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At least 721 records · Page 40Linked to original sources
PubMed2004

An unusual admixture of neoplastic and metaplastic lesions of the female genital tract in the Peutz-Jeghers Syndrome.

BACKGROUND: Peutz-Jeghers Syndrome (PJS) is a rare autosomal dominant condition with variable penetrance characterized by gastrointestinal hamartomatous polyps and mucocutaneous pigmentation. Patients with PJS have an increased risk for breast, gastrointestinal and female genital tract cancers. CASE: Multiple genital tract neoplasms in a 41-year-old Italian woman with PJS are described. The patient presented with abdominal pain due to intussusception. A CT scan of the abdomen also showed a left adnexal mass, diagnosed as ovarian mixed serous and mucinous borderline tumor. An ovarian microscopic sex cord tumor with annular tubules (SCTAT) was incidentally diagnosed together with a minimal deviation mucinous adenocarcinoma of the uterine cervix. Also areas of typical hyperplasia of the tubal mucosa with mucinous metaplasia were found. CONCLUSION: This appears to be one of the rare cases reported in literature in which PJS is complicated by multiple and contemporaneous genital tract tumors and rare histological findings. The clinical significance of recurrence of these unusual genital tract tumors and histological alterations in PJS patients is reviewed.

Adult↗
PubMed2006

Conservative management in primary genital lymphomas: the role of chemotherapy.

BACKGROUND: The female genital lymphomas are an extremely rare disease accounting for less than 0.5% of gynecological cancers and for 1.5% of all NHL. Because of their low incidence there is no widely accepted consensus on its treatment. Literature data support a radiotherapy-based treatment in case of primary genital lymphomas stages I-II. The role of chemotherapy as neoadjuvant or exclusive treatment is still to be defined. METHODS: From 1984 to 2003, the treatments in our institution of 19 patients with genital lymphoma were reviewed. Nine women presented with cervical, 3 with vaginal, 1 with cervical-vaginal, 2 with vulvar and 4 with ovarian lymphoma. Seven were staged IE, nine IIE, one IIIE and two IVE. As a whole, chemotherapy was used in 18/19 cases: chemotherapy was proposed as first line treatment in 12 cases, while surgery in 7 (followed by chemotherapy in 6 cases). RESULTS: Primary chemotherapy alone obtained a complete response (CR) in 9/12 patients; pathological complete response (pCR) was confirmed in 3 operated patients out of 9. Partial response (PR) was observed in 3, requiring radiotherapy. Chemotherapy obtained CR after incomplete surgical debulking in 3 out of 4 cases. Two patients relapsed in the group treated with chemotherapy alone. Both have been salvaged by further chemotherapy. Only one patient deceased due to her tumor after surgery and chemotherapy. CONCLUSION: The use of exclusive chemotherapy obtained promising results not only as regards survival rates but also for reducing the need of radiotherapy. A conservative management based on exclusive chemotherapy in primary genital lymphoma stages I-II may be attempted in selected patients desiring pregnancy.

Adult↗
PubMed1997

Patterns of genital injury in female sexual assault victims.

OBJECTIVE: New colposcopic protocols allow examiners to better document genital trauma in rape victims. We report our findings on the locations and types of genital injury seen in female assault victims versus women engaging in consensual sex. STUDY DESIGN: Physical examinations were performed on 311 rape victims seen by San Luis Obispo County's Suspected Abuse Response Team between 1985 and 1993 and contemporaneously on 75 women after consensual sexual intercourse. RESULTS: Among 213 (68%) victims with genital trauma, 162 (76%) had 3.1 mean sites of injury. Comparatively, 8 (11%) consenting women had just single-site trauma. Two hundred (94%) victims had trauma at one or more of four locations, as follows: posterior fourchette, labia minora, hymen, fossa navicularis. Trauma types varied by site; tears appeared most often on the posterior fourchette and fossa, abrasions appeared on the labia, and ecchymosis was seen on the hymen. CONCLUSION: A localized pattern of genital trauma can frequently be seen in women reporting nonconsensual sexual intercourse; such findings are useful for the clinical forensic examiner.

Adolescent↗
PubMed2002

Lower genital tract infection and endometritis: insight into subclinical pelvic inflammatory disease.

OBJECTIVE: To investigate the association between lower genital tract infections and subclinical PID. Fallopian tube damage is a common complication of acute symptomatic pelvic inflammatory disease (PID), yet most women with tubal factor infertility do not have a history of acute PID. Subclinical PID is believed to be an important cause of tubal factor infertility. METHODS: We conducted a cross-sectional study among women attending a sexually transmitted diseases or ambulatory gynecology clinic. A convenience sample of 556 women with bacterial vaginosis, gonorrhea, or chlamydia, or women at risk for gonorrhea or chlamydia were enrolled. Women diagnosed with acute PID were not eligible to participate. The main outcome was subclinical PID, as defined by the presence of histologic endometritis. RESULTS: Subclinical PID was more common in women with lower genital tract infection than in uninfected women. Subclinical PID was present in 27% of women with Chlamydia trachomatis (odds ratio 3.4; 95% confidence interval [CI] 1.8, 6.3) and in 26% of women infected with Neisseria gonorrhoeae (odds ratio 2.4; 95% CI 1.1, 5.1). Among women with bacterial vaginosis, 15% had endometritis (odds ratio 2.7; 95% CI 1.02, 7.2). CONCLUSION: Subclinical PID is common among women with lower genital tract infections. Additional prospective studies are necessary to determine the reproductive impact of these asymptomatic upper genital tract infections.

Adolescent↗
PubMedDate not supplied

Genital manifestations and reproductive health in female residents of a Wuchereria bancrofti-endemic area in Tanzania.

To assess the significance of lymphatic filariasis for the development of chronic genital manifestations and for reproductive health in women, we conducted a cross-sectional study of 2 villages in north-eastern Tanzania including interview and gynaecological examination of adult women, focusing primarily on reproductive history and genital health. In a population of 2165 residents, prevalence of Wuchereria bancrofti microfilaraemia was 28%, and geometric mean intensity of microfilariae (mf) was 722 mf/mL. Leg lymphoedema (elephantiasis) was present in 4.2% of adults aged > or = 15 years, and hydrocoele in 26.5% of adult males. Five hundred and thirty women completed an interview, and 404 of these completed a gynaecological examination. Most women were Muslims (72%), polygamy was common (29%), and 49% of women had undergone circumcision (clitoridectomy). Presence of microfilaraemia did not influence fertility or fertility-related variables including age at menarche, parity, spontaneous abortion, stillbirth, Caesarean section and premature labour, nor presence of primary or secondary infertility. Mf status was strongly correlated with abnormal menstruation pattern in the 30+ years age-group (P = 0.001), but not in the < 30 years age-group. Cervical, vaginal and vulval pathology was unrelated to mf status. Two women, aged 46 and 77 years, had vulval oedema of probable filarial origin, both were mf negative. Overall, microfilaraemia appeared to have no influence on genital disease or reproductive health, and chronic manifestations of lymphatic filariasis of the genitals does not appear to be a substantial problem in women.

Adolescent↗
PubMed1995

Fibrous hamartoma of infancy: a report of two cases in the genital region.

OBJECTIVES: Fibrous hamartoma of infancy (FHI) is an uncommon subcutaneous proliferative lesion usually found in the upper portions of the body, particularly in males during the first 2 years of life. We report 2 cases of FHI in the genital region. METHODS: We retrospectively reviewed the charts of children treated at Children's Hospital and Health Center, with FHI located in the genital region. RESULTS: We report 2 cases of FHI in the genital region, 1 involving the scrotum and 1 the labium majus. CONCLUSIONS: FHI should be considered in the differential diagnosis of genital masses in children. The histologic features are characteristic, local excision of the tumor is curative, and the local recurrence rate is low.

Child↗
PubMed1997

Skin graft reconstruction of chronic genital lymphedema.

OBJECTIVES: We present a simple, reliable method of scrotal and penile reconstruction yielding satisfactory cosmetic and functional results for patients with disabling chronic genital lymphedema. METHODS: Nine patients were treated with wide excision of the affected genital skin and subsequent coverage of exposed areas with split-thickness skin grafts in a single-stage procedure. RESULTS: All patients have had excellent cosmetic results without recurrence of genital lymphedema or compromise of sexual function postoperatively. CONCLUSIONS: Single-stage reconstruction for idiopathic genital lymphedema by radical skin excision and split-thickness skin grafting provides gratifying functional and cosmetic results.

Chronic Disease↗
PubMed1997

The use of EMLA cream and 1% lidocaine infiltration in men for relief of pain associated with the removal of genital warts by cryotherapy.

BACKGROUND: Surgical procedures used to remove genital warts (cryotherapy, electrodesiccation) are painful. Attempts to reduce the discomfort of surgery by prior lidocaine infiltration anesthesia are compromised by the pain of the infiltration. OBJECTIVE: Our purpose was to determine the efficacy of topically applied lidocaine/prilocaine cream to reduce the pain of lidocaine infiltration and the pain associated with cryotherapy to remove genital warts. METHODS: Men, scheduled for removal of genital warts by cryotherapy, were randomly selected to receive one of three treatments: (1) lidocaine/prilocaine cream application, (2) 1% lidocaine infiltration, and (3) lidocaine/prilocaine cream application followed by infiltration of 1% lidocaine. RESULTS: Application of lidocaine/prilocaine cream for 15 minutes markedly reduced the pain of lidocaine infiltration. The combination of lidocaine/prilocaine cream followed by infiltration of 1% lidocaine gave greater pain relief from the cryotherapy than did either anesthetic alone. CONCLUSION: The application of lidocaine/prilocaine cream as an adjunct to lidocaine infiltration reduced the pain of infiltration and the pain associated with cryotherapy for the removal of genital warts.

Anesthesia, Local↗
PubMed1999

Penile cancer among patients with genital lichen sclerosus.

BACKGROUND: Genital lichen sclerosus (LS) has sporadically been reported to be associated with penile squamous cell carcinoma (SCC). OBJECTIVE: The purpose of this study was to assess the risk of malignant degeneration in a series of male patients affected by genital LS. METHODS: All cases of histologically proven epithelial malignancy associated with penile LS recorded in our pathology files over a 10-year period (1987-1997) were reviewed. Assessment for presence of human papillomavirus (HPV) was performed from paraffin-embedded tissues using polymerase chain reaction (PCR). RESULTS: Five of 86 white and uncircumcised men with genital LS (mean age at diagnosis, 53 years; range, 22-83 years) showed malignant or premalignant histopathologic features: 3 had SCC, one had erythroplasia of Queyrat (unifocal SCC in situ), and one verrucous carcinoma. The average lag time from onset of LS was 17 years (range, 10-23 years). Histologically, transition from LS to frank neoplastic foci was evident in all cases of SCC. In these SCC cases, areas of epithelial dysplasia were well evident at the tumor periphery. In the remaining cases, the histologic findings were consistent with erythroplasia of Queyrat and verrucous carcinoma. PCR detected HPV 16 infection in 4 of the 5 cases; one SCC patient was negative for HPV. CONCLUSION: Malignant changes were associated with 5.8% of the cases of penile LS in our series. Therefore patients with genital LS are at considerable risk of the development of penile SCC, as well as other epithelial and in situ carcinomas, namely verrucous carcinoma and erythroplasia of Queyrat. HPV infection probably plays a major role because 4 of 5 patients were positive for HPV. Histologically, epithelial dysplasia may represent a precancerous stage before the development of neoplasia in atrophic nonproliferative LS lesions, as its presence at the tumor periphery in our SCC biopsy samples seemed to suggest.

Adult↗
PubMed1998

Genital tuberculosis in a HIV infected woman: a case report.

The incidence of HIV-associated tuberculosis is increasing worldwide, especially in developing countries. HIV infected patients rapidly develop clinically significant disease, respond poorly to complete treatment and present with extrapulmonary tuberculosis. Although a relative increase of genital tuberculosis would be expected, this has not been reported. Probably, tuberculous systemic disease is diagnosed earlier, before genital tuberculosis occur. The present study is a report of case of a young African female patient, who was admitted with symptoms of acute pelvic inflammatory disease due to genital tuberculosis and proved to be HIV infected. The patient was managed by intravenous antibiotic administration, but since no clinical or laboratory improvement was achieved, a laparotomy and salpingooophorectomy was performed. Histopathology revealed tuberculosis and after that the patient proved to be HIV infected. Further investigation did not reveal pulmonary or other extragenital manifestation of tuberculosis. The only manifestation of HIV infection and genital tuberculosis was the symptoms of an acute pelvic inflammatory disease, which is extremely rare.

Adult↗
PubMed1997

Genital myiasis (Wohlfahrtiosis) in camel herds of Mongolia.

Genital infestations caused by Wohlfahrtia magnifica (Schiner, 1862) has been reported as being a common problem encountered in female camels in the Gobi desert. Thus, a field investigation to establish the prevalence of wohlfarthiosis in camel herds in the eastern Gobi district was carried out between May and July 1994. The objectives of the study were to establish the relevance of genital myiasis, and to describe the disease patterns, clinical course and pathomorphological changes associated with it. The field study was designed to suit the specific ecological, infrastructural and logistic conditions. Two cross-sectional samples were taken from 45 selected herds in six different areas of the Chatanbulag Sumon to obtain data on herd structure, age distribution, and the breeding history of infested female animals. Post partum events and previous occurrence of genital myiasis were recorded by use of a standardised questionnaire. Clinically infested animals were first detected visually. All camels to be investigated further were subsequently immobilised using ropes and the genitals were examined for tissue lesions and the presence of larvae. Examination of 1676 Bactrian camels from 45 selected herds in six different areas of the Chatanbulag Sumon in the Eastern Gobi district, Mongolia, led to an estimate of Wohlfahrtia magnifica infestation rates between 8-10%. Most myiasis cases were found in older females (> 4 yr), younger animals were infested at a lower rate. Highest prevalence rates were discovered during June and July, highest levels of infestation occurred in the Aman Us Chudak region with infestation rates up to 15%.

Age Factors↗
PubMed2004

Listening to "felt needs": investigating genital prolapse in western Nepal.

The global prevalence of genital prolapse is estimated to be 2-20% in women under age 45. In Nepal, genital prolapse appears to be widespread, but little published evidence exists to buttress this claim. This paper presents findings of two studies, one ethnographic and one clinic-based, in western Nepal. The ethnographic study involved 16 focus group discussions with 120 community members and key informants, and covered community perceptions and women's experience of prolapse and its perceived causes and consequences. The clinic-based study was conducted among 2,072 women who presented with gynaecological complaints and received a diagnosis. One in four of them had genital prolapse, of whom 95% had self-reported the prolapse. The most commonly perceived causes of prolapse were lifting heavy loads, including in the post-partum period. The adverse effects reported included difficulty urinating, abdominal pain, backache, painful intercourse, burning upon urination, white watery discharge, foul-smelling discharge, itching, and difficulty lifting, sitting, walking and standing. The results confirm prolapse as a significant public health problem in western Nepal. We strongly recommend developing systematic, rotational gynaecological clinics in rural districts, the use of a screening checklist and counselling for prevention and early management of genital prolapse by district health workers for family planning and antenatal patients.

Adult↗
PubMed2000

Abnormal genital tract bleeding.

The etiology of abnormal genital tract bleeding encompasses a wide range of disorders that can be secondary to anatomic changes of the female genital tract, infection, endocrinologic disorders, malignancies, and systemic illness. Appropriate workup is guided by age-related differential diagnoses for abnormal bleeding. Modern diagnostic tools can quickly focus the evaluation and allow timely intervention. Most abnormal genital tract bleeding is uterine bleeding, which is one of the most common gynecologic problems that health care providers will face. It accounts for approximately 15% of office visits and 25% of gynecologic operations. Abnormal uterine bleeding in reproductive-age women is defined as bleeding at abnormal or unexpected times or by excessive flow at the time of an expected menses. The average menstrual cycle length and duration of flow is 28 days and 4 days, respectively, with an average blood loss of 35 cc (1). Any bleeding should be considered abnormal in premenarchal girls and in post-menopausal women except for those with predictable withdrawal bleeding taking hormone replacement therapy. This article will review the categories of abnormal genital tract bleeding and the diagnostic tools needed to establish the correct diagnosis. Common clinical cases will be presented to illustrate the presenting symptoms, differential diagnoses, workup, treatment, and long-term follow-up.

Adolescent↗
PubMed2003

Male infertility and genital chlamydial infection: victim or perpetrator?

The role of Chlamydia trachomatis in the cause of male infertility is under discussion. This paper attempts to summarize data from the literature, which support the role of C. trachomatis in male infertility or oppose this suggestion. The following observations are based on a survey of the literature: 1) Chlamydia trachomatis is a frequent pathogen in male genital inflammation, the micro-organisms are rarely present in healthy men. 2) Without doubt, C. trachomatis causes inflammations of the male urethra and the epididymis. Prostatitis and glandulitis vesicalis are discussed controversially. 3) Chlamydia trachomatis antigen or DNA is not demonstrable in secretions of the male accessory glands including the semen with sufficient reproducibility. However, it is easily demonstrable in urethral swabs and the urine. 4) Determination of chlamydial antibodies in serum or semen does not conclusively indicate a current infection with C. trachomatis. 5) There are no conclusive studies showing that men infected with C. trachomatis are less fertile than uninfected men. 6) The male genital chlamydial infection is a threat to the female genital organs, because C. trachomatis infection of the female genital organs may be deleterious to female fertility.

Chlamydia Infections↗
PubMedDate not supplied

Langerhans cell histiocytosis of the female genital tract: a literature review.

Langerhans cell histiocytosis (LCH) is a rare malignant disease involving the accumulation of a monoclonal proliferation of cells in various organs, that phenotypically resemble Langerhans cells (LC). LCH is not merely a hyperplasia of LC, as it typically affects organs that are outside of their normal physiologic distribution. Normal Langerhans cells are bone marrow-derived dendritic cells that populate the epidermis and are distinguished by the presence of Birbeck granules and cell surface protein CD1a. LC act as sentinels; they recognize, internalize, and process antigens encountered in the skin. Upon encountering an antigen, LC become activated with subsequent maturation and induction of their migratory capacity. Langerhans cells in patients with LCH are aberrant and profoundly differ from normal LC. The clinical spectrum of LCH is quite diverse; multiple organs can be affected. "Pure" genital Langerhans cell histiocytosis is a rare presentation, with only 12 previously reported cases. Due to the rarity of this disease, treatment of genital LCH is still very diverse. No modality is proven to be superior in improving patient outcome, and relapses frequently occur after surgery. Dramatic responses of cutaneous and ano-genital lesions to thalidomide and interferons have been reported. We advocate the use of immuno-modulating agents in LCH of the female genital tract first, rather than surgery.

Adjuvants, Immunologic↗
PubMed2006

Primary surgery of genital prolapse: a shift in treatment tradition.

BACKGROUND: The use of complete repairs in genital prolapse surgery has been questioned because of the possible adverse effects of the surgery on the urogenital and sexual function and selective repairs have been advocated. The aims of this study were to establish information about genital prolapse surgery and to analyze whether a shift from extensive prolapse surgery with complete repairs to selective repairs occurred during a 10-year period. METHODS: A retrospective study of 610 consecutive patients operated upon for genital prolapse during 1983 (Period I) and 1993 (Period II) in a sample of three Swedish hospitals was conducted. Data were obtained from the patient records. 542 women had primary surgery and were analyzed with emphasis on demographic, clinical, and surgical data. RESULTS: The demographic and clinical data of the patients showed no significant differences between the two periods. In Period I, 69% of the patients underwent complete repair compared with 37% in Period II (p<0.001). The proportion of prolapse operations without posterior colporrhaphy increased significantly from the first to the second period from 14 to 43% (p<0.001). CONCLUSION: The surgery for genital prolapse seems to have changed from complete repairs towards selective repairs and posterior colporrhaphy was more often avoided in the second period. The implication of this shift in surgical treatment on pelvic floor function is not known. Further studies are needed to disclose the effect of the surgery on pelvic floor function and dysfunction in the long term.

Adult↗
PubMedDate not supplied

Abnormal Papanicolaou smears, genital tract infections, and contraception.

Cervical cancer ranks second among all cancers in women world-wide, and the rate of invasive cervical cancer among women under 50 is rising in the United States. Risk factors for abnormal Papanicolaou (Pap) smears and invasive cervical cancer include genital tract infections. This study was designed to compare the rates of genital tract infections and the contraceptive choices of a random sample of 800 women, using an ex post facto design. The Pap positive women had a significantly higher rate of genital tract infections than did the Pap negative women but did not differ significantly in use of contraceptive methods. Findings support those of other researchers suggesting genital tract infections as risk factors for abnormal Pap smears and are consistent with the literature in suggesting a role for oral contraceptive pills (OCPs) in acquisition of the human papillomavirus (HPV). Caregivers can help empower women to reduce their risks through informed choices about protection and sexual behaviors.

Adolescent↗
PubMedDate not supplied

Genital ulcers after treatment with all-trans-retinoic acid in a child with acute promyelocytic leukemia.

All-trans-retinoic acid (ATRA) has been shown to improve the outcome of patients with acute promyelocytic leukemia (APL). However, various adverse effects of ATRA treatment have been noted, such as scrotal and genital ulcers in adult patients. The authors report genital ulcers that developed in a child with APL after ATRA treatment. An 8-year-old girl with APL was treated with ATRA for 21 days and after discontinuation of ATRA treatment she developed genital ulcers. Systemic and local antibiotic pomades were applied and the lesions improved within 15 days. In conclusion, genital ulcers may develop in children with APL as a complication of ATRA treatment and physicians should be alert to this possibility.

Child↗