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J Surg Oncol 2021 Jun 12. Epub 2021 Jun 12.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California, USA.

Background And Objectives: Suspicious peritoneal cytology refers to the result of peritoneal cytology testing that is insufficient in either quality or quantity for a definitive diagnosis of malignancy. This study examined characteristics and survival outcomes related to suspicious peritoneal cytology in endometrial cancer.

Methods: A population-based retrospective study by querying the National Cancer Institute's Surveillance, Epidemiology, and End Results Program was conducted. Read More

Fertil Steril 2021 Jun 8. Epub 2021 Jun 8.

Department of Obstetrics and Gynecology, Harbor-University of California-Los Angeles Medical Center and The Lundquist Institute, Torrance, California. Electronic address:

Objective: To determine the expression and functional roles of indoleamine 2,3-dioxygenase 1 (IDO1) and tryptophan 2,3-dioxygenase (TDO2) in leiomyoma.

Design: Experimental study.

Setting: Academic research laboratory. Read More

Int Urogynecol J 2021 Jun 11. Epub 2021 Jun 11.

James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW, UK.

Introduction And Hypothesis: The practice of histopathological assessment of the uterus following hysterectomy for benign indications including pelvic organ prolapse (POP) surgery is common and often routine. While pathology is not anticipated, the finding of pathology requiring further action is always a concern, in particular CIN (cervical intraepithelial neoplasia) or cervical/uterine malignancy. We aimed to perform a systematic review to understand the prevalence of actionable uterine and cervical pathology in hysterectomy specimens performed for POP. Read More

Clin Oncol (R Coll Radiol) 2021 Jun 7. Epub 2021 Jun 7.

Mount Vernon Cancer Centre, Northwood, UK; Division of Cancer Sciences, University of Manchester, Manchester, UK. Electronic address:

About one-fifth of endometrial cancers are 'high risk', which carries a poorer prognosis. Management strategies to optimise their survival have been under investigation for many years. Despite recent advances, their overall survival remains relatively poor. Read More

J Matern Fetal Neonatal Med 2021 Jun 10:1-9. Epub 2021 Jun 10.

Department of Obstetrics and Gynecology, University of California - Irvine, Irvine, CA, USA.

Objective: To assess differences in the perioperative complication rate between patients with placenta accreta spectrum (PAS) with and without complicating factors.

Methods: This retrospective cohort study included subjects who underwent cesarean hysterectomy with histology-proven PAS between 23 0/7 and 42 0/7 weeks gestational age (GA) from 1 July 2008 to 11 April 2017. Perioperative outcomes were compared between those with uncomplicated PAS and "complicated PAS," defined as PAS subjects who experienced ≥2 bleeding episodes, preterm premature rupture of membranes (PPROM), or premature contractions requiring tocolysis. Read More

Am J Obstet Gynecol 2021 Jun 7. Epub 2021 Jun 7.

Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina USA; Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina, USA. Electronic address:

Background: Bilateral oophorectomy before menopause, or surgical menopause, is associated with negative health outcomes, including increased risk of stroke and other cardiovascular outcomes; however, surgical menopause also dramatically reduces ovarian cancer incidence and mortality rates. Because there are competing positive and negative sequelae of surgical menopause, clinical guidelines have not been definitive. Previous research indicates that White women have higher rates of surgical menopause than other groups. Read More

J Pak Med Assoc 2021 Jun;71(6):1686-1688

MBBS 5th Year Student, Aga Khan University Hospital, Karachi, Pakistan.

Pseudomyxoma Peritonei, a massive mucinous peritoneal collection due to a rare epithelial neoplasm, can be effectively treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS-HIPEC). A 43-year-old female, previously treated for mucinous ovarian carcinoma with CRS-HIPEC, and total abdominal hysterectomy and bilateral salpingo-oophorectomy, presented with new-onset abdominal distension and early satiety. She was diagnosed with Pseudomyxoma Peritonei. Read More

J Obstet Gynaecol Res 2021 Jun 9. Epub 2021 Jun 9.

Department of Obstetrics and Gynecology, Hokkaido University Hospital, Sapporo, Japan.

Aim: Cytological cervical cancer screening for pregnant women is routinely performed and still plays an essential role in Japan because of the considerably low rate of human pappillomavirus (HPV) vaccination. Though almost all pregnant women undergo cytological screening at their first trimester, we experienced invasive cervical cancers (ICC) diagnosed during pregnancy or postpartum period. We investigated the characteristics of perinatally diagnosed ICCs to clarify the difficulty in diagnosis during the pregnancy. Read More

J R Stat Soc Ser C Appl Stat 2020 Nov 25;69(5):1189-1208. Epub 2020 Aug 25.

Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104.

Rising medical costs are an emerging challenge in policy decisions and resource allocation planning. When cumulative medical cost is the outcome, right-censoring induces informative missingness due to heterogeneity in cost accumulation rates across subjects. Inverse-weighting approaches have been developed to address the challenge of informative cost trajectories in mean cost estimation, though these approaches generally ignore post-baseline treatment changes. Read More

Am J Case Rep 2021 Jun 10;22:e931614. Epub 2021 Jun 10.

Department of Anesthesiology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.

BACKGROUND Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal dominant disorder of the connective tissue. Over time, patients with FOP experience decreased range of motion in the joints and the formation of a second skeleton, limiting mobility. Patients with FOP are advised to avoid any unwarranted surgery owing to the risk of a heterotopic ossification flare-up. Read More

Int J Clin Oncol 2021 Jun 9. Epub 2021 Jun 9.

Department of Obstetrics and Gynecology, Tokai University, 143, Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.

Objective: The aim of this retrospective analysis is to reveal clinicopathological findings and clinical outcome of patients with stage IB1/IB2 (FIGO 2018) uterine cervical cancer.

Methods: Based on the database of the Japanese Gynecologic Oncology Group, 2194 patients with stage IB1/IB2 (FIGO 2018), who underwent radical hysterectomy between 1/1/2004-12/31/2008, were identified as eligible for this retrospective study.

Results: Patients with squamous cell carcinoma had significantly frequent lympho-vascular space invasion than those with non-squamous cell carcinoma in both stage IB1 and IB2 (stage IB1; 29. Read More

Ginekol Pol 2021 Jun 9. Epub 2021 Jun 9.

Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.

Uterus transplantation is a non-lifesaving vascularized composite allotransplantation procedure requiring immunosuppression until removal of the graft. The focus of uterus transplantation is changing regarding refining individual treatment procedures included in this complex treatment of absolute uterine factor infertility, such as robot-assisted donor hysterectomy. The inferior hypogastric nerve plexus should be preserved during robotic dissection of the ureter and uterine vessels to prevent postoperative complications such as urine and fecal evacuation disturbances and sexual disorders. Read More

Ginekol Pol 2021 Jun 9. Epub 2021 Jun 9.

Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Objectives: To analyze intraoperative and postoperative complications according to Clavian-Dindo Classification (CDC) and evaluate the influence of clinicopathological features on the feasibility and safety of total laparoscopic hysterectomy (TLH) in patients that underwent surgery in a tertiary center.

Material And Methods: We retrospectively reviewed the database of 469 patients that underwent surgery for patients who underwent extra facial TLH from 2013 to 2020.

Results: A total of 86 (18. Read More

Ginekol Pol 2021 Jun 9. Epub 2021 Jun 9.

Department of Radiotherapy, Chair of Oncology, Medical University of Lodz, Poland.

Objectives: Our study evaluates the impact of adjuvant treatment with external beam radiotherapy (EBRT) combined with vaginal high-dose-rate brachytherapy (HDR BT) on health-related quality of life (HRQL) in patients with early-stage endometrioid endometrial carcinoma.

Material And Methods: We assessed HRQL of patients based on the EORTC QLQ-C30 questionnaire, with endometrial cancer specific HRQL module - EORTC QLQ-EN24. From March 2019 to April 2020 we enrolled 20 patients with early-stage endometrioid endometrial carcinoma, qualified for adjuvant treatment after hysterectomy. Read More

Am J Surg Pathol 2021 Jul;45(7):988-996

Department of Pathology, Hospital de la Santa Creu i Sant Pau, Institute of Biomedical Research (IIB Sant Pau), Autonomous University of Barcelona, Barcelona, Spain.

Atypical endometrial hyperplasia (AEH) is considered a precursor of endometrioid carcinoma. The 2020 World Health Organization (WHO) classification divides endometrial hyperplasia into 2 categories: hyperplasia without atypia and atypical hyperplasia/endometrioid intraepithelial neoplasia (EIN); however, this classification does not consider the degree of nuclear atypia. We graded nuclear atypia for estimating the risk of finding carcinoma at hysterectomy. Read More

Int J Med Sci 2021 13;18(12):2697-2704. Epub 2021 May 13.

Department of Gynecology Oncology and Robotic Surgery, Center of Hope, University of Nevada, Reno School of Medicine, Reno, NV, USA.

To identify the pattern of recurrence and assess the clinicopathologic prognostic factors for survival after robotic radical hysterectomy (RRH) in the treatment of stage IB cervical cancer. From December 2008 to March 2018, 64 cervical cancer patients who underwent RRH with pelvic lymph node dissection by a single surgeon were enrolled in this retrospective historical cohort timeline study. The patient's status was estimated in terms of operative outcomes, pathologic results, and survival outcomes. Read More

Clin Epidemiol 2021 1;13:407-416. Epub 2021 Jun 1.

Department of Obstetrics and Gynecology, NIDO | Denmark, Gødstrup Hospital, Herning, Denmark.

Background: Hysterectomy (removal of the uterus) is a common surgical procedure in gynecology. Although minimally invasive surgical procedures have been introduced, hysterectomy is still associated with risk of short- and long-term complications. Given that hysterectomized women are no longer at risk of either hysterectomy or being diagnosed with endometrial or cervical cancer, it is important to describe trends in hysterectomy rates. Read More

J Anaesthesiol Clin Pharmacol 2021 Jan-Mar;37(1):85-89. Epub 2021 Apr 10.

Department of Gynecology and Obstetrics, School of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey.

Background And Aims: Transcutaneous electrical nerve stimulation (TENS) is a noninvasive complementary therapy for postoperative pain management. The effect of TENS on quality of recovery (QoR) and pain treatment in the early postoperative period is not well documented. The aim of this study was to evaluate the effect of TENS on postoperative QoR and pain in patients who had undergone a total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH + BSO). Read More

BMC Womens Health 2021 Jun 8;21(1):238. Epub 2021 Jun 8.

Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine, 377-2 Ohno-higashi, Osaka-sayama, Osaka, 589-8511, Japan.

J Coll Physicians Surg Pak 2021 Jun;30(6):719-721

Department of Gynae Unit 1, Jinnah Hospital, Lahore, Pakistan.

Atypical polypoid adenomyoma (APAM) is a rare polypoidal benign tumor of uterus, which usually presents with irregular vaginal bleeding in women of reproductive age. It has the potential of malignant transformation but does not metastasise. It may coexist with endometrial hyperplasia and adenocarcinoma; and so, is usually misdiagnosed. Read More

J Surg Res 2021 Jun 5;266:421-429. Epub 2021 Jun 5.

Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado. Electronic address:

Introduction: This study aims to characterize longitudinal care management and evaluate the relationship between various patient factors and the likelihood of choosing risk-reducing behaviors in women with increased risk of developing breast cancer.

Methods: A retrospective study was conducted to evaluate all adult female patients who had at least one clinic visit with a surgical provider for discussion of breast cancer risk assessment between January, 2017 to July, 2020 at an academic center. Patients with prior history of breast cancer were excluded. Read More

J Womens Health (Larchmt) 2021 Jun 8. Epub 2021 Jun 8.

Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan, USA.

Quality of life (QOL) and psychological health has been reported to be decreased among women with gynecological conditions such as uterine fibroids (UFs). Women enrolled in the Comparing Options for Management: PAtient-centered REsults for Uterine Fibroids (COMPARE-UF) registry, receiving procedural therapy for symptomatic UFs, were eligible for this analysis if they completed a series of health-related QOL surveys administered at three time points (baseline, 6-12 weeks postprocedure, and 1 year postprocedure;  = 1486). Ethical approval for this study was obtained at each recruiting site and the coordinating center (NCT02260752, clinicaltrials. Read More

J Turk Ger Gynecol Assoc 2021 Jun 8. Epub 2021 Jun 8.

Department of Gynecology Oncology, Hospital Puerta de Hierro, Madrid, Spain.

Objective: The diagnosis of endometrial cancer is made by biopsy sampling with pathological analysis, but it is extremely important to make an accurate diagnosis in order to plan the specific treatment, and we suggest that HE4 in the endometrial tissue and in serum could be tools to make the diagnosis more precise.

Material And Methods: Our prospective study compared patients with endometrial cancer against non-endometrial cancer ones, matched with several variables. The inclusion criteria were females older than 18 years old that accepted to participate in the research study but that had never underwent surgery for other oncological pathologies, whether for ovarian, colon, cervical carcinoma or uterine sarcoma, and none of them had received preoperative chemo or radiotherapy; moreover, they could not have any severe renal or liver pathology. Read More

Best Pract Res Clin Obstet Gynaecol 2021 May 6. Epub 2021 May 6.

Royal Marsden Hospital, London, SW3 6JA, UK; St George's University of London, Cranmer Terrace, Tooting, London SW17 0RE, UK. Electronic address:

Radical vaginal trachelectomy (RVT) is the oldest fertility-sparing procedure for stage 1b cervical cancer. For that reason, there are more published data for RVT than for all the other radical trachelectomy approaches. However, there are no randomised controlled studies between RVT and radical hysterectomy proving the comparability of survival and no randomised controlled studies comparing a vaginal approach with open, standard laparoscopy and robotic approaches. Read More

J Obstet Gynaecol Can 2021 06;43(6):697-698

Department of Obstetrics and Gynecology, CHU de Québec, Université Laval, Québec, QC.

J Obstet Gynaecol Can 2021 06;43(6):697

Prince Rupert, BC.

Am J Obstet Gynecol MFM 2021 Jun 4:100417. Epub 2021 Jun 4.

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.

Objective: This study aimed to review the effect of endometriosis on the prevalence of placenta previa, postpartum hemorrhage, and surgical outcomes in placenta previa patients with endometriosis.

Data Sources: In compliance with the Preferred Reporting Items for Systematic Reviews guidelines, a systematic review of the literature was conducted through December 31, 2020, using PubMed, Scopus, and the Cochrane Library.

Study Eligibility Criteria: Comparative studies between pregnant women with and without endometriosis, as well as studies that investigated the surgical outcomes in placenta previa patients with and without endometriosis, were included. Read More

Aust N Z J Obstet Gynaecol 2021 Jun 7. Epub 2021 Jun 7.

Sydney Women's Endosurgery Centre, St George Private Hospital, Sydney, New South Wales, Australia.

Background: Hysterectomy is the most commonly performed benign gynaecological surgery. Recently, the rates of minimally invasive hysterectomy have fallen due to the banning of mechanical morcellation techniques that rendered minimal invasive gynaecology surgeons unable to extract large uteri from the relatively small colpotomy incisions.

Aims: This study aims to share our experience in utilising Colpo-V incision to remove large uterine specimens transvaginally and report its success and complication rates to promote a minimal invasive approach in patients with large uteri without the need to perform large abdominal incisions or transabdominal morcellation. Read More

Eur J Contracept Reprod Health Care 2021 Jun 7:1-9. Epub 2021 Jun 7.

Department of Gynecology, Institut Mère Enfant Alix de Champagne, University hospital of Reims, Reims, France.

Purpose: To evaluate the different techniques for Essure microinserts removal and to assess the risk of fracture of the device and the intra- and post-operative complications in relation to surgical technique variants.

Methods: Electronic search in Medline, Scopus and Embase databases using the following keywords: Essure; Essure removal; Essure surgical technique.

Results: Out of 95 articles in the initial database, 17 studies were eligible for inclusion in our literature review. Read More

Womens Health (Lond) 2021 Jan-Dec;17:17455065211017068

International Institute for Population Sciences, Mumbai, India.

Objective: Using the unit-level data of women aged 15-49 years from National Family Health Survey-IV (2015-2016), the article maps the prevalence of hysterectomy across districts in India and examines its determinants.

Methods: Descriptive statistics, multivariate techniques, Moran's Index and Local indicators of Spatial Association were used to understand the objectives. The data were analysed in STATA 14. Read More