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1.
Soshi Kusunoki Kuan-Gen Huang Angelito Magno 《Taiwanese journal of obstetrics & gynecology》2018,57(1):141-143
Objective
There are some reports of cervical cancer with uterus didelphys but a case of clear cell carcinoma (CCCC) with Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) syndrome is extremely rare. The aim of this paper was to report a case of CCCC with OHVIRA syndrome and the difficulty in making a preoperative diagnosis.Case report
A 65 years old woman presented with postmenopausal bleeding and pelvic examination showed right paracervical mass. Preoperative confirmation of cervical carcinoma was difficult due to the location of the mass, which was inaccessible by cervical punch biopsy. Pelvic examination revealed a large mass in pelvic cavity without parametrial invasion and ultrasound showed approximately 70 mm cervical tumor. Laparoscopic surgery revealed clear cell carcinoma of the para-endocervix with OHVIRA syndrome.Conclusion
In the case of cervical carcinoma with OHVIRA syndrome, laparoscopic surgery is preferable for the diagnosis and management. 相似文献2.
Renato Augusto Moreira de Sá Valeria Pereira de Moraes Marianne Cecília da Costa Soares Heron Werner Gerson Ribeiro Jorge Lopes Edward Araujo Júnior 《Journal d'obstetrique et gynecologie du Canada》2018,40(1):75-77
Background
Complete uterine rupture is a rare and severe intrapartum complication with high rates of maternal and fetal mortality. Asymptomatic uterine rupture is a very rare condition with one unique previous case described in the literature. Three-dimensional virtual models allow an immersive virtual reality of maternal-fetal structures with better understanding by the parents and the medical team.Case
We demonstrate a case of asymptomatic rupture uterine with a large amniocele and protruded legs and umbilical cord at 28 weeks of gestation by using a 3-D virtual model from ultrasound scan data.Conclusion
3-D virtual models may be applied to the assessment of obstetric complications, thereby allowing a novel 3-D spatial view of maternal-fetal structures. 相似文献3.
Karina Kapczuk Zbigniew Friebe Kinga Iwaniec Witold Kędzia 《Journal of pediatric and adolescent gynecology》2018,31(3):252-257
Study Objective
To assess the clinical course of obstructive Müllerian anomalies found in girls after menarche.Design
A retrospective case series of adolescents who, between 2009 and 2016, were treated for vaginal or uterine obstructive malformations diagnosed after menarche.Setting
Division of Gynecology, Poznań University of Medical Sciences, Poznań, Poland.Participants and Interventions
Twenty-two patients who, at the age range between 11.4 and 18.2 (median, 13.1) years, between 2 and 74 (median 7.5) months after menarche, underwent surgical repair of obstructive genital anomaly.Main Outcome Measures
Müllerian defect type, presentation, radiologic findings, pre- and postoperative course.Results
Eighteen patients (18 of 22; 81.8%) were diagnosed with obstructed hemivagina ipsilateral renal anomaly syndrome. One patient (1 of 22; 4.5%) was diagnosed with uterus didelphys and unilateral cervical atresia. Three patients (3 of 22; 13.6%) had unicornuate uterus with a cavitated, noncommunicating rudimentary horn. The right side was affected in 13 patients (13 of 22; 59.1%), and the left side in 9 patients (9 of 22; 40.9%; P > .05). All but 1 patient had renal agenesis on the side of obstruction. Before repair of the obstructive genital anomaly, 4 patients underwent unnecessary surgeries for misdiagnosed ovarian cysts. Serious complications (pelvic inflammatory disease, vesicovaginal fistula) occurred in 2 patients with microperforated pyocolpos. Pelvic endometriosis was found in 4 of our patients.Conclusion
Our case series suggests that obstructed hemivagina ipsilateral renal anomaly syndrome is the most common obstructive Müllerian anomaly diagnosed in adolescents after menarche. The differential diagnosis for unilateral kidney agenesis accompanied by dysmenorrhea in adolescent girls should include obstructive genital tract anomaly. Accurate diagnosis of an obstructive genital anomaly early after menarche might help prevent unnecessary surgeries and infection-related complications. Meanwhile, prompt surgical correction of an obstructive genital tract anomaly results in relief of symptoms and might reduce the risk of endometriosis. 相似文献4.
Shinichi Togami Toshihiko Kawamura Mika Fukuda Shintaro Yanazume Masaki Kamio Hiroaki Kobayashi 《Taiwanese journal of obstetrics & gynecology》2018,57(4):479-482
Objective
To assess the clinicopathological characteristics and clinical management of patients diagnosed with mullerian adenosarcoma of the uterine cervix.Materials and methods
Records of six patients surgically treated for cervical mullerian adenosarcoma were reviewed.Results
The median age of the patients was 50 years (range, 17–74). Four patients presented with vaginal bleeding and two of them had watery discharge as the primary symptoms. Three nulliparous patients who hoped to preserve their uterus were included in this study and only one of the three patients received fertility-preservation surgery. Five patients underwent hysterectomy (simple in 3, modified radical in 2) with bilateral salpingo-oophorectomy or bilateral salpingectomy. One patient underwent conization of the cervix to preserve her fertility as there was no sarcomatous overgrowth, heterologous elements, or deep cervical stromal invasion. A recurrence of cervical mullerian adenosarcoma with sarcomatous overgrowth was observed in one patient who underwent simple hysterectomy.Conclusion
The presence of sarcomatous overgrowth and deep cervical stromal invasion are associated with poor prognosis. Along with adequate counseling, fertility-preservation surgery may be an acceptable option for exophytic cervical mullerian adenosarcoma in the cases that do not show sarcomatous overgrowth and deep cervical stromal invasion. 相似文献5.
Tsia-Shu Lo Sukanda Bin Jaili Rami Ibrahim 《Taiwanese journal of obstetrics & gynecology》2017,56(4):534-537
Objective
Urethral diverticulum is uncommon, therefore appropriate evaluation, preoperative planning and counseling must be done in order to make correct diagnosis and prevent complications.Materials and methods
A case of anterior vaginal wall mass was treated elsewhere by a gynecologist as periurethral cyst abscess; incision and drainage were done but a symptom of pus discharge was observed after 2 weeks. Therefore, exploration, cyst wall excision and primary closure were done though histopathological examination surprisingly confirmed the presence of urethral tissue suggestive of diverticulum.Results
Subsequently, she developed persistent urinary leakage along with urethrovaginal fistula for which they again performed pervaginal multilayer closure. Patient was later referred to us with recurrent urethrovaginal fistula. We performed posterior urethral fistulectomy with anterior vaginal wall flap and multilayer closure. Three years follow up reveals complete recovery.Conclusion
Even urethral diverticulum is a rare condition, should be kept in mind as early diagnosis and management. 相似文献6.
Kate C. Arnold Theresa C. Thai LaTasha B. Craig 《Journal of pediatric and adolescent gynecology》2018,31(1):64-66
Background
Isolated uterine didelphys requires no treatment in contrast to cervical agenesis, which requires a hysterectomy. Because of this, correct diagnosis of Müllerian anomalies is paramount for making recommendations for patient care.Case
A 15-year-old girl presented to clinic with pelvic pain and primary amenorrhea. Uterine didelphys with bilateral cervical agenesis was diagnosed using imaging. Hysterectomy was recommended and diagnosis was confirmed at surgery and according to anatomic pathology.Summary and Conclusion
Our patient with uterine didelphys with bilateral cervical agenesis presented a diagnostic challenge, because, to our knowledge, it has never been reported before in the literature. Her pattern of anomalies had significant implications for future fertility. Radiology exam was vital to confirming this diagnosis in a young, virginal female patient. 相似文献7.
8.
Jennifer E. McCabe-Beane Sara M. Stasik-O&#x;Brien Lisa S. Segre 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》2018,47(1):105-113
Objectives
To examine the incremental identification of emotional distress in mothers of hospitalized newborns by screening for anxiety in addition to depression and to provide practical information about anxiety screening scales to facilitate instrument selection and screening implementation by nurses in the NICU.Design
In this secondary data analysis, screening data from the recruitment phase of a feasibility trial to evaluate a nurse-delivered counseling intervention for emotionally distressed mothers of newborns in the NICU were used to examine the effect of anxiety screening.Setting
A Level IV NICU at a large academic medical center in the Midwestern United States.Participants
Women 18 years of age and older (N = 190) with newborns in the NICU.Methods
Participants completed multiple measures of depression and anxiety symptoms.Results
Of participants who had negative screening results on a depression-only screening instrument, 4.7% to 14.7% endorsed clinically significant anxiety symptoms depending on the screening instrument used.Conclusion
Screening for anxiety in mothers of newborns in the NICU resulted in identification of distressed mothers who would otherwise have been missed during routine depression-only screening. Multiple options for anxiety screening exist that add incremental information to depression-only screening and require little additional burden on providers and mothers of newborns in the NICU. 相似文献9.
Akihiro Takeda Kazuko Watanabe Shotaro Hayashi Sanae Imoto Hiromi Nakamura 《Journal of pediatric and adolescent gynecology》2017,30(2):251-255
Background
Gynandroblastoma is an extremely rare ovarian sex cord tumor with malignant potential.Case
An 18-year-old adolescent experienced intermittent vaginal bleeding. A year later, a right adnexal mass with a heterogeneous imaging appearance was identified. Laparoendoscopic single-site ovarian tumorectomy was performed. A histopathological examination showed gynandroblastoma composed of juvenile granulosa and Sertoli-Leydig cells. Because the tumor was upstaged to stage Ic because of cyst rupture during surgery, three cycles of adjuvant chemotherapy with carboplatin and paclitaxel were added. Three years after surgery, no signs of recurrence have been noted.Summary and Conclusion
The present findings can help clinicians make an accurate preoperative imaging diagnosis of gynandroblastoma with a juvenile granulosa cell component and plan an adequate treatment strategy for this rare, potentially malignant neoplasm. 相似文献10.
Abraham Degarege Karl Krupp Kristopher Fennie Tan Li Dionne P. Stephens Laura A.V. Marlow Vijaya Srinivas Anjali Arun Purnima Madhivanan 《Journal of pediatric and adolescent gynecology》2018,31(5):494-502
Study Objective
The aim of this study was to compare the parental attitudes and beliefs about human papillomavirus (HPV), cervical cancer, and HPV vaccine between urban and rural areas, India.Design
Cross-sectional.Setting
Mysore, India.Participants
Parents of school-going adolescent girls.Interventions
Parents completed a self-administered questionnaire.Main Outcome Measures
Attitudes and beliefs about HPV, cervical cancer, and HPV vaccine.Results
A total of 1609 parents from urban (n = 778) and rural (n = 831) areas participated in this study. Most of the parents had never heard about HPV (73.6%), did not know that their daughters could get an HPV infection (62.7%) or cervical cancer (64.1%) in the future, and believed that HPV vaccine was not effective (67.1%). Parents living in the urban area were more likely to believe that HPV infection (adjusted odds ratio [aOR], 2.69; 95% confidence interval [CI], 1.43-5.06) and cervical cancer (aOR, 2.68; 95% CI, 1.83-3.91) could cause serious health problems than those living in the rural area. The odds of agreeing that HPV vaccination will make girls sexually active was lower among urban than rural parents (aOR, 0.55; 95% CI, 0.33-0.94). There was no significant difference among parents in the urban and rural areas in their beliefs about susceptibility of their daughter to HPV infection or cervical cancer, and beliefs about the safety and ability of HPV vaccine to protect against cervical cancer.Conclusion
Rural parents might be reluctant to recommend behaviors that can help prevent HPV infection and cervical cancer such as HPV vaccination for their daughters. 相似文献11.
Camille Martel-Billard Emilie Faller Maia Delaine Thomas Boisramé Jean-Jacques Baldauf Cherif Youssef Akladios 《Journal of minimally invasive gynecology》2017,24(1):14-15
Study Objective
To demonstrate the technique of laparoscopic radical trachelectomy (LRT) and laparoscopic pelvic lymphadenectomy for early cervical cancer.Design
Case report (Canadian Task Force Classification Study design III).Setting
Tertiary referral centre in Strasbourg, France.Background
Over the past 15 years, gynecologic oncologists have sought ways to preserve female fertility when treating invasive cervical cancer. Many cases of cervical cancer have been diagnosed in young women with a desire to preserve their fertility. As more women are delaying childbearing, fertility preservation has become an important consideration. Radical hysterectomy and bilateral pelvic lymphadenectomy represent the standard surgical treatment for stage IA2-IB1 cervical cancer. In some women with small localized invasive cervical cancer, there is hope for a pregnancy after treatment. Vaginal radical trachelectomy (VRT) is a fertilitypreserving surgical procedure for early-stage cervical cancers. The National Comprehensive Cancer Network has published guidelines stating that radical trachelectomy is part of the standard of care for women desiring to preserve their future fertility. VRTwas introduced in 1987 with its first reported use in 1994, and since then more than 1000 cases of VRT have been reported involving more than 250 live births. The tumor recurrence rate is between 4.2% and 5.3%, and the mortality rate is between 2.5% and 3.2%. However, VRT has several limitations despite results demonstrating the safety of the procedure. One limitation is that it is an inadequate procedure for nulliparous patients and those with history of previous conization with adverse vaginal anatomy. In addition, it is difficult to learn the techniques involved in radical vaginal surgery.Patients
A 26 year-old nulliparous women with a FIGO Stage IB1 squamous cell tumor of the cervix. A first conisation was performed with no safe resection margins.Intervention
In this video we show a type B laparoscopic radical trachelectomy with round ligament and uterine artery preservation. A laparoscopic pelvic lymphadenectomy was also performed. Our institutional review board approved this study.Measurements and Main Results
Operative time was 240 minutes. Intraoperative blood loss was less than 100 mL. The operation was performed successfully with no intraoperative complications. Pathological findings demonstrated the presence of a cervical intraepithelial neoplasia 2 on the anterior lips from an 11 o'clock to a 1 o'clock position. Resection margins were safe. The surgical specimen did not show any residual invasive carcinoma. Twenty one lymph nodes were removed, 7 on the right side, and 14 on the left side. No metastatic adenopathy was found. The patient was discharged on day 11. After 5 months, no late complications or recurrence was detected.Conclusions
LRT appears to be a safe option for women who intend to maintain their desire for a future pregnancy. 相似文献12.
Mei-Yu Peng Chin-Ru Ker Yung-Shih Lee Mei-Ching Ho Te-Fu Chan 《Taiwanese journal of obstetrics & gynecology》2018,57(5):755-759
Objective
Ruptured cervical varicose veins can cause significant vaginal bleeding during the third trimester of pregnancy. The etiology is not uncommon, yet receives little discussion in current literature. We here report such a case with complete evaluations, managements and follow ups; while analyzing similar cases published.Case report
A 34-year-old pregnant woman, gravida 1, presented with sudden onset of painless antepartum hemorrhage at 31+5 weeks of gestation. Speculum examination revealed ruptured cervical varicose veins; further evaluations with transvaginal sonography and magnetic resonance imaging were done to study the extensiveness and characteristics of the lesion. The cervical varices spontaneously regressed by postpartum day 4 and no recurrence was observed in the immediate postpartum follow-up period or in the subsequent pregnancy.Conclusion
The case is unique for the lack of association with placenta previa. Cervical varicose veins rupture should be considered for painless vaginal bleeding during the third trimester pregnancy. 相似文献13.
Chin-Jui Wu Wen-Chun Chang Chi-Hau Chen Chi-An Chen Su-Cheng Huang Bor-Ching Sheu 《Taiwanese journal of obstetrics & gynecology》2017,56(2):143-146
Objective
Radical trachelectomy (RT) is an alternative treatment for preserving fertility in patients with cervical cancer. Because women with operable cervical cancer opting for fertility preservation are scarce, few cases have been reported in Taiwan. Here we report our cases series.Materials and Methods
We retrospectively evaluated seven patients who underwent vaginal RT and three patients who underwent abdominal RT in a single medical institute for a median follow-up period of 5 years.Results
The oncological outcome was highly satisfactory. All patients survived and are currently disease-free, except for two who had recurrence and received additional concurrent chemoradiation therapy. Other complications included urinary tract infection, cervical stenosis, and unilateral hydronephrosis. All complications were manageable with little long-term effects. However, no pregnancy was observed during the 5-year follow-up period.Conclusion
RT is considered a complicated surgical procedure among gynecological operations. Here we review the literature and describe several factors associated with higher pregnancy rates. 相似文献14.
15.
Hyun-Woong Cho Yu-Jin Koo Kyung-Jin Min Jin-Hwa Hong Jae-Kwan Lee 《Journal of pediatric and adolescent gynecology》2017,30(2):203-208
Study Objective
To evaluate the incidence of pelvic inflammatory disease (PID) in virgin women and investigate the clinical characteristics of the patients.Design
Retrospective chart review and literature review.Setting
Tertiary academic center.Participants
Virgin women who were confirmed to have PID via surgery from 2002 to 2014.Interventions
None.Main Outcome Measures
The evaluation of medicosurgical history, clinical progress, surgical record, and pathologic reports.Results
Of 122 patients diagnosed with PID via surgery, 5 women were virgins (4.1%). The median age was 21 years (range, 14-24 years), and all patients presented with abdominal pain. The median diameter of the pelvic abscess pocket on preoperative imaging was 4.5 cm (range, 2.6-15 cm). Only 1 case was preoperatively diagnosed as a tubo-ovarian abscess; the others were expected to be benign ovarian tumors, such as endometrioma and dermoid cysts. No possible source of infection was identified for any patient, except 1 who had a history of an appendectomy because of a ruptured appendix. The results of the histopathological analysis of the excisional biopsy performed during surgery in 4 cases were consistent with acute suppurative inflammation. After postoperative antibiotic use, the conditions of all patients stabilized, and they were discharged from the hospital on median postoperative day 9.Conclusion
PID in virgin women is rare, but it should be considered in all women with abdominal pain, regardless of sexual history. 相似文献16.
Christine M. Pennesi Brian Kenney Rajan Thakkar Christina Ching Geri Hewitt Katherine McCracken 《Journal of pediatric and adolescent gynecology》2018,31(6):640-643
Background
Heavy, prolonged menstrual bleeding is common in adolescents and results from a variety of etiologies.Case
A 13-year-old, virginal girl was referred for prolonged, heavy vaginal bleeding despite combined oral contraceptive use and elected management with a levonorgestrel intrauterine device. A preprocedure exam revealed a plastic foreign body embedded in the posterior vaginal fornix, however, attempted removal in the office was unsuccessful. Subsequent computed tomography imaging of the pelvis revealed a vaginal foreign body, complex adnexal mass, and hydroureter. The patient underwent exam under anesthesia and diagnostic laparoscopy, but required conversion to exploratory laparotomy for removal of a foreign body because of vaginal perforation abutting the rectum.Summary and Conclusion
Foreign bodies not easily removed in the outpatient setting should be considered for surgical removal with consideration of preoperative multidisciplinary coordination when imaging reveals intra-abdominal pathology, such as tubo-ovarian abscess and hydroureter. 相似文献17.
Julie S. Downs Amie M. Ashcraft Pamela J. Murray Elise D. Berlan Wändi Bruine de Bruin Joan Eichner Baruch Fischhoff Janie M. Leary Robert B. McCall Elizabeth Miller Jennifer Salaway Janell Smith-Jones Gina S. Sucato 《Journal of pediatric and adolescent gynecology》2018,31(3):291-298.e2
Study Objective
To assess the effects of the Seventeen Days interactive video on young women's perceived self-efficacy for using condoms 6 months after being offered the intervention, relative to a control.Design
Multisite randomized controlled trial.Setting
Twenty participating health clinics and county health departments in Ohio, Pennsylvania, and West Virginia.Participants
Sexually active female adolescents ages 14 to 19 years.Interventions
Seventeen Days (treatment intervention; sex education) vs Driving Skills for Life (control intervention; driving education).Main Outcome Measures
Perceived self-efficacy for condom use.Results
Participants in the Seventeen Days group reported higher perceived condom acquisition self-efficacy after 6 months than those in the driving group. This finding held after controlling for baseline self-efficacy scores and other covariates.Conclusion
The Seventeen Days program shows promise to improve perceived self-efficacy to acquire condoms among sexually active female adolescents—an important precursor to behavior change. 相似文献18.
Sara Reed Kelly A. Curran Amy B. Middleman 《Journal of pediatric and adolescent gynecology》2018,31(2):138-139
Background
Patients’ underlying medical conditions might affect the presentation and progression of an eating disorder.Case
We describe a patient with an undiagnosed, rare, genetic skeletal dysplasia with effects on body mass index that likely led to body image distortion and delayed the diagnosis of an eating disorder.Summary and Conclusion
It is critical to fully assess disordered eating in the context of each patient's clinical status. 相似文献19.
Laurine Vienet-Legué Barbara Hersant Anne Bisdorf Armand Aymard Clémentine Owen Claire Théodore Bernard Jean Paniel Bassam Haddad Cyril Touboul 《Journal of pediatric and adolescent gynecology》2018,31(1):58-61
Background
Congenital arteriovenous malformations (AVMs) are infrequent but represent a serious medical challenge because of their unpredictable progression and high hemodynamic activity.Case
We report on the treatment of a voluminous vulvar AVM in a 16-year-old girl. After failure of medical therapy, we performed a radical surgical resection with preliminary embolization and flap reconstruction.Summary and Conclusion
A multidisciplinary approach is required for AVM management. Early intervention and complete surgical resection combined with preliminary embolization represents the ideal therapy. 相似文献20.
Ana López Carrasco Alicia Hernández Gutiérrez Paula A. Hidalgo Gutiérrez Roberto Rodríguez González José L. Marijuán Martín Ignacio Zapardiel Javier de Santiago García 《Taiwanese journal of obstetrics & gynecology》2017,56(2):243-246