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J Clin Nurs 2021 May 10. Epub 2021 May 10.

Department of Nursing, Faculty of Health Sciences, Mugla Sıtkı Kocman University, Mugla, Turkey.

Aims And Objectives: This study aimed to analyse the association of preoperative pain beliefs with postoperative pain levels in abdominal surgery patients.

Background: Postoperative pain is related to not only clinical and demographic characteristics but also pain beliefs. The perception, intensity and expression of pain as a subjective experience varies among individuals and cultures. Read More

J Minim Invasive Gynecol 2021 May 4. Epub 2021 May 4.

Department of Obstetrics and Gynecology, Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, United States; Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, United States.

Study Objective: Learning to evaluate and treat chronic pelvic pain (CPP) is an established curriculum objective within the Fellowship in Minimally Invasive Gynecologic Surgery (FMIGS). Our aim was to investigate current educational experiences related to the evaluation and management of CPP and the impacts of those experiences on FMIGS fellows and recent fellowship graduates, including satisfaction, confidence in management, and clinical interest in CPP.

Design: The AAGL-Elevating Gynecologic Surgery Special Interest Group for pelvic pain developed a 33-item survey tool to investigate the following topics: 1) current educational experiences with the assessment and management of patients with CPP, 2) satisfaction with fellowship training in CPP, 3) perceived preparedness to treat patients with CPP, 4) plans to incorporate management of CPP into clinical practice, and 5) perceived desires to expand CPP exposure. Read More

Gynecol Oncol 2021 May 3. Epub 2021 May 3.

Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, United States of America. Electronic address:

Objective: Emerging technologies may enable detection of endometrial cancer with methods that are less invasive than standard biopsy methods. This study compares patient pain scores among 3 office gynecologic tract sampling methods and explores their potential determinants.

Methods: A prospective study including 3 sampling methods (tampon, Tao brush (TB), endometrial biopsy (EB)) was conducted between December 2015 and August 2017 and included women ≥45 years of age presenting with abnormal uterine bleeding, postmenopausal bleeding, or thickened endometrial stripe. Read More

J Am Coll Radiol 2021 May;18(5S):S119-S125

Specialty Chair, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Acute pelvic pain is a common presenting complaint in both the emergency room and outpatient settings. Pelvic pain of gynecologic origin in postmenopausal women occurs less frequently than in premenopausal women; however, it has important differences in etiology. The most common causes of postmenopausal pelvic pain from gynecologic origin are ovarian cysts, uterine fibroids, pelvic inflammatory disease, and ovarian neoplasm. Read More

Obstet Gynecol 2021 May 6. Epub 2021 May 6.

Department of Prevention, the Department of Gynecological Oncology, the Department of Pathology, and the Research and Teaching Institute, Barretos Cancer Hospital, Barretos, São Paulo, Brazil; the Department of Gynecologic Oncology and Reproductive Medicine, the University of Texas MD Anderson Cancer Center, Houston, Texas; the Department of Obstetrics and Gynecology, Federal University of Health Sciences of Porto Alegre/Santa Casa de Misericordia de Porto Alegre, Porto Alegre, Brazil; and the Teaching Superintendence, A.C. Camargo Cancer Center, São Paulo, Brazil.

Objective: To evaluate the histologic response rate of high-grade squamous intraepithelial lesions (HSIL) of the cervix after topical application of 5% imiquimod cream.

Methods: In this phase II trial, women with cervical HSIL (cervical intraepithelial neoplasia [CIN] 2-3) were randomly assigned to 250 mg of 5% imiquimod cream applied to the cervix weekly for 12 weeks, followed by loop electrosurgical excision procedure (LEEP) without preceding treatment. The sample size was calculated based on the HSIL regression rates previously reported by Grimm et al. Read More

Gynecol Oncol Rep 2021 May 31;36:100742. Epub 2021 Mar 31.

Rutgers Cancer Institute of New Jersey, United States.

Immunotherapy, specifically immune checkpoint inhibitors (ICPi), has revolutionized our approach to treating all solid tumors, including gynecologic malignancies. Compared to standard chemotherapy, the adverse events associated with immunotherapies, are often mild and localized, although more severe systemic responses can also occur. While dermatitisdermatitis is a most commonly reported side effect of ICPi therapy, cutaneous toxicities have a range of clinical manifestations and can provide a challenge in an otherwise favorable treatment protocol. Read More

Quant Imaging Med Surg 2021 May;11(5):1751-1762

Department of Gynecologic Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.

Background: We aimed to investigate the efficacy and safety of echo contrast-enhanced ultrasound (CEUS) during high-intensity focused ultrasound (HIFU) ablation therapy for abdominal wall endometriosis (AWE).

Methods: A total of 67 patients with AWE were treated with HIFU ablation, and their demographic characteristics were retrospectively analysed. Blood perfusion of the focal lesion was assessed before the operation, during ablation and after the operation with the use of an ultrasound contrast agent, and the effect of the ultrasound contrast agent on treatment was assessed over a 1-year follow-up period. Read More

Curr Opin Anaesthesiol 2021 Jun;34(3):238-245

Department of Anesthesiology, Division of Women's Anesthesia, Duke University School of Medicine, Durham, North Carolina, USA.

Purpose Of Review: Obesity is a major health epidemic, with the prevalence reaching ∼40% in the United States in recent years. It is associated with increased risk of hypertension, diabetes, heart disease, stroke, obstructive sleep apnea (OSA), and gynecologic conditions requiring surgery. Those comorbidities, in addition to the physiologic changes associated with obesity, lead to increased risk of perioperative complications. Read More

J Minim Invasive Gynecol 2021 Apr 29. Epub 2021 Apr 29.

Division of Minimally Invasive Gynecologic Surgery, Baylor College of Medicine, Houston, TX, USA.

Objective: To demonstrate a novel "in-bag" ovarian cystectomy technique for a large adnexal mass in pregnancy.

Design: Stepwise demonstration with narrated video.

Setting: An academic tertiary care hospital. Read More

J Sex Med 2021 Apr 27. Epub 2021 Apr 27.

School of Rehabilitation, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada; Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada. Electronic address:

Background: Dyspareunia affects most women after treatment for gynecologic malignancies. However, to date, evidence-based interventions remain limited and no study has examined the effects of multimodal physical therapy on psychosexual outcomes in these patients.

Aim: To assess the effects of multimodal physical therapy on psychosexual outcomes including sexual distress, body image concerns, pain anxiety, pain catastrophizing, pain self-efficacy and depressive symptoms in women with dyspareunia after treatment for gynecologic malignancies. Read More

Reprod Sci 2021 Apr 29. Epub 2021 Apr 29.

Department of Gynecology and Obstetrics, Division of Reproductive Sciences & Women's Health Research, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross Research Building, Room 624, Baltimore, MD, 21205, USA.

Uterine fibroids feature excessive deposition of types I and III collagen. Previous ex vivo studies showed an FDA-approved collagenase (EN3835)-digested types I and III collagen fibers in fibroid tissues; however, collagenase had not been evaluated in vivo for effects on uterine fibroids. The objective was to assess the safety and tolerability of collagenase injection directly into uterine fibroids. Read More

Local Reg Anesth 2021 19;14:57-65. Epub 2021 Apr 19.

Department of Anesthesiology and Perioperative Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA.

The quadratus lumborum block is a novel truncal block where local anaesthetic is injected adjacent to the quadratus lumborum muscle. It is used for caesarean sections, hip arthroplasty, gynecologic surgery, colectomy, and recently nephrectomy. To date, there are no reviews that outline the efficacy and performance of the quadratus lumborum blocks in patients receiving laparoscopic nephrectomy. Read More

BMC Womens Health 2021 Apr 27;21(1):181. Epub 2021 Apr 27.

Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Background: Due to the scarcity of adequately powered, randomized controlled trials and internationally standardized diagnostic criteria, evidence on the diagnosis and treatment of pelvic congestion syndrome (PCS) is limited. Earlier epidemiologic observations led to the attribution of PCS to the premenopausal state, and a remission of symptoms after menopause is frequently described a hallmark of the pathology. This concept has currently been challenged by radiological studies reporting a notable prevalence of ovarian venous congestion in adult female patients of advanced age. Read More

Minerva Obstet Gynecol 2021 Apr 27. Epub 2021 Apr 27.

Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza, University of Rome, Rome, Italy -

Introduction: Endometriosis affects 10%-15% of women in reproductive age and may cause no-cyclic chronic pelvic pain, dysmenorrhea, dyspareunia, urinary tract symptoms, and it is frequently associated with infertility. The peak of incidence is between 24 and 29 years old and the clinical diagnosis of endometriosis is generally delayed by 6-7 years. Laparoscopy with surgical biopsies is the "gold standard" for the diagnosis of endometriosis, with histological verification of endometrial ectopic glands and/or stroma. Read More

Am J Case Rep 2021 Apr 26;22:e931051. Epub 2021 Apr 26.

Department of Obstetrics and Gynecology, Dr. Soetomo General Academic Hospital, Medical Faculty, Universitas Airlangga, Surabaya, Indonesia.

BACKGROUND No standard guidelines have been specified for a cesarean myomectomy, and several centers remain divided on the justification to perform this procedure, especially for large fibroids. Only a few case reports have been published of cesarean myomectomy for large fibroids. Here, we report 2 cases of successful cesarean myomectomies for large fibroids (>15 cm) during the 38th week of pregnancy. Read More

J Obstet Gynaecol Res 2021 Apr 25. Epub 2021 Apr 25.

Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, South Korea.

Purpose: To investigate whether the use of an activity tracker with feedback increases physical activity and is safe in patients who underwent a midline laparotomy for gynecologic disorders.

Methods: Patients who were planned to undergo a midline laparotomy for gynecologic diseases wore an activity tracker at baseline and from postoperative days 1-6. Patients in the experimental arm could monitor their step counts and were encouraged to achieve the individualized step-count goal daily. Read More

World J Clin Cases 2021 Apr;9(11):2533-2541

Department of Radiation Oncology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China.

Background: Primary ovarian mucinous carcinoma is a rare histologic subtype of epithelial ovarian carcinoma and exhibits considerable morphologic overlap with secondary tumour. It is hard to differentiate primary from metastatic ovarian mucinous carcinoma by morphological and immunohistochemical features. Because of the histologic similarity between primary ovarian mucinous carcinoma and metastatic gastrointestinal carcinoma, it has been hypothesized that ovarian mucinous carcinomas might respond better to non-gynecologic regimens. Read More

Brachytherapy 2021 Apr 15. Epub 2021 Apr 15.

Department of Anesthesiology, Institution of Medicine, University of Tsukuba, Tsukuba, Japan.

PURPOSE Interstitial brachytherapy for gynecologic malignancies is stressful physically and mentally; however, optimal analgesic methods remain unclear. We investigated the effect of analgesic methods on pain and adverse events during interstitial brachytherapy for gynecologic malignancies. METHODS The data of 73 patients who underwent interstitial brachytherapy for gynecologic malignancies between April 2015 and March 2020 were retrospectively analyzed. Read More

Am J Case Rep 2021 Apr 16;22:e930659. Epub 2021 Apr 16.

Department of Minimally Invasive Surgery, The Marchand Institute for Minimally Invasive Surgery, Mesa, AZ, USA.

BACKGROUND Advances in minimally invasive surgery are essential for the improvement of patient care, overall health care efficiency, and total cost reductions. Morcellation, the technique used in the present case, is often used to aid minimally invasive laparoscopic procedures, whereby larger tissue specimens are broken down and divided to be removed via smaller incisions. Morcellation has become controversial in the medical community owing to the risk of the procedure spreading an occult malignancy. Read More

Ann Palliat Med 2021 Mar;10(3):3194-3204

Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

Background: Acupuncture therapy has a wide range of applications in obstetrics and gynecology, especially for patients with reproductive issues, irregular menstruation, dysmenorrhea, and pelvic inflammatory disease. In recent decades, acupuncture therapy has gradually attracted the attention of professionals in China and overseas due to its beneficial effects, and has been the focus of many studies. This study aimed to conduct a statistical analysis of the relevant literature to understand the current application and research status of acupuncture in obstetric and gynecologic diseases. Read More

Fertil Steril 2021 Apr 8. Epub 2021 Apr 8.

Department of Obstetrics and Gynecology, Kurashiki Medical Center, Okayama, Japan.

Objective: To describe the anatomic and technical highlights of a novel nerve-sparing surgery in deep endometriosis (DE) using near-infrared (NIR) fluorescence technology and indocyanine green (ICG).

Design: Stepwise demonstration of this method with narrated video footage.

Setting: An urban general hospital. Read More

Obstet Gynecol 2021 05;137(5):810-819

Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics, Gynecology, and Women's Health, University of Louisville School of Medicine, the University of Louisville School of Medicine, and the Department of Bioinformatics and Biostatistics, University of Louisville School of Public Health and Information Sciences, Louisville, Kentucky.

Objective: To evaluate the utility of adding triamcinolone acetonide to a standard bladder instillation solution for treatment of interstitial cystitis-bladder pain syndrome.

Methods: This was a single-center, randomized, double-blind trial that compared symptom response in women with interstitial cystitis-bladder pain syndrome who underwent six bladder instillations with triamcinolone acetonide or six instillations without. All instillation solutions contained heparin, viscous lidocaine, sodium bicarbonate, and bupivacaine. Read More

Mymensingh Med J 2021 Apr;30(2):402-409

Dr Towhida Nazneen, Junior Consultant, Department of Obs & Gynae, General Hospital Munshigong, Dhaka, Bangladesh; Email: towhida

Ovarian cancer (OC) is the seventh most common cancer among women in the world. Epithelial OC is the most predominant pathological subtype, with five major histotype. All five subtypes that differ in origination, pathogenesis, molecular alterations, risk factors and prognosis. Read More

Congenit Anom (Kyoto) 2021 Apr 8. Epub 2021 Apr 8.

Gynecologic Department, West China Second Hospital of Sichuan University, Chengdu, Sichuan, China.

Congenital vaginal atresia is a rare congenital reproductive tract abnormality. To assess the clinical manifestations and feasibility of preserving uterus for congenital complete vaginal atresia with cervical aplasia, nineteen cases who underwent surgical treatment in West China Second Hospital of Sichuan University were retrospectively studied. The cervical status, clinical manifestations, the rate of vaginal re-stenosis and pelvic inflammation after surgery were assessed. Read More

Arthroscopy 2021 04;37(4):1179-1181

As one of the many causes of groin pain, iliopsoas tendinitis can be hard to identify and even harder to treat. It occurs in the setting of both the native hip joint and following total hip arthroplasty. Internal snapping, or coxa saltans, can result from the iliopsoas snapping over the anterior hip capsule or iliopectineal eminence and can be a source of labral pathology. Read More

J Clin Med 2021 Mar 3;10(5). Epub 2021 Mar 3.

Department of Anesthesiology and Pain Medicine, Chungnam National University Hospital, Daejeon 35015, Korea.

Opioid-sparing effects of nefopam during patient-controlled analgesia (PCA) are well demonstrated. We hypothesized that postoperative pain control with an opioid-equivalent dose of nefopam as a single analgesic agent for PCA would not be inferior to fentanyl in laparoscopic gynecologic surgery. In total, 135 patients were randomly assigned to the N (nefopam 200 mg), NF (fentanyl 500 mcg + nefopam 100 mg), and F (fentanyl 1000 mcg) groups ( = 45 patients per group). Read More

GE Port J Gastroenterol 2021 Feb 11;28(2):134-138. Epub 2020 Jun 11.

Gastroenterology Department, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.

The liver is usually affected in advanced stages of lympho-proliferative diseases, but primary liver lymphomas (PLLs) are rare. The diagnosis is usually late, especially in patients without identifiable risk factors, with consequent worse prognosis. We report the case of a 59-year-old female with progressive worsening pain in the right hypochondrium and weight loss. Read More

J Midwifery Womens Health 2021 03 31;66(2):148-160. Epub 2021 Mar 31.

Baystate Midwifery Education Program, Baystate Medical Center, Springfield, Massachusetts.

Myofascial pelvic pain is a common, nonarticular musculoskeletal disorder characterized by the presence of myofascial trigger points in the lower abdominal wall and/or pelvic floor muscles. Myofascial pelvic pain is involved in an estimated 22% to 94% of cases of chronic pelvic pain, which is one of the most common gynecologic conditions in the United States. Myofascial pelvic pain may exist independently or in conjunction with disorders such as vaginismus, dysmenorrhea, and endometriosis and is frequently a causative factor in sexual pain or dyspareunia. Read More

J Minim Invasive Gynecol 2021 Mar 26. Epub 2021 Mar 26.

Department of Gynecologic Oncology (Drs. Di Donna, Cucinella, Sozzi, and Chiantera); Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.)(Dr. Di Donna), University of Palermo, Palermo; Division of Gynecological Oncology, Department for the Protection of Women's and Children's Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS L.go A. Gemelli, Rome (Drs. Ianieri and Scambia), Italy.

Objective: Surgical demonstration of combined sacral plexus neurolysis and laparoscopic laterally extended endopelvic resection for deep lateral infiltrating endometriosis.

Design: Video showing principles of neurolysis and laparoscopic laterally extended endopelvic resection applied to endometriotic surgery.

Setting: University tertiary referral center. Read More

Asian Pac J Cancer Prev 2021 Mar 1;22(3):705-709. Epub 2021 Mar 1.

Departments of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, People's Republic of China.

Background: Peripheral neurotoxicity is common in patients with digestive malignancies receiving chemotherapy containing oxaliplatin, and there is still no effective drug to prevent or treat this complication.

Methods: Seventy-nine patients receiving chemotherapy containing oxaliplatin were included, and the relationship between chemotherapy regimens, cycles, and cumulative dose of oxaliplatin and peripheral neurotoxicity was analyzed. Patients were divided into two groups of control or intervention. Read More