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At least 487 records · Page 27Linked to original sources
PubMed2003

Late recurrence of squamous cell cervical cancer in an episiotomy site after vaginal delivery.

BACKGROUND: Rarely is late recurrence from cervical cancer diagnosed at the episiotomy site. We report a case of a patient diagnosed with squamous cell cervical cancer at the time of delivery. CASE: Recurrence at the episiotomy site was noted more than 5 years after initial diagnosis of cervical cancer and was treated with surgery and radiotherapy. The patient has had no evidence of disease 54 months after treatment. CONCLUSION: After review of the literature, it appears that surgery combined with radiotherapy is recommended over single modality treatments.

Adult↗
PubMed1991

Use of vaginal hysterectomy for the management of stage I endometrial cancer in the medically compromised patient.

Vaginal hysterectomy was performed on 31 patients with stage I endometrial cancer because of medical problems which placed them at high risk for morbidity and mortality from abdominal surgery. These risk factors included morbid obesity (87%), hypertension (58%), diabetes mellitus (35%), and cardiovascular diseases (26%). The perioperative morbidity was minimal, with only four patients (13%) experiencing complications requiring extended hospital stays and no deaths. Adjuvant radiotherapy was administered in 35% of patients with either deep myometrial invasion or unfavorable histology. The 3- and 5-year disease-free survival rates were 100 and 93%, respectively. The only cancer-related death occurred 4.5 years following surgery. Although the authors are not advocating vaginal hysterectomy as standard treatment of endometrial cancer, this approach provides an acceptable alternative to abdominal surgery in the medically compromised patient.

Adult↗
PubMed2004

Chemotherapy-induced dyspareunia: a case study of vaginal mucositis and pegylated liposomal doxorubicin injection in advanced stage ovarian carcinoma.

BACKGROUND: Chemotherapy can cause vaginal irritation and mucositis, although rarely reported. CASE: A 62-year-old patient with ovarian cancer reported vaginal burning associated with dyspareunia, which emerged 3-5 days after her initial chemotherapy and persisted throughout her treatment. Her discomfort persisted until she was evaluated by our sexual health service and interventions were implemented. On examination, her vaginal vault was erythematous, with mild signs of vaginal atrophy. Her management schema consisted of the following: avoidance of intercourse 3-5 days after chemotherapy, intravaginal vitamin E suppositories three times per week, intravaginal estrogen tablets (initial course of 14 days followed by twice weekly usage), use of lubricants (Astroglide) during coitus, and counseling. Once interventions were introduced, she subsequently resumed sexual intercourse during the remainder of her chemotherapy treatments. CONCLUSION: Patients with sexual complaints during or following cancer treatment can be treated by their community gynecologists or gynecology oncologists or can be treated through a comprehensive sexual health program with restoration of sexual function.

Antibiotics, Antineoplastic↗
PubMed1999

A mullerian duct remnant myoma misdiagnosed as ovarian cancer in a woman with vaginal agenesis--a case report.

Leiomyoma are very common in the normal uterus; however, they are rather rare in mullerian duct remnant. We report a case of mullerian duct remnant leiomyoma associated with vaginal agenesis. The mass had papillary growth with cystic-solid components by ultrasound. Ovarian cancer was suspected preoperatively. Finally, a fibroid with hyalinization and chondroid metaplasia was diagnosed histopathologically. To the best of our knowledge, this is the first case of mullerian duct remnant leiomyoma with degeneration, mimicking ovarian cancer by ultrasound. We provide the clinical details of this case and discuss a diagnostic pitfall.

Adult↗
PubMed1994

Cervical cancer complicated by pregnancy: episiotomy site recurrences following vaginal delivery.

OBJECTIVE: To determine the optimal diagnostic and therapeutic modalities relevant to episiotomy site recurrence of cervical cancer after vaginal delivery. METHODS: Records from the past 30 years were reviewed to identify patients treated at the Mayo Clinic with episiotomy site recurrence of cervical cancer complicated by pregnancy with vaginal delivery. RESULTS: Four patients with episiotomy site recurrence of squamous cell carcinoma of the cervix were treated primarily at the Mayo Clinic. These cervical cancers were originally diagnosed at delivery or in the immediate postpartum period and were treated by radical hysterectomy. Episiotomy site recurrences were detected less than 12 weeks after surgery in three patients and at 2 years in one patient. Three patients have died of recurrent cancer and one is disease-free at 1 year. CONCLUSIONS: Careful screening and examination of cervical abnormalities during pregnancy is required. The primary cancer was not diagnosed until delivery or postpartum in all patients who developed episiotomy site recurrences. If vaginal delivery is elected in a patient with cervical cancer, perineal inspection becomes critical. Including other cases reported in the literature, six of nine with stage IB disease were diagnosed with episiotomy site recurrence within 12 weeks of primary therapy. Consideration should be given to colposcopy of the episiotomy site or random biopsy in these women preoperatively to rule out occult implantation, and this site warrants careful postoperative surveillance.

Adult↗
PubMed2000

Extraperitoneal pelvic lymphadenectomy to complement vaginal operations for cervical and endometrial cancer.

OBJECTIVE: The aim of the current study was to test the applicability of a personal modification of Mitra extraperitoneal pelvic lymphadenectomy in combination with radical vaginal operations for treatment of endometrial and cervical cancer. METHOD: In a prospective series, 82 patients were submitted to extraperitoneal pelvic lymphadenectomy. In 34 cases of stage I endometrial cancer the procedure was combined with a class I vaginal hysterectomy and in 48 cases of cervical cancer stage Ib-IIIb lymphadenectomy was associated with a class II or III radical vaginal hysterectomy. Type of anesthesia, number of lymph nodes removed, operating time, blood loss and postoperative complications were recorded. RESULT: The operation was performed with spinal anesthesia in 43% of the cases. Thirty-seven patients (45%) were high surgical risk because of associated diseases. The median operative time for lymphadenectomy was 20 min for each side; the vaginal procedures took a median of 25 min (class I) and 40 min (class II-III). Blood transfusions were necessary in seven cases (8. 5%). A median of 26 lymph nodes were removed from each patient. Lymphocyst occurred in seven patients (8.5%), retroperitoneal hematoma in two and retroperitoneal abscess in one. CONCLUSION: Extraperitoneal pelvic lymphadenectomy has proven to be a safe and quick technique to complement vaginal operations for endometrial and cervical cancer. Specific features of this approach are: (1) fast, timesaving procedure; (2) possible use of spinal anesthesia; and (3) applicability in high surgical risk patients.

Adult↗
PubMed2003

Longitudinal study of sexual function and vaginal changes after radiotherapy for cervical cancer.

PURPOSE: To investigate the longitudinal course of self-reported sexual function and vaginal changes in patients disease free after radiotherapy (RT) for locally advanced, recurrent, or persistent cervical cancer. MATERIALS AND METHODS: A total of 118 patients referred for RT were included. The patients were assessed, using a validated self-assessment questionnaire, at the termination of RT and 1, 3, 6, 12, 18, and 24 months later. The results were compared with an age-matched control group from the general population. RESULTS: Persistent sexual dysfunction and adverse vaginal changes were reported throughout the 2 years after RT, with small changes over time: approximately 85% had low or no sexual interest, 35% had moderate to severe lack of lubrication, 55% had mild to severe dyspareunia, and 30% were dissatisfied with their sexual life. A reduced vaginal dimension was reported by 50% of the patients, and 45% were never, or only occasionally, able to complete sexual intercourse. Despite sexual dysfunction and vaginal adverse effects, 63% of those sexually active before having cancer remained sexually active after treatment, although with a considerably decreased frequency. CONCLUSIONS: Patients who are disease free after RT for locally advanced, recurrent, or persistent cervical cancer are at high risk of experiencing persistent sexual and vaginal problems compromising their sexual activity and satisfaction.

Adult↗
PubMed2003

Pilot study of vaginal plethysmography in women treated with radiotherapy for gynecological cancer.

OBJECTIVE: After pelvic radiotherapy for gynecological cancer, changes in the vaginal epithelium might influence sexual arousal and satisfaction, leading to dyspareunia and relational problems. The aim of the study was to determine the feasibility of vaginal plethysmography in order to measure physical late effects of this therapy on sexual function. METHODS: Patients treated with radiotherapy for cervical, endometrial, or ovarian cancer, who were in complete remission for over 1 year, underwent vaginal plethysmography to measure changes in vaginal vasocongestion, while watching erotic video fragments. Afterward two questionnaires, designed to measure feelings of sexual arousal during the video, and to identify sexual dysfunction, were completed. The results were compared with those of healthy women. RESULTS: Patients (n = 9) and volunteers (n = 8) did not differ in baseline amplitude of plethysmography and showed comparable changes in vaginal vasocongestion during the various video fragments. The decline in amplitude during the last video fragment in the patient group did not reach significance, but the group of patients is small and heterogeneous. Addressing subjective sexual arousal during the video, patients reported less feelings of lust and desire and fewer bodily sensations while watching than the controls. Patients worried more about the sexual satisfaction of their partners than controls. CONCLUSION: Vaginal plethysmography can be used to measure vaginal vasocongestion in patients treated with radiotherapy to the proximal vagina. In this pilot study the changes of vaginal vasocongestion during sexual arousal between patients and healthy volunteers were not different. This correlates with a comparable sexual satisfaction, although patients reported less feelings of lust.

Adult↗
PubMedDate not supplied

[Cancer of the female sex organs in Baranja: 1985-1990].

Over a 6-year-period (January 1, 1985 to December 31, 1990) 86 women with cancer of genital organs were detected in the region of Baranya. According to the census of the year 1981, 27416 women have lived in Baranya, and in the above mentioned period 23533 examinations were done at the Women Welfare Clinic of the Health Centre Beli Manastir. In the period from 1985 to 1989, the average frequency of cervical cancer was 63.1%, uterine corpus cancer followed with 19.7%, ovarian and tubal with 13.1%, vulvar with 2.6% and vaginal with 1.3%. In the period from January 1 to December 31, 1990, cervical cancer accounted for 45.4% of all cancer cases, corpus cancer for 27.2%, ovarian and tubal cancer for 18.1%, without detection of any vulvar or vaginal cancer cases. In the observed period mean annual incidence of genital cancer was 52.9 per 100,000. According to organ sites mean annual incidence of cervical cancer was 32.1, corpus cancer 10.9, ovarian and tubal cancer 7.3, vulvar 1.2 and vaginal cancer 0.7 per 100,000. During the six year period cervical cancer incidence was reduced from 43.8 in 1985 to 18.2 per 100,000 in 1990. Corpus cancer incidence in 1985 was 14.6 as compared to 10.9 in 1990. Ovarian and tubal cancer incidence in 1985 and 1990 was 10.9 and 7.3, respectively. In the observed period preinvasive lesions of genital organs were discovered in 208 women, 201 (96.6%) of whom had cervical lesions--mean incidence here is 122.2 per 100,000. The overall proportion of preinvasive to invasive cervical lesions in the observed period was 79.1% to 20.9%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Mitoxantrone in the treatment of advanced vulvar and vaginal carcinoma. A gynecologic oncology group study.

Nineteen evaluable patients with advanced carcinoma of the vulva or vagina were treated with mitoxantrone, 12 mg/m2, every 3 weeks. All patients had good performance status and measurable disease and only nine had received prior chemotherapy. No complete or partial responses were noted. The major toxicity was myelosuppression; other toxicity was mild, and no cardiac toxicity or drug deaths occurred. The median progression-free interval was 1.3 months for patients with vulvar cancer and 1.6 months for patients with vaginal cancer. Median survival was 3.2 months for patients with vulvar cancer and 2.7 months for patients with vaginal cancer. Mitoxantrone displays no activity in patients with advanced carcinoma of the vulva or vagina.

Adult↗
PubMed2005

Vaginal oestrogen therapy after breast cancer: is it safe?

The increasing number of breast cancer patients who suffer from menopausal symptoms is mainly due to the extensive use of adjuvant treatments in the younger women. Both short and long-term side effects of oestrogen deficiency may severely impact on the quality of life of these women and should not be underestimated. Hormonal treatments are contraindicated in breast cancer survivors mainly due to the concern that dormant micrometastases may be stimulated to grow. Alternative non-hormonal remedies are now available to alleviate symptoms and to prevent chronic diseases associated with oestrogen deficiency. Urogenital atrophy is an important consequence of oestrogen deprivation that can be effectively treated by vaginal estrogens, although systemic absorption occurs with conventional doses. Preliminary data suggest that much lower doses of vaginal estrogens can alleviate urogenital atrophy without influencing serum estrogenic levels. Further research is warranted to confirm whether vaginal estrogens are safe in symptomatic breast cancer patients who are non-responsive to alternative treatments.

Administration, Intravaginal↗
PubMed2000

[Renaissance of vaginal hysterectomy for cervical carcinoma. 100th anniversary of the first abdominal radical surgery of cervical carcinoma by Ernst Wertheim on November 16, 1898].

In the 100 year long history of the abdominal radical operation of collum carcinoma, due to the continued clinical surgical and scientific work of several generations of physicians, abdominal radical operation with standardized pelvic lymphonodectomy has become the method of choice for surgical treatment of collum carcinoma since 1970. Vaginal radical operation in its various forms has since played only a very restricted role in surgical treatment of collum carcinoma. According to the opinion of the majority of cancer surgeons vaginal radical operation had to be abandoned in view of discontinuous spreading of carcinoma into the regional pelvic lymph nodes. Because of its simplicity vaginal radical operation would still be useful today for very old high-risk patients and very young women with early invasive collum carcinoma detected in cancer screening. In view of our knowledge of the lymph node problem in collum carcinoma, however, this can no longer be the vaginal radical operation of past generations. In order to prevent critical objections to vaginal radical operation, the early attempts of Stoeckel, Suboth Mitra, Bastiaanse, Navratil, Inguilla, and Akashi were resumed. Since 1989 attempts have been made to combine vaginal radical operation of collum carcinoma with laparoscopic pelvic or para-aortic lymphonodectomy. The development has passed the following stages: the development of laparoscopic pelvic and para-aortic lymphonodectomy based on staging criteria the combination of laparoscopic lymphonodectomy with vaginal radical operation of collum carcinoma the combination of laparoscopic lymphonodectomy with complete laparoscopic radical hysterectomy and only subsequent vaginal removal of organs.

Austria↗