44,523 results match your criteria Hysterectomy


Extent of Lymphadenectomy and Postoperative Major Complications Among Women with Endometrial Cancer Treated with Minimally Invasive Surgery.

Am J Obstet Gynecol 2018 Dec 3. Epub 2018 Dec 3.

Northwestern University, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chicago, IL, USA; Robert H Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Center for Healthcare Studies, Institute for Public Health in Medicine, Chicago, IL.

Background: In patients with endometrial cancer sentinel lymphadenectomy is used to accurately prognosticate extent of disease and has been proposed as a method to decrease the incidence of medical and surgical complications associated with more extensive lymphadenectomy. It is unknown if patients who undergo traditional lymphadenectomy experience major postoperative complications at the same rates as those who undergo sentinel lymphadenectomy or those who do not undergo lymphadenectomy.

Objective: To compare the incidence of major postoperative complications among endometrial cancer patients undergoing total laparoscopic hysterectomy with traditional lymphadenectomy versus sentinel or no lymphadenectomy. Read More

View Article
December 2018
2 Reads

Pre-emptive and preventive opioids for postoperative pain in adults undergoing all types of surgery.

Cochrane Database Syst Rev 2018 Dec 3;12:CD012624. Epub 2018 Dec 3.

Department of Surgery and Anaesthesia, Division of Medical Sciences and Graduate Entry Medicine, School of Medicine, University of Nottingham, Uttoxeter New Road, Derby, UK, DE22 3DT.

Background: Postoperative pain is a common consequence of surgery and can have deleterious effects. It has been suggested that the administration of opioid analgesia before a painful stimulus may improve pain control. This can be done in two ways. Read More

View Article
December 2018
2 Reads

Oral and intrauterine progestogens for atypical endometrial hyperplasia.

Cochrane Database Syst Rev 2018 Dec 4;12:CD009458. Epub 2018 Dec 4.

Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, No. 20, Section Three, Ren Min Nan Lu Avenue, Chengdu, Sichuan, China, 610041.

Background: Endometrial carcinoma is the most common gynaecologic malignancy in the world and develops through preliminary stages of endometrial hyperplasia. Atypical endometrial hyperplasia suggests a significant pre-malignant state with frank progression to endometrial carcinoma, and tends to occur at a young age. Oral progestins have been used as conservative treatment in young women with atypical endometrial hyperplasia, but they are associated with poor tolerability and side effects that may limit their overall efficacy. Read More

View Article
December 2018
3 Reads

Robotic surgery in the management of complex pelvic endometriosis.

Int Braz J Urol 2018 Oct 20;44. Epub 2018 Oct 20.

Department of Urology, Hospital Universitario Marqués de Valdecilla, Santander, Spain.

Introduction: Endometriosis consists in the proliferation of endometrial tissue outside of the uterine cavity, predominantly in the ovaries but also in the urinary bladder or bowel. About 10% of fertile women are affected and the main symptoms are pain, menstrual disorders and infertility. Surgery is the treatment option for those symptomatic patients in which medical treatment had no success. Read More

View Article
October 2018
2 Reads

Investigation of the contribution of an underlying platelet defect in women with unexplained heavy menstrual bleeding.

Platelets 2018 Dec 6:1-9. Epub 2018 Dec 6.

b Institute of Cardiovascular Sciences, College of Medical and Dental Sciences , University of Birmingham , Birmingham , UK.

Heavy menstrual bleeding (HMB) is often undiagnosed in women and can cause discomfort and distress. A haemostatic cause for excessive bleeding is often not routinely investigated and can lead to hysterectomy at an early age. A prospective cohort study was carried out to determine whether certain patients with unexplained HMB have an underlying platelet function defect (PFD). Read More

View Article
December 2018
1 Read

Ischemic optic neuropathy in robotic-assisted gynaecologic surgery: A case report.

J Obstet Gynaecol Res 2018 Dec 6. Epub 2018 Dec 6.

Ceyhan State Hospital Ophthalmology Department, Adana, Turkey.

The study was aimed to present a rare case of who developed non arteritic anterior ischemic optic neuropathy (NAION) following robotic-assisted gynaecologic surgery. A 58-year-old female patient presented with vision loss in right eye after non-complicated robotic-assisted total hysterectomy and bilateral salpingo-oopherectomy. We observed on fundoscopy optic disc edema and splinter hemorrhages at the optic disc edges. Read More

View Article
December 2018
3 Reads

The incidence and predictors of gynecologic malignancies among postmenopausal patients with endometrial fluid collection.

Authors:
Zhe Li Lei Li

Arch Gynecol Obstet 2018 Dec 5. Epub 2018 Dec 5.

Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Shuaifuyuan No 1, Dongcheng District, Beijing, China.

Objective: To investigate the incidence and predictors of gynecologic malignancies among postmenopausal patients with endometrial fluid collection (EFC).

Methods: All patients with EFC diagnosed by transvaginal sonography (TVS) were retrospectively reviewed if they had undergone biopsy of the endometrium from January 2008 to January 2016 in a tertiary teaching hospital. Follow-up ended in June 2017. Read More

View Article
December 2018

Laterally-positioned placenta in placenta previa.

J Matern Fetal Neonatal Med 2018 Dec 5:1-161. Epub 2018 Dec 5.

a Department of Obstetrics and Gynecology , Jichi Medical University , Shimotsuke , Tochigi , Japan.

Objectives: To clarify perinatal outcomes of patients with placenta previa (PP) with the placenta mainly positioned in the lateral uterine wall (lateral PP), thereby clinically characterizing this condition.

Study Design: The retrospective cohort study was performed involving patients with lateral PP between January 2006 and December 2016. The placental position was determined and classified by magnetic resonance imaging. Read More

View Article
December 2018
1 Read

Using the Probability of Cesarean from a Validated Cesarean Prediction Calculator to Predict Labor Length and Morbidity.

Am J Perinatol 2018 Dec 3. Epub 2018 Dec 3.

Maternal and Child Health Research Center, Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Objective:  To determine if increasing predicted risk of cesarean was associated with longer labor length and increased morbidity among women undergoing induction with an unfavorable cervix.

Study Design:  Using a publically available database, we evaluated whether a previously validated prediction model for cesarean delivery after induction was associated with labor length, maternal morbidity (third-/fourth-degree lacerations, endometritis, blood transfusion, wound infection, venous thromboembolism, hysterectomy, intensive care unit admission, and death), and neonatal morbidity (blood transfusion, encephalopathy, intraventricular hemorrhage, severe respiratory distress syndrome, necrotizing enterocolitis, and sepsis). Full-term (≥37 weeks) singleton gestations with intact membranes and an unfavorable cervix (Bishop score ≤6 and dilation ≤2 cm) undergoing induction of labor were included. Read More

View Article
December 2018

Type of pelvic disease as a risk factor for surgical site infection in women undergoing hysterectomy.

J Minim Invasive Gynecol 2018 Nov 30. Epub 2018 Nov 30.

The Ottawa Hospital Research Institute, 725 Parkdale Avenue, Ottawa ON, K1Y 4E9.

Study Objective: To quantify the relationship between type of benign pelvic disease and risk of surgical site infection (SSI) after hysterectomy DESIGN: Retrospective Cohort (Classification II-2) SETTING: Hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) PATIENT(S): Women who underwent hysterectomy from 2006-2015 and recorded in NSQIP database INTERVENTION: None MEASUREMENTS AND MAIN RESULTS: SSI risk was compared for type of benign pelvic diseases, patient characteristics (age, race and selected comorbidities) and process of care variables (admission status, type of hysterectomy, and operative time). Among a total of 125,337 women who underwent hysterectomy, 2.48% developed SSI. Read More

View Article
November 2018

Dose-dense paclitaxel/carboplatin as neo-adjuvant chemotherapy followed by radical surgery in locally advanced cervical cancer: a prospective phase II study.

Cancer Chemother Pharmacol 2018 Dec 1. Epub 2018 Dec 1.

Gynecologic Oncology Unit, Department of Women and Children Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Purpose: The role of dose-dense schedules in the neo-adjuvant treatment (NACT) of locally advanced cervical cancer (LACC) has been reported. This phase II study investigated activity of dose-dense paclitaxel/platinum before radical surgery (RS) in LACC patients.

Methods: The primary end-point was the rate of optimal pathological response (OPR: pathological complete/microscopic response). Read More

View Article
December 2018

Hypoxia-Inducible Factor 1-α (HIF-1α) Induces Apoptosis of Human Uterosacral Ligament Fibroblasts Through the Death Receptor and Mitochondrial Pathways.

Med Sci Monit 2018 Dec 3;24:8722-8733. Epub 2018 Dec 3.

Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China (mainland).

BACKGROUND Hypoxia induces cell apoptosis in the uterosacral ligaments of patients with pelvic organ prolapse by upregulation of hypoxia-inducible factor-1α (HIF-1α). This study aimed to investigate the effects of HIF-1α on human uterosacral ligament fibroblasts (hUSLFs) following treatment with the chemical inducer of hypoxia, cobalt chloride (CoCl2), and to explore the underlying mechanisms. MATERIAL AND METHODS Ten women who underwent hysterectomy for benign disease provided uterosacral ligament tissue for cell extraction. Read More

View Article
December 2018
1 Read

Measuring Quality in Minimally Invasive Gynecologic Surgery: What, How, and Why?

J Minim Invasive Gynecol 2018 Nov 29. Epub 2018 Nov 29.

Kaiser Permanente Northern California, Oakland Medical Center. Electronic address:

In healthcare, the goal of maximizing value by improving the quality of care and lowering costs has been notoriously challenging to implement. The fee-for-service model in gynecology and other fields has historically promoted the reduction of non-surgical or minimally invasive approaches in favor of complex, often morbid procedures. In this paper, we seek to define quality and value in the healthcare field and describe strategies that promote quality over production. Read More

View Article
November 2018

Smooth Muscle Cells in Pelvic Washings At Time of Benign Hysterectomy.

J Minim Invasive Gynecol 2018 Nov 28. Epub 2018 Nov 28.

Department of Gynecologic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.

Study Objective: To evaluate if smooth muscle cells can be detected in pelvic washings at the time of intact hysterectomy.

Design: A multi-centered pilot cohort study (Canadian Task Force Classification of Study Design Class II-2).

Setting: Two academically affiliated tertiary referral centers. Read More

View Article
November 2018

Malignant Lymphoma of the Ovary: A Diagnostic Pitfall of Intraoperative Consultation.

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

Departments of Obstetrics and Gynecology (N.I., Y.F., T.S., A.K., T.O., F.K.) Pathology (Y. Ikura, Y. Iwai) Hematology (M.O.), Takatsuki General Hospital, Takatsuki, Japan.

Primary ovarian lymphomas are rare, but can potentially evoke diagnostic problems. We present a case of ovarian lymphoma, in which an ambiguous intraoperative pathologic report led to overtreatment (unnecessary surgery). A 73-yr-old woman with fatigue and low-grade fever was diagnosed as having a left ovarian tumor by imaging modalities. Read More

View Article
December 2018
1 Read

Primary Angiosarcoma of the Cervix: Case Report of a Rare Lesion.

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

Department of Pathology, Royal Gwent Hospital, Newport (V.I.S., I.W.T.) Department of Pathology, University Hospital of Wales, Cardiff (G.L.R.) Department of Musculoskeletal Pathology, Royal Orthopaedic Hospital, Birmingham (V.P.S.) Department of Pathology, Belfast Health and Social Care Trust, Belfast (W.G.M.), UK.

Angiosarcomas of the female genital tract are rare and primary angiosarcoma of the cervix is extremely rare with only one prior case report. We report a case of a primary cervical angiosarcoma in a 43-yr-old woman who presented with heavy vaginal bleeding. Cervical biopsy and subsequent radical hysterectomy showed a malignant vascular tumor which was composed of spindled and epithelioid cells and formed abortive vascular channels. Read More

View Article
December 2018

Performance Characteristics of Endometrial Sampling in Diagnosis of Endometrial Carcinoma.

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

Department of Pathology and Laboratory Medicine, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia (C.T., H.B., P.B.C., C.B.G.) Department of Laboratory Medicine and Pathobiology, University of Toronto (A.P.) Department of Laboratory Medicine Trillium Health Partners (A.P.) Department of Pathology, Health Sciences Center and University of Manitoba, Winnipeg, Manitoba (N.A.), Canada.

Outpatient endometrial biopsy can give false-negative results, with a 0.9% reported posttest probability for endometrial carcinoma (EC) after a negative result. Our objective was to determine if there has been any improvement in the performance characteristics of endometrial biopsy over the last 15 yr. Read More

View Article
December 2018
2 Reads

Cefazolin as surgical antimicrobial prophylaxis in hysterectomy: A systematic review and meta-analysis of randomized controlled trials.

Infect Control Hosp Epidemiol 2018 Dec 5:1-8. Epub 2018 Dec 5.

1Division of Infectious Disease,Department of Medicine,University of Wisconsin School of Medicine and Public Health,Madison,Wisconsin.

Objective: Current practice guidelines recommend cefazolin, cefoxitin, cefotetan, or ampicillin-sulbactam as first-line antibiotic prophylaxis in hysterectomy. We undertook this systematic review and meta-analysis of randomized controlled trials (RCTs) to determine whether cefazolin, with limited antianaerobic spectrum, is as effective in preventing surgical site-infection (SSI) as the other first-choice antimicrobials that have more extensive antianaerobic activity.

Methods: We searched PubMed, Scopus, Web of Science, Cochrane Central, and EMBASE for relevant randomized controlled trials (RCT) in any language up to January 23, 2018. Read More

View Article
December 2018

Prolonged operative time of repeat cesarean is a risk marker for post-operative maternal complications.

BMC Pregnancy Childbirth 2018 Dec 4;18(1):477. Epub 2018 Dec 4.

Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel.

Background: Repeat cesarean delivery (CD) accounts for approximately 15% of all annual deliveries in the US with an estimated 656,250 operations per year. We aimed to study whether prolonged operative time (OT; skin incision to closure) is a risk marker for post-operative maternal complications among women undergoing repeat CD.

Methods: We conducted a cross-sectional retrospective study in a single tertiary center including all women who underwent repeat CD but excluding those with cesarean hysterectomy. Read More

View Article
December 2018

Menopausal hormone therapy and the incidence of carpal tunnel syndrome in postmenopausal women: Findings from the Women's Health Initiative.

PLoS One 2018 4;13(12):e0207509. Epub 2018 Dec 4.

Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America.

Importance: Carpal tunnel syndrome (CTS) is a common and debilitating condition that commonly affects postmenopausal women.

Objective: To determine the effect of menopausal hormone therapy (HT) in healthy postmenopausal women on CTS risk.

Design: We conducted a secondary analysis of the Women's Health Initiative's (WHI) HT trials linked to Medicare claims data. Read More

View Article
December 2018
1 Read

[Key anatomies of DeLancey's three levels of vaginal support theory: an observation in laparoscopic surgery].

Zhejiang Da Xue Xue Bao Yi Xue Ban 2018 Feb;47(4):329-337

Center for Uterine Cancer Diagnosis & Therapy Research of Zhejiang Province, Department of Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China.

Objective: To observe and verify the key anatomies of DeLancey's three levels of vaginal support theory through laparoscopic surgery by space dissection technique.

Methods: The features and stress performance of related anatomies were observed and analyzed in laparoscopic type C hysterectomy and pelvic lymphadenectomy for cervical cancer by natural space exposures.

Results: The main ligament-like structure at level Ⅰ was the uterosacral ligament, which acted as the main apical fixation in the sacral direction, while the cardinal ligament was mainly composed of vascular system, lymph-vessels and loose connective tissue around them, lacking the tough connective tissue structures, which was connected to the internal iliac vascular system. Read More

View Article
February 2018

Case of uterine rupture after multiple intrauterine operations and uterine artery embolization.

J Obstet Gynaecol Res 2018 Dec 3. Epub 2018 Dec 3.

Department of Obstetrics and Gynecology, Aso Iizuka Hospital, Iizuka, Fukuoka, Japan.

Uterine rupture is rare but may result in both maternal and fetal death. The factors involved in such deaths depend on each case, but uterine artery embolization (UAE), the common treatment for hemorrhage, is possibly one factor. UAE may be related to uterine rupture or placenta accreta, but few data exist regarding UAE and uterine rupture. Read More

View Article
December 2018

Simulation and Training of Gynaecological Skills.

Facts Views Vis Obgyn 2018 Mar;10(1):21-27

European Academy of Gynaecological Surgery, 3000 Leuven, Belgium.

In order to offer our patients, the "state of the art" treatment in gynaecology, we need a structured teaching program for trainees concerning the gynaecological skills. In recent years, training and education in endoscopic surgery has been critically reviewed. Clinicians, both surgeons as gynaecologists who perform endoscopic surgery without proper training of the specific psychomotor skills, are at higher risk to increased patient morbidity and mortality. Read More

View Article
March 2018
3 Reads

Vaginal cuff length during radical hysterectomy is a prognostic factor for stage IB-IIA cervical cancer: a retrospective study.

Cancer Manag Res 2018 19;10:5927-5935. Epub 2018 Nov 19.

Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Wuhan 430071, Hubei, People's Republic of China,

Purpose: The aim of this study was to investigate the impact of vaginal cuff length (VCL) resected during radical hysterectomy (RH) on the long-term survival outcomes of patients with cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] stage IB-IIA) and to explore whether VCL is a prognostic factor for cervical cancer.

Methods: A total of 435 eligible patients with stage IB and IIA cervical cancer who underwent RH in Zhongnan Hospital of Wuhan University (Wuhan, People's Republic of China) from January 2007 to February 2017 were retrospectively analyzed. These patients were divided into two groups (VCL ≤2. Read More

View Article
November 2018

Massive hemorrhage protocol activation in obstetrics: a 5-year quality performance review.

Int J Obstet Anesth 2018 Nov 3. Epub 2018 Nov 3.

Department of Transfusion Medicine.

Background: A structured approach to hemorrhagic emergencies in obstetrics has gained popularity with the implementation of massive hemorrhage protocols. The trauma literature suggests that routine quality reviews should be in place to improve patient outcomes. The aim of this study was to develop quality indicators and assess compliance by the clinical team. Read More

View Article
November 2018

Management of placental site trophoblastic tumor: Two case reports.

Medicine (Baltimore) 2018 Nov;97(48):e13439

Interdisciplinary Department of Medicine, Gynecology and Obstetrics Clinic, University of Bari.

Rationale: Placental site trophoblastic tumor (PSTT) is a very rare malignant tumor, belonging to a family of pregnancy-related illnesses, called gestational trophoblastic diseases (GTD). Less than 300 cases of PSTT have been reported in literature, with an incidence of ≈ 1/50,000-100,000 pregnancies representing only 0.23% to 3. Read More

View Article
November 2018
2 Reads

Intralesional and subcutaneous application of Viscum album L. (European mistletoe) extract in cervical carcinoma in situ: A CARE compliant case report.

Medicine (Baltimore) 2018 Nov;97(48):e13420

Institute for Applied Epistemology and Medical Methodology at the University of Witten/Herdecke.

Rationale: Carcinoma in situ (CIS) of the uterine cervix is a premalignant condition of squamous epithelium. The standard treatments are excision and ablation procedures; for women with positive margins, hysterectomy is recommended.

Patient Concerns: A 47-year-old Peruvian woman with recurrent candidal vaginitis had been diagnosed with colpocervicitis and squamous metaplasia 8 years ago, which were not treated. Read More

View Article
November 2018

Primary squamous cell carcinoma of the endometrium in a woman of perimenopausal age: A case report.

Medicine (Baltimore) 2018 Nov;97(48):e13418

Department of Gynecology.

Rationale: Primary squamous cell carcinoma of the endometrium (PSCCE) is a rare entity, and only sporadic cases have been reported in the literature since the 1st report in 1892. This report describes a case of a perimenopausal woman with PSCCE.

Patient Concerns: A 47-year-old, human papilloma virus type 16-positive, perimenopausal woman was admitted to our hospital with irregular vaginal bleeding for 6 months and secondary anemia. Read More

View Article
November 2018

Transverse testicular ectopia associated with persistent Müllerian duct syndrome treated by transseptal orchiopexy: A case report.

Medicine (Baltimore) 2018 Nov;97(48):e13305

Departments of Urology.

Rationale: Persistent Müllerian duct syndrome (PMDS) is rare form of male pseudohermaphroditism characterized by the presence of uterus and fallopian tubes with normal external genitalia and secondary sexual characteristics. Transverse testicular ectopia (TTE) is also a rare form of testicular ectopia that may be associated with PMDS.

Patient Concerns: We present a 2-year-old boy who presented with bilateral non-palpable testes with left inguinal mass. Read More

View Article
November 2018
1 Read

Placenta Accreta: A Spectrum of Predictable Risk, Diagnosis, and Morbidity.

Am J Perinatol 2018 Nov 30. Epub 2018 Nov 30.

Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.

Objective:  Placenta accreta is a feared pathology, in part, because prenatal diagnosis is imperfect. It is not known whether clinical risk factors or sonographic features equally predict the entire graded pathological spectrum of placental overinvasion disease nor whether clinical outcomes differ along the spectrum.

Study Design:  We conducted a mixed methods retrospective study of a cohort of women screened sonographically for placenta accreta, cross-referenced against cases identified by pathological diagnosis ( = 416). Read More

View Article
November 2018
1 Read

Population Level Analysis of Adhesive Small Bowel Obstruction: Sustained Advantage of a Laparoscopic Approach.

Ann Surg 2018 Nov 29. Epub 2018 Nov 29.

Department of Surgery, Massachusetts General Hospital, Boston, MA.

Objective: The objective of this study was to determine the effects of open versus laparoscopic surgery on the development of adhesive small bowel obstruction (aSBO).

Summary Background Data: aSBO is a significant contributor to short and long-term postoperative morbidity. Laparoscopy has demonstrated a protective effect in colorectal surgery, but these effects have not been generalized to other abdominal procedures. Read More

View Article
November 2018

Robot-Assisted Surgery for Benign Distal Ureteral Strictures: Step-by-Step Technique Using the SP Surgical System.

BJU Int 2018 Nov 30. Epub 2018 Nov 30.

Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.

Objectives: To describe the step-by-step techniques for robotic ureteral reimplantation performed by using the Vinci SP surgical system (Intuitive Surgical, Sunnyvale, CA). Different case-scenarios were included with an educational purpose.

Materials And Methods: Three consecutive patients diagnosed with distal benign ureteral strictures were counseled for ureteral reimplantation and accepted to undergo surgery performed by using the da Vinci SP surgical system. Read More

View Article
November 2018
8 Reads

Comparing perioperative vaginal misoprostol to intraoperative pericervical hemostatic tourniquet in reducing blood loss during abdominal myomectomy: a randomized controlled trial

J Turk Ger Gynecol Assoc 2018 Nov 30. Epub 2018 Nov 30.

Department of Obstetrics and Gynecology, University of Ilorin Teaching Hospital, Ilorin, Nigeria

Objective: To compare the effectiveness of perioperative vaginal misoprostol to intraoperative pericervical hemostatic tourniquet in reducing blood loss during abdominal myomectomy.

Material And Methods: A randomized controlled trial involving women with uterine leiomyoma who underwent abdominal myomectomy at a tertiary facility in Nigeria. Participants were recruited after informed consent and randomized into Group I (single dose 400 µg vaginal misoprostol one-hour before surgery) and Group II (intraoperative pericervical hemostatic tourniquet). Read More

View Article
November 2018

Incidence and groups at risk for unexpected uterine leiomyosarcoma: a Dutch nationwide cohort study.

Arch Gynecol Obstet 2018 Nov 30. Epub 2018 Nov 30.

Department of Gynecology, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.

Objective: To estimate the risk of uterine leiomyosarcoma in patients undergoing gynecological surgery and also to identify groups at risk for unrecognized uterine leiomyosarcoma.

Methods: A national cohort study was performed evaluating all uterine leiomyosarcoma (ULMS) diagnosed in The Netherlands between January 2000 and September 2015. Cases were identified and supplied by the nationwide network and registry of histo- and cytopathology in The Netherlands (PALGA). Read More

View Article
November 2018

Interventions to reduce morbidity from vault hematoma following vaginal hysterectomy: a systematic review and meta-analysis.

Int Urogynecol J 2018 Nov 29. Epub 2018 Nov 29.

Department of Urogynaecology, University Hospitals Plymouth NHS Trust, Plymouth, UK.

Introduction And Hypothesis: A frequent complication following vaginal hysterectomy is the formation of vaginal vault hematoma. The objective of our systematic review was to assess the impact of various interventions in reducing the incidence of vault hematoma or postoperative febrile morbidity following vaginal hysterectomy.

Methods: We carried out a systematic search of Cochrane, MEDLINE, Embase, CINAHL, HTA database, PROSPERO, meta-Register of Controlled Trials (mRCT), PubMed, CENTRAL, Google Scholar, conference abstracts, and a hand search of journals from inception until September 2018. Read More

View Article
November 2018

Preoperatively predicting non-home discharge after surgery for gynecologic malignancy.

Gynecol Oncol 2018 Nov 26. Epub 2018 Nov 26.

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA. Electronic address:

Objective: Returning home after surgery is a desirable patient-centered outcome associated with decreased costs compared to non-home discharge. Our objective was to develop a preoperative risk-scoring model predicting non-home discharge after surgery for gynecologic malignancy.

Methods: Women who underwent surgery involving hysterectomy for gynecologic malignancy from 2013 to 2015 were identified from the Michigan Surgical Quality Collaborative database. Read More

View Article
November 2018
2 Reads

Changes of diaphragmatic excursion and lung compliance during major laparoscopic pelvic surgery: A prospective observational study.

PLoS One 2018 29;13(11):e0207841. Epub 2018 Nov 29.

Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Major laparoscopic pelvic surgery requires steep Trendelenburg position with pneumoperitoneum for a long time. We investigated the effect of Trendelenburg position with pneumoperitoneum on diaphragmatic excursion and lung compliance during major laparoscopic pelvic surgery using M-mode sonography. Twenty patients undergoing elective pelviscopic radical hysterectomy were included in this study. Read More

View Article
November 2018

Ovarian reserve after uterine artery embolization in women with morbidly adherent placenta: A cohort study.

PLoS One 2018 29;13(11):e0208139. Epub 2018 Nov 29.

Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel.

Objective: To evaluate ovarian reserve in women after preservative cesarean delivery using uterine artery embolization due to morbidly adherent placenta.

Study Design: A historical cohort study including all women admitted to a single tertiary care center, with morbidly adherent placenta that had preservative cesarean delivery with bilateral uterine artery embolization. Inclusion criteria included gestational age >24 weeks, singleton pregnancy and placenta increta / percreta. Read More

View Article
November 2018

Uterine cancer in Jewish Israeli BRCA1/BRCA2 mutation carriers.

Cancer 2018 Nov 29. Epub 2018 Nov 29.

Oncogenetics Unit, Institute of Human Genetics, and Meirav High Risk Clinic, Chaim Sheba Medical Center, Tel-Hashomer, Israel.

Background: BRCA1/BRCA2 mutation carriers have an increased risk of developing ovarian cancer, leading to the recommendation of risk-reducing salpingo-oophorectomy (RRSO) at 35-40 years of age. The role, if any, that BRCA mutations play in conferring uterine cancer risk, is unresolved.

Method: Jewish Israeli women, carriers of one of the predominant Jewish mutations in BRCA1/BRCA2 from 1998 to 2016, were recruited. Read More

View Article
November 2018
3 Reads

Pelvic Pain and Apical Prolapse Surgery: A Population-Based Retrospective Cohort Study.

Female Pelvic Med Reconstr Surg 2018 Nov 27. Epub 2018 Nov 27.

Obstetrics and Gynecology and.

Objectives: The aims of this study were to evaluate the association of preoperative pelvic pain with operative characteristics and the association of patient and operative characteristics with postoperative pain.

Methods: This is a retrospective cohort study utilizing Clinformatics DataMart, a large national commercial insurance database. We collected data for patients older than 18 years who underwent apical prolapse surgery between January 2005 and December 2014. Read More

View Article
November 2018

Pelvic Organ Prolapse Symptoms in American Samoan Women.

Female Pelvic Med Reconstr Surg 2018 Nov 27. Epub 2018 Nov 27.

International Health Institute, and Department of Epidemiology, Brown University School of Public Health, Providence RI.

Objectives: American Samoa has one of the highest rates of obesity worldwide, making it a population at high risk for pelvic organ prolapse (POP). The primary objective of this study was to describe the presence of POP symptoms and associated degree of bother in American Samoan women. The secondary objective was to determine which characteristics are associated with POP symptoms in this cohort. Read More

View Article
November 2018
2 Reads

Social anxiety among transgender and gender nonconforming individuals: The role of gender-affirming medical interventions.

J Abnorm Psychol 2018 Nov 29. Epub 2018 Nov 29.

Department of Psychology, Temple University.

Transgender and gender nonconforming (TGNC) individuals are at heightened risk for psychological distress, including social anxiety (SA). The current study aimed to examine whether gender-affirming medical interventions (GAMIs) are associated with lower SA among TGNC individuals. Two hundred ninety-one transfeminine and 424 transmasculine participants completed the Trans Health Survey, which assessed SA and interest in or utilization of GAMIs (genital surgery, chest surgery, hormone use, speech therapy, tracheal shave or Adam's apple removal, hair removal). Read More

View Article
November 2018

Recurrent group A streptococcal severe sepsis in the postpartum period.

Int J Gynaecol Obstet 2018 Nov 29. Epub 2018 Nov 29.

Transbaikal Regional Hospital, Chita, Russia.

This report presents the relapse and treatment of streptococcal infection in the postpartum period in a patient with severe group A streptococcal sepsis. Maternal sepsis was estimated to cause around 10.7% of maternal deaths worldwide between 2003 and 2009 [1]. Read More

View Article
November 2018
1 Read

[Enrico Bottini (1835-1903), Italian Physician and Politician: A Master of Antisepsis and a Pioneer of Modern Surgery].

Authors:
Mariano Martini

Acta Med Hist Adriat 2018 Dec;16(2):293-302

Sezione di Storia della Medicina e di Etica, Dipartimento di Scienze della Salute (DISSAL), Università di Genova, Via A. Pastore 1, 16132 Genova, Italia.

Enrico Bottini (Stradella, Pavia, 7 September 1835 - Porto Maurizio, Sanremo, 11 March 1903) was a multifaceted surgeon, who left a strong mark in modern surgery, not only Italian but worldwide. A pupil of Porta and Ribeti, as well as the distinguished French surgeon and anatomist Charles-Marie-Édouard Chassaignac, he has dedicated himself throughout his career to various areas of medicine, ranging from bacteriology and anti-sepsis (use of a derivative of phenic acid) to urological surgery (the so-called "endo-urethral galva-cauterization", also called Bottini's operation, or Perineal incision according to Bottini). He has also successfully dedicated himself to gynecology (trans-vaginal hysterectomy for uterine cancer and surgical treatment of vesicovaginal fistulas), maxillofacial surgery (endo-oral resection of the maxilla, subperiosteal resection of the mandible for the treatment of the stable jaw, total amputation of the larynx and the tongue for carcinomas), the dermosurgery (use of the electrocautery), and the vascular surgery (resection of the inferior vena cava). Read More

View Article
December 2018

The role of supracervical hysterectomy in reducing blood products requirement in the management of placenta accreta: A case control study.

J Matern Fetal Neonatal Med 2018 Nov 28:1-151. Epub 2018 Nov 28.

a Department of Obstetrics and Gynecology , Hadassah , Hebrew University Medical Center , Jerusalem , Israel.

Objective: While surgical management is the treatment of choice for abnormally invasive placenta, the role of supracervical hysterectomy in this setting is not well established. We aimed to compare supracervical versus total cesarean hysterectomy as a surgical option for abnormally invasive placenta.

Methods: We carried out a 8-year retrospective case-control study. Read More

View Article
November 2018

Blunt dissection technique with finger and vessel skeletonization in the posterior vesical wall for abnormally invasive placenta previa.

J Matern Fetal Neonatal Med 2018 Nov 28:1-71. Epub 2018 Nov 28.

a Department of Obstetrics and Gynecology , Gaziantep University , School of Medicine , Gaziantep , Turkey.

Purpose: This study described a new technique to minimize the bleeding resulted from aberrant engorged vessels and unintended bladder injury in cases with abnormally invaded placenta adjacent to posterior bladder wall at cesarean hysterectomy.

Methods: After filling the bladder with 300 ml saline aberrant engorged vessels were identified and skeletonized between lower uterine segment and bladder with blunt dissection by index finger down to the distal end point of cervix.

Results: This technique has beneficial effect on preventing bladder injury and reduces bleeding resulting from the aberrant vessels and the communicating vessels that were based around the vesicouterine fold and the cervico-vesical interface (in the lower part of the cervix); respectively. Read More

View Article
November 2018

Updates on the management of placenta accreta spectrum.

Minerva Ginecol 2018 Nov 27. Epub 2018 Nov 27.

Women ́s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway -

Placenta accreta spectrum (PAS) disorders is a multifactorial process that encompasses a heterogeneous group of conditions characterized by an abnormal invasion of trophoblastic tissue through the myometrium and uterine serosa. PAS is associated with a high burden of adverse maternal outcomes including severe life-threatening hemorrhage, need for blood transfusion, damage to adjacent organs, and death. Prenatal screening of PAS is mandatory so that women may be counselled about the severity of this condition to plan management with a multidisciplinary team and delivery in a specialized center. Read More

View Article
November 2018
1 Read

Histological evaluation of the prevalence of adenomyosis, myomas and of their concomitance.

Minerva Ginecol 2018 Nov 27. Epub 2018 Nov 27.

Department of Medical Area, Institute of Obstetrics and Gynecology, University of Udine, Udine, Italy -

Background: The objective of this study is to evaluate the prevalence of adenomyosis, leiomyomas and of their concomitance in women who underwent hysterectomy.

Methods: An observational study carried out on a cohort of 347 women who underwent hysterectomy from a sample of 2383 patients who had gynecological surgery for benign disease in a single University Hospital between 2013 and 2016. An histological evaluation of all surgical specimens was carried out for the presence of adenomyosis and leiomyomas. Read More

View Article
November 2018
1 Read

Association of chorioamnionitis and its duration with adverse maternal outcomes by mode of delivery: a cohort study.

BJOG 2018 Nov 28. Epub 2018 Nov 28.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina (Chapel Hill, NC).

Objective: To investigate the association of chorioamnionitis and its duration with adverse maternal outcomes by mode of delivery.

Design: A retrospective cohort study.

Setting: Data from the Consortium on Safe Labor Study (CSL) in the USA (2002-2008). Read More

View Article
November 2018
1 Read

Spectrum of urologic complications in obstetrics and gynecology: 13 years' experience from a tertiary referral center.

Turk J Urol 2018 Nov 26:1-6. Epub 2018 Nov 26.

Department of Urology, King George's Medical University, Lucknow, India.

Objective: To analyze the patterns of presentation and management for urologic complications of obstetrics and gynecology in the form of genitourinary fistulas at a tertiary referral center and highlight the social issues associated with them.

Material And Methods: We conducted this retrospective study analyzing 311 patients with genitourinary fistulas after obstetric and gynecologic surgeries between January 2005 and January 2018. We recorded the patients' characteristics and area of residence and then analyzed the etiology, surgical management and success rates by grouping the patients into four types of genitourinary fistulas. Read More

View Article
November 2018