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Ovarian, Fallopian Tube, and Primary Peritoneal Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Robert D. Morgan, Andrew R. Clamp, Gordon C. Jayson
CA 125 is a protein that is released into the plasma of approximately 80% of patients diagnosed with advanced-stage epithelial ovarian cancer. CA 125 concentrations alone are neither sufficiently sensitive nor specific enough to be diagnostic of ovarian cancer,38 as CA 125 may be elevated in other benign gynecological conditions, including endometriosis and pelvic inflammatory disease, and pregnancy, as well as cancers of the uterus, breast, lung, and gastrointestinal tract and other illnesses such as congestive heart failure and liver disease.
Acquired uterine conditions, reproductive surgery, and recurrent implantation failure
Published in Efstratios M. Kolibianakis, Christos A. Venetis, Recurrent Implantation Failure, 2019
Dimitra Aivazi, Eleni Tsakalidou, Grigoris F. Grimbizis
Adenomyosis is an acquired, benign gynecological condition of the myometrium. It is characterized by the presence of endometrial glands and stroma within the myometrium. The neighboring muscle cells respond to this intrusion with hypertrophy and hyperplasia. It can be either diffuse, where endometrial foci are scattered throughout the myometrium or focal, taking the form of adenomyoma (defined as a circumscribed nodule within the myometrium) or adenomyotic cyst, covering different zones of the myometrium (inner or outer myometrium). Histologically, it could range from mostly solid to mostly cystic.
Tumor markers
Published in J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan, An Atlas of Gynecologic Oncology, 2018
CA125 is widely distributed in adult tissues and lacks specificity for OC. Although the exact cutoff might vary depending on the commercial assay, the cutoff is equivalent to the original cutoff of 35 U/mL, which is the 99th centile in a distribution of CA125 values in 888 healthy men and women (Bast et al. 1983). However, CA125 values can show wide variation, with lower levels (20 U/mL) found in postmenopausal women (Alagoz et al. 1994, Bon et al. 1996, Bonfrer et al. 1997, Zurawski et al. 1988). Levels are raised in pregnancy, with peak values occurring in the first trimester (112 U/mL, 65 U/mL correspond to 99th and the 96th centile, respectively) (El-Shawarby et al. 2005, Sarandakou et al. 2007) and postpartum (Spitzer and Kaushal 1998), and return to normal by 10 weeks after delivery (Spitzer and Kaushal 1998). Menstruation (Grover et al. 1992) as well as benign gynecological conditions (pelvic inflammatory disease, fibroids, and endometriosis) increase CA125. Higher values are reported for Caucasian compared to African or Asian women (Pauler et al. 2001). Caffeine intake, hysterectomy, and smoking in some (Pauler et al. 2001) but not all reports (Green et al. 1986) were associated with lower CA125 levels (Pauler et al. 2001). Non-gynecological conditions (tuberculosis, cirrhosis, ascites, hepatitis, pancreatitis, peritonitis, pleuritis) and other cancers (breast, pancreas, lung, and colon cancer) can also cause an elevated CA125.
Urinary incontinence and quality of life in endometrial cancer patients after robotic-assisted laparoscopic hysterectomy with lymph node dissection
Published in Journal of Obstetrics and Gynaecology, 2019
Lioudmila Lipetskaia, Shefali Sharma, Marian S. Johnson, Donald R. Ostergard, Sean Francis
Multiple hypotheses that could explain urinary incontinence have been examined. The suspected aetiological factors include congenital elements, obesity, aging, pregnancy and vaginal delivery. Hysterectomy alone has previously been implicated as a risk factor for urinary incontinence (Milsom et al. 1993; El Toukhy et al. 2004). More recent meta-analysis demonstrated that hysterectomy for benign gynecological conditions does not increase the risk of adverse urinary symptoms and may even improve some urinary function (Lashen et al. 2012). There is a significant lack of data related to lower urinary tract dysfunction in gynaecologic cancer patients. The crude rate of urinary incontinence in our study population of women treated for endometrial cancer was similar to previously published studies (Erekson et al. 2009; Nosti et al. 2012). However, in our patient population, we were not able to demonstrate such high score values indicative of more of an effect on quality of life-related to urinary dysfunction as reported in these two studies. It is possible that robotic-assisted hysterectomies lead to a decreased incidence of post-operative pelvic floor dysfunction with improved quality of life measures because the 3D techniques of the da Vinci robot allows the surgeon to perform finer tissue dissections while avoiding injury to local nerves and other pelvic floor structures.
Comparison between radiofrequency ablation combined with mifepristone and radiofrequency ablation for large uterine fibroids
Published in International Journal of Hyperthermia, 2021
Ning Hai, Qingxiang Hou, Xiangping Dong, Ruijun Guo
Uterine fibroids are a common benign gynecological condition. Approximately, 50% of uterine fibroids cause symptoms that warrant therapy. Symptoms include abnormal uterine bleeding, heavy menstrual bleeding, bulk symptoms and other complications [1]. In recent years, ultrasound-guided (US-guided) radiofrequency ablation (RFA) has been the focus of interest as a minimally invasive strategy for patients with symptomatic uterine fibroids. Previous studies have reported that RFA can provide symptomatic relief and significant improvement in the quality of life [2–10]. However, optimal patients might be those with small fibroids (diameter <5 cm or volume < 180 cm3) [2–5]. For larger fibroids, RFA may not be effective, and the risk of complications may also increase [2–5].
Vaginal length and sexual function after vertical versus horizontal closure of the vaginal cuff after abdominal hysterectomy: a randomised clinical trial
Published in Journal of Obstetrics and Gynaecology, 2022
Omima Tharwat Taha, Noha Al-Okda, Mostafa Ahmed Hamdy
This was a randomised clinical trial conducted at the obstetrics and gynaecology department of Suez Canal University hospitals, after approval of our research ethics committee. The study timing was from August 2019 to April 2020. We recruited women fulfilling the following inclusion and exclusion criteria. Inclusion criteria:women ageing 40–65years, patients undergo hysterectomy for benign gynecological conditions (uterine fibroids, adenomyosis, endometriosis, endometrial hyperplasia declining medical treatment, failed medical treatment for endometrial hyperplasia). Exclusion criteria:(a) malignant disease of the genital tract, (b) previous history of genital radiation, (c) vaginal hysterectomy.