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Journal of Lower Genital Tract Disease

Michal Sheinis, Amanda Selk
OBJECTIVE: To generate a list of items through international expert consensus consisting of both symptoms and clinical signs for inclusion in an adult vulvar lichen sclerosus severity scale. METHODS: This study was carried out as a three-stage Delphi consensus exercise. After an extensive literature review, any items used to determine disease severity in previous clinical trials were compiled into a survey. The Delphi participants were recruited from the International Society for the Study of Vulvovaginal Disease most of whom were gynecologists and in practice for more than 20 years...
November 1, 2017: Journal of Lower Genital Tract Disease
Aarathi Cholkeri-Singh, Philip T Lavin, Christopher G Olson, Emmanouil Papagiannakis, Lori Weinberg
OBJECTIVE: The aim of the study was to determine, in a wide "real-world" setting, whether digital colposcopy with adjunctive dynamic spectral imaging (DSI) mapping increases the detection of women with high-grade cervical intraepithelial neoplasia (CIN). MATERIALS AND METHODS: A multicenter, two-arm, observational, cross-sectional study that recruited women 21 years and older, having colposcopy after a low-grade abnormality screening result. The prospective arm collected outcomes of digital colposcopy with DSI used for identifying biopsy sites at the colposcopists' discretion...
September 25, 2017: Journal of Lower Genital Tract Disease
Karen L Talia, Geoffrey Otton, Suzanne Garland, Samuel Phillips, James Scurry
No abstract text is available yet for this article.
October 2017: Journal of Lower Genital Tract Disease
Adrienne L K Li, Matthew Cesari, R Michael Shier
No abstract text is available yet for this article.
October 2017: Journal of Lower Genital Tract Disease
Julio Mazul, Rebecca B Perkins
No abstract text is available yet for this article.
October 2017: Journal of Lower Genital Tract Disease
Edward J Wilkinson
The "unfortunate experiment" that took place for a period of more than 20 years at the New Zealand Woman's Hospital in Auckland, New Zealand, had tragic results for numerous unsuspecting women and ultimately caused a 20-year setback in cervical cancer screening in New Zealand. The story of Herbert Green's evolving beliefs about cervical cancer, his pursuit of proof for his unfounded theory, based on "no more that a whim and misbelief" according to author Ron Jones, as well as the history of the active as well as passive complicity of superiors and colleagues for years in the rarified realm of academic medicine, is recounted in this engrossing and well-documented book...
October 2017: Journal of Lower Genital Tract Disease
María de Los Reyes Oliver-Pérez, Victoria Bravo Violeta, Beatriz Legorburu Alonso, Diana Betancor Pérez, Vicente Bebia Conesa, Jesús S Jiménez López
OBJECTIVES: This study aimed to evaluate the incidence of anal dysplasia in women at high risk of developing those lesions and to assess the relationships between positive anal cytology and different risk factors. MATERIALS AND METHODS: We performed an observational cross-sectional study involving a patient survey and chart review. The study was conducted at the cervical pathology unit at the Hospital Universitario 12 de Octubre, Madrid, Spain, from 2011 to 2015...
October 2017: Journal of Lower Genital Tract Disease
Debra S Heller
OBJECTIVES: Pathologist-clinician communication has been an ongoing topic in the literature. Pathology reports are geared to assisting clinicians with patient therapy, but sometimes there are barriers to communication. This survey aims to explore clinicians' understanding of their pathology reports in the membership of the International Society for Vulvovaginal Disease (ISSVD). METHODS: An email survey was sent to all members of the ISSVD. RESULTS: Surveys were emailed to 397 members, with 91 responding (23 %)...
October 2017: Journal of Lower Genital Tract Disease
Thomas G Gray, Charlotte Alexander, Georgina L Jones, John A Tidy, Julia E Palmer, Stephen C Radley
OBJECTIVE: Development of an electronic patient-reported outcome measure (PROM) specifically designed for vulval disorders. Psychometric testing of the components of the questionnaire, which assess vulval symptoms, sexual function, and quality of life (QoL). MATERIALS AND METHOD: Development and programming of the instrument (ePAQ-Vulva) was informed by national guidelines for the assessment of vulval disorders, an expert panel, and a survey of 61 vulval clinic patients...
October 2017: Journal of Lower Genital Tract Disease
Avery A Whitis, Susan W Lipinski, Catherine S Bradley, Colleen K Stockdale
OBJECTIVE: The aim of this study was to compare vulvar symptoms between urogynecology patients diagnosed with urinary incontinence (UI) and/or pelvic organ prolapse to women presenting for annual gynecological care. METHODS: This is a retrospective cross-sectional study. Vulvar symptoms (burning, pain, itching, dyspareunia, and discharge) were measured by asking respondents to rate the severity of each symptom from 0 (none) to 10 (most severe). Patient history, diagnoses, and the Urogenital Distress Inventory-6 (UDI-6) score were abstracted from records...
October 2017: Journal of Lower Genital Tract Disease
Francesco Sopracordevole, Lorenzo Moriconi, Jacopo Di Giuseppe, Lara Alessandrini, Elvia Del Piero, Giorgio Giorda, Monica Buttignol, Giovanni De Piero, Vincenzo Canzonieri, Andrea Ciavattini
OBJECTIVE: We undertook a retrospective analysis of the incidence of complications of carbon dioxide (CO2) laser excision for high-grade vaginal intraepithelial neoplasia (HG-VaIN). MATERIALS AND METHODS: Retrospective large case series on 128 CO2 laser excisions for HG-VaIN in 106 women treated at the Department of Gynecologic Oncology, Oncologic Referral Center, Aviano, Italy. These procedures were performed under local anesthesia with a 20-W continuous laser beam focused to a 0...
October 2017: Journal of Lower Genital Tract Disease
Efraim Siegler, Ofer Lavie, Amnon Amit, Zvi Vaknin, Ron Auslander, Zeev Blumenfeld
OBJECTIVE: The aim of this article was to describe the outcome of women diagnosed with cervical intraepithelial neoplasia (CIN) grades 2 or 3 in pregnancy either observed or treated by loop electrosurgical excision procedure (LEEP) in the first 15 weeks of gestation. METHODS: Loop electrosurgical excision procedure during the first 15 gestational weeks compared with observation of CIN2/3. This is a retrospective analysis of a nonrandomized study at tertiary, academic, and referring centers in Israel...
October 2017: Journal of Lower Genital Tract Disease
Efraim Siegler, Yael Goldberg, Tamar Baruch-Finkel, Pninint Shaked-Mishan, Yakir Segev, Lena Machuli, Yoav Siegler, Ron Auslender, Ofer Lavie
OBJECTIVES: In cervical cancer, a number of pathological parameters have been explored for their utility in tailoring a less aggressive approach for patients with low-risk early stage disease. We examined whether, in patients with cervical cancer stage IA1 to IB1, diagnosed by loop excision of the transformation zone (LLETZ), positive for high-risk human papillomavirus (hrHPV), clearance of hrHPV after LLETZ correlates with absence of residual disease at the final pathology after definitive or further surgery...
October 2017: Journal of Lower Genital Tract Disease
Johanna Hansen, Julia Waibel, Sylvia Timme, Gerald Gitsch, Michaela Bossart, Martin K Oehler, Maximilian Klar
OBJECTIVE: The aim of this study was to calculate the validity parameters of the Digene Hybrid Capture 2 (HC2) high-risk human papillomavirus DNA test with and without cytology in the follow-up examinations after laser treatment of the transformation zone or large loop excision of the transformation zone (LLETZ) for cervical intraepithelial neoplasia (CIN). METHODS: We performed a standardized follow-up examination in 113 postlaser and 153 post-LLETZ patients in our colposcopy clinic...
October 2017: Journal of Lower Genital Tract Disease
Kathy M Ceballos, Marette Lee, Darrel A Cook, Laurie W Smith, Lovedeep Gondara, Mel Krajden, Dirk J van Niekerk, Andrew J Coldman
OBJECTIVES: To determine whether Hybrid Capture 2 High-Risk HPV DNA Test (HC2) can be used as a test of cure in women treated for cervical intraepithelial neoplasia grade 2 or worse (CIN 2+) and allow discharge from colposcopy follow-up with a return to a cytology-based screening program for HC2-negative women. MATERIALS AND METHODS: Data were analyzed for all women who underwent a loop electrosurgical excision procedure between August 1, 2008, and June 30, 2011, and had a valid HC2 result after loop electrosurgical excision procedure and follow-up histopathology result, to determine risk of persistent or recurrent CIN 2+ in HC2-positive and HC2-negative women...
October 2017: Journal of Lower Genital Tract Disease
Andrea Ciavattini, Nicolò Clemente, Carlo Antonio Liverani, Paolo Cattani, Luca Giannella, Giovanni Delli Carpini, Stefano Morini, Monica Buttignol, Francesco Sopracordevole
OBJECTIVES: The aim of the present study was to observe the trend of length of cone excisions in women treated with cervical excision procedure in five institutions of Central and Northern Italy. MATERIALS AND METHODS: A multicenter retrospective cohort study was conducted on women who underwent a cervical excision procedure between January 2006 and December 2014. The pertinent clinical, histopathological, and sociodemographic characteristics of each woman were collected...
October 2017: Journal of Lower Genital Tract Disease
Ziad Hilal, Günther A Rezniczek, Nariman El-Fizazi, Clemens B Tempfer
OBJECTIVES: The aim of the study was to compare two conization techniques, large loop excision of the transformation zone (LLETZ), and true cone biopsy electrode excision (TCBEE) in women with cervical dysplasia. MATERIALS AND METHODS: In a randomized clinical trial, we compared LLETZ and TCBEE in women undergoing surgical treatment of cervical dysplasia in a 1:1 ratio. The primary endpoint was resection margin status (RMS), secondary endpoints were fragmentation of the surgical specimen, resection volume, operation time, time to complete hemostasis, blood loss, intraoperative and postoperative complications, surgeon's preference, and patient's postoperative pain, estimated by an 11-level visual analog scale (nVAS11), and a 5-level pictogram...
October 2017: Journal of Lower Genital Tract Disease
Wendy Susan MacNab, Tristan F Holdsworth, Rhona Lindsay, Smruta Shanbhag, Nadeem Siddiqui, Kevin Burton
OBJECTIVE: The aim of this study was to assess the current burden and consistency of stage 1A1 cervical cancer follow-up within Greater Glasgow and Clyde Health Board. METHODS: A retrospective review was undertaken of women diagnosed with and treated of, between 2007 and 2011, stage 1A1 cervical cancer in Greater Glasgow and Clyde Health Board. Data were collected on referral cytology, definitive method of treatment, posttreatment cytology, and rate of recurrence...
October 2017: Journal of Lower Genital Tract Disease
Maria Demarco, Thomas S Lorey, Barbara Fetterman, Li C Cheung, Richard S Guido, Nicolas Wentzensen, Walter K Kinney, Nancy E Poitras, Brian Befano, Philip E Castle, Mark Schiffman
OBJECTIVES: The next round of the American Society for Colposcopy and Cervical Pathology (ASCCP)-sponsored cervical cancer screening and management guidelines will recommend clinical actions based on risk, rather than test-based algorithms. This article gives preliminary risk estimates for the screening setting, showing combinations of the 2 most important predictors, human papillomavirus (HPV) status and cytology result. MATERIALS AND METHODS: Among 1,262,713 women aged 25 to 77 years co-tested with HC2 (Qiagen) and cytology at Kaiser Permanente Northern California, we estimated 0-5-year cumulative risk of cervical intraepithelial neoplasia (CIN) 2+, CIN 3+, and cancer for combinations of cytology (negative for intraepithelial lesion or malignancy [NILM], atypical squamous cells of undetermined significance [ASC-US], low-grade squamous intraepithelial lesion [LSIL], atypical squamous cells cannot exclude HSIL [ASC-H], high-grade squamous intraepithelial lesion [HSIL], atypical glandular cells [AGC]) and HPV status...
October 2017: Journal of Lower Genital Tract Disease
Jeffrey W Hastings, Meredith J Alston, Sara E Mazzoni, Elaine Stickrath
OBJECTIVE: The aim of the study was to determine the frequency that endometrial biopsies (EMBs) performed on postmenopausal (PMP) women with benign endometrial cells (BECs) on Pap test are adequate for assessing malignancy or hyperplasia. METHODS: This is a case series including all PMP women older than 55 years at a single academic institution between January 2008 and September 2015 with a Pap test result including BEC. Patients were identified via an internal cytology database...
October 2017: Journal of Lower Genital Tract Disease
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