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3.
J Am Anim Hosp Assoc ; 58(5): 262-264, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36049236

RESUMO

A 5 yr old, 54-day-pregnant whippet presented for hyperthermia, lethargy, and spontaneous abortion of multiple fetuses. Blood work and clinical signs raised concern for uterine sepsis; therefore, the dog underwent an emergency ovariohysterectomy. Blood and uterine samples cultured a Salmonella species. Following ovariohysterectomy and oral antibiotic therapy, the dog had no further systemic signs. Repeat blood cultures and Salmonella testing were negative. To the authors' knowledge, this is the first report of a Salmonella species causing bacteremia in conjunction with late-term abortion in a dog.


Assuntos
Bacteriemia , Doenças do Cão , Infecções por Salmonella , Aborto Animal , Animais , Bacteriemia/complicações , Bacteriemia/diagnóstico , Bacteriemia/veterinária , Doenças do Cão/diagnóstico , Doenças do Cão/etiologia , Cães , Feminino , Histerectomia/veterinária , Gravidez , Infecções por Salmonella/diagnóstico , Infecções por Salmonella/tratamento farmacológico
4.
In Vivo ; 36(5): 2409-2413, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36099098

RESUMO

BACKGROUND/AIM: Short-term feasibility and safety of single-port total laparoscopic hysterectomy (TLH) compared with conventional multi-port TLH have been previously demonstrated. However, recent studies are insufficient. This study aimed to analyze long-term data from our center to examine the current status of single-port and multi-port TLH. PATIENTS AND METHODS: In 766 patients who received TLH from 2005 to 2019, 325 were single-port and 441 were multi-port. Inclusion criteria were benign and premalignant uterine diseases. To reduce the impact of treatment selection bias and potential confounding factors, inverse probability of treatment weighting was applied. RESULTS: Single-port TLH showed significantly better clinical outcomes for hospital stay, operative time, hemoglobin decrease, and complication rate than the multi-port TLH after correction of biases. C-reactive protein increased after the single-port TLH. CONCLUSION: As laparoscopic surgical instruments and surgeon's skill have been improved, some surgical outcomes have become significantly better in single-port TLH after long-term observation.


Assuntos
Histerectomia , Laparoscopia , Feminino , Humanos , Laparoscopia/efeitos adversos , Tempo de Internação , Duração da Cirurgia
5.
Cochrane Database Syst Rev ; 9: CD012246, 2022 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-36111784

RESUMO

BACKGROUND: With an estimated 570,000 new cases reported globally in 2018, and increasing numbers of new cases in countries without established human papillomavirus (HPV) vaccination programmes, cervical cancer is the third most common cancer in women worldwide. The majority of global disease burden (around 85%) is in low-and middle-income countries (LMICs), with estimates of cervical cancer being the second most common cancer in women in such regions. As it commonly affects younger women, cervical cancer has the greatest impact on years of life lost (YLL) and adverse socioeconomic outcomes compared to all other cancers in women. Management of cervical cancer depends on tumour stage. Radical hysterectomy with lymphadenectomy is the standard primary treatment modality for International Federation of Gynecology and Obstetrics (FIGO) stage (2019) 1B1 to 1B3 disease. However, for larger primary tumours, radical hysterectomy is less commonly recommended. This is mainly due to a high incidence of unfavourable histopathological parameters, which require adjuvant concurrent chemoradiotherapy (CCRT) (chemotherapy given with radiotherapy treatment). CCRT is the standard of care and is widely used as first-line treatment for cervical cancer considered to be not curable with surgery alone (i.e.those with locally advanced disease). However, a sizable cohort of women managed with primary CCRT will have residual disease within the cervix following treatment. Debulking' hysterectomy to remove (debulk) the primary tumour in locally advanced disease, prior to CCRT, may be an alternative management strategy, avoiding the potential need for surgery for residual cervical disease following CCRT, which may be more extensive, or have increased morbidity due to CCRT. However, this strategy may subject more women to unnecessary surgery and its inherent risks. OBJECTIVES: To assess the efficacy and harms of debulking hysterectomy (simple or radical) followed by chemoradiotherapy (CCRT) versus CCRT alone for FIGO (2019) stage IB3/II cervical cancer. SEARCH METHODS: We systematically searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2021, Issue 4), MEDLINE via Ovid (1946 to 12 April 2021) and Embase via Ovid (1980 to 12 April 2021). We also searched other registers of clinical trials, abstracts of scientific meetings and reference lists up to 12 April 2021. SELECTION CRITERIA: We searched for randomised controlled trials (RCTs), quasi-RCTs or non-randomised studies (NRSs) comparing debulking hysterectomy followed by CCRT versus CCRT alone for locally advanced FIGO (2019) stage IB3/II cervical malignancy. DATA COLLECTION AND ANALYSIS: We applied Cochrane methodology, with two review authors independently assessing whether potentially relevant studies met the inclusion criteria. We planned to apply standard Cochrane methodological procedures to analyse data and risk of bias. MAIN RESULTS: We did not find any evidence for or against debulking hysterectomy followed by CCRT versus CCRT alone for FIGO (2019) stage IB3/II cervical cancer. We did not identify any studies assessing the validity of debulking hysterectomy for these women.  AUTHORS' CONCLUSIONS: There was no evidence for or against debulking hysterectomy followed by CCRT versus CCRT alone for FIGO (2019) stage IB3/II cervical cancer.


Assuntos
Neoplasias do Colo do Útero , Quimiorradioterapia/métodos , Procedimentos Cirúrgicos de Citorredução , Feminino , Humanos , Histerectomia/métodos , Estadiamento de Neoplasias , Neoplasia Residual , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/terapia
6.
Medicina (Kaunas) ; 58(9)2022 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-36143817

RESUMO

Background and Objectives: Uterine sarcomas represents only 3% of all the female genital tract ones. The tumoral stage is the most significant prognostic factor. The role of the bilateral salpingo-oophorectomy (BSO) in the surgical management of FIGO stage IA and IB appears still controversial. This review aims to investigate the impact of bilateral adnexectomy in the treatment of uterine sarcoma. Methods: Following the recommendations in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we systematically searched the PubMed, Scopus, Cochrane, Medline, and Medscape databases in February 2022. We applied no language or geographical restrictions, but we considered only English studies. We included the studies containing data about Recurrence Rate (RR), Disease-free Survival (DFS), and Overall Survival (OS). We used comparative studies for meta-analysis. Results: Seventeen studies fulfilled the inclusion criteria; 2 retrospective observational studies, and 15 retrospective comparative studies, And 14 out of the 15 comparative studies were enrolled in meta-analysis. A total of 3743 patients were analyzed concerning the use of adnexectomy with hysterectomy in patients with uterine sarcoma and compared with those who did not. Meta-analysis highlighted a non-significant worsening of the OS in the BSO group compared to the OP group and showed that adnexectomy does not improve the DFS (BSO OR 1.23 (95% CI 0.81-1.85) p = 0.34; I2 = 24% p = 0.22). Conclusions: Most studies selected for our review showed that adnexectomy does not significantly affect the RR, OS, and PFS in treating FIGO stage I uterine sarcomas. Therefore, even if there is a unanimous consensus about bilateral adnexectomy in menopausal patients, preservation of ovarian tissue may be considered in premenopausal women. Nonetheless, there are not enough cases in the literature to recommend this procedure.


Assuntos
Sarcoma , Neoplasias Uterinas , Feminino , Humanos , Histerectomia/métodos , Estadiamento de Neoplasias , Estudos Retrospectivos , Sarcoma/cirurgia , Neoplasias Uterinas/patologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-36141653

RESUMO

For many years, vaginal and abdominal hysterectomies were part of the routine procedures in many departments. Both of them lost their priority due to the introduction of endoscopy and robotic surgery. The disappearing abdominal hysterectomy is certainly reasonable, but the decline of using vaginal hysterectomy seems not to be justified, and it is an optimal example of the recent emergence of the Natural Orifice Surgery discipline. A modified method for vaginal hysterectomy is presented in order to encourage gynecologists to reconsider vaginal hysterectomy as a valid method. This method is the outcome of critical analyses of different vaginal hysterectomy methods. It is simple, reasonable, only ten steps, easy to learn, perform and teach, and proven to be a shorter operation with minimal blood loss and reduced need for analgesics when compared to the traditional way. Endoscopy or robotic surgery is not available everywhere. Therefore, it is important that gynecologists in low-resource settings be familiar with this simple method.


Assuntos
Ginecologia , Procedimentos Cirúrgicos Robóticos , Feminino , Humanos , Histerectomia/métodos , Histerectomia Vaginal/métodos , Estudos Retrospectivos , Vagina/cirurgia
8.
Artigo em Inglês | MEDLINE | ID: mdl-36141917

RESUMO

Radical hysterectomy and plus pelvic node dissection are the primary methods of treatment for patients with early stage cervical cancer. During the last decade, growing evidence has supported the adoption of a minimally invasive approach. Retrospective data suggested that minimally invasive surgery improves perioperative outcomes, without neglecting long-term oncologic outcomes. In 2018, the guidelines from the European Society of Gynaecological Oncology stated that a "minimally invasive approach is favored" in comparison with open surgery. However, the phase III, randomized Laparoscopic Approach to Cervical Cancer (LACC) trial questioned the safety of the minimally invasive approach. The LACC trial highlighted that the execution of minimally invasive radical hysterectomy correlates with an increased risk of recurrence and death. After its publication, other retrospective studies investigated this issue, with differing results. Recent evidence suggested that robotic-assisted surgery is not associated with an increased risk of worse oncologic outcomes. The phase III randomized Robotic-assisted Approach to Cervical Cancer (RACC) and the Robotic Versus Open Hysterectomy Surgery in Cervix Cancer (ROCC) trials will clarify the pros and cons of performing a robotic-assisted radical hysterectomy (with tumor containment before colpotomy) in early stage cervical cancer.


Assuntos
Laparoscopia , Procedimentos Cirúrgicos Robóticos , Neoplasias do Colo do Útero , Feminino , Humanos , Histerectomia/métodos , Laparoscopia/métodos , Estadiamento de Neoplasias , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/métodos , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia
9.
Arch Ital Urol Androl ; 94(3): 315-318, 2022 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-36165477

RESUMO

OBJECTIVE: To compare urodynamic changes before and after hysterectomy (laparoscopic vs. vaginal approach) for benign gynecological diseases. PATIENTS AND METHODS: A total of 90 women with a mean age of 56.36-years were enrolled in this study between August 2019 and April 2021. They were divided into two equal groups (45 patients each). Group, I had a vaginal hysterectomy, and Group II had a laparoscopic hysterectomy. All patients were assessed clinically using ICIQ-FLUTS questionnaire and a uro-dynamic study before and six months after surgery. RESULTS: Both vaginal and laparoscopic hysterectomy did not significantly change the maximum flow rate, voiding time, and average flow rate. The increase in residual urine volume in group I was not significant (p = 0.129), as was in Group II (p = 0.217). All the modifications, however, were within permis-sible limits. According to the cystometry result, volume at initial sensation rose in both groups after surgery, with no statistically significant difference (p = 0.364). After both forms of hysterecto-my, maximum bladder capacity did not vary considerably. Preoperatively, all study participants exhibited no overactivity of the detrusor muscle; nevertheless, following surgery, overac-tivity was noted in 9 patients after vaginal hysterectomy com-pared to three patients after laparoscopic hysterectomy, and all the alterations were within a clinically acceptable range. In addition, the ICIQ-FLUTS score was not significantly different between the study groups. CONCLUSIONS: According to the urodynamic study, hysterectomy for benign uterine conditions, whether vaginal or laparoscopic did not adversely affect urinary bladder function.


Assuntos
Laparoscopia , Urodinâmica , Feminino , Humanos , Histerectomia/efeitos adversos , Histerectomia Vaginal , Pessoa de Meia-Idade , Urodinâmica/fisiologia , Vagina/cirurgia
10.
BMJ Case Rep ; 15(9)2022 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-36162964

RESUMO

Primary ovarian leiomyosarcoma is a very uncommon and aggressive neoplasm. We presented a right-sided ovarian leiomyosarcoma in a woman in her late 40s. No case has been described in the literature till now of primary ovarian leiomyosarcoma in a woman with uterovaginal prolapse. A total abdominal hysterectomy with bilateral adnexectomy, metastasectomy, excision of large tumour deposit over small intestine followed by resection with ileo-ileal anastomosis and omentectomy was performed. The diagnosis was made based on morphology along with immunohistochemistry. The patient was given adjuvant chemotherapy during postoperative period. Due to rarity, there is a dearth of information on the clinical behaviour and best treatment options for these tumours. This case report highlighted the importance of clinical awareness and aimed to provide a baseline to guide clinical practice as well as future research.


Assuntos
Leiomiossarcoma , Neoplasias Ovarianas , Neoplasias Pélvicas , Quimioterapia Adjuvante , Feminino , Humanos , Histerectomia , Leiomiossarcoma/complicações , Leiomiossarcoma/diagnóstico , Leiomiossarcoma/cirurgia , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/cirurgia , Neoplasias Pélvicas/cirurgia , Prolapso
12.
Dis Markers ; 2022: 3611174, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36157208

RESUMO

Objective: To evaluate the clinical efficacy of neoadjuvant chemotherapy plus laparoscopic radical hysterectomy for cervical cancer and the effect on the immune function of patients. Methods: Between January 2021 and December 2021, 42 patients with cervical cancer diagnosed and treated at our hospital were recruited and randomly assigned at a 1 : 1 ratio to receive neoadjuvant chemotherapy plus open radical hysterectomy (control group) or neoadjuvant chemotherapy plus laparoscopic radical hysterectomy (treatment group) (study group). Outcome measures included surgical indices, clinical outcomes, and immunological function. Results: There were no significant differences in the operative time between the two groups (P > 0.05). Patients receiving laparoscopic surgery had significantly less intraoperative bleeding and shorter time lapse before postoperative anal exhaustion, time lapse before out-of-bed activities, and hospital stay versus patients receiving open surgery (P < 0.05). Laparoscopic surgery resulted in a significantly higher efficacy (90.48%) versus open surgery (57.14%) (P < 0.05). After treatment, patients in the study group showed lower levels of carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag), and cancer antigen (CA125) than those in the control group (P < 0.05). After treatment, patients given laparoscopic surgery showed significantly lower CD3+, CD4+, and CD8+ levels and higher CD4+/CD8+ levels versus those with open surgery (P < 0.05). The postoperative conditions of the two groups, including recatheterization, postoperative blood transfusion, and secondary anti-inflammation were not significantly different (P > 0.05). The study group showed a significantly lower incidence of complications (19.05%) than the control group (71.43%) (P < 0.05). Patients in the study group had a lower reoperation rate and a higher survival rate (0.00%, 95.24%) than those in the control group (19.05%, 66.67%) (P < 0.05). Conclusion: Neoadjuvant chemotherapy plus laparoscopic radical hysterectomy effectively improves clinical efficacy, lowers cancer marker levels, improves patients' immune function, reduces the risk of adverse events, and improves patients' prognosis with less intraoperative bleeding, less trauma, faster postoperative recovery, and shorter hospital stay for cervical cancer patients.


Assuntos
Histerectomia , Laparoscopia , Neoplasias do Colo do Útero , Antígeno Carcinoembrionário , Feminino , Humanos , Histerectomia/efeitos adversos , Histerectomia/métodos , Imunidade , Laparoscopia/efeitos adversos , Terapia Neoadjuvante , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias do Colo do Útero/tratamento farmacológico , Neoplasias do Colo do Útero/cirurgia
13.
BMC Urol ; 22(1): 137, 2022 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-36057579

RESUMO

BACKGROUND: Iatrogenic ureteral injury (IUI) is relatively rare, however, can cause sepsis, kidney failure, and death. Most cases of IUI are not recognized until the patient presents with symptoms following pelvic surgery or radiotherapy. Recently, minimally invasive approaches have been used more frequently in the treatment of IUI. This study evaluates urological intervention success rates and long-term clinical outcomes according to the type of IUI following hysterectomy. METHODS: Twenty-seven patients who underwent surgery due to IUI in our clinic following hysterectomy were evaluated between January 2011 and April 2018. Patients were classified according to the time of diagnosis of IUI. The IUI cases diagnosed within the first 24 h following hysterectomy were designated as "immediate" IUI, while that diagnosed late period was considered 'delayed' IUI. The type of IUI was categorized as "cold transection" if it was due to surgical dissection or ligation without any thermal energy, and "thermal injury" if it was related to any energy-based surgical device. Patient information, laboratory and perioperative data, imaging studies, and complications were assessed retrospectively. RESULTS: All cases of delayed diagnosis IUI were secondary to laparoscopic hysterectomy (P = 0.041). Patients with thermal injury to the ureter were mostly diagnosed late (delayed) (P = 0.029). While 31% of the patients who underwent endourological intervention were diagnosed immediately, 69% of them were diagnosed as delayed. These rates were roughly reversed for open reconstructive surgery: 73% and 27% (P = 0.041), respectively. We detected eight ureteral complications in our patient cohort following the urological intervention. In all these failed cases, the cause of IUI was a thermal injury (P = 0.046) and the patients had received endourological treatment (P = 0.005). No complications were detected in patients who undergo open urological reconstructive surgery. While one of the patients who developed urological complications had an immediate diagnosis, seven were in the delayed group (P = 0.016). CONCLUSION: Endourological intervention is performed more frequently in delayed diagnosed IUI following hysterectomy, however, the treatment success rate is low if thermal damage has developed in the ureter. Surgical reconstruction is should be preferred in these thermal injury cases to avoid further ureter-related complications.


Assuntos
Ureter , Feminino , Humanos , Histerectomia/métodos , Doença Iatrogênica , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/cirurgia , Estudos Retrospectivos , Ureter/cirurgia
14.
JSLS ; 26(3)2022.
Artigo em Inglês | MEDLINE | ID: mdl-36071991

RESUMO

Background: Cost and quality are important, complex, and intertwined surgical outcomes. Evidence suggests that major cost drivers include operating room time, length of stay, re-admission, surgical complications, and quality of pre-operative and operative care in general. Our practices shape both costs and quality of gynecologic surgery. Various factors are explored in this review article to present and identify ways to implement cost-effective change that also improve quality of patient care. Database: We searched MEDLINE and PubMed databases for relevant articles. Discussion: Clinical preferences and decisions, surgeon experience, trainee education, and defensive medicine can influence cost. In addition, an incongruent physician-administration relationship may impact decisions across the healthcare system. The accelerating adoption of minimally invasive surgery, particularly the robotic approach, presents both an opportunity and a challenge. An example of practices that improve outcomes, patient satisfaction, and cut cost is pre-operative optimization, enhanced recovery after surgery, and the growing adoption of outpatient hysterectomy. The identification of cost-drivers and finding strategies to improve them would simultaneously improve quality and patient outcomes while reducing costs in minimally invasive gynecologic surgery.


Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos , Robótica , Análise Custo-Benefício , Feminino , Procedimentos Cirúrgicos em Ginecologia , Humanos , Histerectomia
15.
Rom J Morphol Embryol ; 63(1): 191-195, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36074683

RESUMO

Synovial sarcoma (SS) usually affects joints, bursae, and tendons of extremities and is very infrequent in the head and neck, abdomen, thorax, prostate and kidney, skin, blood vessels, and nerves. Primary intra-abdominal SS is exceeding uncommon and has non-specific symptoms or compress surrounding structures. The diagnosis is a challenge, and histopathological and immunohistochemical studies must confirm the hypothesis. We report the case of SS that has origin in peritoneal structures and a longstanding unsuspected course. The patient was a 64-year-old woman who claimed chronic pain in the left iliac fossa, without additional symptoms. She related laparoscopic oophorectomy, cholecystectomy, and abdominal hysterectomy in the previous three decades. There was neither local invasion nor lymph nodal, vascular or neural invasion, and her surgical treatment by open abdominal procedure was uneventful. The herein reported case aims to enhance the index of suspicion.


Assuntos
Parede Abdominal , Sarcoma Sinovial , Parede Abdominal/patologia , Feminino , Humanos , Histerectomia , Masculino , Pessoa de Meia-Idade , Sarcoma Sinovial/diagnóstico , Sarcoma Sinovial/patologia , Tórax
16.
Rev Bras Ginecol Obstet ; 44(8): 790-796, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36075225

RESUMO

OBJECTIVE: This systematic review aims at describing the prevalence of urinary and sexual symptoms among women who underwent a hysterectomy for cervical cancer. METHODS: A systematic search in six electronic databases was performed, in September 2019, by two researchers. The text search was limited to the investigation of prevalence or occurrence of lower urinary tract symptoms (LUTS) and sexual dysfunctions in women who underwent a hysterectomy for cervical cancer. For search strategies, specific combinations of terms were used. RESULTS: A total of 8 studies, published between 2010 and 2018, were included in the sample. The average age of the participants ranged from 40 to 56 years, and the dysfunctions predominantly investigated in the articles were urinary symptoms (n = 8). The rates of urinary incontinence due to radical abdominal hysterectomy ranged from 7 to 31%. The same dysfunction related to laparoscopic radical hysterectomy varied from 25 to 35% and to laparoscopic nerve sparing radical hysterectomy varied from 25 to 47%. Nocturia ranged from 13%, before treatment, to 30%, after radical hysterectomy. The prevalence rates of dyspareunia related to laparoscopic radical hysterectomy and laparoscopic nerve sparing radical hysterectomy ranged from 5 to 16% and 7 to 19% respectively. The difficulty in having orgasm was related to laparoscopic radical hysterectomy (10 to 14%) and laparoscopic nerve sparing radical hysterectomy (9 to 19%). CONCLUSION: Urinary and sexual dysfunctions after radical hysterectomy to treat cervical cancer are frequent events. The main reported disorders were urinary incontinence and dyspareunia.


OBJETIVO: Essa revisão sistemática visa descrever a prevalência de sintomas urinários e sexuais entre mulheres submetidas à histerectomia por câncer cervical. MéTODOS: Uma pesquisa sistemática foi realizada em seis bases de dados eletrônicas, em setembro de 2019, por dois pesquisadores. A busca foi limitada à investigação da prevalência e ocorrência de sintomas do trato urinário baixo e disfunções sexuais em mulheres após histerectomia por câncer cervical. Como estratégia de busca foi utilizada uma combinação específica de termos apenas em inglês. RESULTADOS: Um total de 8 estudos, publicados entre 2010 e 2018, foram incluídos na amostra. A idade média dos participantes foi de 40 a 56 anos, e as principais disfunções investigadas pelos artigos foram sintomas urinários (n = 8). Na literatura analisada, as taxas de incontinência urinária ligadas à histerectomia abdominal radical variaram de 7 a 31%. A mesma disfunção, para histerectomia radical laparoscópica, variou de 25 a 35%, e de 25 a 47% para histerectomia radical laparoscópica poupadora de nervo. A taxa de noctúria variou de 13%, antes do tratamento, a 30%, após histerectomia radical. A prevalência de dispareunia associada à histerectomia radical laparoscópica foi de 5 a 16%. Já a taxa de dispareunia relatada pós-histerectomia radical laparoscópica poupadora situou-se entre 7 e 19%. A dificuldade de alcançar o orgasmo foi relatada após histerectomia radical laparoscópica, variando de 10 a 14%, e também na histerectomia radical laparoscópica poupadora de nervo, variando de 9 a 19%. CONCLUSãO: Disfunções urinárias e sexuais após histerectomia para tratamento do câncer cervical são eventos frequentes. As principais desordens relatadas foram incontinência urinária e dispareunia.


Assuntos
Dispareunia , Laparoscopia , Disfunções Sexuais Fisiológicas , Incontinência Urinária , Neoplasias do Colo do Útero , Adulto , Feminino , Humanos , Histerectomia/efeitos adversos , Pessoa de Meia-Idade , Disfunções Sexuais Fisiológicas/epidemiologia , Disfunções Sexuais Fisiológicas/etiologia , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia , Incontinência Urinária/cirurgia , Neoplasias do Colo do Útero/epidemiologia
17.
Ceska Gynekol ; 87(4): 289-294, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36055791

RESUMO

OBJECTIVE: To summarize recent data and knowledge of laparoscopic power morcellation. METHODS: Review of articles. RESULTS: Laparoscopic morcellation has been introduced to gynecologic surgery in 90s. In 2014, Food and Drug Administration announced negative statement about the morcellation use due to the risk of potential spreading of malignant tumor cells. This statement reduced utilization of morcellation, especially in the United States. Since that, many health institutions and organizations started new researches focused on the safety of this surgical technique. After a couple of years, the morcellation is considered as a useful tool if certain rules are followed. CONCLUSION: Morcellation has a place in laparoscopic operative procedures even in 2022, in condition of correct selection of patients and possible utilization of contained in-bag morcellation.


Assuntos
Laparoscopia , Leiomioma , Morcelação , Miomectomia Uterina , Neoplasias Uterinas , Feminino , Humanos , Histerectomia/métodos , Laparoscopia/métodos , Leiomioma/cirurgia , Morcelação/efeitos adversos , Morcelação/métodos , Estados Unidos , Miomectomia Uterina/métodos , Neoplasias Uterinas/patologia , Neoplasias Uterinas/cirurgia
18.
J Clin Nurs ; 31(19-20): 2706-2715, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36065148

RESUMO

AIMS AND OBJECTIVES: To consolidate and synthesise the current available literature regarding the experiences of endometriosis-associated infertility among women and their partners. BACKGROUND: Endometriosis is highly associated with infertility which in turn affects many women and their partners in their prime reproductive age. DESIGN: A qualitative systematic review and meta-synthesis was conducted using the PRISMA checklist. METHODS: Seven electronic databases (PubMed, Embase, CINAHL, PsycINFO, Scopus, Web of Science and ProQuest Dissertations and Theses) were searched until October 2020. Qualitative studies exploring the experiences of women and/or their partners aged 18 years and above with endometriosis-associated infertility regardless of marital or co-inhabitation status and sexual orientation were included. Studies examining women and/or partners without clinical diagnosis of endometriosis and studies which only focused on the psychosocial experiences of endometriosis were excluded. The Critical Appraisal Skills Program checklist was used to conduct quality appraisal while the Sandelowski and Barroso's two-step approach was used to meta-summarise and meta-synthesise the data from the included studies. RESULTS: Thirteen studies were included. Five themes (1) Emotional response to the diagnosis, (2) Influence on family planning, (3) Desperation to gradual acceptance, (4) Revision of expected life trajectories and (5) Altered dynamics within the couple unit were derived. CONCLUSION: Endometriosis causes great psychological distress among women and their partners. Family planning decisions were especially challenging to make for the couples. Unsuccessful attempts at conceiving were extremely distressing but some couples eventually accepted their situation, with some opting for hysterectomy for health reasons. RELEVANCE TO CLINICAL PRACTICE: Current findings highlight the need for psychosocial support, in-depth fertility counselling and couple-based therapies to support the women with endometriosis and their partners.


Assuntos
Endometriose , Infertilidade , Endometriose/complicações , Serviços de Planejamento Familiar , Feminino , Humanos , Histerectomia , Infertilidade/etiologia , Masculino , Casamento
19.
Open Vet J ; 12(4): 519-524, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36118713

RESUMO

Background: Ovarian granulosa cell tumors (GCTs) are common neoplasms in domestic animals that originate from the sex-cord stromal cells of the ovary. The aim of the present paper was to report a case of ovarian GCT in a 5-year-old Persian female cat and to describe the histopathological pattern of this tumor. Case Description: The cat was brought for a routine diagnostic examination for pregnancy at Albaittar clinic in Tripoli, Libya with a history of 1 month mating before it was brought to the clinic for investigation of progressive behavioral changes. The cat external examination showed noticeable enlargement in the abdomen that was potentially suspected of pregnancy; however, the abdominal ultrasonography showed a great mass located on the right ovary. A therapeutic ovariohysterectomy was performed. The cat's clinical signs resolved, 6 months later it was diagnosed with a mass on the right kidney suspected as metastasis and one week later the cat died. Conclusion: In this case, macroscopic and microscopic studies are discussed and histopathological examination confirmed ovarian GCT with cystic endometrial hyperplasia and suspected metastasis in one kidney.


Assuntos
Doenças do Gato , Tumor de Células da Granulosa , Neoplasias Ovarianas , Animais , Doenças do Gato/diagnóstico , Doenças do Gato/cirurgia , Gatos , Feminino , Tumor de Células da Granulosa/diagnóstico , Tumor de Células da Granulosa/cirurgia , Tumor de Células da Granulosa/veterinária , Histerectomia/veterinária , Líbia , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/cirurgia , Neoplasias Ovarianas/veterinária
20.
Medicine (Baltimore) ; 101(36): e30528, 2022 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-36086674

RESUMO

BACKGROUND: Leiomyomatosis peritonealis disseminata (LPD) is a rare disease characterized by multiple leiomyomas spread all over the peritoneal cavity. It is commonly described as benign in women of reproductive age. Malignant LPD is much rarer. METHODS: We present a case of LPD with low potential malignant change in a 43-year-old female, who felt a lump in her abdomen after laparoscopic myomectomy 10 years ago and laparoscopic hysterectomy 8 years ago. The patient underwent exploratory laparotomy and salpingectomy, greater omentectomy, and pelvic and abdominal mass resection were performed during the surgery. The pathological findings revealed LPD with low potential malignant change, with strong expression of estrogen receptor and progesterone receptor. The patient refused oophorectomy and chose gonadotropin-releasing hormone agonists injection postoperatively. RESULTS: No recurrence was found during the follow-up to date. CONCLUSION: Surgery is the main treatment for LPD, and endocrine therapy is another choice. Although it is reported mostly benign, we need to be alert to the possibility of malignancy.


Assuntos
Neoplasias Gastrointestinais , Leiomiomatose , Neoplasias Peritoneais , Miomectomia Uterina , Adulto , Feminino , Neoplasias Gastrointestinais/cirurgia , Humanos , Histerectomia , Leiomiomatose/patologia , Leiomiomatose/cirurgia , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/cirurgia
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