Should we remove the normal-looking appendix during operations for borderline mucinous ovarian neoplasms?: A retrospective study of 129 cases.

INTRODUCTION: The aim of this study was to determine how often the appendix is involved or the primary source of cancer in women undergoing surgery for mucinous borderline ovarian tumour (mBOT) or invasive mucinous ovarian tumour (IMOT) and to evaluate whether appendectomy is necessary. METHODS: The hospital database was searched for women who underwent surgery and whose final diagnosis was mBOT, IMOT or mucinous appendix carcinoma between 1998 and 2014. RESULTS: One hundred and twenty-nine cases were identified, including 69 mBOT, 51 IMOT and nine primary mucinous appendix carcinomas. Of 97 appendectomies performed, nine lymphoid hyperplasia, two mucocele, one carcinoid tumour of the appendix, one mucinous tumour metastasis from the ovary and nine primary mucinous appendix carcinomas were found and all appendices were grossly abnormal. No recurrence was seen during the follow-up period in 28 patients who had no appendectomy performed for grossly normal appendix. Pathologic diagnosis was normal in all 65 patients whose appendix was noted to be grossly normal and who underwent appendectomy. No recurrence was detected during a median follow-up period of 7 years (range 1-16 years).Sensitivity, specificity, positive and negative predictive value of the macroscopic appearance of the appendix were 100%, 86.67%, 56.52% and 100.00%, respectively. DISCUSSION: If the appendix is grossly normal, it appears unnecessary to perform an appendectomy in patients operated for an adnexal mass and whose frozen section analysis was reported as mBOT or IMOT. CONCLUSION: Appendectomy should not be performed if the appendix is grossly normal.

Sexual dysfunction in infertile Turkish females: prevalence and risk factors.

OBJECTIVES: Our aim was to evaluate the prevalence of and risk factors for sexual dysfunction in infertile Turkish females. STUDY DESIGN: We interviewed 352 infertile and 301 fertile females in the Department of Obstetrics and Gynaecology at Tepecik Training and Research Hospital in Izmir, Turkey. The female sexual function index (FSFI) was used to assess the relationship between infertility and female sexual function. RESULTS: The mean age was similar between the infertile and control groups (29.2±4.3 vs. 28.7±4.0, respectively; p=0.120). The prevalence of sexual dysfunction in infertile females was higher than that in the fertile control group (32.9 vs. 17.2%, p<0.001), and the total FSFI score (26.2±2.5 vs. 28.2±1.7) and the score on each domain of sexual function parameters were significantly lower in the infertile group than in the control group (all p<0.001). Multivariate logistic regression analysis indicated that a duration of marriage and of infertility ≥3 years (odds ratio [OR] 3.79, 95% confidence interval [CI] 1.75-8.20, p=0.001; OR 3.18, 95% CI 1.54-6.55, p=0.002, respectively) and a history of previous infertility treatment (OR 3.07, 95% CI 1.63-5.76, p<0.001) were risk factors for sexual dysfunction in infertile females. CONCLUSIONS: Female sexual dysfunction was higher in the infertile group than the fertile control group in this Turkish population. Duration of marriage and of infertility ≥3 years and a history of previous infertility treatment were the primary risk factors for sexual dysfunction in infertile females.

Diagnosis of primary langerhans cell histiocytosis of the vulva in a postmenopausal woman.

Langerhans cell histiocytosis (LCH) is a very rare disease of female genital tract, most commonly seen in vulva and unusual in postmenopausal period. Herein, we report the 8th case of pure vulvar LCH in a postmenopausal woman. We pay attention to the differential diagnosis in postmenopausal state, features of pathologic diagnosis, and treatment options.