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1.
Rev. Hosp. Ital. B. Aires (2004) ; 42(1): 37-40, mar. 2022. ilus
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1369159

ABSTRACT

El sangrado genital en niñas prepúberes es un signo poco frecuente y siempre requiere determinar su causa. Se necesitan una detallada anamnesis y examen físico, con el conocimiento adecuado de la anatomía uroginecológica, y, en muchos casos, estudios de imágenes y exámenes complementarios, para arribar al diagnóstico. Se presenta el caso de una niña de 7 años con sangrado genital, cuyo examen físico y estudios complementarios fueron poco concluyentes, y que requirió un procedimiento invasivo para su resolución. (AU)


Genital bleeding in prepubertal girls is a rare sign and always requires determining its cause. A detailed history and physical examination are needed, with adequate knowledge of urogynecological anatomy, and in many cases, imaging studies and complementary tests, to arrive at the diagnosis. We present the case of a 7-year-old girl with genital bleeding, whose physical examination and complementary studies were inconclusive, requiring an invasive procedure for its resolution. (AU)


Subject(s)
Humans , Female , Child , Uterine Hemorrhage/etiology , Vagina/injuries , Foreign Bodies/diagnostic imaging , Paper , Ultrasonography , Gynecological Examination
3.
Article in English | LILACS | ID: biblio-1280959

ABSTRACT

Introduction: Chikungunya virus is spreading worldwide due to migration and globalization and could be presented with systemic and with unusual symptoms. Objective: To report a case of virus-transmitted infection detected in a woman during the gynecological examination at a vulvar clinic. Case report: A 73-year-old Caucasian woman attended a vulvar clinic because of dyspareunia and vulvar burning. Ulcers were observed on labia minora and perineum. A Chikungunya was diagnosed by seroconversion in paired specimens. She was prescribed prednisolone 40 mg once a day for 10 days. After oral steroid treatment, the woman had no body rashes or lesions on her genitals. Conclusion: This study emphasized that rare signs of unusual vulvitis with ulcers could be associated with Chikungunya infection.


Introdução: O vírus Chikungunya está se espalhando pelo mundo por conta da migração e da globalização, podendo apresentar sintomas sistêmicos e incomuns. Objetivo: Relatar um caso de infecção pelo vírus detectado em uma mulher por ocasião do exame ginecológico em clínica de patologia vulvar. Relato do caso: Uma mulher caucasiana de 73 anos foi a uma clínica vulvar por causa de dispareunia e queimação vulvar. Úlceras foram observadas nos pequenos lábios e no períneo. O diagnóstico de Chikungunya foi realizado por soroconversão em espécimes pareados. Foi prescrita prednisolona 40 mg uma vez ao dia por dez dias. Após o tratamento com esteróides orais, a mulher não apresentou erupções ou lesões nos órgãos genitais. Conclusão: Este estudo enfatizou que quadros raros de vulvite com úlcera podem estar associados à infecção por Chikungunya.


Subject(s)
Humans , Female , Aged , Ulcer/virology , Vulvitis/virology , Chikungunya Fever/complications , Gynecological Examination
4.
In. Castillo Pino, Edgardo A. Manual de ginecología y obstetricia para pregrados y médicos generales. Montevideo, Oficina del Libro-FEFMUR, 2 ed; 2021. p.43-60, ilus.
Monography in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1372514
5.
In. Castillo Pino, Edgardo A. Manual de ginecología y obstetricia para pregrados y médicos generales. Montevideo, Oficina del Libro-FEFMUR, 2 ed; 2021. p.147-168, ilus.
Monography in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1372523
6.
Rev. bras. ginecol. obstet ; 42(11): 739-745, Nov. 2020. tab
Article in English | LILACS | ID: biblio-1144167

ABSTRACT

Abstract Objective: To evaluate factors associated with anxiety and the effect of simulation-based training (SBT) on student anxiety, self-confidence and learning satisfaction in relation to pelvic and breast examination. Methods: A longitudinal study was conducted with 4th year medical students at the Universidade José do Rosário Vellano. A 12-item, self-report questionnaire on student anxiety at performing gynecological examinations was applied before and after SBT, with answers being given on a Likert-type scale. After training, the self-confidence levels and satisfaction of the students related to the learning process were also evaluated. Results: Eighty students with a mean age of 24.1 ± 4.2 years were included in the study. Of these, 62.5% were women. Pre-SBT evaluation showed that students were more anxious at performing a pelvic examination than a breast examination (2.4 ± 1.0 versus 1.7 ± 0.8, respectively; p < 0.001). The primary reason for anxiety regarding both pelvic and breast examination was fear of hurting the patient. SBT significantly reduced student anxiety (2.0 ± 0.8 versus 1.5 ± 0.5, respectively; p < 0.001). The satisfaction and self-confidence of the students were found to be high (6.8 ± 0.3 and 6.0 ± 0.9, respectively), with no difference between genders. Conclusion: The use of SBT in teaching students to perform pelvic and breast examinations resulted in reduced anxiety and increased self-confidence in a group of medical students of both genders, with high levels of satisfaction in relation to the training.


Resumo Objetivo: Avaliar os fatores relacionados à ansiedade e ao efeito do treinamento baseado em simulação (TBS) na ansiedade, autoconfiança e satisfação do estudante em relação ao aprendizado do exame pélvico e de mamas. Métodos: Estudo longitudinal com alunos do quarto ano de medicina da Universidade José do Rosário Vellano, utilizando questionário autorrespondido com 12 itens em escala tipo Likert sobre a ansiedade em relação ao exame ginecológico, pré e pós-TBS. Após o treinamento, avaliou-se também o grau de autoconfiança e satisfação com o processo de aprendizado. Resultados: Foram incluídos 80 alunos com média etária de 24,1 ± 4,2 anos, dos quais 62,5% eram mulheres. Na avaliação pré-treinamento, a ansiedade dos alunos em relação ao exame pélvico foi maior do que a ansiedade em relação ao exame das mamas (2,4 ± 1,0 versus 1,7 ± 0,8, respectivamente; p < 0,001). O principal motivo de ansiedade em relação tanto ao exame pélvico quanto ao de mamas foi o receio de machucar a paciente. O TBS reduziu significativamente a ansiedade dos alunos (2,0 ± 0,8 versus 1,5 ± 0,5, respectivamente; p < 0,001). A satisfação e autoconfiança dos estudantes foram elevadas (6,8 ± 0,3 e 6,0 ± 0,9, respectivamente), sem diferença entre gêneros. Conclusão: O uso de TBS no ensino de exame pélvico e mamário resultou em uma diminuição na ansiedade e elevada autoconfiança em um grupo de estudantes de medicina, de ambos os gêneros, e bons níveis de satisfação em relação ao treinamento.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Physical Examination , Self Concept , Students, Medical , Gynecological Examination , Simulation Training , Brazil , Breast , Surveys and Questionnaires , Education, Medical, Undergraduate , Gynecology/education
7.
Rev. Bras. Saúde Mater. Infant. (Online) ; 20(2): 633-641, Apr.-June 2020. graf
Article in English | LILACS, SES-SP | ID: biblio-1136431

ABSTRACT

Abstract Objectives: to analyze the access to cervical cancer preventive examination in Pernambuco between 2002 and 2015 by cytopathological exam coverage. Methods: public data from SUS Computer Department were used, then processed by Tabnet and Excel and calculated the slope of the over time coefficient trend by simple regression techniques. Afterwards, they were plotted in thematic maps covering cytopathological exams on Terraview app 4.2.2. Results: Pernambuco State presented an increase of exam coverage trend in all the health regions until 2010. Since that year it started to have stabilization and decreased the tendency. Comparing the coverage of the two first years, in 2002, 42.7% of the cities coverage was below 0.2 and in 2015 the scenario changed, 41.1% of the cities coverage was above 0.6. We emphasize that even in that same year 13.5% of the cities still had a low or too low coverage (less than 0.4). The over time trends in increase and decline were strongly meaningful. Conclusions: this study revealed that all health regions presented a coverage lower than recommended, in some period or in all of them, even with the State growth tendency it demonstrated an unequal and heterogeneous characteristic.


Resumo Objetivos: analisar o acesso ao exame preventivo para o câncer de colo do útero em Pernambuco, entre 2002 e 2015, por meio da cobertura do citopatológico. Métodos: foram utilizados dados de domínio público do Departamento de Informática do SUS, processados no Tabnet e Excel® e calculados os coeficientes de inclinação de tendência temporal, por meio de técnicas de regressão simples. Por fim, foram plotados em mapas temáticos de cobertura de exames citopatológicos no aplicativo Terraview 4.2.2. Resultados: Pernambuco apresentou aumento na tendência de cobertura ao exame para todas as regiões de saúde até 2010. A partir deste ano, apresentou uma tendência de estabilização e diminuição. Ao comparar a cobertura no primeiro e no último ano, em 2002 42,7% dos municípios estavam com cobertura abaixo de 0.2 e em 2015 o cenário muda para 41,1% de municípios com cobertura acima 0.6. Destaca-se que neste mesmo ano 13,5% dos municípios ainda apresentavam uma cobertura baixa e muito baixa (<0.4). Tendências temporais de crescimento e decréscimo tiveram forte significância. Conclusões: todas as regiões de saúde apresentaram cobertura inferior ao preconizado, em algum período ou em todos, mesmo com a tendência estadual de crescimento, demonstrando uma característica heterogênea e desigual.


Subject(s)
Humans , Female , Adult , Middle Aged , Uterine Cervical Neoplasms/prevention & control , Uterine Cervical Neoplasms/epidemiology , Health Status Disparities , Gynecological Examination , Brazil/epidemiology , Indicators of Morbidity and Mortality , Health Services Accessibility
9.
Rev. ciênc. méd., (Campinas) ; 28(1): 21-30, jan.-mar. 2019. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1047801

ABSTRACT

Objetivo Analisar o conhecimento e a adesão ao Papanicolau de mulheres que frequentam Unidades Básicas de Saúde. Métodos Um questionário composto de questões pré-codifi cadas e abertas foi aplicado às usuárias de duas Unidades Básicas de Saúde da cidade de São José do Rio Preto, São Paulo, localizadas em bairros com perfi l socioeconômico distinto. Os dados foram analisados estatisticamente pelo programa Statistical Package for the Social Sciences.Resultados Após a análise de 99 questionários respondidos, ficou evidente um nível de conhecimento melhor sobre o exame de Papanicolau das residentes do bairro com melhores condições socioeconômicas e das mulheres mais jovens. Ficou evidente que muitas fazem esse exame sem saber o devido objetivo desse procedimento. A vergonha e a falta de tempo foram relatadas como motivos relevantes para não realizar o exame. Conclusão A falta de informação sobre o exame de Papanicolau das mulheres com mais de 60 anos e menor nível socioeconômico ficou evidente neste estudo e pode ser considerada um dos aspectos mais relevantes à não adesão à prevenção do câncer do colo de útero. Dessa maneira, ações de saúde alternativas deveriam ser adotadas pelas Unidades Básicas de Saúde para melhor orientar a população e, assim, aumentar a adesão a esse exame.


Objective To analyze the knowledge and adhesion to the Papanicolaou smear test of women attending Basic Health Units. Methods A questionnaire composed of pre-coded and open questions was applied to users of two Basic Health Units of the city of São José do Rio Preto, São Paulo, located in districts with different socioeconomic profiles. The data were statistically analyzed by the Statistical Package for the Social Sciences program. Results After the analysis of 99 questionnaires answered, a better level of knowledge about the Pap smear was found among the residents of the better socioeconomic neighborhood and the younger women. It has become evident that many take this test without knowing the proper purpose of this procedure. Shame and lack of time were reported as relevant reasons for not doing the test. Conclusion The lack of information on the Papanicolaou smear of women over 60 years of age and lower socioeconomic level was evident in this study and may be considered one of the most relevant aspects to non-adherence to cervical cancer prevention. In this way, alternative health actions should be adopted by the Basic Health Units to better guide the population and thus increase adherence to this examination.


Subject(s)
Cervical Intraepithelial Neoplasia , Gynecological Examination , Papanicolaou Test
10.
Saúde Soc ; 28(2): 174-186, abr.-jun. 2019. tab
Article in Portuguese | LILACS | ID: biblio-1014594

ABSTRACT

Resumo Este artigo aborda conversas entre enfermeiras e mulheres, durante consultas ginecológicas para realização de exame citopatológico. Trata-se de estudo qualitativo que analisou as conversas produzidas durante consultas realizadas em três serviços de atenção básica de saúde de um município do Sul do Brasil. A análise das conversas entre enfermeiras e mulheres usuárias dos serviços foi pautada na perspectiva teórico-metodológica da fala-em-interação, abordagem em que as categorias não são definidas a priori, mas emergem a partir das interações entre os falantes. Os fenômenos interacionais de interesse são analisados a partir de excertos de conversas entre três enfermeiras e sete das 26 mulheres que buscaram os serviços de atenção básica em saúde, transcritas segundo as convenções adotadas por analistas da conversa. Por meio de análise das categorias de pertença, observou-se que nas conversas as mulheres se identificam de acordo com os papéis tradicionais de mãe e esposa. Enfermeiras e usuárias compartilham a ideia de que a sexualidade dos homens, pautada no biológico, é irrefreável, e acreditam que devem cumprir as obrigações matrimoniais de esposas, atendendo à necessidade sexual dos maridos, mesmo quando sentem desconforto e dor. Os achados desta pesquisa podem auxiliar os profissionais da saúde a refletirem criticamente acerca das interações conversacionais com as usuárias de serviços de saúde.


Abstract This article is about conversations between nurses and women, during gynecological consultations for cytopathological examination. This is a qualitative study that analyzed the conversations made during consultations carried out in three primary health care services of a municipality in the southern Brazil. The analysis of the conversations between nurses and women users of services was based on the theoretical-methodological perspective of speech in interaction, an approach in which the categories are not defined a priori, but they emerge from the interactions among the speakers. The interactional phenomena of interest are analyzed in excerpts from conversations between three nurses and seven of the 26 women who sought primary health care services, transcribed according to the conventions adopted by conversation analysts. Through the membership categorization analysis, one observed in the conversations women identify themselves with the traditional roles of mothers and wives. Nurses and users share the idea that men's sexuality, based on the biological aspect, is unstoppable and believe they must fulfill spousal obligations, meeting the husbands' sexual needs, even when they feel discomfort and pain. The findings of this study may help health professionals to reflect critically on their conversational interactions with health service users.


Subject(s)
Humans , Female , Pathology , Evaluation Studies as Topic/analysis , Health Personnel , Sexuality , Gynecological Examination , Health Services , Interpersonal Relations , Gender Identity
11.
Femina ; 47(4): 195-197, 20190430. ilus
Article in Portuguese | LILACS | ID: biblio-1046510

ABSTRACT

A presença de pacientes adolescentes tem sido uma situação cada vez mais frequente para os ginecologistas. Dentre os motivos de consulta, destacam-se a avaliação do desenvolvimento da puberdade, distúrbios do ciclo menstrual, corrimento e o desejo de contracepção. Obter a confiança da adolescente é um dos maiores desafios para o profissional que atende uma paciente adolescente, tanto pelos aspectos biopsicossociais como também pelas questões éticas e legais que estão envolvidas na consulta. Embora a consulta ginecológica da adolescente tenha diversos pontos em comum com a da mulher adulta, os aspectos relacionados à sexualidade devem ser indagados com cautela, pois, na maioria das vezes, a adolescente está acompanhada e nem sempre compartilha sua prática sexual com seus familiares. A empatia mútua poderá beneficiar a adolescente, garantindo um momento propício para a abordagem dos cuidados relacionados aos aspectos da sua saúde sexual e reprodutiva.(AU)


Subject(s)
Humans , Female , Adolescent , Adolescent Health/ethics , Gynecology/ethics , Contraception , Gynecological Examination/methods , Medical History Taking/methods
12.
Niger. med. j. (Online) ; 60(3): 144-148, 2019. ilus
Article in English | AIM | ID: biblio-1267649

ABSTRACT

Background: Gynecological emergencies which affect the adolescents may pose a serious challenge to both the patient and the gynecologist. Objectives: The objective of this study is to determine the clinical presentations and management outcomes of emergency adolescent gynecological disorders at Federal Teaching Hospital, Abakaliki. Materials and Methods: This is a retrospective review of all cases of adolescent gynecological emergencies managed at Federal Teaching Hospital Abakaliki between January 1, 2012, and December 31, 2014. Data obtained from their case notes were analyzed using the IBM statistics version 20 (IBM Corp., Armonk, NY, USA). Data were presented using percentages and pie chart. Results: The prevalence of adolescent gynecological emergency disorders was 5.1%. The majority (82%) of the patients belong to the age bracket 15­19 with a mean age of 16.7 (2.4) years. About 90% of the patients were nulliparous. Unmarried patients comprised 80% of the study group. Vaginal bleeding was the most common clinical presentation (86%). The two most common diagnoses were abortion (60%) and sexual assault (26%). Only 10% of sexually active adolescent were using any form of contraception. Care received includes manual vaccum aspiration, laparotomy, and antibiotics. Blood transfusion was given in 18% of the cases. No death was recorded in all the cases. Conclusion: Abortive conditions and sexual assault were the most common clinical diagnosis among adolescents in the study. The percentage of adolescent assaulted in our study is unacceptable and should be prevented and efforts should be made to reduce the high unmet need for contraception seen in the study


Subject(s)
Abortion , Contraception , Emergencies , Gynecological Examination , Hemorrhage , Lakes , Nigeria , Pelvic Inflammatory Disease
13.
In. Castillo Pino, Edgardo A. Tratado de perineología: disfunciones del piso pélvico. Montevideo, Academia Nacional de Medicina, 2019. p.57-67.
Monography in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1343944
14.
Article in English | WPRIM | ID: wpr-760644

ABSTRACT

Angiomatoid Spitz nevus is a variant of melanocytic nevus with prominent vasculature. Due to its pathologic features, angiomatoid Spitz nevus in the vaginal wall is extremely rare. A 42-year-old woman presented to the hospital with abnormal vaginal bleeding. Vaginal examination revealed a 2×2-cm well-demarcated tumor on the posterior wall of the vagina. The mass was successfully removed by complete excision and was diagnosed as angiomatoid Spitz nevus on pathologic examination. We present the first reported case of vaginal angiomatoid Spitz nevus, which caused vaginal bleeding. Although angiomatoid Spitz nevus has many histopathological similarities with malignant melanoma, precise histopathological diagnosis is important for preventing overtreatment.


Subject(s)
Adult , Diagnosis , Female , Gynecological Examination , Humans , Medical Overuse , Melanoma , Nevus, Epithelioid and Spindle Cell , Nevus, Pigmented , Uterine Hemorrhage , Vagina
15.
Rio de Janeiro; s.n; 2018. 61 p. il..
Thesis in Portuguese | LILACS, BDENF | ID: biblio-946755

ABSTRACT

Este estudo tem como objeto os significados atribuídos ao exame Papanicolau por mulheres a partir do processo de interação social. Atualmente, a estratégia mais eficaz no controle do câncer de colo de útero é o rastreamento pelo exame Papanicolau. Contudo, acredita-se que a percepção que as mulheres têm acerca deste tipo de exame, bem como os significados que são atribuídos a ele, influencia na realização do mesmo. Os objetivos deste estudo são: identificar os significados do exame Papanicolau para mulheres e analisar o processo de interação social dessas mulheres com o exame, no contexto do câncer do colo do útero, a partir dos significados por elas atribuídos. Trata-se de pesquisa descritiva e explicativa com abordagem qualitativa. A pesquisa foi realizada em locais públicos de grande circulação de pessoas, situados no município do Rio de Janeiro, devido àgrande diversidade de mulheres nesses locais. Contou com a participação de 10 mulheres que transitavam nesses locais, entre 25 a 64 anos e que já tinham iniciado a vida sexual, divididas em 2 grupos amostrais.Foram realizadas entrevistas com roteiro semiestruturado e os dados foram analisados segundo os pressupostos do interacionismo simbólico e da Grounded Theory. Projeto aprovado pelo CEP/UERJ 1.660.721. Os dados foram organizados em duas categorias que explicam o processo de interação social da mulher com o exame preventivo: "Reproduzindo o discurso de que o exame é importante para prevenção" e "Apesar das dificuldades, tendo que se submeter ao exame Papanicolau regularmente". Na primeira categoria, os dados mostram que as mulheres percebem o exame como uma forma de prevenir doenças em geral com a ideia de receio de agravo. Consideram o exame importante para diagnóstico precoce e prevenção de agravos e sustentam a importância da prevenção na perspectiva do diagnóstico para tratamento por convencimento. Na segunda categoria, as mulheres relatam os motivos que funcionam como barreiras para a realização do exame, tais como: vergonha e desconforto, falta de acesso, falta de sintomas e o impeditivo do trabalho, contudo, apesar disso, relatam realizar o exame regularmente. Emergiu no trabalho uma categoria central: "tendo que se submeter ao exame Papanicolau regularmente", em que fica evidenciado que, apesar de todas as dificuldades, a mulher realiza o exame de Papanicolau para prevenção. Desta forma, conclui-se que, mesmo que não seja de forma regular como preconizado pelos protocolos, a mulher se submete ao exame Papanicolau para prevenção de doenças. Ficou evidente, pelos dados, que é necessário promover atividades que vão além de orientações e informações sobre o câncer do colo do útero e a importância deste exame. É importante criar estratégias de promoção da saúde para estimular a autonomia das mulheres e o empoderamento do próprio corpo, para, assim, propiciar maior cobertura do exame através da adesão regular das mulheres.


This study has as its object the meanings attributed to the Pap smear by women from the process of social interaction. Currently, the most effective strategy in the control of cervical cancer is screening by the Pap smear. However, it is believed that the perception that women have about this type of examination, as well as the meanings that are attributed to it, influences itsexecution. The objectives of this study are: to identify the meanings of the Pap smear for women and to analyze the social interaction process of these women with the examination, in the context of cervical cancer, based on the meanings they assign. It is a descriptive and explanatory research with a qualitative approach. The research was carried out in public places of great circulation of people, located in the city of Rio de Janeiro, due to the great diversity of women around these places. It had the participation of 10 women who transited in these places, between 25 to 64 years and that had already begun their sexual life, separated in a 2 groups sample. Semi-structuredinterviews were conducted and the data were analyzed according to the assumptions of Symbolic Interactionism and Grounded Theory. Project was approved by CEP/UERJ 1.660.721. The data wereorganized in two categories that explain the process of social interaction of women with the Paptest: "Reproducing the discourse thatexamination is important for prevention" and "Despite the difficulties, having got to undergo the Pap smear regularly". In the first category, data showedthat women perceive the test as a way to prevent diseases in general with an idea of fear of any disorders. They consider the exam important for early diagnosis and prevention of diseases and they support the importance of prevention from the perspective of diagnosis for a treatment by professional convincing. In the second category, women reportedreasons that act as barriers to the examination, such as: embarrassment and discomfort, lack of access, lack of symptoms, and theirwork as a hampering; however, they report taking the exam regularly. A central category emerged at work: "having to undergo Pap smear regularly", which showed that despite all the difficulties women perform the Pap smear for prevention. Thus, it is concluded that, even if it is not in a regular way as recommended by the protocols, women undergo Pap smear for disease prevention. Data show that it is necessary to promote activities that would go beyond guidance, giving information about cervical cancer and the importance of this examination. It is important to create health promotion strategies to stimulate women's autonomy and body empowerment, so as to provide greater coverage of the examination through the regular adherence of women.


Subject(s)
Humans , Female , Adult , Middle Aged , Diagnostic Techniques, Obstetrical and Gynecological/nursing , Gynecological Examination/nursing , Papanicolaou Test/nursing , Women's Health
16.
Article in English | WPRIM | ID: wpr-740176

ABSTRACT

OBJECTIVE: Human papillomavirus (HPV) testing is widely incorporated into cervical cancer screening strategies. Current screening requires pelvic examination for cervical sampling, which may compromise participation. The acceptance could be raised by introducing testing on vaginal swabs. We explored the interchangeability of vaginal swabs and cervical smears for HPV testing, by means of a prospective study conducted in female sex workers (FSWs). Besides, we report on the occurrence of 32 different HPV genotypes in FSW with low-grade squamous intraepithelial lesion (LSIL) or high-grade squamous intraepithelial lesion (HSIL). METHODS: Paired physician-collected vaginal swabs and cervical smears from 303 FSW were tested for HPV using the Abbott RealTime High-Risk HPV assay. Cervical cytology was examined on cervical smears. In case of HSIL/LSIL cytological classification (n=52), both samples were genotyped using INNO-LiPa HPV Genotyping Extra II. RESULTS: The overall prevalence of high-risk (HR)-HPV was 51%. In FSW with HSIL/LSIL cervical cytology, the sensitivity and specificity of vaginal samples for the detection of HR-HPV was 100% and 70% and for probable HR-HPV 100% and 91%. The mean number of genotypes identified in vaginal samples (mean=3.5; 95% confidence interval [CI]=2.8–4.2) was significantly higher than in cervical smear samples (mean=2.6; 95% CI=2.1–3.0) (p=0.001). The most frequently encountered HR-HPV genotypes were HPV16, 31, 51, and 52. CONCLUSION: As our study shows that vaginal swabs are equivalent to cervical smears for the detection of (probable) HR-HPV, vaginal swabs can be used for HPV testing in cervical cancer screening strategies. Given the acceptance of vaginal sampling, this finding offers an opportunity to boost screening coverage.


Subject(s)
Chlamydia trachomatis , Classification , DNA , Female , Genotype , Gynecological Examination , Humans , Mass Screening , Mycoplasma genitalium , Neisseria gonorrhoeae , Papillomaviridae , Prevalence , Prospective Studies , Sensitivity and Specificity , Sex Workers , Sexually Transmitted Diseases , Squamous Intraepithelial Lesions of the Cervix , Trichomonas vaginalis , Uterine Cervical Neoplasms , Vaginal Smears
17.
Article in English | WPRIM | ID: wpr-716660

ABSTRACT

OBJECTIVE: To evaluate the effect of tamoxifen on female reproductive organs in women with breast cancer. METHODS: We retrospectively reviewed the medical records of 309 women with breast cancer who were currently receiving tamoxifen and undergoing regular gynecological examination. RESULTS: We evaluated 92 pre- and 217 postmenopausal women. The prevalence of endometrial thickening was 12% in the pre- and 10.6% in the postmenopausal group. An endometrial biopsy was performed in 43 women and confirmed endometrial cancer in 1, endometrial polyps in 14, and endometrial hyperplasia in 4 women. Transvaginal ultrasonography showed 25 cases of newly developed ovarian cysts. Most ovarian cysts had disappeared during follow-up. CONCLUSION: Tamoxifen use in women with breast cancer causes few complications and is considered safe for female reproductive organs in case of regular gynecological examination.


Subject(s)
Biopsy , Breast Neoplasms , Breast , Endometrial Hyperplasia , Endometrial Neoplasms , Endometrium , Female , Follow-Up Studies , Gynecological Examination , Humans , Medical Records , Ovarian Cysts , Ovary , Polyps , Prevalence , Retrospective Studies , Tamoxifen , Ultrasonography
18.
Article in English | WPRIM | ID: wpr-715700

ABSTRACT

Malignant melanoma of the genital tract is a rare disease that is usually diagnosed by chance. When a definite diagnosis is delayed, the prognosis is very poor without standardized treatment. Herein, we describe a 40-year-old patient who presented with a history of bloody vaginal discharge for 7 months. Gynecological examination showed an exophytic, hard and pigmented cervical mass involving the upper vagina. The patient was diagnosed with cervical melanoma after a punch biopsy and underwent a radical hysterectomy, upper vaginectomy, bilateral salpingo-oophorectomy and pelvic lymphadenectomy. After surgeries, the patient underwent 2-cycles of adjuvant immunotherapy with pembrolizumab, but died within 8 months. In this report, treatment with pembrolizumab after radical surgery was not effective for this patient who had a primary cervical melanoma that metastasized to bone and lung tissue. We do not know why pembrolizumab was ineffective for this patient, but there are several possible explanations; further research is needed.


Subject(s)
Adult , Antibodies, Monoclonal, Humanized , Biopsy , Cervix Uteri , Diagnosis , Female , Gynecological Examination , Humans , Hysterectomy , Immunotherapy , Lung , Lymph Node Excision , Melanoma , Prognosis , Rare Diseases , Uterine Cervical Neoplasms , Vagina , Vaginal Discharge
19.
Article in English | WPRIM | ID: wpr-713644

ABSTRACT

In 2017, 10 topics were selected as major clinical research advances in gynecologic oncology. For cervical cancer, efficacy and safety analysis results of a 9-valent human papillomavirus (HPV) vaccine and long-term impact of reduced dose of quadrivalent vaccine were updated. Brief introduction of KEYNOTE trials of pembrolizumab, a monoclonal antibody that blocks the interaction between programmed death (PD)-1 and its ligands, PD-L1 and PD-L2, followed. Tailored surveillance programs for gynecologic cancer related with Lynch syndrome and update on sentinel lymph node mapping were reviewed for uterine corpus cancer. For ovarian cancer, 5 topics were selected including poly(ADP-ribose) polymerases inhibitors and immunotherapy. The other potential practice changers covered in this review were lymphadenectomy in advanced disease, secondary cytoreductive surgery in recurrent disease, weekly dose-dense regimen for first-line chemotherapy, incorporation of bevacizumab maintenance in platinum-sensitive recurrent disease, and effect of platinum-free interval prolongation. Conflicting opinions of academic societies on periodic pelvic examination were introduced in conjunction with relevant literature review. For the field of radiation oncology, results of 2 big trials, The Postoperative Radiation Therapy in Endometrial Carcinoma-3 and Gynecologic Oncology Group-258, for endometrial cancer and recent advance in high-dose-rate brachytherapy for cervical cancer were reported. Topics for breast cancer covered adjuvant capecitabine after preoperative chemotherapy, adjuvant pertuzumab and trastuzumab in early human epidermal growth factor receptor 2-positive disease, olaparib for metastatic cancer in patients with a germline BRCA mutation, 20-year risks of recurrence after stopping endocrine therapy at 5 years, and contemporary hormonal contraception and the risk of breast cancer.


Subject(s)
Bevacizumab , Brachytherapy , Breast Neoplasms , Capecitabine , Chemotherapy, Adjuvant , Colorectal Neoplasms, Hereditary Nonpolyposis , Contraception , Drug Therapy , Endometrial Neoplasms , Female , Gynecological Examination , Humans , Immunotherapy , Ligands , Lymph Node Excision , Lymph Nodes , Molecular Targeted Therapy , Ovarian Neoplasms , Poly(ADP-ribose) Polymerase Inhibitors , Poly(ADP-ribose) Polymerases , Radiation Oncology , ErbB Receptors , Recurrence , Trastuzumab , Uterine Cervical Neoplasms
20.
Article in English | WPRIM | ID: wpr-765752

ABSTRACT

Pelvic organ prolapse (POP) is bulging of one or more of the pelvic organs into the vagina and triggered by multiple causes. It is a very common disorder, especially among older women. POP is characterized by protrusion of the presentation part visible by the naked eye, and problems with urination or bowel movements. POP can be diagnosed based on the onset of symptoms and a pelvic exam, and management options include medical and surgical treatment. Although medical treatment cannot correct the abnormal herniation of the pelvic structures, this can help alleviate symptoms. One of the disadvantages of surgical interventions is recurrence, and advances in surgical techniques have decreased recurrence rates of POP. Therefore, author will explain the gynecology and urology approach and treatment.


Subject(s)
Cystocele , Female , Gynecological Examination , Gynecology , Humans , Pelvic Organ Prolapse , Rectocele , Recurrence , Urination , Urology , Vagina
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