hemoperitoneum associated with spontaneous hemorrhage from a benign uterine leiomyoma. CASE REPORT A 27-year-old single woman presented with generalized acute abdominal pain and vomiting. Read More

Eur J Obstet Gynecol Reprod Biol 2019 Jan 30;234:218-222. Epub 2019 Jan 30.

Division of Gynecologic Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Division of Gynecology, San Carlo di Nancy Hospital, Rome, Italy.

Objective: To investigate the safety, feasibility and oncological adequacy of the Percutaneous Surgical System - PSS in a consecutive series of low-risk endometrial cancer staging.

Study Design: From May 2015 to April 2017, we prospectively performed 30 consecutive percutaneous staging for low/intermediate risk endometrial cancer (FIGO stage IA G1-G2, IB G1-G2, IA G3). All patients were divided in two different groups on the basis of surgical procedure received: Group A included patients submitted to radical Class A hysterectomy and bilateral salpingo-oophorectomy; Group B concerned patients that received a lymph nodal assessment also. Read More

Pediatr Emerg Med Pract 2019 Feb 1;16(Suppl 2):1-2. Epub 2019 Feb 1.

Chief Resident, Emergency Medicine & Pediatrics, University of Arizona, Tucson, AZ

In the emergency department, gynecologic complaints are common presentations for adolescent girls, who may present with abdominal pain, pelvic pain, vaginal discharge, and vaginal bleeding. The differential diagnosis for these presentations is broad, and further complicated by psychosocial factors, confidentiality concerns, and the need to recognize abuse and sexual assault. This issue provides recommendations for the evaluation and management of obstetric and gynecologic emergencies including infectious, anatomic, and endocrine etiologies. Read More

Appl Nurs Res 2019 Feb 12;45:39-44. Epub 2018 Dec 12.

Honor Health Thompson Peak Medical Center, 7400 E. Thompson Peak Parkway, Scottsdale, AZ 85255, United States. Electronic address:

Background: Optimizing early education in gynecological procedures utilizing an Enhanced Recovery after Surgery (ERAS) program and a bundle concept may optimize patient outcomes after surgery.

Purpose: Evaluate whether an ERAS bundle compared to standard education can affect length of stay, 30 day readmission, and patient satisfaction among patients undergoing gynecologic surgery.

Design: Prospective, comparative, randomized design SETTING: 28 bed Medical Surgical Unit SAMPLE/INTERVENTION: 50 patients undergoing hysterectomy, 25 who received post-operative evidence based bundle/standard education, and 25 who received standard education packet. Read More

Am J Obstet Gynecol 2019 Jan 22. Epub 2019 Jan 22.

Department of Obstetrics and Gynecology, Division of Advanced Pelvic Surgery, University of Wisconsin Madison Hospital and Clinics, Madison, Wisconsin. Electronic address:

Background: Opioids are effective for the treatment of postoperative pain, but can cause nausea and are associated with dependency with long term use. Non-opioid medications such as acetaminophen offer the promise of decreasing these non desirable effects while still providing patient comfort.

Objective: To compare intravenous (IV) acetaminophen with placebo and evaluate postoperative pain control and opioid usage after laparoscopic hysterectomy. Read More

Pediatr Emerg Med Pract 2019 Feb 1;16(2):1-24. Epub 2019 Feb 1.

Associate Professor of Emergency Medicine and Pediatrics, Department of Emergency Medicine, University of California San Francisco, San Francisco, CA.

In the emergency department, gynecologic complaints are common presentations for adolescent girls, who may present with abdominal pain, pelvic pain, vaginal discharge, and vaginal bleeding. The differential diagnosis for these presentations is broad, and further complicated by psychosocial factors, confidentiality concerns, and the need to recognize abuse and sexual assault. This issue provides recommendations for the evaluation and management of obstetric and gynecologic emergencies including infectious, anatomic, and endocrine etiologies. Read More

Clin Obstet Gynecol 2019 Mar;62(1):11-21

Department of Obstetrics and Gynecology, Division of Minimally Invasive Gynecologic Surgery, University of North Carolina, Chapel Hill, North Carolina.

The clinical setting in which women's health physicians practice, whether as generalist, obstetricians and gynecologists, or subspecialists, dictates our frequent clinical interaction with "pain." Opioid-containing medications are frequently prescribed within our specialty as a means of immediate pain relief. Opioid-containing medication causes a deep physiological alteration of several systems resulting in potential harm to acute and chronic opioid users. Read More

J Minim Invasive Gynecol 2019 Jan 16. Epub 2019 Jan 16.

Department of Obstetrics and Gynecology, Hospital das Forças Armadas, Lisbon, Portugal (Drs. Mairos and Di Martino).

Study Objective: To assess how the location of intracavitary lesions during office hysteroscopy influences pain scores.

Design: Cohort study.

Setting: Department of Obstetrics and Gynecology, Hospital das Forças Armadas, Lisbon, Portugal. Read More

Adv Clin Exp Med 2019 Jan 15. Epub 2019 Jan 15.

Department of Gynecology, Endocrinology and Gynecologic Oncology, Pomeranian Medical University, Szczecin, Poland.

An approach to ovarian endometrial cysts has changed considerably during recent years, especially in regard to treatment of recurrent endometriosis, fertility sparing and infertility management. Surgical treatment is the primary therapeutic option. The most efficient types of treatment are radical procedures involving adhesiolysis, removal of the cyst along with its capsule and any remaining endometriotic foci. Read More

Eur Rev Med Pharmacol Sci 2019 Jan;23(1):397-401

Área Académica de Medicina, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Circuito Ex Hacienda, Pachuca de Soto Hidalgo, México.

Objective: Metronidazole is an antibiotic widely used in different medical conditions such as trichomoniasis, amoebiasis, and giardiasis among others. Its use has been associated with toxicity; however, it is not well characterized. In this review, we discuss the different therapeutic uses of metronidazole and its side effects in order to aid future investigation in this field. Read More

Histol Histopathol 2019 Jan 18:18085. Epub 2019 Jan 18.

Gynecologic and Obstetric Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.

Introduction: primary extranodal non-hodgkin vaginal lymphoma (PeNHVL) represents a rare entity, with few data published until now. We present here a series of patients with PeNHVL, analyzing our data as part of a detailed review of the available literature.

Methods: the study included a consecutive series of 6 patients with final diagnosis of PeNHVL admitted at our Institution between January 2000 and December 2017. Read More

Aust N Z J Psychiatry 2019 Jan 17:4867418823276. Epub 2019 Jan 17.

1 Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.

Background:: Acetaminophen is a widely used medication for fever and pain management during pregnancy. However, recent studies have found a possible connection between maternal prenatal acetaminophen use and attention deficit/hyperactivity disorder in children.

Objective:: We aimed to explore the association between maternal acetaminophen use during pregnancy and the risk of attention deficit/hyperactivity disorder in offspring. Read More

Int J Surg 2019 Feb 14;62:47-53. Epub 2019 Jan 14.

Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, Kitakyushu, Japan.

Background: Ultrasound-guided nerve blocks are effective; however, their use in the abdominal wall is reportedly associated with a risk of abdominal organ injury. Laparoscopic-guided nerve blocks are thought to be safer than ultrasound-guided nerve blocks. We evaluated the safety and effectiveness of the laparoscopic-guided rectus sheath block (LGRSB) for umbilical incisions after gynecologic laparoscopy. Read More

Medicine (Baltimore) 2019 Jan;98(3):e14190

Department of Orthopedic Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital.

Rationale: Cervical cancer is one of the most common gynecologic malignancies worldwide, and it spreads mainly through direct extension. Distinct metastases are less common and usually spread to distant lymph nodes, lungs, and bones. Bone metastases from cervical cancer are most commonly observed in the pelvis and spine. Read More

JAMA Netw Open 2018 Dec 7;1(8):e185452. Epub 2018 Dec 7.

Department of Gynecologic Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York.

Importance: Opioids are routinely prescribed for postoperative home pain management for most patients in the United States, with limited evidence of the amount needed to be dispensed. Opioid-based treatment often adversely affects recovery. Prescribed opioids increase the risk of chronic opioid use, abuse, and diversion and contribute to the current opioid epidemic. Read More

Menopause 2019 Jan 14. Epub 2019 Jan 14.

University of California, Irvine, CA.

Objective: The treatment of genitourinary syndrome of menopause (GSM) includes prescription hormone therapy, nonhormonal over-the-counter products, and most recently, laser treatment. Although the Food and Drug Administration has cleared fractional carbon dioxide (CO2) laser for a variety of dermatologic and gynecologic indications, lasers have not to date, been approved for use for vulvar/vaginal atrophy, or sexual dysfunction.

Methods: Four case studies that were referred to a tertiary sexual medicine center regarding laser treatment complications for GSM are reported. Read More

Int J Gynecol Cancer 2019 Jan;29(1):147-152

University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

Introduction: Intraperitoneal (IP) chemotherapy improves survival in ovarian cancer but its use has been limited by toxicity with cisplatin-based regimens. The primary objective of this study was to define the maximum tolerated dose and dose-limiting toxicity of intravenous (IV) oxaliplatin and IP docetaxel in women with recurrent ovarian, fallopian tube or peritoneal cancer. Secondary objectives were response rate, time to progression, symptom interference with quality of life, and pharmacokinetics. Read More

J Obstet Gynaecol 2019 Jan 11:1-5. Epub 2019 Jan 11.

b Department of Obstetrics and Gynecology, Medical Faculty , Yuzuncu Yil University , Van , Turkey.

Our objective was to compare the effectiveness of local lidocaine spray (LS) compared to forced coughing (FC) for relieving the pain during colposcopically guided cervical biopsies (CGBs). The study was a randomised study, which included patients with abnormal cervical cytologic results requiring a colposcopic biopsy procedure. The patients were randomly assigned to either the 10% LS or the FC groups before the biopsy procedure. Read More

Case Rep Obstet Gynecol 2018 5;2018:9362962. Epub 2018 Dec 5.

Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Lincoln Medical and Mental Health Center, 234 East 149th Street, Bronx, New York 10451, USA.

Background: Throughout the world, intrauterine contraceptive devices (IUDs) are a frequently used, reversible, popular contraceptive method. They are usually placed without major complications. Uterine perforation is a rarely observed complication. Read More

Cancer Chemother Pharmacol 2019 Jan 8. Epub 2019 Jan 8.

Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, 1500 East Duarte Road, Duarte, CA, 91010, USA.

Purpose: To evaluate intraperitoneal (IP) nab-paclitaxel in patients with advanced malignancies that are primarily confined to the peritoneal cavity in a phase I trial.

Methods: Using a 3 + 3 dose escalation of IP nab-paclitaxel on days 1, 8, and 15 of a 28-day cycle, we evaluated six dose levels (35-175 mg/m/dose). Maximum tolerated dose (MTD) and pharmacokinetics (PK) of IP nab-paclitaxel were determined. Read More

Front Cell Neurosci 2018 21;12:495. Epub 2018 Dec 21.

Pain Research Center, Department of Anesthesiology, University of Cincinnati College of Medicine, Cincinnati, OH, United States.

Pain is the most severe and common symptom of endometriosis. Its underlying pathogenetic mechanism is poorly understood. Nerve sensitization is a particular research challenge, due to the limitations of general endometriosis models and sampling nerve tissue from patients. Read More

Medicine (Baltimore) 2019 Jan;98(1):e13994

Department of Anesthesiology and Reanimation, Mugla Sitki Kocman University, Mugla, Turkey.

Background: We aimed to assess whether an ultrasound (US)-guided oblique subcostal transversus abdominis plane (OSTAP) block would improve the postoperative pain scores and decrease the tramadol consumption after a laparoscopic hysterectomy.

Methods: Sixty-six female patients with American Society of Anesthesiologists I, II, or III, aged 18 to 65 years who were scheduled for laparoscopic hysterectomy for benign gynecologic pathologies were recruited in this randomized, controlled, observer-blinded trial. Sixty patients completed the study. Read More

Afr Health Sci 2018 Sep;18(3):612-622

Ankara University School of Medicine, Department of Surgery.

Objectives And Background: Hysterectomy is the most commonly performed major gynecological operation for both benign and malign gynecologic conditions. After hysterectomy, although some investigators have declared an increased incidence of urinary and anorectal dysfunction, some others could not show any connection.

Methods: The voluntary patients were divided in two groups: abdominal hysterectomy (Group 1) and vaginal hysterectomy (Group 2). Read More

Surg Neurol Int 2018 28;9:239. Epub 2018 Nov 28.

Department of Surgery, Avicenne Military Hospital of Marrakech, Mohammed V University in Rabat, Morocco.

Background: Primary psoas abscess is an unusual clinical entity rarely encountered in the postpartum period. Only seven cases have been reported to date. Here, we present a woman with a primary psoas abscess caused by and occurred 2 months following a normal vaginal birth. Read More

Gynecol Oncol 2018 Dec 23. Epub 2018 Dec 23.

Memorial Sloan Kettering Cancer Center, Medical Oncology, New York, NY 10065, United States of America. Electronic address:

Introduction: Cabozantinib is a receptor tyrosine kinases inhibitor that targets MET (c-MET), VEGF receptor 2 (VEGFR2), RET, AXL, KIT, FLT-3, and TIE-2 and previously showed promising single agent activity in recurrent ovarian cancer.

Methods: This was an open label, 1:1 randomized study of cabozantinib 60 mg orally (PO) daily versus weekly paclitaxel 80 mg/m given 3 out of 4 weeks (NCT01716715); 111 patients were enrolled. Eligibility included persistent or recurrent epithelial ovarian, fallopian tube, or primary peritoneal carcinoma and at least one but no >3 prior chemotherapy regimens. Read More

J Minim Invasive Gynecol 2019 Feb 20;26(2):327-343. Epub 2018 Dec 20.

Department of Obstetrics and Gynecology, Louisiana State University Health Sciences Center, New Orleans, Louisiana (all authors).

Enhanced recovery after surgery (ERAS), or "fast-track" protocol, aims to minimize the physiologic stress of surgery and optimize the rehabilitation of patients. However, there is limited data in obstetrics and gynecology. We reviewed the published literature on ERAS programs in gynecology to evaluate the outcomes and potential key elements for a successful program. Read More

Semin Reprod Med 2018 Mar 19;36(2):164-172. Epub 2018 Dec 19.

Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Penn State Hershey Medical Center, 500 University Dr, Hershey, Pennsylvania.

Chronic pelvic pain is a complex condition with peripheral and central mechanisms of pain. Successful nonsurgical management typically relies on a multimodal approach, with integration of both pharmacologic and nonpharmacologic interventions. This article reviews nonpharmacologic therapies including pelvic floor physical therapy, dietary modifications, psychotherapy, and acupuncture. Read More

Semin Reprod Med 2018 Mar 19;36(2):143-151. Epub 2018 Dec 19.

Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York.

Endometriosis is a nonmalignant gynecologic disorder that can have a significant impact on a woman's quality of life with pelvic pain and possible lasting effects on one's fertility. Symptoms, when present, can be severe and affect many organ systems including the gastrointestinal and urinary systems. Other etiologies of pelvic pain must be ruled out and/or need to be addressed concurrently for optimal patient care. Read More

Semin Reprod Med 2018 Mar 19;36(2):136-142. Epub 2018 Dec 19.

Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Christiana Care Health System, Newark, Delaware.

Fibromyalgia and irritable bowel syndrome are common disorders which often coexist in women with chronic pelvic pain. Like pelvic pain, these disorders describe symptoms without pathologic findings. Women with chronic pelvic pain have a higher prevalence of fibromyalgia (4-31%) and irritable bowel syndrome (8-41%) than the general population. Read More

Semin Reprod Med 2018 Mar 19;36(2):116-122. Epub 2018 Dec 19.

Department of Obstetrics and Gynecology, University of Michigan Health System, Ann Arbor, Michigan.

Dysmenorrhea and noncyclic pelvic pain (chronic pelvic pain) are common in adolescents. The evaluation of teens with dysmenorrhea or chronic pelvic pain is aimed to diagnose possible gynecologic conditions (endometriosis, pelvic inflammatory disease, ovarian cysts, and obstruction of the reproductive tract) and nongynecologic conditions (irritable bowel syndrome, interstitial cystitis, and myofascial pain). The management of chronic pelvic pain in adolescents is often more complex than in adult women because both the adolescent and her parents are counseled and addressed, and her long-term emotional and physical health, fertility, and sexuality are considered. Read More

Gynecol Oncol 2019 02 14;152(2):310-315. Epub 2018 Dec 14.

Moffitt Cancer Center, Tampa, FL, United States of America. Electronic address:

Objective: Increasing age has been associated with higher risk of chemotherapy-related toxicities, often resulting in treatment disruptions or discontinuations. Age has also been evaluated as a potential risk factor for chemotherapy-induced peripheral neuropathy (CIPN), but current understanding of recovery from CIPN in older adults after treatment is limited. The goal of the current study was to: 1) evaluate longitudinal change in patient-reported CIPN symptoms from the start of chemotherapy to one year post-chemotherapy; and 2) examine treatment modifications in older (≥65 years) and younger patients (<65 years). Read More

Arch Gynecol Obstet 2018 Dec 17. Epub 2018 Dec 17.

Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Purpose: Cancer survivors frequently experience cancer or treatment-related symptoms and functional morbidities that can be addressed through rehabilitation services, but these symptoms often go unnoticed and seldom managed. This study seeks to investigate the undetected patient symptoms and functional loss related to the activities of daily living (ADLs) in ovarian cancer patients during chemotherapy and to identify the influence of chemotherapy on such loss.

Methods: Ovarian cancer patients undergoing chemotherapy were identified from June to August 2016, who were treated at the department of Gynecology and Obstetrics of two tertiary hospitals. Read More

Medicine (Baltimore) 2018 Dec;97(49):e13470

Department of Obstetrics and Gynecology.

In the recent 20 years, primary vaginal adenosis is extremely rare and the data of clinical presentations, management, and outcome have not been studied systematically.In this retrospective study, women with vaginal adenosis between January 1997 and June 2017 were identified from the hospital's medical records. Data on patient age, history, symptoms, mass location, size, diagnosis, complications, treatment, and recurrence were analyzed by SPSS 20. Read More

Gynecol Oncol Rep 2019 Feb 22;27:8-10. Epub 2018 Nov 22.

Department of Obstetrics and Gynecology, Division of Gynecology and Gynecologic Subspecialties, University of Wisconsin Hospital and Clinics, Madison, WI, United States.

Background: Various ovarian neoplasms may show histological findings that are morphologically indistinguishable from adult granulosa cell tumor (AGCT).

Case Presentation: A 36 year-old women presented with left lower extremity pain and numbness. Ultrasound revealed a 10 cm left adnexal mass treated with ovarian cystectomy. Read More

PeerJ 2018 4;6:e5995. Epub 2018 Dec 4.

Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan, Taiwan.

Background: Adnexal torsion is a gynecologic emergency that requires surgical treatment. In this study, we reviewed the surgical outcomes of women with adnexal torsion in eastern Taiwan (Hualien county, area 4,629 km, 330,000 residents).

Methods: This retrospective study included 42 women diagnosed with surgically-proven adnexal torsion from January 1, 2010, to September 31, 2015. Read More

Int J Gynecol Pathol 2018 Dec 3. Epub 2018 Dec 3.

Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.

Primary extrarenal Wilms tumor of the gynecologic tract is extremely rare with scattered case reports occurring in the ovary, uterine corpus and cervix. Only 9 cases of primary ovarian Wilms tumor have been reported to date. Here, we provide an extensive literature review and describe 2 patients with ovarian Wilms tumor: a 36-yr-old female (patient 1) and a 16-yr-old female (patient 2), both presenting with abdominal pain and suspected ovarian torsion. Read More

Facts Views Vis Obgyn 2018 Mar;10(1):47-50

Sint-Jozef Kliniek, Department of gynecology and obstetrics, Kasteelstraat 23, 2880 Bornem, Belgium.

Undescended ovary is a rare congenital gynecologic condition, frequently associated with urogenital malformations including unicornuate uterus and ectopic kidneys or renal agenesis. Although ectopic ovaries are mostly found during an infertility work up, its role in infertility is still unknown. We report a 38-year-old patient presenting with pain in the right lower quadrant. Read More

Contraception 2018 Nov 27. Epub 2018 Nov 27.

Stanford University, Department of Obstetrics and Gynecology, Division of Family Planning Services and Research, 300 Pasteur Drive, HG 332, Palo Alto, CA, USA 94305. Electronic address:

Objective(s): To compare pain scores during cervical dilator placement prior to dilation and evacuation (D&E) with patient-administered vaginal lidocaine gel versus lidocaine paracervical block (PCB).

Study Design: We conducted an unblinded randomized trial of women ≥18 years of age undergoing surgical abortion at ≥16 weeks' gestation in two outpatient clinics. We randomized participants to receive self-administered lidocaine gel 2% 20 mL intravaginally 15-30 min before procedure initiation or lidocaine 1% 12 mL PCB immediately prior to dilator placement. Read More

Int J Surg Case Rep 2018 16;53:390-393. Epub 2018 Nov 16.

Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA.

Background: Patients with gastrointestinal or gynecologic malignancy may show disease progression within the abdomen and pelvis causing bowel obstruction in the absence of clinical evidence of disease outside of the peritoneal space. Bowel obstruction eventually results and has a profound effect on quality of life eventually leading to the demise of these patients.

Methods: In order to improve the quality of life and combat the requirement for a nasogastric tube, a combination of total parenteral nutrition (TPN) to allow adequate caloric intake plus cervical esophagostomy to drain intestinal secretions was utilized as a palliative treatment long-term for patients with malignancy-associated bowel obstruction. Read More

Pain Med 2018 Nov 27. Epub 2018 Nov 27.

Department of Clinical & Health Psychology, University of Florida, Gainesville, Florida.

Objective.: Pain is common among women with gynecologic cancer and contributes to depressed mood, sleep disturbances, and likelihood of future chronic pain. Little is known about how psychosocial factors are associated with central sensitization of pain in gynecologic cancer. Read More

J Bone Miner Res 2018 Dec 26;33(12):2099-2113. Epub 2018 Nov 26.

Departments of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO, USA.

The bone is the third most common site of metastasis for a wide range of solid tumors including lung, breast, prostate, colorectal, thyroid, gynecologic, and melanoma, with 70% of metastatic prostate and breast cancer patients harboring bone metastasis. Unfortunately, once cancer spreads to the bone, it is rarely cured and is associated with a wide range of morbidities including pain, increased risk of fracture, and hypercalcemia. This fact has driven experts in the fields of bone and cancer biology to study the bone, and has revealed that there is a great deal that each can teach the other. Read More

Clin Obstet Gynecol 2019 Mar;62(1):48-58

Department of Obstetrics and Gynecology, Wright-Patterson Medical Center, Wright State University Boonshoft School of Medicine, Dayton, Ohio.

Chronic pelvic pain is a commonly encountered clinical entity, and many women with this chronic pain condition will be treated at some point in time with opioids for management of their pain. Clinicians in women's health are frequently asked and expected to participate in the care of women with chronic pelvic pain, as well as other gynecologic pain conditions, and should be familiar with the role of opioid therapy for these conditions. The goal of this article is to help determine which patients may be appropriate candidates for the initiation or continuation of opioid therapy for gynecologic pain. Read More

Front Pharmacol 2018 8;9:1238. Epub 2018 Nov 8.

State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China.

Colchicine (Col) is considered a kind of highly effective alkaloid for preventing and treating acute gout attacks (flares). However, little is known about the underlying mechanism of Col in pain treatment. We have previously developed a customized virtual target identification method, termed IFPTarget, for small-molecule target identification. Read More

Urol Clin North Am 2019 Feb;46(1):79-85

Glickman Urological and Kidney Institute, Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.

Pelvic organ prolapse is common in parous women, although few report symptoms. The incidence of posterior compartment prolapse, or rectocele, is less well-reported. Posterior vaginal wall prolapse is associated with pain, constipation, and splinting. Read More

Rural Remote Health 2018 11 16;18(4):4630. Epub 2018 Nov 16.

Department of Obstetrics and Gynaecology, Orange Base Hospital, 1530 Forest Road, Orange, NSW 2800, Australia

Introduction: Evidence is lacking on the profile of gynaecological conditions affecting women in the Solomon Islands, including the availability and quality of surgical management.

Methods: Prospective analysis of hospital records was undertaken on all patients who underwent gynaecological surgery at Gizo Hospital, Western Province during a 6-day program led by volunteer Australian surgeons. Patient data on pre-operative history, investigation results, performed surgical procedures and postoperative recovery were collected. Read More