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https://www.readbyqxmd.com/read/29240893/risk-and-reputation-obstetricians-cesareans-and-consent
#1
Jacqueline H Wolf
When physicians performed cesarean sections in the nineteenth century, they customarily sought agreement from all present before proceeding. In contrast, after the introduction of electronic fetal monitoring in the late 1960s, obstetricians obtained permission for a cesarean by offering a choice that ensured consent-give birth by cesarean or give birth vaginally to a damaged or dead baby. This article argues that the manner in which physicians obtained consent for cesareans in the nineteenth century was one factor that kept the cesarean rate low, while the manner in which physicians obtained consent in the late twentieth and early twenty-first centuries was one factor driving up the cesarean rate...
December 12, 2017: Journal of the History of Medicine and Allied Sciences
https://www.readbyqxmd.com/read/29237906/clinical-efficacy-of-preoperative-vaginal-intracavitary-irradiation-for-stage-ib2-and-iia-cervical-cancer
#2
Fengshuang Li, Yumei Wu, Weimin Kong, Jiandong Wang, Xia Hao, Juwei Niu, Laifu Bai
OBJECTIVE: The purpose of this study was to evaluate the clinical efficacy of preoperative vaginal intracavitary irradiation for Stage Ib2 and IIa cervical cancer. MATERIALS AND METHODS: From June 2008 to June 2014, data from 78 Stage Ib2 and IIa cervical cancer patients (age ≤75 years) with a diameter of local lesions >4 cm were collected in our hospital. Before treatment, all cases were confirmed by biopsy. The patients' general state was good, Karnofsky Performance Score ≥90, heart and lung functioning was normal, and patients were able to tolerate the surgery...
2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/29237218/-cylindric-abdominoperineal-rectum-exstirpation-with-partial-vulvar-and-vaginal-resection-as-well-as-perineal-and-vaginal-defect-reconstruction-by-a-vertical-rectus-abdominis-myocutaneous-vram-flap
#3
Christian Krautz, Klaus Weber, Roland Croner, Axel Denz, Matthias Maak, Raymund E Horch, Robert Grützmann
Introduction Patients with low rectal cancer or anal cancer undergoing abdominoperineal excision (APE) benefit from extended surgery and the subsequent avoidance of surgical "waisting" at the level of the puborectalis muscle. The method of cylindrical APE was introduced by T. Holm and led to a reduction of intraoperative perforations and involvement of circumferential resection margins, and subsequently reduced the risk of local recurrence. The use of myocutaneous flaps reduces perineal wound complications, which occur in up to 60% of patients with primary closure of perineal defects, especially following neoadjuvant radiochemotherapy...
December 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29234570/vaginal-cuff-closure-in-minimally-invasive-hysterectomy-a-review-of-training-techniques-and-materials
#4
REVIEW
Katherine Smith, Aileen Caceres
Hysterectomy is one of the most common surgeries performed each year and can be indicated for many gynecologic conditions. The development of minimally invasive surgery has transformed this procedure, resulting in improved outcomes, superior cosmesis, and quicker return to normal function. Vaginal cuff closure is a critical component of hysterectomy, with many variations in surgical technique and materials. This review provides an overview of intracorporeal suturing and knot-tying techniques at the level of a junior resident in obstetrics and gynecology and describes several validated models that have been developed to test resident skill level in vaginal cuff closure...
October 11, 2017: Curēus
https://www.readbyqxmd.com/read/29232268/pelvic-organ-prolapse-repair-using-the-uphold-vaginal-support-system-5-year-follow-up
#5
Päivi Rahkola-Soisalo, Tomi S Mikkola, Daniel Altman, Christian Falconer
OBJECTIVE: This study aimed to assess the long-term (5 years) outcomes of the Uphold Vaginal Support System for symptomatic vaginal apical prolapse with or without anterior colporraphy. METHODS: In total, 164 (81.2%) of 202 women operated on in 24 centers were reached for follow-up. Outcomes were assessed by using the Pelvic Organ Prolapse Quantification, the Pelvic Floor Distress Inventory 20, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire questionnaires...
December 11, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29232267/concomitant-anterior-repair-preoperative-prolapse-severity-and-anatomic-prolapse-outcomes-after-vaginal-apical-procedures
#6
Charles W Nager, Cara L Grimes, Tracy L Nolen, Clifford Y Wai, Linda Brubaker, Peter C Jeppson, Tracey S Wilson, Anthony G Visco, Matthew D Barber, Gary Sutkin, Peggy Norton, Charles R Rardin, Lily Arya, Dennis Wallace, Susan F Meikle
OBJECTIVE: The aim of the study was to compare anterior and overall prolapse prevalence at 1 year in surgical participants with or without concomitant anterior repair (AR) at the time of sacrospinous ligament fixation (SSLF) or uterosacral ligament suspension (ULS). METHODS: This is a secondary analysis of two surgical trials; concomitant AR was performed at surgeon's discretion. Anterior anatomic success was defined as pelvic organ prolapse quantification of prolapse point Ba ≤0 and overall success was defined as pelvic organ prolapse quantification points Ba, Bp, and C ≤0 at 12 months...
December 11, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29232258/development-and-history-of-morcellators
#7
Ceana Nezhat, Robert K Zurawin
PURPOSE OF REVIEW: Controversy exists surrounding extraction of tissue in gynecologic surgery using morcellators following cases of disseminated uterine cancers discovered after the use of electromechanical morcellators. This chapter traces the history of tissue extraction in gynecology and reviews the evolving scientific data and opinions regarding the future of morcellation. RECENT FINDINGS: Since the initial Food and Drug Administration warning about morcellation in 2014, subsequent studies do not support the Food and Drug Administration's high incidence of occult uterine cancer...
December 11, 2017: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29229578/left-lateral-endosurgical-extraperitoneal-total-hysterectomy-with-para-aortic-and-pelvic-lymphadenectomy-a-novel-approach-for-the-obese-patient-with-endometrial-cancer
#8
Gwenael Ferron, Javier De Santiago, Denis Querleu, Alejandra Martinez, Martina Aida Angeles, Berenice Boulet, Frederic Guyon, Ignacio Zapardiel
STUDY OBJECTIVE: To describe the left lateral extraperitoneal approach to perform complete para-aortic and pelvic lymphadenectomy and transverse total hysterectomy from left to right as a novel approach to treat obese patients with endometrial cancer. Laparoscopic management of obese patients represents a challenge for the gynecological surgeon. The extraperitoneal approach is technically easier in the obese patient as it naturally creates a bowel-free operative field. DESIGN: A prospective pilot bicentric and descriptive study (Canadian Task Force III) evaluating the feasibility and reproducibility of the transverse total hysterectomy and complete lymphadenectomy through left endoscopic extraperitoneal approach in obese patients with endometrial cancer...
December 8, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29227723/interventions-to-address-sexual-problems-in-people-with-cancer-american-society-of-clinical-oncology-clinical-practice-guideline-adaptation-of-cancer-care-ontario-guideline
#9
Jeanne Carter, Christina Lacchetti, Barbara L Andersen, Debra L Barton, Sage Bolte, Shari Damast, Michael A Diefenbach, Katherine DuHamel, Judith Florendo, Patricia A Ganz, Shari Goldfarb, Sigrun Hallmeyer, David M Kushner, Julia H Rowland
Purpose The adaptation of the Cancer Care Ontario (CCO) guideline Interventions to Address Sexual Problems in People With Cancer provides recommendations to manage sexual function adverse effects that occur as a result of cancer diagnosis and/or treatment. Methods ASCO staff reviewed the guideline for developmental rigor and updated the literature search. An ASCO Expert Panel ( Table A1 ) was assembled to review the guideline content and recommendations. Results The ASCO Expert Panel determined that the recommendations from the 2016 CCO guideline are clear, thorough, and based upon the most relevant scientific evidence...
December 11, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29217927/magnitude-and-factors-associated-with-post-cesarean-surgical-site-infection-at-hawassa-university-teaching-and-referral-hospital-southern-ethiopia-a-cross-sectional-study
#10
Samuel Wodajo, Mehretu Belayneh, Samson Gebremedhin
Background: Surgical site infection (SSI) after cesarean section (CS) increases maternal morbidity, hospital stay and medical cost. However, in Ethiopia, limited evidence exists regarding the magnitude and risk factors of post-CS wound infection. The purpose of this study was to determine the prevalence of - and factors associated with the problem among mothers who gave birth in Hawassa University Teaching and Referral Hospital, Southern Ethiopia. Methods: Hospital based cross-sectional study was conducted based on the medical records of 592 women who underwent CS from June 2012 to May 2013...
May 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/29215524/urinary-tract-injury-in-gynecologic-laparoscopy-for-benign-indication-a-systematic-review
#11
Jacqueline M K Wong, Pietro Bortoletto, Jocelyn Tolentino, Michael J Jung, Magdy P Milad
OBJECTIVE: To perform a comprehensive literature review of the incidence, location, etiology, timing, management, and long-term sequelae of urinary tract injury in gynecologic laparoscopy for benign indication. DATA SOURCES: A systematic review of PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov was conducted. METHODS OF STUDY SELECTION: Four hundred thirty-three studies were screened for inclusion with 136 full-text articles reviewed...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29215514/misoprostol-with-foley-bulb-compared-with-misoprostol-alone-for-cervical-ripening-a-randomized-controlled-trial
#12
Zainab Al-Ibraheemi, Lois Brustman, Brianne E Bimson, Natalie Porat, Barak Rosenn
OBJECTIVE: To test the hypothesis that cervical ripening using a combination of misoprostol and a transcervical Foley bulb leads to delivery within a shorter time compared with misoprostol alone. METHODS: This randomized controlled trial was offered to women admitted for cervical ripening. Inclusion criteria were gestational age 37 weeks or greater with intact membranes, singleton fetus, cephalic presentation, and Bishop score 6 or less. Exclusion criteria included, among others, prior uterine surgery, ruptured membranes, and any contraindication to vaginal delivery...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29215511/liposomal-bupivacaine-during-robotic-colpopexy-and-posterior-repair-a-randomized-controlled-trial
#13
Jennifer Yeung, Catrina C Crisp, Donna Mazloomdoost, Steven D Kleeman, Rachel N Pauls
OBJECTIVE: To evaluate the effect of liposomal bupivacaine on postoperative pain among patients undergoing robotic sacrocolpopexy with posterior repair. METHODS: This was a randomized, patient-blinded, placebo-controlled trial of women undergoing robotic sacrocolpopexy with posterior repair. Liposomal bupivacaine or normal saline placebo was injected into laparoscopic and vaginal incisions at completion of surgery. Perioperative care was standardized. Visual analog scales were collected at 4, 18, and 24 hours postoperatively in hospital...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29215508/opioid-knowledge-and-prescribing-practices-among-obstetrician-gynecologists
#14
Annetta M Madsen, Lauren M Stark, Phinnara Has, Jenna B Emerson, Jay Schulkin, Kristen A Matteson
OBJECTIVE: To describe obstetrician-gynecologists' (ob-gyns) knowledge and prescribing practices regarding opioid analgesics. METHODS: We conducted a cross-sectional survey of a national sample of American College of Obstetricians and Gynecologists Fellows and Junior Fellows who are part of the Collaborative Ambulatory Research Network. We used a sequential mixed-method approach. We collected data on opioid knowledge and typical prescribing practices, including number, type, and indication for prescriptions...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29212492/using-patient-data-to-optimize-an-expert-based-guideline-on-convalescence-recommendations-after-gynecological-surgery-a-prospective-cohort-study
#15
Esther V A Bouwsma, Johannes R Anema, A Vonk Noordegraaf, Henrica C W de Vet, Judith A F Huirne
BACKGROUND: Convalescence advice is often based on tradition and anecdote from health care providers, rather than being based on experiences from patients themselves. The aim of this study was to analyse recovery in terms of resumption of various daily activities including work, following different laparoscopic and abdominal surgery in order to optimize an expert-based guideline on convalescence recommendations. METHODS: This is a prospective cohort study conducted in nine general and one university hospital in the Netherlands...
December 6, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29207957/placenta-response-of-inflammation-and-oxidative-stress-in-low-risk-term-childbirth-the-implication-of-delivery-mode
#16
Yabin Hu, Kun Huang, Yuanfang Sun, Jianqing Wang, Yeqing Xu, Shuangqin Yan, Peng Zhu, Fangbiao Tao
BACKGROUND: Caesarean delivery rate is increasing gradually in China and there is no doubt that delivery mode is closely associated with the maternal health and infant development.This study examined the independent effect of delivery mode on placenta inflammation response and oxidative stress response. METHODS: A total of 3474 pregnant women recruited in Ma'anshan Birth Cohort Study were the initial study population. Data on maternal socio-demographic characteristics and pre-pregnancy BMI were collected at their 1st antenatal checkups...
December 6, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29207786/recurrent-vaginal-cuff-dehiscence-in-a-treated-case-of-carcinoma-cervix
#17
Sunesh Kumar, Seema Singhal, Yamini Kansal, Dayanand Sharma
Vaginal Cuff Dehiscence (VCD) is partial or total separation of anterior and posterior vaginal cuff layers. We report a case of recurrent vault cuff dehiscence in a patient of cervical carcinoma. A 60-year-old treated case of carcinoma cervix post surgery and radiotherapy was found to have vault dehiscence and intestinal prolapse second time during a routine speculum examination. She underwent an emergency laparotomy and closure of vault. Vaginal Cuff Dehiscence with Evisceration (VCDE) is a rare but potentially fatal complication following hysterectomy...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29205981/pregnancy-and-delivery-after-a-cesarean-section
#18
Marja Vääräsmäki, Tytti Raudaskoski
One out of seven of all parturients and one out of five primigravid women deliver by caesarean section. Of four women having undergone caesarean section, three will give birth vaginally, provided that the indication for surgery has been temporary by nature. Spontaneous beginning of labor and a previous vaginal delivery improve the chances of succesful of vaginal delivery. Rupture of the uterus in subsequent pregnancies is the most feared sequel to a caesarean section, with an occurrence of 0.2 to 1.5%. Delivery by caesarean is indicated in case of previous rupture of the uterus, hysterotomy through vertical incision, and more than two previous caesarean sections...
2017: Duodecim; Lääketieteellinen Aikakauskirja
https://www.readbyqxmd.com/read/29201518/transobturator-four-arms-mesh-in-the-surgical-management-of-stress-urinary-incontinence-with-cystocele
#19
Hammouda Sherif, Tarek Soliman Othman, Amr Eldkhakhany, Hussein Elkady, Adel Elfallah
Objective: This study aims to evaluate safety and efficacy of four arms polypropylene mesh in the long- term follow-up in the management of stress urinary incontinence (SUI) associated with cystocele. Material and methods: This prospective study was conducted on 50 female patients with SUI associated with cystocele. Patients underwent placement of transobturator four-arms mesh implants. Stress incontinence was evaluated using cough stress test with and without prolapse reduction, Stamey's grading of SUI, the validated Arabic version of the International Consultation on Incontinence Questionnaire-Short Form and King Health Questionnaire forms...
December 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/29193230/deep-infiltrating-endometriosis-comparison-between-2-dimensional-ultrasonography-us-3-dimensional-us-and-magnetic-resonance-imaging
#20
Stefano Guerriero, Juan Luis Alcázar, Maria Angela Pascual, Silvia Ajossa, Maura Perniciano, Alba Piras, Valerio Mais, Bruno Piras, Federica Schirru, Melis Gian Benedetto, Luca Saba
OBJECTIVES: To evaluate the diagnostic accuracy of 2-dimensional (2D) and 3-dimensional (3D) transvaginal ultrasonography (US) in comparison with magnetic resonance imaging (MRI) for identification of deep infiltrating endometriosis. METHODS: In this prospective observational study, 159 premenopausal women who underwent surgery for a clinical suspicion of deep infiltrating endometriosis were prospectively enrolled. All women underwent 2DUS, 3DUS, and MRI. The following 3 locations of deep endometriosis were considered: (1) intestinal; (2) other posterior lesions (retrocervical septum, rectovaginal septum, uterosacral ligaments, and vaginal fornix); and (3) anterior...
November 30, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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