Ceska Gynekol [JOURNAL]
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200 papers
Preeclampsia and diabetes mellitus.
Hornová M, Šimják P, Anderlová K
Ceska Gynekol · 2023 · PMID 38171923 · Publisher ↗
OBJECTIVE: The purpose of this paper is to provide a review of recent research on the relationship between preeclampsia and diabetes mellitus in pregnancy. METHODOLOGY: A structured search for literary sources in PubMed...
OBJECTIVE: The purpose of this paper is to provide a review of recent research on the relationship between preeclampsia and diabetes mellitus in pregnancy. METHODOLOGY: A structured search for literary sources in PubMed and ScienceDirect databases using keywords, followed by a selection of papers based on solid methodology. RESULTS: Preeclampsia is a serious condition, which complicates 2-7% of pregnancies. It causes maternal complications (organ dysfunction) and fetal complications (pathological haemodynamic parameters of the uteroplacental unit and fetal growth restriction). Pregnant women with pregestational diabetes have a 2- and 4-times higher risk of developing preeclampsia and the ones with gestational diabetes have 1.3-times higher risk. The main identified risk factors are inadequate compensation of diabetes, diabetic nephropathy, retinopathy and the duration of diabetes. To minimalize the risk of developing preeclampsia, a composite screening has been implemented. With a positive result a preventive use of acetylsalicylic acid from at the latest 16 and up until the 36th week is advised. Preeclampsia is also a risk factor for developing diabetes mellitus and other cardiovascular diseases later in life. For that reason, a long-term dispensary of women who had preeclampsia in pregnancy is recommended.
Effect of pelvic floor status on the outcome of pelvic organ prolapse surgery.
Dvořák J, Mašata J, Fučík T … +2 more , Martan A, Švabík K
Ceska Gynekol · 2023 · PMID 38171922 · Publisher ↗
Pelvic organ prolapse (POP) is a common diagnosis with an incidence in the population of up to 50%. POP causes restrictions in everyday life and reduces patients' quality of life. Therapy is either conservative in the fo...
Pelvic organ prolapse (POP) is a common diagnosis with an incidence in the population of up to 50%. POP causes restrictions in everyday life and reduces patients' quality of life. Therapy is either conservative in the form of physiotherapy or the use of different types of pessaries, possibly. in case of inappropriateness or failure of conservative treatment, an operative solution is chosen. Avulsion injury of the levator ani muscle (MLA) is a strong factor in the development of POP. Some patients undergo repeated surgeries for POP, negatively impacting their quality of life. Studies show that the stage of POP and avulsion injury is associated with an increased risk of recurrence after index prolapse surgery. Ultrasound diagnosis of MLA injuries might help in predicting the risk of recurrence. Assessment of pelvic floor function is crucial for the success of surgical management of POP.
Assisted oocyte activation.
Trávník P, Ješeta M, Hűttelová R … +4 more , Křen R, Landsmann L, Nesvadbová A, Tauwinklová G
Ceska Gynekol · 2023 · PMID 38171921 · Publisher ↗
OBJECTIVE: Currently, there is a rapid increase in studies on assisted oocyte activation, which can significantly improve the process of in vitro fertilization. Fertilization of oocytes by conventional methods and by int...
OBJECTIVE: Currently, there is a rapid increase in studies on assisted oocyte activation, which can significantly improve the process of in vitro fertilization. Fertilization of oocytes by conventional methods and by intracytoplasmic sperm injection can be affected by insufficient activation of the oocyte. The reason is mainly deviations in the enzymatic equipment of sperm or oocytes or a non-functional activation cascade. In many cases, fertilization can be achieved using artificial oocyte activation by applying calcium ion donors to the oocytes after sperm microinjection. However, opinions on the safety and reliability of this method are not uniform. The aim of the thesis is to present current knowledge about assisted oocyte activation and its impact not only on in vitro fertilization, but also on subsequent embryonic and fetal development. METHODOLOGY: Research of relevant literature in Web of Science, PubMed/Medline and Scopus databases. RESULTS AND CONCLUSIONS: Based on the literature data and the authors' own experience, it follows that this method is effective and safe from the point of view of further development of the embryo, fetus and postnatal development. Extensive meta-analyses focused on this method were carried out, which did not find a negative impact not only on the embryonic and fetal development of the individual, but this method did not have associated with a negative impact on the psychosomatic development of the children.
Methods and techniques of fertility preservation in patients with endometriosis.
Sisková I, Mekiňová L, Hudeček R … +2 more , Ješeta M, Šimová S
Ceska Gynekol · 2023 · PMID 38171920 · Publisher ↗
UNLABELLED: : Objective: Endometriosis is a chronic disease with a relatively high prevalence in the female population. Both the disease itself and its surgical treatment can adversely affect the fertility of patients. F...
UNLABELLED: : Objective: Endometriosis is a chronic disease with a relatively high prevalence in the female population. Both the disease itself and its surgical treatment can adversely affect the fertility of patients. For this reason, endometriosis is offered as a possible indication for fertility preservation by cryopreservation methods. The aim of this paper is to present the current knowledge on the options of fertility preservation in this subpopulation. METHODS: Search of relevant literature in PubMed/Medline, Web of Science and Scopus databases. RESULTS: Fertility preservation by cryopreservation methods has so far been used mainly in the care of women with cancer. With increasing experience, the effectiveness and availability of these methods have increased significantly and the indication spectrum has been extended to selected benign diseases such as endometriosis. Three techniques are currently established in practice: embryo cryopreservation, oocyte cryopreservation and ovarian tissue cryopreservation. Oocyte cryopreservation is the most commonly used technique, since it is the most advantageous for the patient and, according to the available data, is an effective way to increase the chances of future pregnancy for patients with endometriosis The purpose is to realize the protection of reproduction before the planned operation. CONCLUSION: The diagnosis of endometriosis negatively affects the fertility of women. For some patients, the solution is fertility preservation by cryopreservation methods. Further clinical studies are needed to define exact, practically applicable indication criteria, potential risks of procedures and their benefits and cost-effectiveness.
Outcome of a patient with Herlyn-Werner-Wunderlich syndrome treated with Balloon septostomy - pre- and postsurgical ultrasound findings.
Dosedla E, Ballová Z, Gašparová P … +2 more , Sitáš M, Calda P
Ceska Gynekol · 2023 · PMID 38171919 · Publisher ↗
Herlyn-Werner-Wunderlich syndrome is an unusual congenital anomaly defined by a triad of congenital defects of the female urogenital tract - homolateral renal agenesis, uterus duplex and obstructed hemi-hematometrocolpos...
Herlyn-Werner-Wunderlich syndrome is an unusual congenital anomaly defined by a triad of congenital defects of the female urogenital tract - homolateral renal agenesis, uterus duplex and obstructed hemi-hematometrocolpos whose etiology remains still unclear. Pelvic pain, dysmenorrhea and palpable mass due to the hematocolpos or hematometra are the most common clinical symptoms. Endometriosis is considered to be a prevalent finding in these young patients possibly explaining the pathophysiological mechanism of endometriosis as the result of retrograde menstruation. Early diagnosis and subsequent treatment are important to prevent the development of severe complications. In general, clinical and reproductive outcomes after drainage of the hematometrocolpos are reported to be satisfactory. A 13-year-old patient presented with pelvic pain and was diagnosed with OHVIRA syndrome treated with Balloon septostomy.
DNA analysis of partial hydatidiform mole revealing triandric monogynic tetraploidy.
Gergely L, Korbeľ M, Repiská V … +4 more , Danihel Ľ, Hutník J, McCullough L, Priščáková P
Ceska Gynekol · 2023 · PMID 38171918 · Publisher ↗
The authors present a case of a partial hydatidiform mole where DNA analysis (STR - short tandem repeat genotyping) showed a triandric monogynic tetraploid genome composition with a XXXY gonosomal complement. This geneti...
The authors present a case of a partial hydatidiform mole where DNA analysis (STR - short tandem repeat genotyping) showed a triandric monogynic tetraploid genome composition with a XXXY gonosomal complement. This genetic finding clinicopathologically correlates with a partial hydatidiform mole, although it is rare in comparison with the typical, diandric monogynic triploid partial moles. The genetic analysis definitively confirmed the suspected diagnosis of a partial mole. To exclude the possibility that molar pregnancy represented retained products of conception after elective pregnancy termination, STR profiles from molar pregnancy and previous products of conception were compared. Short tandem repeats genotyping is a useful molecular genetic method in the differential diagnosis of partial hydatidiform moles, where clinical-pathological findings are frequently ambiguous.
A rare case of a live abdominal pregnancy in a woman with subsequent gestation in utero.
Hájek Z, Šindlář M, Strupplová J … +1 more , Kobilková J
Ceska Gynekol · 2023 · PMID 38171917 · Publisher ↗
This report concerns now 40-year-old healthy woman who was born alive and healthy from an ectopic pregnancy in the abdominal cavity, with placental localization on the omentum. This was a historical case report 40 years...
This report concerns now 40-year-old healthy woman who was born alive and healthy from an ectopic pregnancy in the abdominal cavity, with placental localization on the omentum. This was a historical case report 40 years ago, as at that time doctors had little information about similar case in the world. Even today, in the era of modern medicine, we find only rare cases where a child developed outside the uterine cavity is born healthy and without developmental deformities. The mother subsequently had a normal intrauterine pregnancy 2 years later, ending with a caesarean section and the birth of a healthy boy.
An updated perspective on diagnostics and treatment of idiopathic granulomatous mastitis.
Vanovčanová L, Minariková E
Ceska Gynekol · 2023 · PMID 38171916 · Publisher ↗
AIM: To present our experiences with the anti-inflammatory treatment of idiopathic granulomatous mastitis (IGM) and highlight the imaging and anamnestic specifics of its diagnosis. METHODS: Patients with acute inflammato...
AIM: To present our experiences with the anti-inflammatory treatment of idiopathic granulomatous mastitis (IGM) and highlight the imaging and anamnestic specifics of its diagnosis. METHODS: Patients with acute inflammatory breast disease underwent ultrasound examination followed by a collection of anamnestic data, and histological analysis of the process was performed using core-cut bio psy, confirming IGM. Subsequently, anti-inflammatory treatment was administered, consisting of a combination of colchicine, vitamin E, and local compresses made from an infusion of Plantago lanceolata. We also recorded any additional treatments administered extra muros prior to histological analysis (such as antibio tics, surgical intervention, and time from onset of symptoms to confirmation of diagnosis). We analyzed the effect of the anti-inflammatory treatment administered, including the onset of improvement, adverse effects, recurrences, and duration of treatment required for symptom resolution. RESULTS: Between 2016 and 2022, we diagnosed and histologically confirmed IGM in 53 patients through bio psy. Of these, 45 (84.9%) underwent the anti-inflammatory treatment we proposed, while eight (15.1%) opted for a different form of therapy. Currently, 27 patients (60%) are without treatment and clinical manifestations. The average duration of treatment was 34 months, and improvement in the clinical condition was observed within 2-8 weeks (average of 3 months). Four patients (14.81%) reported dyspepsia as an adverse effect. Recurrence occurred in five patients (18.52%) after 1-36 months (average of 7 months). Patients (22, 81.48%) who completed the treatment are without difficulties for 3-70 months (average of 34 months). The remaining 18 patients (40%) are currently undergoing treatment, lasting 3-41 months (average of 19 months). CONCLUSION: Anti-inflammatory treatment with colchicine, along with supportive therapy (compresses made from an infusion of Plantago lanceolata and vitamin E), represents a promising trend in the therapy of IGM, with minimal adverse effects.
Pregnancy termination indications and outcomes before 24 weeks of gestation - a case series.
Doğru Ş, Akkuş F, Atci AA … +2 more , Erdoğan AC, Acar A
Ceska Gynekol · 2023 · PMID 38171915 · Publisher ↗
OBJECTIVE: This study aimed to assess termination of pregnancy (TOP) indications and obstetric outcomes before the 24th gestational week. MATERIALS AND METHODS: This is a retrospective study that includes terminations pe...
OBJECTIVE: This study aimed to assess termination of pregnancy (TOP) indications and obstetric outcomes before the 24th gestational week. MATERIALS AND METHODS: This is a retrospective study that includes terminations performed in singleton pregnancies between December 2021 and December 2022 in the Perinatology Clinic of Necmettin Erbakan University Meram Medical Faculty. According to the reasons for TOP, all patients were divided into three groups: maternal, fetal, and obstetric reasons. The termination approach and outcomes were evaluated in all cases. RESULTS: A total of 210 patients were included in the study. Considering termination indications, 18 (8.5%) patients had maternal causes, 127 (60.5%) had fetal causes, and 65 (31%) had obstetric causes. Maternal causes were significantly higher in the 1st trimester and fetal causes in the 2nd trimester (P = 0.001). In the maternal group, 77.8% dilatation and curettage were used, 70.1% misoprostol and 29.9% misoprostol + Foley catheter in the fetal group, and 66.2% misoprostol in the obstetric group (P = 0.0001). The length of hospital stay and recurrent revision curettage were not statistically different between the fetal, maternal, and obstetric groups (P = 0.099, P = 0.8, respectively). CONCLUSION: Termination options should be offered for complicated pregnancies due to fetal, maternal, or obstetric reasons. Pregnancy termination week and indication affect morbidity.
Medical Termination of Pregnancy (MToP) in the 1st trimester - the role of human chorionic gonadotropin and ultrasound in pregnancy diagnosis and MToP follow-up.
Dvořák V, Slunska P, Maděrková Tozzi M … +4 more , Langová K, Kroutilova V, Pilka R, Ľubušký M
Ceska Gynekol · 2023 · PMID 38171914 · Publisher ↗
OBJECTIVE: In the Czech Republic, it is possible, to carry out Medical Termination of Pregnancy (MToP) in the 1st trimester up until the 49th day of secondary amenorrhea. The aim of the study is to analyse the significan...
OBJECTIVE: In the Czech Republic, it is possible, to carry out Medical Termination of Pregnancy (MToP) in the 1st trimester up until the 49th day of secondary amenorrhea. The aim of the study is to analyse the significance of serum/urine human chorionic gonadotropin (hCG) assessment and ultrasound (US) examination in pregnancy diagnosis and MToP follow-up. METHODS: In 2017-2018, MToP was carried out in a total of 109 women by administering a combination of mifepristone (600 mg orally) and misoprostol (400 mcg orally). Serum/urine (LSUP - low sensitivity urine pregnancy test) hCG assessment and US examination were performed at pregnancy diagnosis and MToP follow-up. RESULTS: At pregnancy diagnosis, there was a positive and medium strong correlation between serum hCG and size of the gestational sac - GS (R = 0.711; P 1,000 IU/L and LSUP test was always positive). In 5.5% of women (6/109), a subsequent surgical intervention was carried out including those with ongoing pregnancy (N = 5); missed abortion (N = 1) was treated by additional misoprostol, where surgical intervention was not necessary. CONCLUSION: At pregnancy diagnosis, there is a positive and medium strong correlation between serum hCG and CRL. In MToP follow-up, a negative LSUP test enables reliable exclusion of ongoing pregnancy and missed abortion. In case of a positive LSUP test, US examination should be performed; however, surgical intervention should not be indicated solely on the basis of uterine cavity dilatation.
Are the serum delta neutrophil index and systemic inflammatory index useful as predictive parameters for preeclampsia and HELLP syndrome?
Dal Y, Karagün Ş, Akkuş F … +2 more , Akay K, Coşkun A
Ceska Gynekol · 2023 · PMID 38171913 · Publisher ↗
OBJECTIVE: We aimed to determine whether the serum delta neutrophil index and other systemic inflammatory index parameters can have an auxiliary effect in the diagnosis when used with other bio chemical markers in preecl...
OBJECTIVE: We aimed to determine whether the serum delta neutrophil index and other systemic inflammatory index parameters can have an auxiliary effect in the diagnosis when used with other bio chemical markers in preeclampsia and HELLP syndrome and to determine the role of inflammation in the pathogenesis of these diseases. MATERIALS AND METHODS: 121 pregnant women who met the inclusion and exclusion criteria were included in the study. 52 pregnant women diagnosed with preeclampsia and 19 pregnant women diagnosed with HELLP syndrome were included in the study group, and 50 healthy pregnant women were included in the control group. Demographic data, hematological and bio chemical parameters, and inflammatory markers (serum delta neutrophil index - DNI - and systemic inflammatory index parameters) of the groups were recorded and compared between groups. RESULTS: In terms of neutrophil lymphocyte ratio, platelet lymphocyte ratio, and DNI, the HELLP group was different from both groups. The control and preeclampsia groups were similar. In terms of monocyte-to-lymphocyte ratio, the preeclampsia group was different from both groups. The control and HELLP groups were similar. In terms of the systemic inflammatory index, all groups were similar. CONCLUSION: In our study, we found that when maternal serum DNI values are used together with other bio chemical parameters, it can help in the diagnosis of preeclampsia and HELLP syndrome, and inflammation may play a role in the pathogenesis of these diseases.
Is there a difference between acute appendicitis in pregnant and non-pregnant women?
Guňková P, Tulinský L, Toman D … +4 more , Martínek L, Vrtková A, Špaček R, Šimetka O
Ceska Gynekol · 2023 · PMID 38171912 · Publisher ↗
OBJECTIVE: Acute appendicitis is the most common indication for surgical intervention during pregnancy for non-gynaecological or non-obstetric causes. The aim of this study was to compare perioperative and postoperative...
OBJECTIVE: Acute appendicitis is the most common indication for surgical intervention during pregnancy for non-gynaecological or non-obstetric causes. The aim of this study was to compare perioperative and postoperative outcomes of acute appendectomies in pregnant and non-pregnant patients of childbearing age. METHODS: A retrospective clinical study focused on the comparison of perioperative and postoperative outcomes of acute appendectomy in pregnant and non-pregnant patients of reproductive age between January 2012 and December 2021 at the University Hospital in Ostrava. RESULTS: A number of 308 patients underwent acute appendectomy, 25 pregnant and 283 non-pregnant. There were no statistically significant differences in age, ASA (American Society of Anesthesiologists) classification, duration of complaints, baseline C-reactive protein values, sensitivity or specificity of sonography. A statistically significant difference was found in the leukocyte count between subgroups (P = 0.014) and in the number of laparoscopic procedures performed between the two subgroups (P < 0.001; 98.9% non-pregnant vs. 80.0% pregnant). There was also a statistically significant difference in the length of hospital stay, with the pregnant subgroup having a longer hospital stay (P = 0.014) and a statistically significant difference in the rate of postoperative complications between the defined subgroups (P = 0.039). Serious complications were described predominantly in the subgroup of pregnant patients, where they reached 12% compared to non-pregnant patients, where they were 2.8%. The mortality rate of the cohort was zero. CONCLUSION: The results of the study support the fact that pregnancy may be associated with complicated forms of acute appendicitis. Accurate and early diagnosis not only prevents the development of complicated forms of appendicitis but also reduces the number of negative appendectomies in pregnancy.
Home births as a "right" of female patients in the context of medicine, legislation and court jurisprudence.
Erdősová A, Gašparová P, Ballová Z … +1 more , Dosedla E
Ceska Gynekol · 2023 · PMID 37932058 · Publisher ↗
Currently, in the Czech Republic and Slovakia, more and more women prefer a planned home birth to a hospital birth, despite the fact that the hospital provides a safe environment for laboring women, thanks to the possibi...
Currently, in the Czech Republic and Slovakia, more and more women prefer a planned home birth to a hospital birth, despite the fact that the hospital provides a safe environment for laboring women, thanks to the possibility to intervene at any time in case of complications. These women consider childbirth a natural process, while obstetric care is often considered unnecessary. According to the World Health Organization, birth can only be defined as physiological after birth. Even though women can give birth without medical assistance, it is not possible to identify in advance the mothers and newborns who will need some kind of intervention during childbirth. Although a planned home birth is associated with fewer maternal interventions and the probability of a spontaneous vaginal birth, compared to a planned hospital birth, the risk of neonatal death is two- to three-times higher.
Early treatment of vulvar synechiae in childhood - prevention of late complications.
Janštová A, Nováčková M
Ceska Gynekol · 2023 · PMID 37932057 · Publisher ↗
Synechiae of the vulva occurs especially in girls in the so-called resting hormonal period with a minimal serum concentration of estrogens. If the external genitalia of the girl are not treated properly, the mucous membr...
Synechiae of the vulva occurs especially in girls in the so-called resting hormonal period with a minimal serum concentration of estrogens. If the external genitalia of the girl are not treated properly, the mucous membrane of the vaginal entrance is not regularly checked and mechanically removed, then the smegma of the opposite mucous membranes of the vulva can stick together. The place of the adhesion of epithelium in the vaginal introitus can be covered by a new epithelium and can create a firm adhesion, synechiae of the vulva, which is usually asymptomatic and is discovered incidentally during pediatric examination. Clinically significant vulvar synechiae can cause impaired bladder evacuation and recurrent lower urinary tract infections. Dissection of synechiae in the stage of conglutination or thin adhesion is performed manually on an outpatient basis, but extensive and firm adhesions must be divided surgically under general anesthesia. Local application of cream with estriol or betamethasone is also used for the therapy of synechiae of the vulva, but this treatment is more time-consuming compared to rapid manual separation and requires good compliance of the girls and their parents. The prevention of synechiae is based on the education of parents by pediatricians and gynecologists about the need for regular checks of the external genitalia and sufficient hygiene.
Viable invasive cervical pregnancy treated with minimally invasive procedures.
Cerovac A, Habek D
Ceska Gynekol · 2023 · PMID 37932056 · Publisher ↗
With an incidence of 1% of all ectopic pregnancies, cervical ectopic pregnancy (CEP) is due to possible early misdiagnosis or bleeding and rupture can become a life-threatening condition with the need for urgent hysterec...
With an incidence of 1% of all ectopic pregnancies, cervical ectopic pregnancy (CEP) is due to possible early misdiagnosis or bleeding and rupture can become a life-threatening condition with the need for urgent hysterectomy, which has been seen in clinical practice recently. We present a case of early diagnosed invasive CEP treated with combined minimally invasive procedure (MIP) due to acute pelvic pain and bleeding. In our case, we applied several of these methods to a primigravida with early invasive CEP with fertility preservation. By combining the self-described local medications with uterotonics and cervical anaemia treatment, intravenous tranexamic acid and MIP, we were able to preserve the uterus with minimal blood loss and the possibility of future conception.
Diagnosis of thanatophoric dysplasia using clinical exome screening.
Holub M, Sekowská M, Smetanová D … +4 more , Koudová M, Sobolová K, Šinská A, Heřman H
Ceska Gynekol · 2023 · PMID 37932055 · Publisher ↗
Bone dysplasias are a broad, heterogeneous group of diseases. Thanatophoric dysplasia is a rare bone dysplasia, but it is the most common lethal skeletal dysplasias. The major role in diagnostics plays a high-quality ult...
Bone dysplasias are a broad, heterogeneous group of diseases. Thanatophoric dysplasia is a rare bone dysplasia, but it is the most common lethal skeletal dysplasias. The major role in diagnostics plays a high-quality ultrasound examination in the 2nd trimester and the latest methods of genetic testing, including clinical exome testing. Knowing the correct diagnosis is crucial for the future of the fetus and the couple.
Nascent myoma as a cause of urinary retention.
Tomanová M, Semerádová I, Lukáčová I
Ceska Gynekol · 2023 · PMID 37932054 · Publisher ↗
We present the case of a 47-year-old woman with a bulky, nascent necrotic myoma, which at first glance appeared to be a malignant process in the cervix. It caused significant retention of urine due to compression of the...
We present the case of a 47-year-old woman with a bulky, nascent necrotic myoma, which at first glance appeared to be a malignant process in the cervix. It caused significant retention of urine due to compression of the bladder and ureters, hydronephrosis and deterioration of renal function. A fully developed picture of the "bulge syndrome" dominated - lymphedema of the lower limbs and lower abdomen, pain in the lower abdomen, constipation, secondary secondary urinary infection, and paradoxical ischuria. During a gynecological examination in a specula, a strong-smelling, necrotic tumour was visualized reaching half of the vagina, which was causing a bloody discharge, which brought the patient to the examination. A biopsy was taken from the tumour. A permanent urinary catheter was inserted into the urinary bladder with gradual adjustment of renal functions. Due to the difficulties and the benign histological findings from the biopsy, a simple abdominal hysterectomy with bilateral salpingectomy from a lower midline incision was indicated. The operation was complicated by an extensive adhesive process and blood loss of 1,200 mL, with a decrease in hemoglobin in the blood count from 128 g/L to 79 g/L and the need for three blood transfusions. In the postoperative period, there is a prompt recovery of spontaneous micturition with normalization of bladder function, subsidence of lymphedema and subjective complaints of the patient.
Relugolix combination therapy and symptoms of uterine myomatosis - selected case reports of indication spectrum and treatment outcomes.
Hudeček R, Klát J, Pohl K … +6 more , Prokopenko A, Mikulášek L, Šimová S, Krčál P, Ševčík A, Tomeš P
Ceska Gynekol · 2023 · PMID 37932053 · Publisher ↗
OBJECTIVE: An illustrative review of the indications for relugolix combination therapy (RCT) in the management of symptoms associated with uterine myomatosis. METHODS: A set of annotated case reports from outpatient and...
OBJECTIVE: An illustrative review of the indications for relugolix combination therapy (RCT) in the management of symptoms associated with uterine myomatosis. METHODS: A set of annotated case reports from outpatient and clinical practice. RESULTS: The file includes a non-invasive methodology for defining excessive menstrual bleeding using the pictorial bleeding assessment chart (PBAC). It also presents the use of RCT as a fertility-sparing procedure prior to elective myomectomy and the management of isthmic fibroids as an uterine factor of infertility. Cases of RCT of adenomyosis in primary sterility and in extragenital forms of endometriosis are commented. Emergent events associated with complications of myomatosis in pregnancy are represented by a case report of necrotizing diff use myomatosis in puerperium. The differential-diagnostic confusion of adnexal pathology and myomatosis, RCT as a final solution to failed pharmacotherapy, and the alternative of hysterectomy in premenopause illustrate the diverse spectrum of indications for pharmacological treatment, including the possibility of dual therapy with RCT and aGnRH. CONCLUSION: Relugolix combination therapy as an effective and safe causal treatment expands the therapeutic spectrum and options for reproductive medicine specialists and registering gynaecologists. The availability of conservative treatment in combination with surgical treatment leads to optimalization and greater effectiveness of therapeutic procedures and increased quality of life for women with myomatosis.
Monitoring the relationship between overactive bladder and mobility disorders in women with multiple sclerosis.
Grus C
Ceska Gynekol · 2023 · PMID 37932052 · Publisher ↗
BACKGROUND: Currently, there is a lack of studies monitoring the relationship between lower urinary tract symptoms and mobility disorders in women with multiple sclerosis. The aim of this study was to monitor the relatio...
BACKGROUND: Currently, there is a lack of studies monitoring the relationship between lower urinary tract symptoms and mobility disorders in women with multiple sclerosis. The aim of this study was to monitor the relationship between overactive bladder and mobility impairments in women with multiple sclerosis. METHODS: A number of 106 female patients with multiple sclerosis (MS) with relapsing-remitting (RR) form, disability stage: EDSS ≤ 6.5, from the specialized outpatient clinic of the Department of Neurology, Faculty of Medicine, University of Medical Sciences in Košice. Urinary leakage symptoms were assessed by the modified International Consultation on Incontinence Questionnaire (ICIQ UI-SF), and overactive bladder symptoms were assessed by the Short Overactive Bladder Symptoms Questionnaire (OAB-q). The Multiple Sclerosis Impact Scale (MSIS-29) and the Rivermead Mobility Index (RMI) were used. CONCLUSION: In MS patients, we found the following correlations: a significant positive mean correlation between the severity of OAB and UI symptoms and physical attributes. We found a significant positive moderate correlation between severity of OAB and UI symptoms and psychological attributes. We found a negative significant moderate correlation between OAB and UI symptom severity and mobility. It was confirmed that the more severe the symptoms of UI and OAB, the greater the difficulty of mobility in performing physical activities, and thus the negative impact of SM disease on patients' psychological health increases.
Implementation of the ERAS protocol in gynecology and oncogynecology - evaluation of a pilot study.
Brtnický T, Malecová M, Koliba P … +5 more , Hubka P, Sládková P, Hodyc D, Škodová M, Zikán M
Ceska Gynekol · 2023 · PMID 37932051 · Publisher ↗
OBJECTIVE: To describe the implementation process and evaluate the success of compliance with the recommended ERAS protocol in the Czech healthcare system. METHODS: The study included 163 patients from March to September...
OBJECTIVE: To describe the implementation process and evaluate the success of compliance with the recommended ERAS protocol in the Czech healthcare system. METHODS: The study included 163 patients from March to September 2022, a total of 7 months. Patients were divided into three groups according to the type of surgery. Clinical protocol: Oncogynecology, hysterectomy and laparoscopy. The implementation was realized in three phases (preparation, implementation of the protocol itself and evaluation). RESULTS AND CONCLUSIONS: The cumulative adherence rate was 90% or more in all three groups. Based on the pilot results at our department, we evaluated the ERAS concept as a well-implemented tool for gynaecological departments in the Czech healthcare system.
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