Ceska Gynekol [JOURNAL]
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200 papers
New staging of endometrial carcinoma - FIGO 2023.
Hruda M, Sehnal B, Halaška MJ … +4 more , Drozenová J, Robová H, Pichlík T, Rob L
Ceska Gynekol · 2024 · PMID 38704224 · Publisher ↗
AIM: To review the changes in the new version of the FIGO 2023 staging system for endometrial cancer. METHODS AND RESULTS: The new FIGO 2023 endometrial cancer staging system provides key updates for the diagnosis and tr...
AIM: To review the changes in the new version of the FIGO 2023 staging system for endometrial cancer. METHODS AND RESULTS: The new FIGO 2023 endometrial cancer staging system provides key updates for the diagnosis and treatment of endometrial cancer. An important step in diagnosis is molecular classification, which allows more accurate risk stratification for recurrence and the identification of targeted therapies. The new staging system, based on the recommendations of the international societies ESGO, ESTRO and ESP, incorporates not only the description of the pathological and anatomical extent of the disease, but also the histopathological characteristics of the tumour, including the histological type and the presence of lymphovascular space invasion. In addition, the staging system uses molecular testing to classify endometrial cancers into four prognostic groups: POLEmut, MMRd, NSMP and p53abn. Each group has its own specific characteristics and prognosis. The most significant changes have occurred in stages I and II, in which the sub-staging better reflects the biological behaviour of the tumour. This update increases the accuracy of prognosis and improves individualized treatment options for patients with endometrial cancer. CONCLUSION: The updated FIGO staging of endometrial cancer for 2023 incorporates different histologic types, tumour features, and molecular classifications to better reflect the current improved understanding of the complex nature of several endometrial cancer types and their underlying bio logic behaviour. The aim of the new endometrial cancer staging system is to better define stages with similar prognosis, allowing for more precise indication of individualised adjuvant radiation or systemic treatment, including the use of immunotherapy.
Interprofessional cooperation with a dermatovenerologist - specifics of hidradenitis suppurativa management in gynaecological practice.
Ivanková B, Kampe T, Baloghová J
Ceska Gynekol · 2024 · PMID 38704223 · Publisher ↗
Hidradenitis suppurativa is a chronic immune-mediated inflammatory disease that is manifested by formation of painful nodules, abscesses and suppurating fistulas, primarily in the intertriginous spaces. This painful, oft...
Hidradenitis suppurativa is a chronic immune-mediated inflammatory disease that is manifested by formation of painful nodules, abscesses and suppurating fistulas, primarily in the intertriginous spaces. This painful, often under-diagnosed disease affects much more women. They are also exposed to certain specific challenges in the management of this disease, especially during menstruation or pregnancy. The treatment requires the interdisciplinary cooperation of a dermatologist, gynaecologist, obstetrician and last but not least an algesiologist and psychotherapist. Above all, early and correct diagnosis, initiation of therapy in the early stages of the disease, is a key, which also plays a fundamental role in controlling inflammatory activity, preventing complications and further prognosis.
Haemorrhagic stroke in pregnancy.
Svobodová N, Kaščák P, Bojda M
Ceska Gynekol · 2024 · PMID 38704222 · Publisher ↗
OBJECTIVE: To present a case of acute haemorrhagic stroke during 3rd trimester of pregnancy and to describe management and successful delivery of healthy baby. CASE REPORT: Haemorrhagic stroke is responsible for signific...
OBJECTIVE: To present a case of acute haemorrhagic stroke during 3rd trimester of pregnancy and to describe management and successful delivery of healthy baby. CASE REPORT: Haemorrhagic stroke is responsible for significant morbidity and mortality. Prognosis can be improved only by urgent diagnosis and care. We report a case of pregnant woman at 37th week of pregnancy with acute haemorrhagic stroke of unknown etiology with clinical appearance of thunderclap headaches and overall disorientation. We describe diagnostic approach and a successful management followed by further differential diagnosis and treatment. The foetus was delivered by acute caesarean section at 37th week of pregnancy. CONCLUSION: Occurrence of haemorrhagic stroke in pregnancy is rare. There are no specific guidelines that recommend the time and mode of delivery; therefore, each case is assessed individually.
Fecal incontinence risk factors and pregnancy.
Vasyliuk S, Cheredarchuk A, Rymarchuk M … +3 more , Bondarev R, Proshchenko O, Mykytyuk A
Ceska Gynekol · 2024 · PMID 38704221 · Publisher ↗
MATERIALS AND METHODS: We conducted an analysis on 231 pregnant women. A proctologist examined the patients three times: in the 1st trimester (within the first 15 weeks), in the 3rd trimester (29-40 weeks), and 12 months...
MATERIALS AND METHODS: We conducted an analysis on 231 pregnant women. A proctologist examined the patients three times: in the 1st trimester (within the first 15 weeks), in the 3rd trimester (29-40 weeks), and 12 months after childbirth. RESULTS: The total number of fecal incontinence observations among women included in the study was 66 cases (28.6%), detected at the final visit. Risk factors for fecal incontinence with a high probability were age over 36 years (P = 0.001), low physical activity (P = 0.034), three or more pregnancies resulting in childbirth (P = 0.022), history of hemorrhoids (P = 0.027), perianal discomfort on the first visit (P = 0.045), and constipation on the first visit (P = 0.006). Factors such as being overweight, marital status, education, living conditions, living area, and infant size did not have significance for fecal incontinence. DISCUSSION: Pregnancy- and obstetric-related risk factors contributing to fecal incontinence are multifactorial, including factors such as multiple childbirths with trauma to the pelvic muscles or anal sphincter muscles, chronic constipation, age, and vaginal deliveries. However, currently, there is no clear concept for the prevention of fecal incontinence in pregnant women. CONCLUSION: The prevalence of fecal incontinence among pregnant women is 12.9%, which increases to 28.6% one year after childbirth. The most common complaint was involuntary passage of intestinal gas. Risk factors for fecal incontinence with a high probability included being over 36-years old, low physical activity, three or more pregnancies resulting in childbirth, a history of hemorrhoids, perianal discomfort, and constipation in the 1st trimester of pregnancy.
Peritumoral stroma and systemic inflammatory response in cervical cancer.
Santana Otano S, Melo AM, Ferreira Souza FB … +7 more , Souto Morlin J, de Castro Côbo E, Macêdo Barcelos AC, Rua Micheletti AM, Prata Jammal M, Candido Murta EF, Simões Nomelini R
Ceska Gynekol · 2024 · PMID 38704220 · Publisher ↗
OBJECTIVE: To compare cervical stroma in advanced cervical cancer with the control group; to compare, in the pre-treatment period, hemogram parameters in patients with advanced cervical cancer with the same parameters as...
OBJECTIVE: To compare cervical stroma in advanced cervical cancer with the control group; to compare, in the pre-treatment period, hemogram parameters in patients with advanced cervical cancer with the same parameters as the control group; and to verify if there is an association of stromal markers with prognostic factors in cervical cancer. MATERIALS AND METHODS: We prospectively evaluated 16 patients diagnosed with advanced invasive cervical cancer. A control group of 22 patients was used (uterine leiomyoma). Immunohistochemistry was performed to verify the stromal immunostaining of alpha-smooth muscle actin (SMA) and fibroblast activation protein alpha (FAP). Immunostainings and hemogram parameters were compared using Fisher's exact and Mann-Whitney Test, respectively. RESULTS: Strong FAP immunostaining was more frequent in patients with cervical cancer when compared with patients with leiomyoma (P = 0.0002). Regarding SMA, strong immunostaining was also found more in the group of cancer patients compared to the control group (P < 0.00001). The neutrophil-lymphocyte ratio (NLR) values were higher in the cancer patient group compared to the control group (P = 0.0019). There was no association of the parameters studied with prognostic factors. CONCLUSIONS: Strong FAP and SMA immunostaining was found more in patients with cervical cancer when compared to the control group. NLR values were also higher in cervical cancer.
Dynamics of serum levels and reference ranges of copeptin in the 3rd trimester of pregnancy in healthy pregnant women with uncomplicated pregnancy and delivery.
Roubalová L, Gardlo A, Horejskova S … +3 more , Dudova A, Krofta L, Ľubušký M
Ceska Gynekol · 2024 · PMID 38704219 · Publisher ↗
OBJECTIVE: Copeptin is a stable fragment of vasopressin. Copeptin levels have been found to reflect the degree of endothelial stress in various conditions, including acute coronary syndrome. Copeptin may be a bio marker...
OBJECTIVE: Copeptin is a stable fragment of vasopressin. Copeptin levels have been found to reflect the degree of endothelial stress in various conditions, including acute coronary syndrome. Copeptin may be a bio marker for endothelial stress during pregnancy. However, there is still a lack of understanding of its dynamics and levels throughout pregnancy. This study aims to describe intra-individual and longitudinal changes in copeptin levels at 30th and 36th gestational weeks in healthy pregnant women with uncomplicated pregnancy and delivery and to establish specific reference ranges. METHODS: A total of 125 pregnant women with uncomplicated pregnancy and delivery were included. These women were monitored throughout their pregnancy and gave birth at the Department of Obstetrics and Gynecology Olomouc University Hospital. The blood was taken at ~30 and ~36 gestational weeks. Serum copeptin levels were measured using a Kryptor Compact PLUS analyzer. For statistics, we used R software and the "referenceRanges" package. RESULTS: It was found that serum levels of copeptin were significantly higher in the 36th week group than in the 30th week group (P < 0.05). Cook's distance was used to eliminate outliers. The 30th week median was 3.377 pmol/l, reference range = 1.343-7.829 pmol/l, and the 36 week was median 4.735 pmol/l and reference range = 2.06-13.2 pmol/l. In the 36th week reference range, the median was higher than in healthy, non-pregnant women (P < 0.05). Copeptin values can exceed 10 pmol/l, particularly after the 36th week. In the 3rd trimester, this value may indicate cardiovascular and endothelial overload. CONCLUSION: Copeptin levels were found to vary significantly depending on gestational week. The proposed reference ranges take into account the increased secretion of vasopressin in pregnancy. The existence of specific upper reference limits represents a potential advantage in detecting pregnant women prone to hypertensive disease in the 3rd trimester.
New recommendations for informing patients and gamete donors in assisted reproduction.
Konečná H, Elišková Z, Honzová I
Ceska Gynekol · 2024 · PMID 38418257 · Publisher ↗
The number of cycles of assisted reproduction using donor body parts is increasing significantly. In Europe alone, around one hundred thousand children are born each year who have some relationship to three or more paren...
The number of cycles of assisted reproduction using donor body parts is increasing significantly. In Europe alone, around one hundred thousand children are born each year who have some relationship to three or more parents. The European expert guarantor European Society of Human Reproduction and Embryology therefore issued a recommendation in 2022 to inform donors, recipients and children born in this way. Our article analyses developments in this area and proposes a solution for the Czech Republic. It is necessary for providers to immediately respond to the fact that the anonymity of donation can no longer be guaranteed, and to adapt the content of consultations and informed consents of potential donors and applicants accordingly. Legislation then has two possible solutions: first to adopt a system of "polyparenthoods" or second to fundamentally limit donation cycles.
Birth plan - legal and medical aspects.
Erdősová A, Gašparová P, Ballová Z … +1 more , Dosedla E
Ceska Gynekol · 2024 · PMID 38418256 · Publisher ↗
A birth plan is a document that defines mother's preferences and expectations regarding childbirth and early puerperium. The purpose of the birth plan is to establish communication about mother's birth wishes and to prop...
A birth plan is a document that defines mother's preferences and expectations regarding childbirth and early puerperium. The purpose of the birth plan is to establish communication about mother's birth wishes and to properly convey them to the health care providers. With increasing computerization of society, birth plan is currently the subject of heated debate. In this article, we present historical view of the birth plan, as well as current legislation regarding the birth plan, as we do not consider legal awareness of obstetricians to be sufficient at the moment. The purpose of this article is to appeal to the professional public so they have up-to-date information about the birth plan, especially in discussions with patients, but also during forensic procedures. The preservation of excellent perinatological results under our circumstances is only possible by providing professional, empathetic and very intimate health care in hospital institutions.
Uterovesical fistula and its treatment in Sub-Saharan Africa.
Brtnický T, Simono Charadan AM, Koliba P … +4 more , Malecová M, Dubová O, Hubka P, Zikán M
Ceska Gynekol · 2024 · PMID 38418255 · Publisher ↗
Aim of the study to summarize the current information on diagnostic and treatment options for uterovesical fistula as a consequence of iatrogenic complication. Methods: Literature review of available information on surgi...
Aim of the study to summarize the current information on diagnostic and treatment options for uterovesical fistula as a consequence of iatrogenic complication. Methods: Literature review of available information on surgical treatment options for uterovesical fistula resulting from previous caesarean section and comparison with our own experience in the developing world. Conclusion: Uterovesical fistula is an abnormal communication between the bladder and uterus. The cause of this pathology in most cases is an iatrogenic complication, most commonly arising after a caesarean section. The incidence of this pathology varies significantly geographically. In developed countries, these fistulas are rather rare. On the other hand, in developing countries, uterovesical fistulas are more common with a significant impact on the subsequent life of the patient due to generally inaccessible health care.
Female orgasm, reproduction and couple relationships.
Pastor Z
Ceska Gynekol · 2024 · PMID 38418254 · Publisher ↗
A deficit or problematic achievement of female orgasm is often classified as a sexual disorder that creates complications in the sex life of couples. This assumption is generally accepted, even though vaginal anorgasmia...
A deficit or problematic achievement of female orgasm is often classified as a sexual disorder that creates complications in the sex life of couples. This assumption is generally accepted, even though vaginal anorgasmia is an accepted statistical norm and non-coital methods of generating female orgasm are not as easy as they are for men. Female orgasms manifest themselves in different ways; they are variable and can be dependent on a number of variable factors. Some theories suggest a high degree of correlation between the capacity for orgasmic experience, sexual attitudes and behaviour, but also with reproductive potential or the stability of the given couple's relationship. Female orgasm is often seen as a discriminatory mechanism influencing attitudes towards sexuality or even as a kind of fertility catalyst. There is no consensus on the importance of female orgasm. The results of some relevant studies refute theories about the female orgasm's positive influence on adaptive functions of the couple's relationship, as well as its influence on fertility. The orgasm in women is most likely an evolutionary by-product of its male variant, since the clitoris and penis have an identical embryonic basis of development. Female anorgasmia should not be considered an unquestioned diagnosis, let alone a psychiatric construct leading to a paradigm in which anorgasmia is categorically the cause of frustration or other problems.
Ultrasound finding of endometrial polyp and factors increasing risk of malignancy.
Koblížková M, Bretová P, Felsinger M … +3 more , Minář L, Bednaříková M, Weinberger V
Ceska Gynekol · 2024 · PMID 38418253 · Publisher ↗
This article presents a comprehensive review of factors that increase the risk of malignancy in ultrasound findings of an endometrial polyp. We collected original studies, reviews, and meta-analyses that dealt with the t...
This article presents a comprehensive review of factors that increase the risk of malignancy in ultrasound findings of an endometrial polyp. We collected original studies, reviews, and meta-analyses that dealt with the topic of endometrial polyps and the risk of developing endometrial cancer. Each presumed risk factor was analysed individually. According to searched studies, abnormal uterine bleeding, old age, and body mass index are valid risk factors for developing endometrial cancer in endometrial polyps. Lynch syndrome patients are also in a high-risk group for endometrial cancer. On the other hand, the number of polyps, their size, diabetes mellitus, hypertension, and positive family history are factors with inconclusive results. There are either not enough data or different results among several studies.
Primary perineal endometriosis - a case report and literature review.
Tian Y, Pei K, Bai J … +1 more , Wang P
Ceska Gynekol · 2024 · PMID 38418252 · Publisher ↗
Endometriosis is a common gynecological disease caused by the implantation of active endometrial cells outside the uterine cavity. In most cases, endometriosis occurs in the pelvic area, such as the ovary, Douglas' pouch...
Endometriosis is a common gynecological disease caused by the implantation of active endometrial cells outside the uterine cavity. In most cases, endometriosis occurs in the pelvic area, such as the ovary, Douglas' pouch, or uterine sacral ligament. Some rare cases of extrapelvic endometriosis can also occur in the perineum, urinary system, gastrointestinal tract, nervous system, chest, subcutaneous tissue, and skin. Endometriosis of the perineum is usually secondary to obstetric trauma, such as perineal laceration or episiotomy. To date, few cases of spontaneous perineal endometriosis have been reported. Herein, we report a rare case of spontaneous deep perineal endometriosis. Notably, the patient had typical symptoms of regular pain during menstruation with no history of delivery or perineal trauma. The patient recovered well after postoperative gonadotropin releasing hormone agonist injection.
Occult invasive cervical cancer, FIGO stage III, with a negative Pap smear test - clinical presentation and brief review of the literature.
Meloni P, Simari T, Roberta L … +6 more , Cassella I, Brizio R, Conturso R, Russo D, Araujo Júnior E, Tonni G
Ceska Gynekol · 2024 · PMID 38418251 · Publisher ↗
Occult cervical cancer is rare and is diagnosed incidentally after a simple hysterectomy. The staging upon histological examination is usually International Federation of Gynecology and Obstetrics (FIGO) stage I, rarely...
Occult cervical cancer is rare and is diagnosed incidentally after a simple hysterectomy. The staging upon histological examination is usually International Federation of Gynecology and Obstetrics (FIGO) stage I, rarely higher with negative preoperative diagnostic tests such as a Pap smear. The clinical case in question is a rare case of cervical carcinoma diagnosed at the time of hysterectomy with a negative exo-endocervical Pap smear, diagnostic tests including transvaginal ultrasound, abdominal magnetic resonance imaging and abdominal computed tomography with a diagnosis of degenerating myoma or suspected sarcoma. In the operating theatre, the surgical radicality was modified and the operation was completed with removal of the parameters, vaginal collar and bilateral pelvic lymphadenectomy. The final histological examination indicated FIGO stage III, for which the patient underwent radiotherapy and chemotherapy.
Occurrence of acute retrobulbar hemorrhage during birth.
Hurt K, Krajcová A, Zikán M
Ceska Gynekol · 2024 · PMID 38418250 · Publisher ↗
Presentation of acute retrobulbar subperiostal hemorrhage (hematoma) in the course of delivery. The occurrence, possible threats and recommended methods of treatment are described. Introduction: Acute retrobulbar hemorrh...
Presentation of acute retrobulbar subperiostal hemorrhage (hematoma) in the course of delivery. The occurrence, possible threats and recommended methods of treatment are described. Introduction: Acute retrobulbar hemorrhage is always a serious condition. Even if not connected with other ocular trauma, it could cause permanent blindness. The reason is based on constriction of the eye, decreasing of the blood supply and thus disruption of the oxygen supply to sensitive retinal tissues. After a short time, these tissues start to deteriorate and lose their natural function. This event is often connected with exophthalmia and diplopia. The primary diagnostic procedure is to measure intraocular pressure (IOP). Even if the ideal diagnostic tools are not accessible, performing a lateral canthotomy (event. with inferior cantholysis) is recommended to relieve IOP in acute situations. Normal intraocular pressure is considered to be 8-21 mmHg. Case report: Our 29-year-old female patient was in the second stage of delivery and suddenly got retrobulbar hemorrhage, resulting in exophthalmia and diplopia. Her baby was delivered shortly after the event. The following delivery course was normal, including her perineum repair and puerperium. Our patient was fortunate because her visual acuity and IOP were normal. Therefore, we chose an observational treatment strategy. After 5 weeks, we noted successful disintegration of the hematoma and decreased exophthalmia and diplopia without other consequences. Conclusion: We described retrobulbar subperiostal bleeding in our patient in the course of delivery. We depicted possible threats that could result in blindness and described recommended methods of treatment. Even if such a situation is extremely rarely, we believe that knowledge of these guidelines could help medical professionals broaden their treatment options. This particularly occurs when a trained eye surgeon is not available.
Pandemic fear and psychological resilience in pregnant women after the pandemic - a study in Turkey.
Akkuş M, Akkuş F
Ceska Gynekol · 2024 · PMID 38418249 · Publisher ↗
The aim of this study was to investigate the levels of pandemic-related fear, depression, stress and anxiety in pregnant women in different trimesters after the pandemic and to examine their relationship with psychologic...
The aim of this study was to investigate the levels of pandemic-related fear, depression, stress and anxiety in pregnant women in different trimesters after the pandemic and to examine their relationship with psychological resilience. Methods: A total of 250 women were included in the study, including 125 pregnant women and 125 healthy controls. The participants were divided into three groups according to their trimester of pregnancy. The Depression-Anxiety-Stress Scale 21 (DASS-21), the Epidemic Disease Anxiety Scale (EDAS) and the Short Psychological Resilience Scale (SPRS) were used to measure depression, anxiety, stress and psychological resilience. Results: Pregnant women had significantly higher DASS-21 total scores [19 (4-42) ] than healthy controls [11 (1-42) ], P = 0.001. The prevalence of depression, anxiety and stress was 23.2%, 44% and 20% respectively in pregnant women compared to 12.8%, 31.2% and 9.6% in healthy controls. DASS-21 total scores were highest in the 1st (21.2 ± 5.8) and 3rd (22.8 ± 8.9) trimesters and lowest in the 2nd (16.1 ± 6.9) trimesters. The DASS-21 total score was positively correlated with the EDAS total score and the pandemic perception subscale. SPRS total score was negatively correlated with anxiety, stress and DASS-21 total score. Conclusion: Pregnant women experienced higher levels of depression, anxiety, stress, and pandemic anxiety than non-pregnant women in the post-pandemic period. Psychological resilience was negatively associated with depression, anxiety, and stress in pregnant women. These findings indicate that the pandemic negatively affects the mental health of pregnant women and the importance of providing psychological support services to protect their mental health.
Discrepancies in staging and perioperative classification of pelvic endometriosis according to #Enzian 2021.
Križanová K, Chvátal R, Križan V … +2 more , Shibaeva M, Hudeček R
Ceska Gynekol · 2024 · PMID 38418248 · Publisher ↗
AIM: The aim of this study is to compare the extent of ovarian endometriosis diagnosed at preoperative staging with subsequent perioperative findings. Definition of discrepancies observed according to the #Enzian 2021 cl...
AIM: The aim of this study is to compare the extent of ovarian endometriosis diagnosed at preoperative staging with subsequent perioperative findings. Definition of discrepancies observed according to the #Enzian 2021 classification. MATERIAL AND METHODS: The cohort includes 62 patients of reproductive age with preoperative findings of ovarian endometrioma. Patients were divided according to the #Enzian 2021 classification into subgroups (O1, O2 + O3) with unilateral and bilateral findings. The percentage concordance of preoperative and perioperative findings was evaluated. RESULTS: In the evaluation of ovarian involvement, the preoperative ultrasound diagnosis shows almost 100% agreement with the findings on the ovaries during surgery. Periadnexal adhesions were predicted preoperatively in only half of the cases. The difference in laterality was confirmed with T3 involvement in the O2 + O3 subgroup. In the bilateral involvement, the finding of the presence of grade 3 adhesions was doubled. An association of ovarian form of endometriosis (O2-O3) with deep infiltrating endometriosis of the small pelvis was observed in 50% of the cohort. CONCLUSION: The ovarian form of endometriosis is associated with the occurrence of other endometriosis lesions in the small pelvis. In this study, it was confirmed that preoperative staging underestimates the extent of endometriosis in the small pelvis. In the surgical management of ovarian endometriosis, extensive adhesive process should be expected.
Importance of vaginal packing after laparoscopic sacrocolpopexy - retrospective study.
Marinič Veverková A, Kališ V, Smažinka M … +2 more , Havíř M, Rušavý Z
Ceska Gynekol · 2024 · PMID 38418247 · Publisher ↗
To compare the subjective and objective results of laparoscopic sacrocolpopexy (LSC) with and without the introduction of a vaginal packing one year after surgery. Methodology: This is a retrospective cohort study of 125...
To compare the subjective and objective results of laparoscopic sacrocolpopexy (LSC) with and without the introduction of a vaginal packing one year after surgery. Methodology: This is a retrospective cohort study of 125 women after laparoscopic sacrocolpopexy operated on in 2013-2016 with complete annual follow-up. Patients with a total hysterectomy were excluded from the study. Basic patient characteristics, preoperative POP-Q and surgery data were collected. The subjective outcome of the surgery was assessed using the PGI-I (patient global impression of improvement). The anatomic outcome of the surgery was evaluated using the composite definition of surgical failure based on POP-Q (Ba ≥ -1, C ≥ -3, Bp ≥ -1). Patients were divided into two groups according to whether or not they had vaginal packing after surgery. Statistical analysis was performed using c2, Wilcoxon and Fischer test according to the distribution of normality. Results: A total of 125 women were enrolled in the study; 48 (38.4%) after LSC, 58 (46.4%) with concomitant supracervical hysterectomy and 19 (15.2%) after sacrohysterocolpopexy. Vaginal packing was introduced for 24-48 hours after surgery in 86 (68.8%) women. The groups did not differ in age, body mass index, smoking or preoperative pelvic organ prolapse quantification system. We did not observe statistically significant differences in PGI-I first year after surgery. The difference in anatomic surgical failure did not reach statistical significance, although more failures were observed in the group without packing (12.8 vs. 3.5%; P = 0.09). The mean C-point value one year after surgery was lower in the non-tamponade group (-7 vs. -7.5; P < 0.009). No mesh extrusion or serious complications were recorded in the monitored group. Conclusion: Vaginal packing after LSC probably does not affect patient satisfaction after surgery, however, it may be associated with better anatomical outcome one year after the surgery. The results of the study must be confirmed by a more detailed prospective evaluation.
Preoperative and postoperative staging in endometrial cancer - a prospective study.
Brych O, Drozenová J, Pichlík T … +6 more , Hruda M, Rob L, Robová H, Waldauf P, Themistocleous P, Halaška MJ
Ceska Gynekol · 2024 · PMID 38418246 · Publisher ↗
OBJECTIVE: The aim of this study was to determine how often changes the stage of the tumour in definitive histology against preoperative clinical stage in patient cohort with diagnosed endometrial cancer. METHODS: We eva...
OBJECTIVE: The aim of this study was to determine how often changes the stage of the tumour in definitive histology against preoperative clinical stage in patient cohort with diagnosed endometrial cancer. METHODS: We evaluated prospectively a cohort of 166 patients with endometrial cancer. They all underwent abdominal hysterectomy, bilateral salpingo-oophorectomy, sentinel lymph node biopsy. Patients with high-risk tumours also pelvic lymfadenectomy. We collected data of preoperative diagnostic biopsy and postoperative definitive histology. The data were statistically processed. RESULTS: Detection of sentinel lymph node was successful in 71.1%, bilateral successful detection was in 40.6%. Discrepancy of tumour grade between preoperative biopsy and definitive histology was generally 31.4%. Upgrading of the tumour was in 22 (14.4%) cases, downgrading in 26 (17%) cases. Upgrade from low-risk to high-risk group of tumours was noticed in eight cases. Histopathological tumour type changed in 6.6%, 4.6% moved to histopathologic high-risk group. The tumour stage changed in definite histology in 57.3%, in 19.2% of cases moved from stage low/intermediate-risk group to intermediate-high/high-risk disease group. CONCLUSION: Correct assessment of preoperative clinical stage and histological grade of endometrial cancer is burdened with a high inaccuracy rate. A lot of cases is up-staged after surgical staging and moved to intermediate-high/high-risk disease group. Results confirm the importance of oncogynaecologic centre II. evaluation of histopathology findings from diagnostic biopsies made in referring hospitals. Sentinel lymph node biopsy should be performed even in clinically low/intermediate-risk disease group.
Emergent hysterectomy for placenta accreta spectrum - some additional techniques.
Matsubara S
Ceska Gynekol · 2023 · PMID 38171925
Abstract loading — click title to view on PubMed.
Diagnosis of complicated gynaecological inflammations by computed tomography - one center experience.
Korčáková E, Ferda J, Presl J
Ceska Gynekol · 2023 · PMID 38171924 · Publisher ↗
The aim of this article is to acquaint the gynaecological public with our experience with the use of computed tomography in the diagnosis of fluid collections in women with clinical suspicion of complicated pelvic inflam...
The aim of this article is to acquaint the gynaecological public with our experience with the use of computed tomography in the diagnosis of fluid collections in women with clinical suspicion of complicated pelvic inflammation or a complication after gynaecological surgery. We present diagnostic dilemmas that radiologists deal with, including differential diagnoses. We also deal with the benefits for the referring gynaecologist, and we also discuss the possible discrepancy between his expectations and the result of the examination.
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