Does Home Birth Reduce the Risk of Pelvic Organ Prolapse?

Objectives: To determine the relationship between vaginal birth and the development of POP among women who deliv­ered in non-hospital settings (home birth). Material and methods: Data were collected retrospectively from the files of patients who presented to a hospital outpatient clinic between April 1, 2011 and April 1, 2012 with complaints of urinary incontinence, uterine sagging, vaginal mass, or vaginal pain. The patients’ age, height, weight, body mass index, menopause age, number of deliveries, and presence of hypertension and diabetes mellitus were noted. Patients whose urogynecologic evaluation included POP Quantification (POP-Q) scoring were included in the study. The patients were separated into a group of women who had never given birth and another group of women with one or more deliveries. Results: Of the 179 patients in the study, 28 had never given birth and 151 had given birth at least once. The nulliparous patients had no cystocele, rectocele, or uterine prolapse. The prevalence rates of cystocele, rectocele, and uterine prolapse were significantly higher in the multiparous group. Cystocele, rectocele, and uterine prolapse development were significantly correlated with number of deliveries, but there was no statistical association with age, body mass index, menopausal age, diabetes mellitus, or hypertension. univariate analysis reveals that the only factor effective in the development of cytocele, rectocele and prolapse is the number of births. Conclusions: Our study suggests that only number of deliveries is associated with development of cystocele, rectocele, and uterine prolapse in women who gave birth by vaginal route in residential settings

Zgodność badania kolposkopowego wykonanego przy wykorzystaniu skali Reida z histopatologią

Objectives: The aim of the study was to evaluate the diagnostic efficacy of colposcopy and to determine the strength of correlation between colposcopic impression using the Reid Colposcopic Index (RCI) and histopathology. Material and methods: This was a prospective cross-sectional study carried out at the colposcopy clinic of Bakırköy Dr Sadi Konuk Education and Research Hospital, Department of Obstetrics and Gynecology, between June 2011 and September 2011. A total of 105 women who met the selection criteria were included in the study. All women underwent colposcopy and the final diagnosis was made using RCI. Colposcopy-guided biopsy was obtained from the abnormal areas. In cases when colposcopy did not reveal any lesion, a four-quadrant biopsy from the squamocolumnar junction was taken, which served as the gold standard. Results: According to the Reid scoring system, there were 60% of benign cases, whereas 27.6%, 5.7%, and 6.7% of the women were diagnosed with CIN 1, CIN 2, CIN 3, respectively. As far as histologic results were concerned, 62.9% of the subjects were benign, whereas 25.7%, 3.8%, and 7.6% of the patients were diagnosed with CIN 1, CIN 2, CIN 3, respectively. The correlation between the Reid scoring system and histologic results was statistically significant (p>0.05). Conclusions: The correlation between colposcopic lesions graded with RCI and histology was strong, particularly in women who had HGSIL on a Pap smear. Good correlation between colposcopic imaging using RCI and histopathology makes it a reproducible technique, easy to implement in colposcopy clinics.Cel pracy: Celem tej pracy jest ocena skuteczności diagnostycznej badania kolposkopowego i zbadanie zgodności obrazów kolposkopowych, uzyskanych przy użyciu skali Reida (RCI) z histopatologią. Materiał i metody: Badanie prospektywne, przekrojowe przeprowadzono w okresie od czerwca 2011 do września 2011 w Szpitalu Naukowo - Badawczym Bakırköy Dr Sadi Konuk w Pracowni Kolposkopii Kliniki Ginekologiczno- Położniczej. Do badania włączono 105 kobiet odpowiadających kryteriom. Wszystkie pacjentki miały wykonane badanie kolposkopowe i przy użyciu skali RCI postawiono diagnozę. Wykonano biopsję obszarów nieprawidłowych pod kontrolą kolposkopu. U kobiet, u których nie wykryto kolposkopowo patologii, wykonano biopsję na granicy nabłonków w czterech kwadrantach, które uznano jako złoty standard. Wyniki: Według skali Reida wykryto 60% zmian niezłośliwych, podczas gdy u 27,6% zdiagnozowano CIN 1, u 5,7% CIN 2, i u 6,7% CIN 3. Na podstawie badania histopatologicznego znaleziono 62,9% pacjentek ze zmianami niezłośliwymi, 25,7% CIN 1, 3,8% CIN 2, i 7,6% CIN 3. Związek indeksu RCI z histopatologią jest statystycznie znaczący (p>0.05). Dyskusja: Istnieje wysoki stopień zgodności pomiędzy prognozą dysplazji wykonaną przy pomocy RCI, a dysplazją w wynikach ostatecznych histologii. Zgodność jest jeszcze wyraźniejsza zwłaszcza u pacjentów z nieprawidłowym wynikiem wymazu HGSIL. Wysoka zgodność obrazów uzyskanych przy użyciu RCI z histopatologią zapewnia możliwość łatwej integracji tego narzędzia w pracowniach kolposkopowych, a także pozwala na stosowanie go przez innych lekarzy ginekologów

Surgical management of squamous cell vulvar cancer without clitoris, urethra or anus involvement

Vulvar cancers, which constitute 5% of all gynecologic cancers, are the fourth most common female genital cancers, preceded by uterine, ovarian and cervical cancers. The treatment methods employed for vulvar cancers have changed over the years, with previously applied radical surgical approaches, such as en bloc resection, being gradually suspended in favor of treatment approaches that require dissection of less tissue. While the removal of less tissue, which today's approaches have focused on, prevents morbidity, this method seems to result in higher risks of recurrence. It is therefore important that the balance between preventing the recurrence of the disease and forefending against postoperative complications and vulvar deformity be properly understood. As a working assumption, if patients with vulvar cancer are diagnosed at an early stage, properly evaluated and administered appropriate treatment, the most positive results can be obtained. This paper aims to highlight this assumption and demonstrate, through the provision of actual data, how to plan the treatment approach for patients who are diagnosed early. Statements extracted from the National Comprehensive Cancer Network (NCCN) Guidelines Version 1.2016 Sub-Committees on vulvar squamous cell carcinoma and articles by the European Society of Gynaecological Oncology (ESGO) regarding Vulvar Cancer Recommendations were used to obtain updated information. (C) 2017 The Authors. Published by Elsevier Inc

Surgical management of squamous cell vulvar cancer without clitoris, urethra or anus involvement

Vulvar cancers, which constitute 5% of all gynecologic cancers, are the fourth most common female genital cancers, preceded by uterine, ovarian and cervical cancers. The treatment methods employed for vulvar cancers have changed over the years, with previously applied radical surgical approaches, such as en bloc resection, being gradually suspended in favor of treatment approaches that require dissection of less tissue. While the removal of less tissue, which today's approaches have focused on, prevents morbidity, this method seems to result in higher risks of recurrence. It is therefore important that the balance between preventing the recurrence of the disease and forefending against postoperative complications and vulvar deformity be properly understood. As a working assumption, if patients with vulvar cancer are diagnosed at an early stage, properly evaluated and administered appropriate treatment, the most positive results can be obtained. This paper aims to highlight this assumption and demonstrate, through the provision of actual data, how to plan the treatment approach for patients who are diagnosed early. Statements extracted from the National Comprehensive Cancer Network (NCCN) Guidelines Version 1.2016 Sub-Committees on vulvar squamous cell carcinoma and articles by the European Society of Gynaecological Oncology (ESGO) regarding Vulvar Cancer Recommendations were used to obtain updated information

Does the Increased Rate of Serous Component (<= 25% vs. >25%) Increase Recurrence in Endometrial Cancer With Serous Plus Endometrioid Histology?

Objective: The aim of the study is to investigate the effect of increasing serous component ratio on survival in endometrium cancer patients with serous plus endometrioid histology

Comparison of Long-Term Survival Rates of Primary Surgery and Surgery After Neoadjuvant Chemotherapy in Ovarian Cancer

Introduction: To compare long-term survival of primary debulking surgery (PDS) and interval debulking surgery (IDS) after neoadjuvant chemotherapy (NAC) in patients with advanced ovarian cancer

Is Surgical Treatment an Option for Locally Advanced Cervical Cancer in the Presence of Central Residual Tumor after Chemoradiotherapy?

Objective To evaluate the outcomes of surgical treatment in patients with chemoradiotherapy (CRT)-resistant and locally advanced cervical cancer (LACC)