Genital Prolapse in Pregnant Woman as a Presentation of Aggressive Angiomyxoma: Case Report and Literature Review.

Background: Aggressive angiomyxoma is a rare entity within mesenchymal cell neoplasms, especially in pregnant women. Its main characteristic is the ability to infiltrate neighboring structures and to recur. Case Presentation: We present the case of a pregnant woman who debuted with a genital prolapse in the second trimester of pregnancy. She was diagnosed with bilateral ovarian teratomas and a pelvic mass of which the diagnosis could not be established until delivery. The route of delivery used was cesarean section since the genital prolapse behaved as a previous tumor. After the puerperium, the patient was referred for consultation to complete the study of the mass. The extension study was carried out with a negative result. The patient underwent surgery for tumor exeresis. Hormonal treatment was not administered according to the patient's preferences. Conclusions: Aggressive angiomyxoma is a benign neoplasm that should be considered in the differential diagnosis of pelvic tumors in women. In pregnant women, the vaginal route of delivery is not contraindicated as long as the tumor does not obstruct the birth canal. The definitive treatment is surgery, preferably performed in a second stage after delivery.

Effects of SARS-CoV-2 Pandemic on the Mental Health of Spanish Ob-Gyn Specialists-A Nationwide Study.

It has been reported that frontline health professionals have suffered from an increased rate of mental disorders as a consequence of the SARS-CoV-2 pandemic. OBJECTIVE: This study aims to evaluate the impact of the pandemic on the mental health of Spanish specialists in the obstetrics and gynecology fields after the fifth Spanish COVID-19 wave. METHODS: Psychometric screening of the professionals was performed using a nationwide online survey designed by the Psychosocial Obstetrics and Gynecology taskforce. Post-traumatic stress disorder (PTSD), depression, and general anxiety disorder were screened. RESULTS: We found high scores for PTSD, depression, and generalized anxiety disorder. Up to 12.4% of specialists met the PTSD criteria, 12.8% showed complex PTSD, 37% showed depression, and up to 37% had a positive screening for generalized anxiety disorder. Our results showed that the pandemic has particularly affected the group of female Ob-Gyn specialists, with significant higher scores in depression and anxiety scales. CONCLUSIONS: As a lesson learned for the future in case of new health emergencies, it would be very important to provide professionals with adequate psychological support, ensuring enough human and material resources, flexible work shifts, and facilities to reconcile work and family-life, especially in the case of female specialists.

Measuring Resilience in Women with Endometriosis.

Endometriosis is a multifactorial disease with pathophysiological factors not yet well known; it also presents a wide symptomatic range that makes us think about the need for multidisciplinary management. It is a chronic disease in which there is no definitive treatment, and is associated in a large majority of cases with psychological pathology. Connecting comorbidities and multimorbidities on a neurobiological, neuropsychological, and pathophysiological level could significantly contribute to their more successful prevention and treatment. In our study, resilience is analyzed as an adjunctive measure in the management of endometriosis. Methods: A multi-centre, cross-sectional study was performed to analyse resilience levels in a sample of Spanish women suffering from endometriosis. CDRIS-25, CDRIS-10, BDI, the STAI, and the SF-36 Health Questionnaire were used for assessments. A representative group of 202 women with endometriosis was recruited by consecutive sampling. Exploratory and confirmatory factor analyses were performed for both resilience scales. Results: Mean CDRIS-25 and CDRIS-10 scores were 69.58 (SD 15.1) and 29.37 (SD 7.2), respectively. Women with adenomyosis and without signs of deep endometriosis showed the lowest scores. The best predictive model included women's age, years of endometriosis evolution, number of pregnancies, and history of fertility problems as the best predictive factors. Conclusions: Women build resilience as the number of years of evolution of the disease increases. Symptoms such as dyspareunia and continued abdominal pain were more prevalent among less resilient women.

Correlates of Sexual Function in a Sample of Spanish Women with Endometriosis.

BACKGROUND: In the present study, we aim to report on the sexual function of women experiencing symptoms of endometriosis, analysing the clinical and psychosocial factors that may be associated. METHODS: A multicentre cross-sectional study was performed to analyse the sexual function in a sample of 196 Spanish women with endometriosis, using the Female Sexual Function Inventory. RESULTS: The Female Sexual Function Inventory (FSFI) was validated in our endometriosis study group. The mean FSFI score for the sample was 22.5 (SD 6.6), with 20.9 and 26.9 being in the 25th and 75th percentiles, respectively. Although physical sexual pain and dyspareunia were factors that influenced the sexual function of women with endometriosis, our results show that the impairment was multifactorial. CONCLUSIONS: We found impaired sexual function in women diagnosed with endometriosis. The final model included deep endometriosis, depression, age, and unemployment as strongest predictive factors for poor (deteriorated) sexual function.

Prophylactic salpingectomy and prophylactic salpingoophorectomy for adnexal high-grade serous epithelial carcinoma: A reappraisal.

At present, there is no effective screening of ovarian cancer. Primary prevention may be the only strategy to decrease the mortality from ovarian cancer, not only in women at high risk but also at low risk. Several recent studies have identified the distal fimbriae end of the fallopian tubes as primary precursor of High-grade serous carcinoma. Serous tubal intraepithelial carcinomas and occult invasive serous carcinomas have been identified in 2-17% of the fallopian tubes of BRCA1/2 positive women undergoing risk-reducing salpingo-oophorectomy. Removal of the fallopian tubes with ovarian preservation has been suggested as a reasonable strategy that could reduce the risk of developing ovarian carcinoma in both low and high-risk women. It has been proposed after childbearing in women at high risk to be followed by bilateral oophorectomy at a later date. Bilateral salpingectomy is also suggested for low risk women, at the time of other benign gynaecologic surgery as a primary preventive strategy. Some studies have shown a risk reduction of ovarian cancer in women with bilateral prophylactic salpingectomy. Current research regarding bilateral salpingoophorectomy as primary prevention approach of ovarian cancer is reviewed here. In addition, the potential use of bilateral salpingectomy as prevention approach of ovarian cancer is discussed.

Endometritis granulomatosa: hallazgo histológico en procesos de diferente etiología / Granulomatous endometritis: an histological finding in processes with distinct etiology

La endometritis granulomatosa es una inflamación crónica que se define histológicamente por la presencia de granulomas en un endometrio con un infiltrado linfoplasmocitario. Su hallazgo en una biopsia o pieza de endometrio, debe hacer pensar en tuberculosis (TBC) genital. Esta TBC era una infección rara en la mujer, las localizaciones endometriales, tubárica y ovárica casi siempre secundaria de otra localización. Más rara en mujeres posmenopáusicas, se cree debida a la escasez de los cultivos del endometrio atrófico. El diagnóstico definitivo de TBC genital es el cultivo del bacilo de Koch. La presunción se puede hacer si aparecen granulomas en la biopsia y Mantoux positivo. Su tratamiento es médico y con buen pronóstico. Presentamos 5 casos clínicos en posmenopáusicas, diagnosticados entre junio de 2001 y abril de 2003

Granulomatous endometritis is a chronic inflammation histologically characterized by the presence of granulomas in an endometrium with lymphoplasmacytic infiltrate. A finding of granulomatous endometritis in the biopsy or endometrial specimen should lead to suspicion of genital tuberculosis. This infection used to be rare in women. Tubal, endometrial and ovarian localizations are almost always secondary to a focus in another location. This entity is less frequent in postmenopausal women, probably because the atrophic endometrium provides a poor environment for growth of the tuberculosis bacillus. The definitive diagnosis of genital tuberculosis is culture of the Koch bacillus. A presumptive diagnosis can be made on the basis of granulomas in biopsy and a positive Mantoux test. Treatment is medical and the prognosis is good. We present five cases of genital tuberculosis in postmenopausal women, diagnosed between June 2001 and April 2003